Objective:To analyze the safety and efficacy of PD-1 inhibitors versus chemotherapy or ipilimumab in advanced melanoma.Methods:PubMed,CNKI,VIP and Wanfang databases were searched to collect randomised controlled trials of PD-1 inhibi-tors in treatment of advanced melanoma.The search time was from the establishment of the database to May 1,2022.Two reviewers independently screened the literature,extracted data,and assessed risk of bias of included studies.Meta-analysis was performed using RevMan5.4 and STATA16 software.Results:A total of 7 studies were included.Meta-analysis results show that:①Safety:Compared with chemotherapy,PD-1 inhibitor treatment had fewer adverse events,especially in the blood system;compared with ipilimumab alone,PD-1 inhibitor combined with ipilimumab had more adverse events,especially liver function indicators;there was no signifi-cant difference in the incidence of total adverse events between PD-1 inhibitor monotherapy and ipilimumab monotherapy.②Efficacy:The PFS,OS and ORR of PD-1 inhibitor versus chemotherapy or ipilimumab were HR=0.54,95%CI(0.45,0.62),P<0.05,HR= 0.69,95%CI(0.58,0.80),P=0.03 and OR=3.16,95%CI(2.59,3.86),P<0.05,respectively.Conclusion:PD-1 inhibitors have good efficacy in treatment of advanced melanoma,while different combination methods and different control treatments may have different efficacy.Limited by the quantity and quality of included studies,more research evidence is needed to support this.

Objective To investigate the safety and effectiveness of laparoscopic orchiopexy assisted by needle grasper hydrodissection for cryptorchidism.Methods From September 2020 to September 2022,21 children with cryptorchidism on 25 sides underwent laparoscopic orchiopexy assisted by needle grasper hydrodissection in our department.The water injection function of needle grasper was applied to inject normal saline into the retroperitoneal space to fully separate the retroperitoneum from the vas deferens and spermatic cord,establishing a liquid barrier to protect the vas deferens and spermatic cord.Then the retroperitoneum was bridge-likely cut off with the assistance of needle grasper.The vas deferens and spermatic cord were completely released in accordance with the principle of integrity and non-destructiveness,then the testes were successfully induced and fixed.Results During the operation,15 cases of inguinal cryptorchidism and 6 cases of intra-abdominal cryptorchidism were confirmed.There were 17 cases of unilateral cryptorchidism and 4 cases of bilateral cryptorchidism.All the 25 testes were successfully re-located into the dartos pouch of the scrotum under laparoscopic guidance.The operation time was 35-75 min(mean,45.1±14.3 min),and there were no surgical complications.During follow-ups for 12-24 months in 21 cases,the testicles were found located in the scrotum without retraction,atrophy,incision infection,incision hernia,or inguinal hernia.Conclusions Needle grasper hydrodissection assisted laparoscopic orchiopexy can effectively protect the vas deferens and spermatic cord.The operation is simple,safe,and effective.

[Abstract] Objective: To systematically evaluate the efficacy and safety of nivolumab plus ipilimumab versus nivolumab monotherapy in the treatment of malignant tumors, so as to provide evidence-based medical proof for clinical administration. Methods: Databases, such as PubMed, CNKI, VIP, and Wanfang Data, were searched from January 2000 to January 2022 to collect the clinical trial data in terms of nivolumab plus ipilimumab versus nivolumab monotherapy for malignant tumors were published in both domestic and abroad. Two reviewers independently evaluated the quality of included RCTs, and extracted and cross-checked the data. RevMan 5. 4 was used for the Meta-analysis. Results: A total of 7 RCTs studies including 10 articles were included. Compared with the nivolumab monotherapy group, the OS of patients in the combined treatment group was significantly improved (HR=0.86, 95% CI:0. 75-0.99, P=0. 03), and the PFS was significantly prolonged (HR=0.69, 95% CI: 0.55-0.85, P=0.000 6). However, as for safety, treatment-related adverse events (OR=3.18, 95% CI: 1.55-6.55, P=0.002) and adverse events leading to drug discontinuation (OR=7.11, 95% CI: 4.85-10.42, P<0.000 01) in the combination therapy group were significantly higher than those in the monotherapy group. Conclusion: Compared with nivolumab monotherapy, nivolumab plus ipilimumab can significantly improve the OS and PFS of tumor patients, but is also associated with more treatment-related adverse events and adverse events leading to drug discontinuation. Therefore, it is necessary to pay attention to follow-up and regular monitoring to prevent the occurrence of serious adverse reactions.

The most common metastatic site of prostate cancer is the bone, followed by the lung, bladder, liver, and adrenal gland. We report on a rare case of pancreatic metastasis from prostate cancer. A 52-year-old patient was admitted to the hospital with epigastric pain for 20 days. PET-CT showed malignant lesions in the prostate and pancreas, and prostate and pancreas puncture biopsies were performed, respectively. The patient was diagnosed as prostate cancer with pancreatic metastasis according to the pathological findings. After undergoing androgen deprivation therapy and docetaxel chemotherapy for 6 cycles, reexamination revealed that the pancreatic metastases had disappeared.

Objective: To investigate the clinical significance of monitoring ETV6-RUNX1 fusion gene in children with acute lymphoblastic leukemia (ALL) after allogeneic stem cell transplantation (allo-HSCT) . Methods: Clinical data of 13 children received allo-HSCT in Peking University Institute of Hematology from May 2009 to March 2016 were retrospectively collected. The ETV6-RUNX1 gene was examined by real-time quantitative polymerase chain reaction (RQ-PCR) . The correlation between its expression level and the disease status was analyzed. Results: Of 13 enrolled ALL cases, the ETV6-RUNX1 expression of 7 patients converted to positive after transplant at a median time of 137 days (range, 28-270 days) . The expression level of the first positive sample was 0.034% (range, 0.004%-0.061%) . The duration from ETV6-RUNX1 positive to hematological relapse was 196 days (range, 28-666 days) . Four patients experienced relapse at a median time of 294 days (range, 104-803 days) after allo-HSCT. The ETV6-RUNX1 expression converted to positive prior to MRD. Patients with positive ETV6-RUNX1 gene expression pre-transplantation would be more likely to relapse. Conclusion Monitoring ETV6-RUNX1 by RQ-PCR could be used to evaluate MRD status after allo-HSCT. Patients with positive ETV6-RUNX1 after transplant had a poor prognosis.

Objective To screen the incidence of transient hypertension in conventional hypertensive management population of hypertension and analysis it's related etiology and constituent ratio.Methods People who met the diagnosis of hypertension were selected from inpatient and outpatient of this department.All patients were followed up for 2 months of home blood pressure monitoring,if the patients who were normal when monitoring home blood pressure were included in the trial and symptomatic hypertension was excluded.Results Three hundred of patients met the diagnostic criteria for hypertension,46 cases (15.3％) met the standard of transient hypertension,the etiology and constituent ratio of transient hypertension in the observed cases were as follows:25 cases (54.3％) of anxiety and depression,8 cases (17.4％) of acute cerebrovascular disease,7 cases (15.2％) of sleep disorders,4 cases(8.7％) of a variety of head and face pain,1 (2.2％)case of epilepsy tonic clonus,1 (2.2％)case of vertigo.Conclusion The application of interactive management of home blood pressure measurement is particularly helpful for screening patients with transient hypertension,and it can timely avoid excessive anti-hypertensive treatment.

Objective To analyze nursing measures in operating room in prevention of gastrointestinal surgery incision infection.Methods A total of 110 patients with gastrointestinal surgery were divided into control group and study group,with 55 cases in each group.The control group was given routine operating room nursing measures,while the study group was given predictive operating room nursing measures for gastrointestinal surgery incision infection.intraoperative and postoperative incision healing condition,hospitalization expenses and hospitalization time of two groups were compared.Results Class-A healing rate in the study group was 80.00％,which was higher than 58.18％ in the control group (P ＜ 0.05);Class-C healing rate was 1.82％,which was lower than 14.55％ in the control group (P ＜0.05);There was no statistically significant difference compared with two groups in class-B healing rate (P ＞ 0.05).Team operation time,time to first defecation,time to first exhaust were lower than that in the control group (P ＜ 0.05).The team hospitalization expenses and hospitalization time were lower than that in the control group (P ＜ 0.05).Conclusion Predictive operating can effectively prevent the gastrointestinal surgery incision infection,guarantee the incision healing effect,shorten the operation time,speed up the postoperative rehabilitation,and save medical expense,so it is suitable for clinical application and promotion.

Objective To analyze nursing measures in operating room in prevention of gastrointestinal surgery incision infection.Methods A total of 110 patients with gastrointestinal surgery were divided into control group and study group,with 55 cases in each group.The control group was given routine operating room nursing measures,while the study group was given predictive operating room nursing measures for gastrointestinal surgery incision infection.intraoperative and postoperative incision healing condition,hospitalization expenses and hospitalization time of two groups were compared.Results Class-A healing rate in the study group was 80.00％,which was higher than 58.18％ in the control group (P ＜ 0.05);Class-C healing rate was 1.82％,which was lower than 14.55％ in the control group (P ＜0.05);There was no statistically significant difference compared with two groups in class-B healing rate (P ＞ 0.05).Team operation time,time to first defecation,time to first exhaust were lower than that in the control group (P ＜ 0.05).The team hospitalization expenses and hospitalization time were lower than that in the control group (P ＜ 0.05).Conclusion Predictive operating can effectively prevent the gastrointestinal surgery incision infection,guarantee the incision healing effect,shorten the operation time,speed up the postoperative rehabilitation,and save medical expense,so it is suitable for clinical application and promotion.

Objective To investigate the state of perceived discrimination,mental health knowledge and self-discrimination of the public,and analyze the relationship among these variables,and explore the mediating effect of mental health knowledge between the perceived discrimination and self-discrimination.Methods A total of 1 088 residents in Guangzhou City were assessed with the Perceived Devaluation-Discrimination Scale (PDDS),Attitudes about Mental Illness Associated Stigma Scale-Chinese Version (AMIASS-C) and Mental Heahh Knowledge Questionnaire (MHKQ).Results The average score of PDDS was 2.63±0.35.The rate of mental health knowledge was 72.4％(788/1 088) and the score of AMIASS-C was 2.58±0.45.The perceived discrimination,mental health knowledge and self-discrimination were significantly correlated with each other,r=0.320,-0.240,P＜0.01.The mental health knowledge played a negative mediating role between perceived discrimination and self-discrimination.Conclusions The mental health knowledge was a mediator between perceived discrimination and self-discrimination.

To explore the efficacy of managing benign prostatic hyperplasia (BPH) by family doctor system service in a local community.Among 132 BPH patients recruited from January 2012 to December 2013,74 of them received family doctor system service while the remainder medications only.After 6 months,international prostate symptom score (10.3 ± 5.6) and quality-of-life (2.98 ± 0.95) significantly improved in management group versus control group.And there were significant statistical differences (P ＜ 0.05).The intervention management of family doctor system service is effective for improving the symptoms and quality-of-life of BPH patients.