Objective:To evaluate the effectiveness and safety of concurrent chemoradiotherapy combined with nimotuzumab in the treatment of patients with inoperable esophageal squamous cell carcinoma (ESCC).Methods:A retrospective analysis was conducted on the clinical data of 503 patients with inoperable ESCC who underwent concurrent chemoradiotherapy in the Department of Radiation Oncology, Changzhou No. 2 People′s Hospital Affiliated to Nanjing Medical University and Department of Radiation Oncology, Affiliated Hospital of Jiangnan University from 2014 to 2020. Among these patients, 69 received concurrent chemoradiotherapy combined with nimotuzumab (the combined therapy group) and 434 received concurrent chemoradiotherapy alone (the concurrent chemoradiotherapy group). Patients of both groups were matched at a ratio of 1∶2 using the propensity score matching (PSM) method. As a result, 168 patients were determined for clinical analysis, including 61 in the combined therapy group and 107 in the concurrent chemoradiotherapy group. The short-term efficacy and adverse reactions of both groups were compared. The overall survival (OS) curves and progression-free survival (PFS) curves were plotted using the Kaplan-Meier method for the Log-rank test.Results:The two groups showed no statistical difference ( P > 0.05) in clinical baseline characteristics after the PSM. The objective response rate (ORR) of the combined therapy group was significantly higher than that of the concurrent chemoradiotherapy group with statistically significant differences (85.2% vs. 71.0%, χ2 = 4.33, P = 0.037). There was no statistical difference (98.4% vs. 91.6%, P > 0.05) in the disease control rate (DCR) between the two groups. The combined therapy group had median PFS of 28.07 months and 1-, 3-, and 5-year PFS ratios of 78.2%, 37.5% and 29.1%, respectively. The concurrent chemoradiotherapy group had mPFS of 19.54 months and 1-, 3-, and 5-year PFS ratios of 72.9%, 28.3% and 21.3%, respectively. Both groups showed statistically significant differences in PFS ( χ2 = 4.49, P = 0.034). The combined group had median OS of 34.93 months and 1-, 3-, and 5-year OS ratios of 88.5%, 46.8% and 37.4%, respectively. The concurrent chemoradiotherapy group had mOS of 24.30 months and 1-, 3-, and 5-year OS ratios of 81.3%, 35.2% and 28.0%, respectively. Both groups showed statistically significant differences in OS (χ 2= 5.11, P = 0.024), but did not show statistical differences ( P > 0.05) in the severity degree of each adverse effect during the treatment. Conclusions:Concurrent chemoradiotherapy combined with nimotuzumab can improve the ORR and prolong the PFS and OS of patients with inoperable ESCC compared with concurrent chemoradiotherapy alone. Furthermore, combining with nimotuzumab does not increase adverse effects and can be tolerated by patients with high safety.

Objective:To study the effects of poly adenosine diphosphate ribose polymerase (PARP) inhibitors niraparib and pamiparib on the radiosensitivity of breast cancer cell lines MCF-7 and MDA-MB-436, and to explore its mechanism.Methods:MCF-7 and MDA-MB-436 cells were divided into control group, niraparib group, pamiparib group, radiation group, combination group treated with niraparib and radiation, and combination group treated with pamiparib and radiation, respectively. The effects of drugs on cell proliferation and radiosensitivity were measured by CCK-8 assay and colony formation assay, respectively. The effect of drugs combined with radiation on cell cycle and apoptosis were detected by flow cytometry. Immunofluorescence method was used to detect the changes of γ-H2AX focal number of cells. The expressions of FANCG, Bax and Bcl-2 mRNA and protein were detected by qPCR and Western blot, respectively.Results:Both niraparib and pamiparib inhibited the proliferation of breast cancer cells MCF-7 and MDA-MB-436 in a time-dose dependent manner. With the increase of irradiation dose, D0, Dq, SF2 value of MCF-7 and MDA-MB-436 cells decreased, and SER D0 and SER Dq value increased. Compared with control group, the percentages of cells in G 2/M phase were increased ( tMCF-7=41.66, 44.08, P<0.05; t436=24.69, 18.91, P<0.05), the percentage of cells in G 0/G 1 phase were decreased ( tMCF-7=8.67, 29.61, P<0.05; t436=26.39, 29.12, P<0.05), and the cell apoptosis rate was significantly increased ( tMCF-7=11.17, 11.71, P<0.05; t436=42.68, 15.89, P<0.05) in the combination group. Compared with control group, the number of γ-H2AX foci of MCF-7 cells in the radiation group and combination group treated with niraparib and radiation increased significantly at 2 h after irradiation ( t=8.89, 21.72, P<0.05). At 24 h after irradiation, the number of γ-H2AX foci basically returned to normal level in the radiation group but remained at a higher level in the combination group ( t=8.82, P<0.05). Compared with control group, the expressions of FANCG and Bcl-2 mRNA decreased ( tFANCG=14.07, P<0.05; tBcl-2=29.21, P<0.05), the expression of Bax mRNA increased ( t=8.90, P<0.05), and the expression of FANCG and Bcl-2 proteins decreased ( tFANCG=7.09, P<0.05; tBcl-2=10.24, P<0.05), while the expression of Bax protein increased ( t=2.90, P<0.05) in the combination group. Conclusions:PARP inhibitors niraparib and pamiparib can increase the radiosensitivity of breast cancer MCF-7 and MDA-MB-436 cells probably through down-regulating the expression of FANCG in FA-BRCA pathway, up-regulating apoptosis-related genes and inhibiting DNA damage repair.

Objective:To construct a targeted and accurate evaluation system for facial and cervical wounds and scars of burn patients.Methods:The method combining literature analysis and survey research was adopted, and the basic principles of item system construction were followed. From June to August 2020, based on the aesthetic standards of facial and cervical plastic surgery, the topographic map assessment system for facial and cervical wounds and scars of burn patients was preliminarily formed, focusing on the assessment of wounds and scars in the necks and faces of patients after burns. In September 2020, 38 experts in the relevant fields were consulted in advance and the questionnaire was revised according to the experts' opinions. From December 2020 to March 2021, the Delphi method was applied to conduct inquiry by correspondence with 35 experts in relevant fields from Guangzhou, Shenzhen, Shanghai, Beijing, and other cities, who met the inclusion criteria, and the items were screened and established. The effective recovery rate of inquiry questionnaire was calculated to determine the level of enthusiasm of experts, the average authority coefficient of all items was calculated to determine the level of expert authority, the average importance expert score, the average coefficient of variation, and the average full score rate of all the third-level items were calculated to determine the concentration of expert opinions, the average coefficients of variation and Kendall's harmony coefficients of the importance, sensitivity, and operability expert scores of all the third-level items were calculated to determine the degree of coordination of expert opinions. The Kendall's harmony coefficients for the importance, sensitivity, and operability expert scores of all the third-level items were statistically analyzed with chi-square test.Results:Among the 35 experts consulted by Delphi method, mainly were male, aged (48±10) years, with 8-38 years of working experience, mainly with associate senior titles and above, all with a bachelor's degree or above education background, and of whom 11 were burn experts, 7 were wound repair experts, 4 were plastic surgery experts, and 13 were rehabilitation medicine experts. Finally, a topographic map assessment system for facial and cervical wounds and scars of burn patients was formed, including 4 first-level items, 21 second-level items, 40 third-level items, and 1 mask. The effective recovery rate of inquiry questionnaire was 100% (35/35). The average authority coefficient of all items was 0.89. The average importance expert score was 4.67, the average coefficient of variation of importance expert score was 0.01, and the average full score rate of all the third-level items was 86.3%. The average coefficients of variation of the importance, sensitivity, and operability expert scores of all the third-level items were 0.01, 0.01, and 0.02, respectively. The Kendall's harmony coefficients for the importance, sensitivity, and operability expert scores of all the third-level items were statistically significant (with χ2 values of 1 201.53, 745.67, and 707.07, respectively , P<0.05). Conclusions:The established topographic map assessment system for facial and cervical wounds and scars of burn patients has high scientificity and reliability, which can be used for the evaluation of facial and neck wounds or scars in burn patients.

Objective:To explore the effect of specialized nursing technology assistance model in primary hospitals.Methods:From January 2019 to December 2020, 172 nurses from three primary hospitals in Suzhou were selected by convenience sampling to carry out technology assistance by specialized nurses. The nurses' professional identity, core competence, patient satisfaction and the incidence of nursing adverse events were compared before and after the assistance.Results:After the assistance, the total scores of professional cognition, professional social support, professional social skills, coping with professional frustration, professional self-reflection, and professional identity of nurses in primary hospitals were higher than those before the assistance, with statistically significant differences ( P<0.05) . The scores of nurses' critical thinking, scientific research, clinical nursing, interpersonal relationship, professional development, educational consultation and nurses' core competence in primary hospitals were higher than those before the assistance, with statistically significant differences ( P<0.05) . The patient satisfaction was higher than that before the assistance, also with a statistically significant difference ( P<0.01) . The incidence of nursing adverse events was 1.05% (108/10 245) , lower than 1.55% (146/9 436) before the assistance, and the difference was statistically significant ( P<0.05) . Conclusions:The specialized nursing technology assistance model is helpful to enhance the professional identity of nurses in primary hospitals, promote the cultivation of nurses' core competence, and improve the quality of nursing.

Objective:To investigate the online learning situation of students in Chongqing Medical University during the COVID-19 epidemic, analyze the advantages and disadvantages of online learning, and provide reference for the improvement of online teaching.Methods:Random sampling was adopted to conduct online questionnaire survey among undergraduates of Chongqing Medical University in the form of anonymous questionnaire. SPSS 22.0 was used for chi-square test.Results:There were significant differences in learning outcomes between students living in different places during the epidemic period ( P<0.05). The results showed that 34% of students thought the advantages of online learning were "freedom of learning time", "freedom of learning place", "abundant resources and available to watch videos repeatedly". According to the analysis of disadvantages of online learning, 39% of the students believed that online learning had "poor personal self-control ability to ensure learning efficiency", "no sense of reality in the experimental courses", "lack of learning atmosphere, decrease of the learning motivation", "tedious learning process, requiring constant software upgrading and replacement." Conclusion:Firstly, for special periods, we should unify online learning platforms in the whole university. Then, we should strengthen the publicity of online courses. Finally, teachers should drive the classroom atmosphere during the online teaching and improve students' learning efficiency.

This study aimed at exploring the economic operation and developing trend of county-level public TCM hospitals in Guangxi Province,promoting the comprehensive reform of county-level public hospitals with feasible countermeasures and suggestions.In this study,forty-seven county-level public TCM hospitals were involved in the analysis of their economic operations and benefits by constituent ratio analysis,ratio analysis and trend analysis.As a result,the average gross income of the hospitals exceeded the total expenditure with a slight surplus.Drug income contributed the biggest share of the medical income,while the ratio of Chinese drug income to the medical income was increasing year by year.The debt ratio increased from 38.7％ in 2009 up to 44.6％ in 2013,being over 30％ in this period.In conclusion,it was demonstrated that problems were found in the lack of financial assistance,the low efficiency of economic management and the increasing average medical charges,which should be addressed by increasing investments to TCM hospitals,strengthening the performance appraisal and adjusting the charges of TCM medical services.

Objective:To explore the role CD4+CD45RO+memory T cells in the pathogenesis of Hashimoto's thyroiditis (HT) by detecting the percentages of CD4+CD45RO+ memory T cells in peripheral blood mononuclear cells in peripheral blood of newly diagnosed HT patients. Methods:53HT patients and 43 matched healthy controls (HC) were included in this study. According to the thyroid functions,HT patients were divided into euthyroid subset(HT-A,n =15) ,subclinical hypothyroidism(HT-B,n=14) and overt hypothyroidism subset (HT-C,n=24). The percentages of CD4+CD45RO+memory T cells in PBMCs,as well as the level of serum IFN-γ and IL-17,and thyroid functions,and the titers of thyroid-specific autoantibodies (TPOAb,TgAb) were respectively detected by flow cytometry,ELISA,and ECLIA. Results:The percentages of CD4+CD45RO+ memory T cells in PBMCs,as well as the level of serum IFN-γ and IL-17,the titers of TPOAb,TgAb were all significantly higher than that in HC(P<0. 01). Bivariate correlation revealed that the percentages of CD4+CD45RO+ memory T cells positively correlated with the level of serum IFN-γ,TPOAb and TgAb(P<0. 01,P=0. 015,P<0. 01) in HT patients. Conclusion:The significant increase of CD4+CD45RO+memory T cells in peripheral blood of patients with HT suggested a role of CD4+CD45RO+ memory T cells in the pathogenesis of this disease.

Objective To investigate the clinical efficacy ofHejie Fenxiao Decoction on damp-heat patients with acute kidney injury (AKI).Methods Totally 68 patients were divided into the control group and the treatment group according to the patients’ willings. Both groups were given treatment, such as elimination of the incentives and symptomatic treatment. Besides, patients of the treatment group acceptedHejie Fenxiao Decoction for 30 days. The changes of renal function indexes, such as serum creatinine (SCr), blood urine nitrogen (BUN), uric acid (UA), albumin (ALB) and integral of TCM syndrome, were observed, and recovery ratio and clinical endpoints were compared.Results SCr and eGFR of both group were improved on day 14 (P<0.05). After treatment, the renal function recovery ratio and renal replacement ratio in the two groups showed obvious differences (P<0.05);although survival rate of treatment group was higher than control group, it showed no statistical significance (P>0.05);clinical endpoints analysis of the two groups showed statistical significance (P<0.05). The difference of integrals of TCM syndrome between the two groups showed statistical significance (P<0.05) on day 14.ConclusionHejie Fenxiao Decoction combined with basic regular Western medicine can better improve the clinical symptom, recover the renal function, and decrease the rate of renal replacement and death of AKI damp-heat patients.

Immediate-implant-immediate-loading restoration exhibits many advantages, such as recovery appearance, early function, short implant period, reduced operation frequency and trauma, and less pain, among others. This report introduced a case of immediate-implant-immediate-loading restoration failure because of implant neck split.
Dental Implantation, Endosseous ; Dental Prosthesis, Implant-Supported ; Dental Restoration Failure ; Humans

Immediate-implant-immediate-loading restoration exhibits many advantages, such as recovery appearance, early function, short implant period, reduced operation frequency and trauma, and less pain, among others. This report introduced a case of immediate-implant-immediate-loading restoration failure because of implant neck split.