Objective:To investigate the factors in fluencing thyroid function abnormality(TFA)and its relationship with the clinical efficacy of sindilizumab treatment in patients with advanced gastric cancer.Methods:The clinical data of 180 patients with advanced gastric cancer treated with sintilimab at Jinan People's Hospital from January 2021 to June 2024 were retrospectively reviewed.Patients were assigned in-to the TFA group and the normal control group according to thyroid function.Factors influencing the occurrence of TFA were investigated using the χ2 test and multifactorial Logistic regression.Kaplan-Meier analysis and the Log-rank test were used for comparison between groups.Univariate and multivariate Cox regression were used to assess the correlation between TFA and therapeutic efficacy.Results:A total of 52 patients developed TFA.Univariate analysis showed that history of thyroid nodule,treatment regimen,liver metastasis,and car-cinoembryonic antigen(CEA)were associated with the development of TFA.Multifactorial Logistic regression analysis showed that history of thyroid nodule,treatment regimen,and CEA were independent risk factors for the development of TFA(P<0.05).The objective response rate(ORR;34.6%vs.14.1%,P=0.002),disease control rate(DCR;69.2%vs.59.8%,P=0.024),and 1-year survival rate(59.6%vs.28.9%,P=0.012)were all better in the normal control group than those in the TFA group.Cox regression analysis showed that occurrence of TFA,liver meta-stasis,and≥6 treatment cycles were all independently associated with progression-free survival and overall survival in patients with ad-vanced gastric cancer(P<0.05).Conclusions:History of thyroid nodule,treatment regimen,and CEA may influence the occurrence of TFA.TFA may be a potential predictor of the efficacy of sindilizumab therapy for advanced gastric cancer,with patients who develop TFA poten-tially having better treatment outcomes.

Objective:To investigate the factors in fluencing thyroid function abnormality(TFA)and its relationship with the clinical efficacy of sindilizumab treatment in patients with advanced gastric cancer.Methods:The clinical data of 180 patients with advanced gastric cancer treated with sintilimab at Jinan People's Hospital from January 2021 to June 2024 were retrospectively reviewed.Patients were assigned in-to the TFA group and the normal control group according to thyroid function.Factors influencing the occurrence of TFA were investigated using the χ2 test and multifactorial Logistic regression.Kaplan-Meier analysis and the Log-rank test were used for comparison between groups.Univariate and multivariate Cox regression were used to assess the correlation between TFA and therapeutic efficacy.Results:A total of 52 patients developed TFA.Univariate analysis showed that history of thyroid nodule,treatment regimen,liver metastasis,and car-cinoembryonic antigen(CEA)were associated with the development of TFA.Multifactorial Logistic regression analysis showed that history of thyroid nodule,treatment regimen,and CEA were independent risk factors for the development of TFA(P<0.05).The objective response rate(ORR;34.6%vs.14.1%,P=0.002),disease control rate(DCR;69.2%vs.59.8%,P=0.024),and 1-year survival rate(59.6%vs.28.9%,P=0.012)were all better in the normal control group than those in the TFA group.Cox regression analysis showed that occurrence of TFA,liver meta-stasis,and≥6 treatment cycles were all independently associated with progression-free survival and overall survival in patients with ad-vanced gastric cancer(P<0.05).Conclusions:History of thyroid nodule,treatment regimen,and CEA may influence the occurrence of TFA.TFA may be a potential predictor of the efficacy of sindilizumab therapy for advanced gastric cancer,with patients who develop TFA poten-tially having better treatment outcomes.

OBJECTIVE: To investigate the clinicopathological features of intestinal diffuse large B-cell lymphoma (DLBCL). METHODS: The clinical features, pathological morphology, immunophenotype, and EBER in situ hybridization of 136 DLBCL patients diagnosed in Jinan People's Hospital Affiliated to Shandong First Medical University from January 2007 to October 2014 were analyzed retrospectively. A total of 136 DLBCL samples were obtained, the DLBCL sites were categorized as: duodenum (n=23), ileocecal region (n=63), other small intestine (n=29), rectum (n=7), and other large intestine (n=14). Survival curves for the DLBCL patients were plotted using the Kaplan-Meier method and judged by the Log-rank test. RESULTS: Patients with DLBCL of the ileocecal region and other small intestine except duodenum were mainly male (P=0.042), and had a higher proportion of limited-stage tumors(P=0.015), and lower International Prognostic Index (IPI) (P=0.001). Patients with DLBCL of ileocecal region had higher incidence of lactate dehydrogenase elevation (P=0.007), and higher incidence of intestinal obstruction or perforation (P<0.001) than those with DLBCL of other regions. The 5-year overall survival and 5-year progression-free survival of patients with DLBCL in ileocecal and other small intestine sites were higher than those in other sites, but the differences were not statistically significant (P=0.135, 0.459). Fifty percent of intestinal DLBCL were germinal center B cell-like (GCB) subtypes. A low-grade B-cell lymphoma was found in 21% of 136 tumor samples. In ileocecal and other small intestinal specimens, the proportion of low-grade B-cell lymphoma was 29%, and the difference was statistically significant(P=0.025). About 16% of 136 DLBCL samples expressed follicular lymphoma while no mucosa-associated lymphoid tissue lymphoma . The Epstein-Barr virus-encoded RNA-1 (EBER1) positive rate of duodenal DLBCL was significantly higher than that of other sites (5/23, 22% vs 2/63, 3%, P=0.001). CONCLUSION The intestinal DLBCL is commonly observed in male, and ileocecal is the most primary site. Patients with DLBCL of the ileocecal region and small intestine except duodenum have low IPI, high proportion of limited-stage tumors, low level of lactate dehydrogenase, high incidence of intestinal obstruction or perforation, and low incidence of inert lymphoma. The EBER1 positive rate of DLBCL in duodenal is higher.
Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Male ; Prognosis ; Retrospective Studies

Objective: To evaluate the effects of dietary behaviors on the risk of hypertension, diabetes and cardiovascular diseases. Methods: A total of 12 208 subjects aged 18-60 years old were investigated by questionnaires to collect demographic data, dietary behaviors and lifestyle information, when they did health examination in a tertiary hospital in Beijing from 2014 to 2019. During the observation period of five year, the incidence of hypertension, diabetes and cardiovascular diseases were collected through health examination files every year. The multivariate logistic regression model was employed to analyze the associations of dietary behaviors with hypertension, diabetes and cardiovascular diseases. Results: The study included 6 218 ( 50.93% ) males and 5 990 ( 49.07% ) females. The cumulative incidence rates of hypertension, diabetes and cardiovascular diseases were 7.75%, 2.72% and 3.49%, respectively. The multivariate logistic regression analysis indicated that the high-sodium diet ( OR=1.422, 95%CI: 1.191-1.697 ) , eating fast ( OR=1.457, 95%CI: 1.102-1.974 ), eating more refined grain ( OR=1.251, 95%CI: 1.050-1.490 ) and drinking milk less than once a week ( OR=1.316, 95%CI: 1.022-1.697 ) were risk factors for hypertension. The high-sodium diet ( OR=1.344, 95%CI: 1.048-1.725 ), eating fast ( OR=1.733, 95%CI: 1.046-2.871 ), eating more meat ( OR=1.651,95%CI: 1.263-2.158 ) were risk factors for diabetes. High-sodium diet ( OR=1.501, 95%CI: 1.192-1.889 ) was risk factors for cardiovascular disease. Conclusion The diet with high sodium, more meat and refined grain as well as eating fast can increase the risk of hypertension, diabetes and cardiovascular diseases.

Objective: To explore the difference of personality characteristics of physicians, nurses, medical skills and administrative personnel in a general hospital and its influence on job burnout. Methods: Employee entered the hospital before 2018 were enrolled in the current study and the position was classified as physicians, nurses, medical technician and administrative staff. Minnesota Multiphasic Personality Inventory (MMPI) was completed by the employee at the time of entering the hospital. Status of job burnout was assessed in 2018 using the Maslach Burnout Inventory-General Survey (MBI-GS) . Results: Physicians have a higher rate of paranoia than others (P<0.05) , and administrative staff and medical technician have a slightly higher score than the other two categories of people (P<0.05) , and administrators lie at a higher rate than others (P<0.05) . Further analysis found that personality traits did not have a significant association with job burnout at the time of entry. Conclusion The administrative and medical staff is slightly more irritable, the administrative staff lying slightly higher score, the staff after the entry of job burnout is not affected by the personality characteristics of the onboarding.

Objective To observe the effect of Kidney-nourishing, Blood-activating, Phlegm-resolving and Resuscitation-inducing Decoction(KBPRD)on the expression of N-methyl-D-aspartate(NMDA)receptor subtype 1,2A,2B(NR1,NR2A,NR2B)in the cochlear spiral ganglion neurons(SGN)of tinnitus rats and to explore its mechanism, thus to provide experimental evidence for the treatment of tinnitus with KBPRD. Methods Sixty rats were randomly divided into normal group,model group,western medicine group,and low-,middle-,and high-dose Chinese medicine groups, 10 rats in each group. Rats were given intraperitoneal injection of sodium salicylate combined with water deprivation to induce tinnitus model. After successful establishment of the model, the rats in low-,middle-,and high-dose Chinese medicine groups were given gastric administration of KBPRD in the dosage of 5.5, 11, 22 g·kg-1·d-1 respectively, the rats in western medicine group were given gastric administration of 5 mg·kg-1·d-1 of carbamazepine,and rats in the model group and normal group were given gastric administration of 2 mL of normal saline,once every day,treatment time covering 8 weeks. The expression levels of NR1,NR2A,and NR2B in the cochlear SGN was detected by immunoblotting and real-time quantitative reverse transcription-polymerase chain reaction(qRT-PCR)after 8 weeks of treatment. Results Compared with the normal group,the expression levels of NR1, NR2A and NR2B in the model group were increased, the difference being significant (P < 0.05). Compared with the model group,the expression of NR1,NR2A and NR2B in low-,middle-,and high-dose Chinese medicine groups were significantly decreased(P<0.05).Conclusion KBPRD is effective on relieving tinnitus of rats, and its mechanism is correlated with lowering the increased expression of NR1,NR2A and NR2B in SGN of tinnitus rats.

OBJECTIVETo explore the curative efficacy of methotrexate(MTX) combined with rituxan for treating patients with primary central nervous system(CNS) lymphoma.

METHODSOne hundred patients with primary CNS lymphoma in our hospital were randomly divided into targeted treatment group(50 cases) and traditional treatment group (50 cases). Targeted treatment group adopted the therapy of high-dose methotrexate combined with rituxan, the traditional treatment group adopted the high-dose methotrexate combined with whole brain radiotherapy. The results of relevant imaging examination, clinical data, imaging, follow-up and the survival time were analysed and compared between these 2 groups.

RESULTSIn the targeted therapy group, there were 33 cases in CR, 9 cases were in stable condition, and 5 cases were in partial response, and 3 cases in the progressive stage. In the group of traditional treatment group, 29 cases reached complete remission, 5 cases were in stable condition, 11 cases were in partial response, and 5 cases were in the progressive stage. In the targeted treatment group and traditional treatment group, the median progression-free survival time was 28 and 11 months, respectively.

CONCLUSIONThe first choice for treatment scheme of PCNSL is high-dose methotrexate chemotherapy combined with whole brain radiotherapy, that showed a certain curative effect, but the adverse reactions are larger, and a big late neuro toxic reaction may occur, while high-dose methotrexate combined PCNSL rituxan treatment shows high curative effect, less adverse reaction and low side effects. This treatment also has a more positive value for the elderly patients with PCNSL.

OBJECTIVE:To observe the effects of Paclitaxel,Cisplatin combined with Recombinant human (Rh) endostatin on the efficacy and related indexes of patients with non-small cell lung cancer(NSCLC). METHODS:78 patients with Ⅲb or ⅣNSCLC were randomly divided into control group(39 cases)and observation group(39 cases). Control group received Paclitaxel injection 135-175 mg/m2,d1,intravenous infusion,once a day+Cisplatin injection 25 mg/m2,3 times a day,d1-3,intravenous infu-sion. Observation group additionally received Rh endostatin injection 15 mg/m2,adding into 500 ml 0.9% Sodium chloride injec-tion by slow intravenous infusion 3-4 h,d1-14,then stopped for 7 d. 21 d was regarded as 1 treatment course,it lasted 6 courses. Clinical efficacy,programmed death ligand-1(PD-L1)level,quality of life(QOL)score before and after treatment,and the inci-dence of adverse reactions in 2 groups were observed. RESULTS:All patients completed 2 courses of chemotherapy. There were 3 patients in observation group and 4 patients in control group quitted the study with uncompleted 6 weeks of chemotherapy due to in-tolerance or adverse reactions. The remission rate in observation group was significantly higher than control group,with statistical significance (P<0.05). Before treatment,there were no significant differences in PD-L1 level and QOL score in 2 groups (P>0.05). After treatment,PD-L1 level and QOL score in 2 groups were significantly lower than before,and observation group was lower than control group,with statistical significance (P<0.05). And there was no significant difference in the incidence of ad-verse reactions in 2 groups (P>0.05). CONCLUSIONS:Paclitaxel,Cisplatin combined with Rh endostatin can improve the short-term efficacy of patients with NSCLC,inhibit PD-L1 expression,improve QOL,and do not increase the incidence of adverse reactions.

Objective To investigate the correlation of plasma N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) level with echocardiographic indicators and P wave terminal force of lead V 1 (PtfV1) in the patients with hypertension and paroxysmal atrial fibrillation(PAF) .Methods Fifty‐six outpatients and inpatients with hypertension were divided into the PAF group (n=26) and the sinusrhythm group (n=30) .Thirty age‐matched and gender‐matched healthy volunteers were taken as the control group . The plasma NT‐proBNP level was determined .Left ventricular enddiastolic diameter (LVEDD) ,left atrial diameter(LAD) and left ventricular ejection fraction(LVEF) were examined by echocardiography .the 12‐lead electrocardiogram was routinely performed Pt‐fV1 was calculated .Results The plasma NT‐proBNP level in the PAF group was higher than that in the sinusrhythm group and the control group ,the difference was statistically significant (P<0 .05) .The plasma NT‐proBNP level in the PAF group was de‐creased significantly after successful cardioversion .The plasma NT‐proBNP level in the PAF group was positively correlated with LVEDD(r=0 .543 ,P<0 .05) and LAD (r=0 .606 ,P<0 .01) .The plasma NT‐proBNP level was negatively correlated with LVEF (r= -0 .750 ,P<0 .01) and positively correlated with the PtfV 1 absolute value (r= 0 .513 ,P< 0 .01) .Conclusion The plasma NT‐proBNP level can better reflect the heart structure and function in the patients with atrial fibrillation .Detecting the plasma NT‐proBNP level combined with echocardiographic indicators and PtfV 1 is conducive to comprehensively assess the heart function in the patients with hypertension and PAF .

Objective To evaluate the feasibility of plasma NT-pro brain natriuretic peptide guided therapy of β1-blocker to patients with moderate and severe heart failure.Methods A total of 1 95 patients with moderate and severe heart failure were ran-domized to the clinical group and the BNP group.The use of β1-blocker was guided by monitoring clinical representation and the changes of BNP values respectively.The duration of initiative use ofβ1-blocker,the recurrence of heart failure,the mortality due to heart failure and the mean dosage ofβ1-blocker were observed and analysed.Results Compared with the clinical group,the time of initiative use ofβ1-blocker was significantly shorter in NT-proBNP group[(5.89±1.76)d vs .(7.03±2.08)d,P <0.01].The mean dosage ofβ1-blocker is significantly higher in BNP group than that in clinical group[(47.65 ± 13.09 )mg/d vs .(35.08 ± 1 1.08) mg/d,P <0.01].The recurrence and mortality of heart failure were similar in two groups(P >0.05).Conclusion NT-proBNP-guided therapy ofβ1-blocker might contribute to early use and tolerance of higher dosage ofβ1-blocker in patients with NYHA Ⅲ-Ⅳ class heart function,with no extra adverse event.