Objective:To analyze the effect and safety of vibrating mesh atomization inhalation of pulmonary surfactant (PS) combined with nasal continuous positive airway pressure (NCPAP) in the treatment of neonatal respiratory distress syndrome (NRDS).Methods:150 Children with NRDS in department of pediatrics of the Second Affiliated Hospital of Air Force Medical University from May 2021 to May 2024 were enrolled as study subjects for a prospective cohort study. According to the propensity score matching, children who adopted traditional intratracheal infusion of PS combined with NCPAP were selected as infusion group (75 cases), and children who received vibrating mesh atomization inhalation of PS combined with NCPAP treatment were included in atomization group (75 cases). The therapeutic effect, breathing conditions, blood gas changes [pH value, arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2)] and NCPAP parameters changes [fraction of inspired oxygen (FiO 2), oxygenation index (OI), positive end-expiratory pressure (PEEP)] before and after treatment and incidence rates of adverse reactions were compared between groups. Normally distributed quantitative data were expressed as xˉ± s, and t test was used for inter-group comparison. Counting data were expressed as case(%), and χ2 test was used for inter-group comparison. Comparison of repeated measurement indicators at different time points using repeated meausurement analysis of variance. Results:There was no statistical significance in the total effective rate of treatment between groups ( P>0.05). The NCPAP treatment time and oxygen therapy time were (4.69±0.61) d and (14.52±1.16) d in atomization group, significantly shorter than (5.08±0.80) d and (15.30±1.28) d in infusion group ( t=3.36, 3.91, P=0.001, <0.001). The success rate of one-time weaning in atomization group was 88.00% (66/75), significantly higher than 73.33% (55/75) in infusion group ( χ2=5.17, P=0.023). After 3 and 7 days of treatment, the pH [(3 d : 7.31±0.04, 7 d: 7.34±0.03) and (3 d: 7.35±0.03, 7 d: 7.38±0.02)], PaO 2 [(3 d: (58.55±6.51) mmHg (1 mmHg=0.133 kPa), 7 d: (68.19±7.58) mmHg ) and (3 d: (65.16±7.24) mmHg, 7 d: (75.57±8.40) mmHg)] in infusion group and atomization group increased obviously over time, and the pH and PaO 2 were significantly higher in atomization group than those in infusion group ( t=6.93, 8.68, 5.88, 5.65, all P<0.001). The PaCO 2 in infusion group and atomization group (3 d: (48.45±5.38 ) mmHg, 7 d: (43.64±4.85 ) mmHg) and (3 d: (45.41±5.02) mmHg, 7 d: (40.35±4.59) mmHg) decreased obviously over time at 3 and 7 days of treatment, and the PaCO 2 in atomization group was significantly lower than that in infusion group ( t=3.58, 4.27, both P<0.001). After 3 days of treatment, FiO 2 [(41.06±4.67)% and (38.52±4.21)%] and PEEP [(4.39±0.19) cmH 2O (1 cmH 2O=0.098 kPa) and (4.28±0.13) cmH 2O] in infusion group and atomization group decreased obviously, and the indicators in atomization group were significantly lower than those in infusion group ( t=3.50, 4.14, both P<0.001). After 3 days of treatment, oxygenation index (OI) in infusion group and atomization group [(278.35±30.48) mmHg and (296.67±32.96) mmHg] increased obviously, and the OI in atomization group was significantly higher than that in infusion group ( t=3.53, P<0.001). The incidence of adverse reactions in atomization group was 4.00% (3/75), significantly lower than 13.34% (10/75) in infusion group ( χ2=4.13, P=0.042). Conclusion:Both vibrating mesh atomization inhalation of PS or traditional infusion of PS combined with NCPAP have similar efficacy in the treatment of NRDS, but vibrating mesh atomization inhalation of PS combined with NCPAP can more effectively improve the breathing conditions, blood gas indicators and NCPAP parameters of children, and has higher safety.

Objective:To develop a vasectomy intention scale (VIS) and evaluate its reliability and validity for assessing men's intentions toward vasectomy.Methods:Based on the Theory of Planned Behavior, the VIS was developed through a process that included literature review, panel discussions, expert consultations, and a pilot survey. A total of 264 men seeking vasectomy consultation at the Andrology Center, Department of Urology, the Third Xiangya Hospital of Central South University between December 2023 and December 2024 were recruited to assess reliability and validity of the VIS.Results:The VIS comprises 11 items across three dimensions: "background" factors, "stance and behavior" factors and "information" factors. The scale demonstrated satisfactory internal consistency (Cronbach's α=0.739). Correlations between each dimension and the total scale ("background" factors r=0.849, "stance and behavior" factors r=0.744, "information" factors r=0.440) exceeded inter-dimension correlations (ranging from 0.145 to 0.312), confirming robust construct validity. The vasectomy rates among men with different intention levels were 65.7% (92/140) in the high-intention group, 28.9% (33/114) in the moderate-intention group, and 0% (0/11) in the low-intention group, with a statistically significant difference (χ2=43.42, P<0.001). Conclusion:The VIS exhibits strong reliability and validity, serving as a validated instrument for measuring the strength of men's vasectomy intentions.

Objective:To develop a vasectomy intention scale (VIS) and evaluate its reliability and validity for assessing men's intentions toward vasectomy.Methods:Based on the Theory of Planned Behavior, the VIS was developed through a process that included literature review, panel discussions, expert consultations, and a pilot survey. A total of 264 men seeking vasectomy consultation at the Andrology Center, Department of Urology, the Third Xiangya Hospital of Central South University between December 2023 and December 2024 were recruited to assess reliability and validity of the VIS.Results:The VIS comprises 11 items across three dimensions: "background" factors, "stance and behavior" factors and "information" factors. The scale demonstrated satisfactory internal consistency (Cronbach's α=0.739). Correlations between each dimension and the total scale ("background" factors r=0.849, "stance and behavior" factors r=0.744, "information" factors r=0.440) exceeded inter-dimension correlations (ranging from 0.145 to 0.312), confirming robust construct validity. The vasectomy rates among men with different intention levels were 65.7% (92/140) in the high-intention group, 28.9% (33/114) in the moderate-intention group, and 0% (0/11) in the low-intention group, with a statistically significant difference (χ2=43.42, P<0.001). Conclusion:The VIS exhibits strong reliability and validity, serving as a validated instrument for measuring the strength of men's vasectomy intentions.

Objective:To analyze the effect and safety of vibrating mesh atomization inhalation of pulmonary surfactant (PS) combined with nasal continuous positive airway pressure (NCPAP) in the treatment of neonatal respiratory distress syndrome (NRDS).Methods:150 Children with NRDS in department of pediatrics of the Second Affiliated Hospital of Air Force Medical University from May 2021 to May 2024 were enrolled as study subjects for a prospective cohort study. According to the propensity score matching, children who adopted traditional intratracheal infusion of PS combined with NCPAP were selected as infusion group (75 cases), and children who received vibrating mesh atomization inhalation of PS combined with NCPAP treatment were included in atomization group (75 cases). The therapeutic effect, breathing conditions, blood gas changes [pH value, arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2)] and NCPAP parameters changes [fraction of inspired oxygen (FiO 2), oxygenation index (OI), positive end-expiratory pressure (PEEP)] before and after treatment and incidence rates of adverse reactions were compared between groups. Normally distributed quantitative data were expressed as xˉ± s, and t test was used for inter-group comparison. Counting data were expressed as case(%), and χ2 test was used for inter-group comparison. Comparison of repeated measurement indicators at different time points using repeated meausurement analysis of variance. Results:There was no statistical significance in the total effective rate of treatment between groups ( P>0.05). The NCPAP treatment time and oxygen therapy time were (4.69±0.61) d and (14.52±1.16) d in atomization group, significantly shorter than (5.08±0.80) d and (15.30±1.28) d in infusion group ( t=3.36, 3.91, P=0.001, <0.001). The success rate of one-time weaning in atomization group was 88.00% (66/75), significantly higher than 73.33% (55/75) in infusion group ( χ2=5.17, P=0.023). After 3 and 7 days of treatment, the pH [(3 d : 7.31±0.04, 7 d: 7.34±0.03) and (3 d: 7.35±0.03, 7 d: 7.38±0.02)], PaO 2 [(3 d: (58.55±6.51) mmHg (1 mmHg=0.133 kPa), 7 d: (68.19±7.58) mmHg ) and (3 d: (65.16±7.24) mmHg, 7 d: (75.57±8.40) mmHg)] in infusion group and atomization group increased obviously over time, and the pH and PaO 2 were significantly higher in atomization group than those in infusion group ( t=6.93, 8.68, 5.88, 5.65, all P<0.001). The PaCO 2 in infusion group and atomization group (3 d: (48.45±5.38 ) mmHg, 7 d: (43.64±4.85 ) mmHg) and (3 d: (45.41±5.02) mmHg, 7 d: (40.35±4.59) mmHg) decreased obviously over time at 3 and 7 days of treatment, and the PaCO 2 in atomization group was significantly lower than that in infusion group ( t=3.58, 4.27, both P<0.001). After 3 days of treatment, FiO 2 [(41.06±4.67)% and (38.52±4.21)%] and PEEP [(4.39±0.19) cmH 2O (1 cmH 2O=0.098 kPa) and (4.28±0.13) cmH 2O] in infusion group and atomization group decreased obviously, and the indicators in atomization group were significantly lower than those in infusion group ( t=3.50, 4.14, both P<0.001). After 3 days of treatment, oxygenation index (OI) in infusion group and atomization group [(278.35±30.48) mmHg and (296.67±32.96) mmHg] increased obviously, and the OI in atomization group was significantly higher than that in infusion group ( t=3.53, P<0.001). The incidence of adverse reactions in atomization group was 4.00% (3/75), significantly lower than 13.34% (10/75) in infusion group ( χ2=4.13, P=0.042). Conclusion:Both vibrating mesh atomization inhalation of PS or traditional infusion of PS combined with NCPAP have similar efficacy in the treatment of NRDS, but vibrating mesh atomization inhalation of PS combined with NCPAP can more effectively improve the breathing conditions, blood gas indicators and NCPAP parameters of children, and has higher safety.

Objective To investigate the efficacy and safety of camrelizumab monoclonal antibody combined with molecular-targeted therapy in elderly patients with unresectable or advanced hepatocellular carcinoma(HCC).Methods A retrospective analysis was performed for the patients with unresectable/advanced HCC who attended six hospitals from January 1,2019 to March 31,2021,and all patients received camrelizumab monoclonal antibody treatment,among whom 84.8%also received targeted therapy.According to the age of the patients,they were divided into elderly group(≥65 years)and non-elderly group(＜65 years).The two groups were assessed in terms of overall survival(OS),progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),and immune-related adverse events(irAE).The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups;the independent samples t-test was used for comparison of normally distributed continuous data,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups.The Kaplan-Meier method was used for survival analysis,and the log-rank test was used for comparison of survival curves.Univariate and multivariate Cox proportional hazards regression analyses were used to determine the independent influencing factors for PFS and DCR at 6 months.Results A total of 99 HCC patients were enrolled,with 27 in the elderly group and 72 in the non-elderly group.The elderly group had an OS rate of 67.8%,an ORR of 44.4%,and a DCR of 74.1%at 12 months and a median PFS of 6.4(95%confidence interval[CI]:3.0-12.4)months,with no significant differences compared with the non-elderly group(all P＞0.05).The median OS was unavailable for the elderly group,while the non-elderly group had an OS of 18.9(95%CI:13.0-24.8)months;there was no significant difference between the two groups(P=0.485).The univariate and multivariate Cox regression analyses showed that major vascular invasion(MVI)was an independent risk factor for PFS(hazard ratio[HR]=2.603,95%CI:1.136-5.964,P=0.024)and DCR(HR=3.963,95%CI:1.671-9.397,P=0.002)at 6 months,while age,sex,etiology of HBV infection,presence of extrahepatic metastasis,Child-Pugh class B,and alpha-fetoprotein＞400 ng/mL were not associated with PFS or DCR at 6 months.For the elderly group,the incidence rates of any irAE and grade 3/4 irAE were 51.9%and 25.9%,respectively,with no significant differences compared with the non-elderly group(P＞0.05),and skin disease was the most common irAE in both groups(39.4%).Conclusion Camrelizumab monoclonal antibody combined with molecular-targeted therapy has similar efficacy and safety in patients with unresectable/advanced HCC aged≥65 years and those aged＜65 years.MVI is associated with suboptimal response to immunotherapy and poor prognosis.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Aimed at developing new formulation, amorphous solid dispersion of itraconazole was prepared via hot-melt extrusion technology and compared with sporanox for improving its dissolution. According to the solubility parameter and glass transition temperature, Soluplus, Kollidon VA64, HPMCAS and Eudragit EPO were used as carriers. After screening the carriers by modulated temperature-differential scanning calorimetry(MT-DSC), the amorphous solid dispersion was prepared successfully and characterized by MT-DSC, polarized light microscope(PLM), X-ray powder diffraction(XRPD)and Fourier Transform InfraRed(FT-IR). Results suggested that the amorphous form of ITZ solid dispersion and whether the interaction between polymer and ITZ was appeared. Using 30% and 50% drug loading, solid dispersion were tested by in vitro dissolution and kinetic solubility tests. When using Soluplus(3 ∶7)as carrier and extrusion temperature of 170 ℃, dissolution rate of itraconazole was improved significantly compared to Sporanox. In 40 ℃, 75% RH condition, itraconazole in the solid dispersion was amorphous for 30 d with no crystal observed. MT-DSC indicated the molecular level miscibility between Soluplus and amorphous itraconazole was probably the main cause of solubilization. The result from this research help understanding the solublization of amorphous itraconazole and future formulation development.

Objective To translate The Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T) into Chinese,and assess its reliability and validity in Chinese hospitalized patients. Methods The original PURPOSE-T was translated into Chinese and back translated and modified for cultural adaptation according to guidelines.The reliability and validity of the Chinese version of PURPOSE-T were tested in 230 hospitalized patients. Results The Chinese version of PURPOSE-T consists of three parts and contains 25 entries. The inter-rater consistency Kappa coefficient was 0.798, the weighted Kappa coefficient was 0.843. The evaluation results were compared with binary variables with a Kappa coefficient of 0.745. The test-retest reliability Kappa coefficient and the weighted Kappa coefficient were 0.863 and 0.892. Two classified assessment Kappa coefficient was 0.857. The item content validity index ranged from 0.83 to 1.00, and the scale content validity index was 0.98. The phi correlation coefficient of PURPOSE-T and Braden scale was 0.781; the phi correlation coefficient of Waterlow Scale evaluation result was 0.777. The correlation coefficient between Chinese PURPOSE-T items and Braden scale items ranged from 0.605 to 0.877 (P<0.01), and the Waterlow Scale items ranged from 0.599 to 0.887 (P<0.01). Conclusions The Chinese version of PURPOSE-T appears to possess adequate validity, test-retest reliability and internal consistency. The newly translated Chinese version of PURPOSE-T may be used to assess the risk of pressure injury in inpatients in China.

Objective:To investigate the influence of water tank on endotoxin(ET)content in hemodialysis fluid.Methods:Specimens of hemodialysis fluid were collected from 36 hemodialysis centers in Shanghai from Nov 2010 to Oct 2012,and the ET content in hemodialysis fluid were detected by chromogenic substrate method.Results:A total of 2694 samples have been obtained from 36 hemodialysis centers during the 2 years’period.The contents of ET below 0.1 EU/mL were detected in 2348 (87.16%)samples,between 0.1 EU/mL and 0.5 EU/mL in 260(9.65%)samples,and above 0.5 EU/mL in 86(3.19%) samples.Water tanks were used in 19 of the 36 hemodialysis centers.ET contents of hemodialysis fluid in the hemodialysis cen-ters which used water tanks were higher than those didn’t use water tanks,and the difference showed statistical significance (P <0.05).Conclusion:The usage of water tank could significantly increase the ET content in hemodialysis fluid.Monitoring of water storage equipment should be strengthened.

To study the pharmacokinetics of ~(131)I-Metuximab injection (Licartin) combined with transarterial chemoembolization (TACE) for treatment of hepatocellular carcinoma (HCC). MethodsLicartin (27.75 MBq/kg) and the mixture of anticancer drug and Lipiodol were sequentially administered with interval of 20 minutes to 15 patients with HCC via a transfemoral catheter.After the Licartin was administrated, the pharmacokinetic and biodistribution data were evaluated through venous blood samples,urine collections,and 4 γ-scintigraphies (SPECT) over 7 days. The pharmacokinetic parameters were determined from integration of the blood radioactivity-time curves using the SPSS 12.0 software. The tumor-no-tumor ratio (T/NT) was calculated by ROI. Absorbed doses in organ were estimated according to the medical internal radiation dose formalism. The biodistribution of licartin within patient's body at different time points was compared for various organs using analysis of variance for repeated measures, as well as the T/NT ratio. ResultsThe blood radioactivity-time curves followed the dynamics two-compartment model, with the major pharmacokinetic parameters including t_(1/2)α(1.96±1.65) h, and t_(1/2)α(19.07±5.91) h,and t_(1/2)β (57.09±10.92) h, and C_(max) 2.113×10~9min~(-1)·L~(-1), and AUC_(0-∞) 1.302×10~(11) h·min~(-1)·L~(-1), respectively. The accumulated urine radioactivity was 52.2% of administrated dosage during 144 h after administration. There were statistical significant difference of biodistribution of licartin and T/NT ratio between organs at different time points (F=6.583, P<0.01 and F=3.546, P<0.01). SPECT scans showed the significant accumulation of the radioconjugate in liver tumor and faint uptake in other organs for 14 days. Tumor-to-liver ratio decreased from 2.88±1.02 at 3 h to 1.64±0.40 at 168 h (n=7). Organ absorbed dose was (3.19±1.01) Gy in liver (n=12) and (0.55±0.09) Gy in red marrow (n=7). ConclusionLicartin combined with TACE for treatment of HCC is helpful to significantly accrete the radioconjugate in liver tumor, and protect normal organs from radiotoxictiy.