Objective To evaluate the efficacy and safety of tislelizumab intravenous injection combined with pirarubicin intravesical instillation in the treatment of non-muscle-invasive bladder cancer(NMIBC).Methods This study is a randomized controlled trial,including 80 patients with NMIBC who underwent transurethral resection of bladder tumor(TURBT)at the urology department of Central Hospital of Guangdong Nongken from January 1,2021,to December 31,2022.The patients were randomly assigned to either the experi-mental group(treated with tislelizumab intravenous injection combined with pirarubicin intravesical instillation,n=40)or the control group(treated with pirarubicin intravesical instillation alone,n=40).The primary efficacy endpoints included progression-free survival(PFS),recurrence rate,and radiological progression rate.Safety was assessed by the type and incidence of treatment-related adverse e-vents(AEs).Results The median PFS in the experimental group was significantly longer than that in the control group(16 months vs 9months,P=0.034).The 1-year and 2-year recurrence rates in the experimental group were significantly lower than in the control group(7.5％vs 15.0％,P=0.034;12.5％ vs 22.5％,P=0.019).The radiological progression rate in the experimental group was significantly lower than that in the control group(7.5％vs20.0％,P=0.019).No treatment-related deaths occurred in either group.The incidence of fatigue was significantly higher in the experimental group than in the control group(25.0％vs 10.0％,P=0.048),while other adverse events showed no significant differences and were predominantly mild to moderate(Grade 1-2),manageable with symptomatic treatment.Conclusion Tislelizumab intravenous injection combined with pirarubicin intravesical instillation significantly prolongs PFS,reduces recurrence rates,and inhibits tumor progression in NMIBC patients,with good safety and tolerability.This combi-nation offers a safe and effective new strategy for postoperative NMIBC management.

Objective:To construct an internal quality evaluation system based on the structure-process-outcome(SPO)model,and to analyze its applied effect in the quality management for equipment in the ward of neurology of third-level grade-A hospital.Methods:The internal quality evaluation system for medical equipment based on SPO model realized comprehensive management for medical equipment in the ward of neurology of third-level grade-A hospital through structural design,platform management and outcome feedback.Thirty using medical equipment in the wards of the neurology of Shenzhen Longhua District Central Hospital from May,2022 to April,2024 were selected.The equipment that were used from May,2022 to April,2023 were managed by using conventional management method,and the equipment that were used from May 2023 to April 2024 were managed by using internal quality evaluation system(SPO model management method)based on SPO model.A self-made questionnaire was adopted to investigate and research the satisfaction degree of 35 equipment-related managers,and the operating quality of equipment,error rate of clinical operation and increased degree of equipment benefit of the two management methods were compared.Results:The execution rate of equipment,standard rate of disinfection,timely rate of failure treatment and pass rate of quality detection of adopting SPO model management method were respectively(94.15±4.63)%,(92.69±3.36)%,(93.65±4.36)%and(90.62±3.14)%,which were higher all than these of conventional management method,and the differences of them between two methods were statistically significant(t=14.218,14.582,11.813,14.859,P<0.05).The occurrences of misuse,operation error and human error were respectively one,one and two equipment in 30 equipment by using SPO model management method,and the incidence rates of them were respectively 3.333%,3.333%and 6.667%,which were lower all than those of conventional management method,and the differences of them between two methods were statistically significant(x2=11.882,13.416,12.272,P<0.05).The average scores of 35 managers for convenience,used effect,emergency use and automatic warning efficiency of adopting SPO model management method to use equipment were respectively(92.36±3.14)points,(93.21±4.36)points,(91.25±3.36)points and(94.23±4.36)points,all of which were higher than those of conventional management method,and the differences of them between two methods were statistically significant(t=12.849,11.894,11.417,11.401,P<0.05).The average values of the increased degrees of cost-benefit and social-benefit of equipment of using SPO model management method were respectively(4.36±0.96)%and(3.25±0.65)%,which were higher than these of conventional management method,while the average value of the increased degree of maintenance management expenditure of using SPO model management method was(1.56±0.69)%,which was lower than that of conventional management method,and the differences of them between two methods were statistically significant(t=11.754,14.438,16.320,P<0.05).Conclusion:The application of the internal quality evaluation system based on SPO model for medical equipment in the management for medical equipment in neurology wards of third-level grade-A hospital can improve the operation quality of equipment,and reduce the error rate of operating equipment,and enhance the satisfaction of relevant managers in using equipment.

Objective To evaluate the efficacy and safety of tislelizumab intravenous injection combined with pirarubicin intravesical instillation in the treatment of non-muscle-invasive bladder cancer(NMIBC).Methods This study is a randomized controlled trial,including 80 patients with NMIBC who underwent transurethral resection of bladder tumor(TURBT)at the urology department of Central Hospital of Guangdong Nongken from January 1,2021,to December 31,2022.The patients were randomly assigned to either the experi-mental group(treated with tislelizumab intravenous injection combined with pirarubicin intravesical instillation,n=40)or the control group(treated with pirarubicin intravesical instillation alone,n=40).The primary efficacy endpoints included progression-free survival(PFS),recurrence rate,and radiological progression rate.Safety was assessed by the type and incidence of treatment-related adverse e-vents(AEs).Results The median PFS in the experimental group was significantly longer than that in the control group(16 months vs 9months,P=0.034).The 1-year and 2-year recurrence rates in the experimental group were significantly lower than in the control group(7.5％vs 15.0％,P=0.034;12.5％ vs 22.5％,P=0.019).The radiological progression rate in the experimental group was significantly lower than that in the control group(7.5％vs20.0％,P=0.019).No treatment-related deaths occurred in either group.The incidence of fatigue was significantly higher in the experimental group than in the control group(25.0％vs 10.0％,P=0.048),while other adverse events showed no significant differences and were predominantly mild to moderate(Grade 1-2),manageable with symptomatic treatment.Conclusion Tislelizumab intravenous injection combined with pirarubicin intravesical instillation significantly prolongs PFS,reduces recurrence rates,and inhibits tumor progression in NMIBC patients,with good safety and tolerability.This combi-nation offers a safe and effective new strategy for postoperative NMIBC management.

Objective:To construct an internal quality evaluation system based on the structure-process-outcome(SPO)model,and to analyze its applied effect in the quality management for equipment in the ward of neurology of third-level grade-A hospital.Methods:The internal quality evaluation system for medical equipment based on SPO model realized comprehensive management for medical equipment in the ward of neurology of third-level grade-A hospital through structural design,platform management and outcome feedback.Thirty using medical equipment in the wards of the neurology of Shenzhen Longhua District Central Hospital from May,2022 to April,2024 were selected.The equipment that were used from May,2022 to April,2023 were managed by using conventional management method,and the equipment that were used from May 2023 to April 2024 were managed by using internal quality evaluation system(SPO model management method)based on SPO model.A self-made questionnaire was adopted to investigate and research the satisfaction degree of 35 equipment-related managers,and the operating quality of equipment,error rate of clinical operation and increased degree of equipment benefit of the two management methods were compared.Results:The execution rate of equipment,standard rate of disinfection,timely rate of failure treatment and pass rate of quality detection of adopting SPO model management method were respectively(94.15±4.63)%,(92.69±3.36)%,(93.65±4.36)%and(90.62±3.14)%,which were higher all than these of conventional management method,and the differences of them between two methods were statistically significant(t=14.218,14.582,11.813,14.859,P<0.05).The occurrences of misuse,operation error and human error were respectively one,one and two equipment in 30 equipment by using SPO model management method,and the incidence rates of them were respectively 3.333%,3.333%and 6.667%,which were lower all than those of conventional management method,and the differences of them between two methods were statistically significant(x2=11.882,13.416,12.272,P<0.05).The average scores of 35 managers for convenience,used effect,emergency use and automatic warning efficiency of adopting SPO model management method to use equipment were respectively(92.36±3.14)points,(93.21±4.36)points,(91.25±3.36)points and(94.23±4.36)points,all of which were higher than those of conventional management method,and the differences of them between two methods were statistically significant(t=12.849,11.894,11.417,11.401,P<0.05).The average values of the increased degrees of cost-benefit and social-benefit of equipment of using SPO model management method were respectively(4.36±0.96)%and(3.25±0.65)%,which were higher than these of conventional management method,while the average value of the increased degree of maintenance management expenditure of using SPO model management method was(1.56±0.69)%,which was lower than that of conventional management method,and the differences of them between two methods were statistically significant(t=11.754,14.438,16.320,P<0.05).Conclusion:The application of the internal quality evaluation system based on SPO model for medical equipment in the management for medical equipment in neurology wards of third-level grade-A hospital can improve the operation quality of equipment,and reduce the error rate of operating equipment,and enhance the satisfaction of relevant managers in using equipment.

OBJECTIVE To provide prenatal diagnosis for families affected with tuberous sclerosis complex and explore the correlation between phenotype and genotype. METHODS For probands from 10 families, all exons and splicing regions of the TSC1 and TSC2 genes were analyzed with high throughput DNA sequencing. Suspected mutations were verified by Sanger sequencing. RESULTS All probands were found to have mutations, which included 1 case with TSC1 mutation and 9 cases with TSC2 mutations (missense mutations in 6, nonsense mutations in 2, and frameshifting mutation in 1 case). Prenatal diagnosis was provided for 9 cases, and 1 fetus was found to carry a mutation. Genetic analysis has identified a novel pathogenic mutation (TSC2 c.2415-2416 ins GT). CONCLUSION Identification of pathological mutations for tuberous sclerosis complex can facilitate genetic counseling and prenatal diagnosis for the affected families.

Objective To summarize the MRI manifestations of immunosuppressive drugs associated encephalopathy after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with aplastic anemia. Methods Fifteen patients with immunosuppressive drugs associated encephalopathy after allogeneic hematopoietic stem cell transplantation for aplastic anemia during January 2014 to October 2016 were analyzed retrospectively. There were 7 males and 8 females, aged from 3 to15 years old, with the median age of 7 years old. Ten cases presented dizziness and headache while other 4 cases presented blurred vision, blind and gaze. Only one case suffered from seizure and loss of consciousness. MRI patterns including distribution, morphology and signal intensity were analyzed after treatment. Follow up MRI were performed after reducing drug dose and symptom remission. The duration of immunosuppressive drugs associated encephalopathy of the 15 cases were 1-14 months, with 6 months in 9 cases. Results Focal lesions were found in 11 cases, in which the deep nuclei were involved in one case and the white matter was involved in 10. Four patients showed both cerebral cortex and white matter lesions, including cerebellum and brainstem invasion in one patient. No corpus callosum lesions were found. Various degree of brain atrophy was found in all patients. Cortical lesions showed swelling and involved subcortical white matter presented as arc shape or strip-like lesions. Patchy patterns were found in deep white matter. Thin layer shaped lesions were found in the periventricular white matter. Small flake-like lesions were found in the brain stem and the cerebellum. The lesions showed hypointensity on T1WI, equal or high signal on T2WI. T2WI FLAIR showed equal or high signal;DWI in the cortex and subcortical white matter lesions showed iso-or high signal, while other lesions were isointense. Eight cases acquired clinical relief in short term without obvious improvement on MRI image. Both clinical symptoms and imaging findings improved in 6 cases. One case showed clinical relief but progression on MRI. Conclusions MRI is an effective way to find immunosuppressive drugs-related encephalopathy in children with aplastic anemia after allogeneic hematopoietic stem cell transplantation. It can help the diagnosis and provide the information for clinical treatment.

Objective To summarize the MRI manifestations of immunosuppressive drugs associated encephalopathy after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with aplastic anemia. Methods Fifteen patients with immunosuppressive drugs associated encephalopathy after allogeneic hematopoietic stem cell transplantation for aplastic anemia during January 2014 to October 2016 were analyzed retrospectively. There were 7 males and 8 females, aged from 3 to15 years old, with the median age of 7 years old. Ten cases presented dizziness and headache while other 4 cases presented blurred vision, blind and gaze. Only one case suffered from seizure and loss of consciousness. MRI patterns including distribution, morphology and signal intensity were analyzed after treatment. Follow up MRI were performed after reducing drug dose and symptom remission. The duration of immunosuppressive drugs associated encephalopathy of the 15 cases were 1-14 months, with 6 months in 9 cases. Results Focal lesions were found in 11 cases, in which the deep nuclei were involved in one case and the white matter was involved in 10. Four patients showed both cerebral cortex and white matter lesions, including cerebellum and brainstem invasion in one patient. No corpus callosum lesions were found. Various degree of brain atrophy was found in all patients. Cortical lesions showed swelling and involved subcortical white matter presented as arc shape or strip-like lesions. Patchy patterns were found in deep white matter. Thin layer shaped lesions were found in the periventricular white matter. Small flake-like lesions were found in the brain stem and the cerebellum. The lesions showed hypointensity on T1WI, equal or high signal on T2WI. T2WI FLAIR showed equal or high signal;DWI in the cortex and subcortical white matter lesions showed iso-or high signal, while other lesions were isointense. Eight cases acquired clinical relief in short term without obvious improvement on MRI image. Both clinical symptoms and imaging findings improved in 6 cases. One case showed clinical relief but progression on MRI. Conclusions MRI is an effective way to find immunosuppressive drugs-related encephalopathy in children with aplastic anemia after allogeneic hematopoietic stem cell transplantation. It can help the diagnosis and provide the information for clinical treatment.

Objective To explore the effects of co‐cultured heat‐treated candida glabrata with rat tracheal epithelial (RTE) cells on the expression of Dectin‐1 and the production of IL‐6 and TNF‐α.Methods RTE cells in vitro were co‐cultured with heat‐treated candida glabrata bacteria liquid for 2 ,4 ,6 h ,while without co‐cultured RTE cells were used as control group .We observed the morphological changes of RTE cells ,detected the protein expressions of Dectin‐1 by Western blot ,used real‐time PCR to detecte the mRNA expressions of IL‐6 and TNF‐αand measured protein expression of IL‐6 and TNF‐αby ELISA .Results With the pass‐ing of time ,the RTE cells were damaged extensively and the expression of Dectin‐1 ,IL‐6 and TNF‐αbecame more and more signifi‐cant .Obviously ,there had significant difference in the expression of Dectin‐1 ,IL‐6 and TNF‐α between the co‐cultured 2 h group and the control group ,the co‐cultured 4 h group and the co‐cultured 2 h group ,the co‐cultured 6 h group and the co‐cultured 4 h group (P<0 .05) .Conclusion RTE cells have natural immune function .The Dectin‐1 involves in the recognition of heat‐treated Candida glabrata ,activating secretion of IL‐6 and TNF‐αand mediating inflammatory reaction .IL‐6 plays a negative regulation role .

Objective To understand the status of water contact and labor practice of residents in plateau mountain schisto?somiasis endemic areas in Yunnan Province so as to provide the evidence for formulating the strategy of prevention and control of schistosomiasis in the next step of work. Methods A total of 412 residents aged 6-65 years old in 2 villages were randomly sampled and investigated with questionnaires for their water contacts and labor practices in plateau valley schistosomiasis endem?ic areas. Then the schistosome infection status of the residents was surveyed with the indirect hemagglutination assay IHA . Re?sults Among the 412 residents investigated the rate of water contact was 88.35% and the main causes of water contact were watering and swimming and playing. The percentages of residents who had schistosomiasis history were 1.16% 0.00%30.80% 3.85% and 0 in them who had swimming and playing water?contacts bathing watering washing hands and others respectively χ2=38.96 P<0.01 . The positives of IHA in the above?mentioned residents were 18.60% 0.00% 37.60%23.08% and 0 respectively χ2=12.61 P<0.05 . Conclusions The productive infested water contact is the main way of schistosome infection. Therefore the changes of labor practices and water contact of the residents are very important for the ef?fective prevention and control of schistosomiasis transmission.

Objective To evaluate the effect of comprehensive schistosomiasis control measures based on infection source control in plateau mountain areas of Yunnan Province. Methods From 2006 to 2004,four administrative villages were selected as test areas from plateau canyon and plateau basin endemic areas in Jindun Town,Heqing County,two villages each type,and the comprehensive control measures were implemented,including the examination and treatment of schistosomiasis,Oncomela?nia hupensis snail survey and control,health education,improving drinking water and lavatories,banning grazing,constructing sanitary pen of livestock,replacing cattle with machine,etc. The schistosome infection state and snail status in 2006 were treat?ed as the baseline information,and the effect of the comprehensive measures were evaluated. Results The infection rate of hu?man in plateau canyon areas decreased from 4.94%in 2006 to 0.06%in 2014,and that of livestock decreased from 1.11%to 0. In plateau basin areas,there was only 1 case of schistosomiasis found in Xiaolian Village in 2007,and no any other cases found in the other years,the infection rates of livestock dropped from 7.38%to 0. Compared with 2006,the snail areas in the two type areas decreased by 74.89%and 75.30%,respectively,meanwhile,the percentage of snail area,the occurrence rate of frames with snails,as well as the average density of living snails also decreased,and no infected snails were found since 2008. Xidian and Xinzhuang villages in plateau canyon area reached the criteria of schistosomiasis transmission controlled in 2009,and Xiao?lian and Kangfu villages in plateau basin reached the criteria of transmission interrupted in 2014. Conclusions The comprehen?sive schistosomiasis control measures based on infection source control can effectively control the endemic situation of schistoso? miasis in plateau areas of Yunnan Province. In the future,we should pay an equal attention to the infection sources control and snail control to consolidate and amplify the achievement of schistosomiasis control.