Objective To develop a nomogram based on pulmonary nodules preoperative CT signs and 3D quantitative parameters for predicting mediastinal lymph node metastases in patients with clinical stage ⅠA lung adenocarcinoma.Methods The imaging data of 164 patients who underwent preoperative CT scan and systematic lymph node dissection were analyzed retrospectively.Commercially available AI software was used to extract 3D quantitative parameters of pulmonary nodules automatically,and CT signs of pulmonary nodules were analyzed.Logistic regression was used to explore the role of these parameters in predicting pathological nodal involvement.A nomogram prediction model was established,then discrimination and calibration of the model were evaluated.Results Among 164 enrolled patients,19(11.6％)were tested positive for mediastinal lymph node metastases at pathology review.The nomogram incorporated spiculation,lobulation,the largest cross-sectional area,and carcinoembryonic antigen(CEA).The model showed great discrimination and calibration,with a C-index of 0.942[95％confidence interval(CI)0.923-0.961].The predicted value of the model fitted well with the actual observed value on the calibration curve.Conclusion The nomogram prediction model based on preoperative CT signs,3D quantitative parameters,and CEA can estimate the probability of mediastinal lymph node metastases in clinical stage ⅠA lung adenocarcinoma.This model may help with clinical decision-making and individualized evaluation.

The placement of the flexible ureteroscopic sheath during lithotripsy may injure the ureter. We have developed a double-tube flexible ureteral access sheath. Thirteen patients with renal calculi were treated with double-tube and flexible sheath in one stage. CT examination of 13 cases showed that the ureter was normal. The double-tube flexible ureteral access sheath makes the operation of sheathing easy, safe and effective.

Objective:To explore the feasibility and efficacy of laparoscopic resection of abdominal and retroperitoneal cystic masses in children.Methods:A retrospective analysis of 11 cases of abdominal and retroperitoneal cystic masses in Department of Pediatric Surgery, Quanzhou First Hospital Affiliated to Fujian Medical University from June 2015 to January 2019 was performed, and all the patients underwent laparoscopic resection or laparoscopic-assisted resection, with 6 cases of boys and 5 cases of girls, aged 8 months to 10 years (with the average of 59 months). Meanwhile, 9 cases were from the abdominal cavity and 2 cases were from the retroperitoneum.Results:All patients underwent laparoscopic or laparoscopic-assisted resection without switching to laparotomy.The operation time was 60-210 minutes, with the average of 120 minutes.The intraoperative blood loss was 5-30 mL, with the average of 10 mL.There was no blood transfusion.All patients were discharged 3-8 days after surgery, with the average of 5 days.The postoperative pathological results included 5 cases of mature teratoma, 1 case of paraneoplastic cyst, 2 cases of intestinal duplication, 2 cases of lymphangioma, and 1 case of hepatic cyst.Totally, 11 cases were followed up for 7-51 months, with the average of 20.9 months.No recurrence occurred.Conclusions:Laparoscopic or laparoscopic-assisted resection of abdominal and retroperitoneal cystic masses has advantages of minimal invasion, rapid recovery in children, and it is safe and effective.

Objective To investigate the significance of albumin-bilirubin (ALBI) score in predicting prognosis of hepatocellular carcinoma (HCC).Methods The clinical data of 644 HCC patients were retrospectively analyzed from May 2010 to May 2013 in the First People's Hospital of Changde City and the Affiliated Tumor Hospital of Guangxi Medical University.Peripheral blood test results were used to calculate ALBI score,and ALBI score was categorized into the following 3 groups:grade 1,grade 2,grade 3.Overall survival(OS) and disease free survival(DFS) were evaluated by the Kaplan-Meier method.And independent prognostic predictors were determined by the Cox proportional hazard model.Results Multivariate analysis showed that ALBI grade 2 was an independent risk factor for OS(P＜0.05).The ALBI grade stratified patients into at least two distinct overall survival cohorts (P＜0.05),whereas the CP grade did not.The ALBI grade also classified patients with CP grade A patients into two distinct overall survival cohorts (P＜0.05).In the subgroup analysis,the ALBI grade seemed to be an independent factor in terms of Barcelona Clinical Liver Cancer staging system(BCLC) 0-C.Conclusion For patients with HCC who underwent R0 resection,the ALBI grade is a good predictor of OS in HCC patients,and the above conclusions is true in patients with BCLC stage 0-C.

Objective To understand the current state of research and clinical application of α-asarone injection.Method Literature search was conducted and the pharmacology, toxicology, preparation, clinical application and adverse reactions of α-asarone were reviewed.Results α-asarone injection has strong relieving effects on cough and asthma, but the quality of production is varying, adverse reactions are often reported, and the toxicological effects need to be further investigated.Conclusions α-asarone injection has a certain clinical effect, but the reports of related adverse reactions are gradually increased.Its toxicity remains to be further studied, and the product quality standard system and instructions need also to be further improved.

Objective To compare the clinical significance of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting prognosis of patients with hepatocellular carcinoma (HCC).Methods The clinical data of 661 patients with HCC were retrospectively analyzed.Routine peripheral blood test results were used to calculate the NLR and PLR,and the receiver operating characteristic (ROC) curves were drawn.Using the thresholds of NLR and PLR,the patients were divided into the low NLR group and the high NLR group,and the low PLR group and the high PLR group.Overall survival (OS) and disease free survival (DFS) were evaluated by the Kaplan-Meier method.Independent prognostic predictors were determined by the Cox proportional hazard model.Results The NLR and PLR thresholds were 2.790 and 99,respectively.Analysis of the ROC curves showed higher NLR and PLR were significantly associated with poorer OS and DFS (all P ＜ 0.05).Multivariate analysis showed that NLR was an independent risk factor of OS and DFS (both P ＜ 0.05).The results remained unchanged when the NLR was further analyzed by applying different cut-off values of 2.810 and 3.In subgroup analysis,NLR remained an independent factor of Barcelona Clinical Liver Cancer staging system (BCLC) 0/A/B (P ＜ 0.05 for all measurements).Conclusion An elevated preoperative NLR could be a better prognostic predictor for HCC patients in comparison with PLR,especially for BCLC 0/A/B patients.

This study aimed at optimizing the extraction process of Bi Xie Fen Qing (BXFQ) drink using ultrasound-microwave cooperation with central composite design-response surface method in comparison with the traditional decoction process.Taking microwave frequency,amount of water,extraction time as the main detection factors,diosgenin,glycyrrhizic acid and the extract yield were tested as the evaluation indexes;and taking an integrated score as response value for response surface and contour,predictive analysis was carried out and the optimum extraction conditions were achieved.It was found that the optimum extraction process of BXFQ drink was identified:the microwave frequency was 434 W,water addition was 18.4 times,extraction time was 9.3 mins and the ultrasonic frequency was fixed at 50 W.Under the optimum process,the diosgenin extraction yield rate was 23.17％ (mg· g-1),extraction yield rate of glycyrrhizic acid was 0.64％ (g·g-1),and the extraction yield rate of extractum was 34.12％ (g·g-1).All the indexes were superior to those of the traditional method.It is concluded that the composite design-response surface method is suitable for the extraction optimization of BXFQ drink with favorable predictability of the mathematical model.The optimized ultrasoundmicrowave cooperation was easy to operate with high extraction efficiency.It is suitable for industrialized production with the provision of a scientific reference for the modern formulation development of BXFQ drink.

Objective: To analyze factors influencing antiretroviral therapy (ART) adherence among human immunodeficiency virus (HIV) patients receiving ART at the town level in Ili Kazakh Autonomous Prefecture (Ili) in May 2015 and to document enhanced ART for acquired immunodeficiency syndrome (AIDS) cases. Methods: A cross-sectional survey was conducted using one-on-one interviews and data collection from the system of AIDS follow-up management in three ART services centers at the town level of Ili. The subjects were HIV-infected individuals, aged 18 years or older, who were receiving ART during the survey. The surveys collected demographic characteristics, information related to ART and status of engaging ART, smoking and drinking behavior, depression, and quality of life. Results: A total of 412 participants completed the survey. The age was (41.1±8.0) years (range, 19-67 years). Approximately 60.9% (251) were male and 39.1% (161) were female. The survey showed that 75.0% (309) of participants were in good adherence and the P₅₀ (P₂₅, P₇₅) of quality of life was 56.31 (50.55, 59.42). Females demonstrated better adherence to ART (82.6% (n=133)) than males (70.1% (n=76)) (χ²=8.16, P=0.005). The compliance rate of participants (78.0% (n=54)) with depression was higher than non-depressed participants (63.5% (n=255)) (χ²=7.52, P=0.008). Multivariate logistic regression analyses showed that the probability of good adherence to ART increased with increasing quality of life (OR=1.06, 95%CI:1.02-1.09). Moreover, participants who consumed alcohol or disclosed their HIV infection status to families were less likely to have good adherence to ART (OR=0.26, 95% CI:0.13-0.53 and OR=0.31, 95% CI:0.13-0.72, respectively). Additionally, employed participants were also less likely to have good adherence to ART compared with unemployed participants (OR=0.45, 95% CI:0.21-0.97). Conclusion HIV/AIDS patients primarily showed good adherence to ART. Factors related to ART adherence included alcohol consumption, informing family of infection, work status, and quality of life.

Objective To study the nutritional status in different age patients with esophageal cancer during radiotherapy. Methods Ninety nine patients with esophageal carcinoma accepted radiotherapy in Zhejiang Cancer Hospital from June 2012 to August 2013 were enrolled. Patients were divided into two groups by their age: the younger age<60 years; and the older age ≥60 years. Nutritional status was measured weekly during radiotherapy, and European Nutritional Risk Screening (NRS) 2002 were used to evaluate the risk of malnutrition. Results The malnutritional incidence during radiotherapy was 23.5%-29.4% and 33.8%-49.2% in the younger group and the older group, respectively. Compared with baseline nutritional parameters, triceps skinfold thickness (TSF) of the<60 years group started to differ at the first week after the start of radiotherapy (first week to the sixth week:9.14±8.67;7.80±2.90;7.62±2.83;7.56± 2.79;7.90±2.91;7.36±2.67, respectively, all P<0.01);compared with baseline nutritional parameters(2.09± 1.28), ≥60 years group started to differ at the second week (2.34 ± 1.24, P<0.05) after the start of radiotherapy for NRS2002 the third week, 2.49 ± 1.24, P=0.016;the fourth week, 2.51 ± 1.30;P=0.013, the fifth week, 2.55 ± 1.29, P=0.006; the sixth week, 2.57 ± 1.26, P=0.004. There was no significant difference between each time point for TSF in>60 years group (P>0.05). No significant difference was found for body mass index (BMI), arm circumference (AC), arm muscle circumference (AMC) in each group (P>0.05). Conclusion The elderly patients with esophageal cancer had significantly increased risk of malnutrition and decreased nutritional status than the younger patients during radiotherapy. Early start of nutrition interventions in the elderly patients may be benefitted.

Objective To evaluate the nutritional status and risks in elderly patients with esophageal cancer during their radiotherapy; to provide the evidence of nutritional assessment tools and interventions in clinical practice. Methods This retrospective study investigated 65 patients with esophageal cancer ( >60 years) who had undergone radiotherapy in Zhejiang Cancer Hospital from June 2012 to August 2013. Nutritional status was assessed at the beginning and after the radiotherapy in every week; nutritional risks were screened every week with the help of NRS 2002. Results Compared with the status at the beginning of radiotherapy, the significant higher nutritional risk emerged: in the second week of the radiotherapy with NRS2002 [(2. 34 ± 1. 24) vs (2. 09 ± 1. 28);Z=3. 234, P<0. 01];the second week with body mass index (BMI) [(20. 21 ± 3. 03) vs (20. 51 ± 3. 06); t=3. 626,P<0. 01]; the third week with arm circumference (AC) [(24.69 ±2.87) vs (24.96 ±2.93);t=2.456,P<0.05]. The differences of triceps skinfold (TSF) and arm muscle circumference (AMC) had no significance (P>0. 05). The incidence of malnutrition during radiotherapy was 33. 8% -49. 2%; the score of NRS2002 was negatively correlated with BMI, TSF, AC and AMC. Nutritional support were provided to 62(93. 8%)patients, three (4. 8%) of the patients received enteral nutrition (EN), 59 (95.2%) patients received parenteral nutrition (PN). Conclusions The risk of malnutrition is high in elderly patients with esophageal cancer and will even worse with the process of radiotherapy. NRS2002 can precisely detect nutritional risks and provide the evidence of nutritional interventions in clinical practice.