Objective To investigate the efficacy and safety of cryoablation combined with Camrelizumab monoclonal antibody in the treatment of hepatocellular carcinoma(HCC).Methods A total of 103 HCC patients who were admitted to our hospital from June 2020 to June 2023 were enrolled and randomly divided into combined treatment group with 53 patients and control group with 50 patients.The patients in the control group received percutaneous argon-helium cryoablation,and those in the combined treatment group received percutaneous argon-helium cryoablation combined with Camrelizumab monoclonal antibody.The two groups were compared in terms of short-term response,changes in T lymphocyte subsets after treatment,changes in liver function and alpha-fetoprotein(AFP)after treatment,and progression-free survival and overall survival during follow-up.The t-test was used for comparison of normally distributed continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to plot survival curves,and the log-rank test was used for comparison of survival time between the two groups.Results The combined treatment group had significantly higher overall response rate and disease control rate than the control group(χ2=4.156 and 4.348,P=0.042 and 0.037).After treatment,the combined treatment group had significant increases in the percentages of CD3+and CD4+T lymphocytes and CD4+/CD8+ratio(P＜0.05)and a significant reduction in the percentage of CD8+T lymphocytes(P＜0.05),while the control group had no significant changes in T lymphocyte subsets after treatment(P＞0.05),and compared with the control group after treatment,the combined treatment group had significantly higher percentages of CD3+and CD4+T lymphocytes and CD4+/CD8+ratio(all P＜0.05)and a significantly lower percentage of CD8+T lymphocytes(P＜0.05).After treatment,both groups had significant reductions in the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and AFP(all P＜0.05)and a significant increase in the level of albumin(Alb)(P＞0.05),and compared with the control group after treatment,the combined treatment group had significantly lower levels of ALT,AST,and AFP(all P＜0.05)and a significantly higher level of Alb(P＜0.05).There were no significant differences in the incidence rates of grade Ⅲ—Ⅳ(moderate to severe)adverse reactions between the two groups(P＞0.05).Compared with the control group,the combined treatment group had significantly better median progression-free survival(21.32 months vs 15.31 months,χ2=4.689,P=0.030)and median overall survival(28.36 months vs 20.75 months,χ2=5.030,P=0.025).Conclusion Argon-helium cryoablation combined with Camrelizumab monoclonal antibody can effectively improve short-term response,enhance immune function,and prolong survival time,with a favorable safety profile.

This study overviewed equivalence demonstration, the principles for the selection of comparative devices, the difficulties in equivalence demonstration, and the equivalence demonstration of special medical devices. In addition, the concept of equivalence demonstration was adopted for the products exempted from clinical evaluation, and there were many confusion in actual use. The operation points and difficult points of equivalence demonstration for the products exempted from clinical evaluation were introduced in order to provide reference for medical device colleagues.

Objective:To investigate whether the bladder neck descent and the area of levator ani hiatus obtained on the maximum Valsalva were consistent at the lithotomy position and separating-legs-holding-knees position.Methods:Forty four subjects who underwent perineal pelvic floor four-dimensional ultrasound at 6-8 weeks postpartum in Third Hospital of Longgang Shenzhen from November 2019 to January 2020 were enrolled in this study. All subjects were able to effectively complete the maximum Valsalva maneuver both at the lithotomy position and the separating-legs-holding-knees position. The bladder neck descent and hiatus area of the levator Ani on the maximum Valsalva at these two positions were measured and compared.Results:The bladder neck descent at the separating-legs-holding-knees position was higher than that at the lithotomy position [(41.06±8.25)mm vs (39.96±8.10)mm; t=-2.965, P=0.005], and the hiatus area of levator Ani at the separating-legs-holding-knees position was larger than that at the lithotomy position[(27.55±4.90)cm 2 vs (26.32±4.76)cm 2; t=-3.820, P<0.001]. Conclusions:The bladder neck descent and the area of levator Ani hiatus on the maximum Valsalva at separating-legs- holding-knees position are larger than those on the maximum Valsalva at the lithotomy position.

Objective To analyze the status and influencing factors of job satisfaction of nurses at public hospitals, providing references for the teambuilding strategy of nurses. Methods Questionnaire survey method was used, in October 2017, to study job satisfaction of 1,047 nurses at 13 public general hospitals, for a countermeasure study. Results Job satisfaction of the nurses was found at a medium level. Specifically, their overall job satisfaction score was 3. 68, and the satisfaction scores of the following dimensions from high to low were: on-the-job training (3. 91), hierarchical nurse use (3. 79), performance appraisal (3. 68), promotion evaluation (3. 67), and remuneration (3. 62) respectively. Contents of the five dimensions are strongly related to the overall job satisfaction (r＞0. 6). Job satisfaction scores of nurses with their differences in positions, annual income, and hospital level were significantly different (P＜ 0. 05). The three main influencing factors for talent turnover rate are remuneration, workplace pressure and work environment. Conclusions Higher remuneration, improved hierarchical management system, and greater attention to nursing care at secondary hospitals are very important for effectively improving the job satisfaction of nurses and ensuring the health care industry.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.

Objective Comparison the coincidence rate in the colloidal gold method and the passive agglu-tination method to detect mycoplasma pneumoniae (MP) infection, discuss the clinical value in rapid diagnosis of MP infection in the two methods. Methods Two-hundred patients with MP infection, including 100 cases in the the children group, and 100 cases in the adult group, were detected in MP-IgM antibody in serum with the colloidal gold method and the passive agglutination method. Results The positive rate of MP-IgM antibody with the passive agglutination method were slightly higher than that of the colloidal gold method in the children group (P > 0.05), While the positive rate of MP-IgM antibody with the passive agglutination method in the adult group were signifi-cantly higher than that of the colloidal gold method (P<0.05). When the antibody titer of MP-IgM antibody were 1:60, ≥1:320 in the children group, the coincidence rate of the positive results with the colloidal gold method and the passive agglutination method were 95.40%, 95.30%;When the antibody titer of MP-IgM antibody were 1:80, 1:160,≥1:320 in the adult group, the coincidence rate of the positive results with the colloidal gold method and the passive agglutination method were 0, 61.90%, 63.80%. Conclusions In the pediatric MP infection, for the high an-tibody titer of MP-IgM antibody, the positive coincidence rate with the colloidal gold method can reach clinical diag-nostic requirements. Clinical physicians according to the age and disease process of patients choose the appropriate method in order to realize the simple, rapid and accurate diagnosis of mycoplasma pneumoniae infection.

Objective To compare the different ways of alkaline mouthwash slobber use in preventing the oral infection in patients with fever. Methods The patients who satisfied the requirements were involved and randomly divided into A, B and C group. A group did not use alkaline mouthwash; B group prescribed alkaline mouthwash slobber following the doctor's advice; C group received propaganda and demonstration of intensive use of the alkaline mouthwash, and then used the slobber in right way under the surveillance of nurses. The infection rates of oral ulcer and oral leukoplakia were compared and analyzed among the three groups. Results The incidence rates of oral ulcer and oral leukoplakia gradually decreased among the three groups and the differences had statistical significance (χ2=9.243,P=0.010;χ2=6.495,P=0.033).Compared with A group, there was no significant differences in the rates of oral ulcers and oral leukoplakia between Group A and B(OR=0.486, 95%CI:0.113-2.087;OR=0.557, 95%CI: 0.120-2.583), but the incidence rates of oral ulcers and oral leukoplakia gradually decreased(OR=0.024, 95%CI:0.002-0.293;OR=0.036, 95%CI:0.003-0.448)in C group. Conclusions Strengthening use of alkaline mouthwash slobber is more effective in preventing oral infection in patients with fever compared with the routine way of mouthwash use.

AIM: To investigate the role of renin-angiotensin system (RAS) disequilibrium in hyporeactivity and injury of aorta after tourniquet shock ( TS) by observing the changes of aortic contractile reactivity and RAS components after TS.METHODS:Male C57BL/6 mice (8 months old) were divided into 7 groups including control group and 6 mod-el groups.The mice in model groups were sacrificed at reperfusion of 10 min, 1 h, 2 h, 4 h, 6 h and 12 h.The mice in control group were not subjected to tourniquet ligation .The Doppler flowmetry was used to determine the limb blood flow . The carotid artery catheter was applied to detect the blood pressure .The isolated vascular tension tester was available to measure the reactivity of the aorta .HE staining combined with transmission electron microscopy was used to evaluate the morphology of injured aortas .The protein expression of AT 1 receptor , Mas receptor , ACE and ACE2 was measured by Western blot.The serum contents of Ang Ⅱand Ang (1-7) were detected by ELISA.RESULTS:Compared with control group, the blood flow in model groups decreased gradually with the prolongation of reperfusion time .The blood pressure in-creased at 10 min after reperfusion, and then decreased gradually.Accordingly, vascular reaction to norepinephrine (NE) in-creased at 10 min and then descended .The vascular reactivity reached the lowest level at 4 h.Morphological injury score in-creased gradually .Vascular AT1 receptor and ACE2 proteins were reduced , while Mas receptor and ACE proteins were up-regulated compared with control group .The content of AngⅡin the serum elevated, while the content of Ang (1-7) was re-duced.CONCLUSION:The mechanism of aortic reaction to NE increased temporarily in the early stage of shock and then decreased .It may be related to the morphological injury of aorta and the imbalance of RAS .

Objective T o determine the normal range of the 33 elements (Li, Be, B, mg, Al, Ca, Ti, V , Cr, mn, Fe, Co, Ni, Cu, Zn, Ga, As, Se, Rb, Sr, Zr, mo, Ag, Cd, Sb, Cs, Ba, Au, Hg, Tl, Pb, Th and U ) in human whole blood of general population in Hunan province. Methods Blood samples were ana-lyzed by inductively coupled plasma-mass spectrometry (ICP-mS ) to determine the normal range. T he influences of district, gender and age to the element content in blood samples were also observed. Re-sults T he normal range of 33 elements in blood samples fromgeneral population in Hunan province were obtained. Gender was shown to statistically influence the concentrations of B, mg, Ca, Ti, mn, Fe, Co, Cu, Zn, As, Se, Rb, Sr, Ag, Cd, Cs, Hg and Pb (P<0.05), while age was shown to influence the concentrations of Co, Ni, Cs and Hg in women (P<0.05) as well as Cu, Se and Hg in men(P<0.05). Conclusion Although there are variables in different districts, the normal ranges of trace element in blood of the four cities in Hunan province are established.

Objective To promote the idea and practice of truthful conduct of research among fellow researchers by creating a research integrity training mode for Chinese postgraduates.Methods Based on the RCR (Responsible Conduct of Research) training module,a common research education initiative adopted by many American research institutes,and through literature review and social science study,this paper explored the idea of develop a research integrity training mode for Chinese postgraduates.Results A thorough explanation and analysis was given to the five major aspect of research integrity training mode,including theoretical basis,training objectives,operational procedure,neces sary conditions for application and training evaluation.Conclusion Research integrity training is one of the most important contents of graduate education,and a well designed training mode is the first and foremost step of developing a responsible and credible environment in academia of China.