In order to evaluate the safety and effectiveness of endoscopic hemorrhoids treatment, a retrospective analysis was conducted on data of 166 patients with grade I to Ⅲ hemorrhoids who underwent endoscopic treatment in the First Affiliated Hospital of University of Science and Technology of China from January 2018 to June 2020 with complete follow-up data. There were 35 cases in the simple sclerotherapy group, 104 cases in the simple ligation group, and 27 cases in the ligation combined sclerotherapy group. The results showed that, no serious complications occurred in the 3 groups after surgery. In the simple ligation group and the ligation combined with sclerotherapy group, the incidence of postoperative anal pain [35.6% (37/104) and 33.3% (9/27), respectively,] and anal pendant distension [70.2% (73/104) and 70.4% (19/27), respectively] were higher, but symptoms could be tolerated or relieved after simple treatment. The satisfaction of patients in the 3 groups was all more than 90% before discharge, and the degree of operation acceptance was more than 95%. The effective rate of the 3 groups was above 90.0% at 3 months after surgery, At 12 months after surgery, the effective rate of the simple sclerotherapy group was the lowest [74.3% (26/35)], and the effective rate of the other two groups was still above 85.0%. In conclusion, minimally invasive treatment for internal hemorrhoids under endoscopy is safe and effective with effective improvement of symptoms, high postoperative satisfaction of patients and high degree of acceptance.

Objective:To compare the efficacy and safety of endoscopic sclerotherapy with polycinnamol solution and foam in the treatment of grade II hemorrhagic internal hemorrhoids.Methods:From September 2020 to June 2021, 81 patients with grade II hemorrhagic internal hemorrhoids were collected from the Department of Gastroenterology, the First Affiliated Hospital of University of Science and Technology of China. They were randomly divided into an observation group and a control group. The observation group was injected with polycinnamol solution, and the control group was injected with polycinnamol foam. All of them were treated with endoscopic sclerotherapy. The clinical data of the two groups were compared and analyzed. The operation time, immediate hemostasis rate, incidence of postoperative complications (such as fever, pain, bleeding and Urinary retention), recurrence and rebleeding rate of the two groups were observed, and the efficacy and safety of the two groups in the treatment of grade II hemorrhagic internal hemorrhoids were compared.Results:There was no statistically significant difference in basic data between the two groups of patients (all P>0.05), indicating comparability. The surgical operation time of the observation group patients [(7.40±1.18)min] was shorter than that of the control group [(13.88±0.95)min] ( P<0.05); The injection dose of polycinnamol [(5.79±1.61)ml] in the observation group was higher than that in the control group [(4.38±1.92)ml] ( P<0.05). The immediate postoperative hemostasis rate in the observation group was the same as that in the control group (100%). The incidence of postoperative fever (7.32%), perianal pain (4.88%), bleeding (7.32%), and urinary retention (4.88%) complications in the observation group had no significant difference from that in the control group [postoperative fever (5.00%), anal pain (7.50%), bleeding (7.50%), and urinary retention (2.50%)] (all P>0.05). Two months after surgery, the rebleeding rate in the observation group (4.88%) was not significantly different from that in the control group (7.50%) ( P>0.05), but the rebleeding score in the observation group (1.21±0.63) was lower than that in the control group (2.62±0.71), with a statistically significant difference ( P<0.05). The rebleeding rate (2.44%) and the rebleeding score (2.33±1.51) in the observation group were lower than those in the control group [the rebleeding rate (12.50%) and the rebleeding score (5.54±2.42)] at 12 months after follow-up, and the differences were statistically significant ( P<0.05). Conclusions:Endoscopic sclerotherapy is effective in the treatment of grade II hemorrhagic internal hemorrhoids. There is no significant difference in the immediate and short-term hemostasis rate and the incidence of complications between two different dosage forms of sclerotherapy, namely, polycinnamol solution and foam, but the operation of the solution injection is more time-saving and the long-term recurrence rate is lower, which is worthy of clinical application.

Objective To investigate the clinical effectiveness and adverse events of domestic programmed cell death -1 (PD-1) inhibitor in the treatment of advanced non-HBV non-HCV-related hepatocellular carcinoma (NBNC-HCC). Methods A totals of 31 patients with advanced NBNC-HCC who received domestic PD-1 inhibitor in the Affiliated Hospital of Xuzhou Medical University from June 2019 to February 2022 were retrospectively enrolled and their clinicopathological data were retrieved from their medical records and analyzed, i.e., the time to disease progression (TTP), disease control rate (DCR), objective response rate (ORR), and adverse events were recorded and statistically analyzed. The Kaplan-Meier method was used for survival analysis. Results Among these 31 patients, only one achieved the complete response and four achieved the partial response, and six had the stable disease, but 20 showed a disease progression, resulting in an ORR of 16.1% and a (DCR of 35.5%. The median TTP was 7.2 months [95% confidence interval: 6.4-8.0) months]. The incidence of adverse events was 61.30% and the common adverse events were skin rash (29.03%) and hypertension (22.58%). However, there was no grade 4 adverse reactions or related death in these patients. Conclusion Advanced NBNC-HCC patients had a relative weak response to the PD-1 inhibitor although the adverse events were controllable. Future multi-center prospective clinical trials are needed to validate the data.

OBJECTIVE To establish an evaluation syste m of clinical effec tiveness of Drug Selection Guideline for Medical Institutions，and to provide reference for drug selection in medical institution. METHODS Retrieved from relevant Chinese government websites ，PubMed，Embase，CBM and CNKI ，etc.，from the inception to Sept. 14th 2021，related contents of clinical effectiveness related to three secondary indicators ，such as “recommended level and strength of guideline ”“clinical pathway ”and “evidence and level of efficacy ”were extracted respectively ；evaluation system was construction for the clinical effectiveness. RESULTS A total of 5，4 and 17 policy documents or literatures were included according to “recommended level and strength of guideline”“clinical pathway ”and“evidence and level of efficacy ”，respectively.“The recommended level and strength of drug guideline”could reflect the clinical effectiveness of drugs ，and the evaluation content referred to the recommended level and strength of the selected drugs in the guidelines for corresponding indications. “Clinical pathway ”was the embodiment of drug effectiveness, and the evaluation content referred to the clinical path of whether the selected drugs were included in the corresponding indications. The evaluation contents of “evidence and level of efficacy ”were different between chemical medicine/ biological agent and Chinese patent medicine ；evidence and quality level of efficacy research for chemical medicine/biological agent referred to GRADE system ，while those for Chinese patent medicine referred to classic works or clinical experience inheritance. Therefore，the evaluation contents of this index system were the evidence and quality level of the efficacy research related to selected drugs. CONCLUSIONS The evaluation system of clinical effectiveness of drugs constructed from the perspective of drug selection in medical institutions can lay the foundation of evaluation system for the construction of Drug Selection Guideline for Medical Institutions ，and also provide reference for drug selection in medical institutions.

Objective To detect circulating tumor cells (CTCs) in the peripheral blood of patients with pancreatic cancer using a new nano microfluidic chip and to explore the relationship between CTCs and clinicopathological feature,postoperative recurrence and prognosis of pancreatic cancer.Methods The peripheral blood samples of 53 patients with pancreatic cancer who underwent curative resection in the second affiliated hospital of Jiaxing college of medicine were collected from January 2015 to January 2017.The CTCs from peripheral blood were detected by novel nano microfluidic chip.The cut-off value for CTCs-positive and negative groups was 1 CTC.The relationship between CTCs positive and postoperative recurrence and prognosis of pancreatic cancer were evaluated.Results The number of CTCs for 23 pancreatic cancer of 53 patients ranged from 5 to 196 per ml,and the mean number was 78.5 ± 44.7 per ml;the rate of CTCs-positive patients was 43.4％ (23/53).There were significant correlation between CTCs with vascular invasion (P =0.001),but but CTCs was not correlated with the gender,age,the presence of clinical symptoms,tumor size,pathological type,lymph metastasis and TNM stage.31 patients had tumor recurrence,and the rate of tumor recurrence was 58.5％.Among them,there were 13 cases with tumor local recurrence,10 cases with tumor distant metastasis (including liver,lung,kidney,etc.) and 8 cases with both tumor local recurrence and distant metastasis.The median recurrence free survival time of all patients was 14.0 months (13.0-17.0) and the median overall survival time was 19.0 months (15.5-24.0).The cumulative one-year and two-year recurrence free survival rate were 66.9％,12.2％ for patients with CTCs-positive and 88.3％,42.2％ for CTCs-negative patients,and the differences were statistically significant (both P ＜ 0.05).The cumulative one-year and two-year overall survival rate were 85.4％,33.6％ for patients with CTCs-positive and 96.3％,62.2％ for CTCs-negative.There was no difference in statistics in cumulative one-year overall survival rate and with a statistically significant difference in cumulative two-year overall survival rate (P =0.028).Conclusions Peripheral blood CTCs of pancreatic cancer can be effectively detected by a novel nano microfluidic chip.There were significant correlation between CTCs with vascular invasion and survival time after surgery.CTCs may be a potential prognostic indicator of the postoperative recurrence and prognosis of pancreatic cancer.

Objective To establish a novel method using a nano microfluidic chip to detect circulating tumor cells (CTCs) in peripheral blood in gallbladder carcinoma,and to study the relationship between CTCs with clinicopathology and prognosis in these patients.Methods The peripheral blood samples of 51 patients with gallbladder carcinoma were collected from June 2014 to January 2017.The CTCs from peripheral blood samples were detected by a novel nano microfluidic chip.This study aimed to study the correlation between CTCs with the clinical and pathological features.The significance of CTCs on prognosis in patients with gallbladder carcinoma was also analyzed.Results The positive rate of CTCs in the peripheral blood of gallbladder carcinoma patients was 43.1％ (22/51).There were significant correlations between CTCs with liver metastasis (P ＜ 0.05) and Nevin staging (P ＜ 0.05).The 1-and 2-year overall survival (OS) in patients with CTCs were 70.7％ and 35.3％,and the 1-and 2-year OS in patients without CTCs were 92.0％ and 56.1％.There was a significant difference in the 2-year OS (P ＜ 0.05) but no significant difference in the 1-year OS between the 2 groups of patients (P ＞ 0.05).Conclusions Peripheral blood CTCs in patients with gallbladder carcinoma were efficaciously detected by a novel nano microfluidic chip.Peripheral blood CTCs was closely related to the Nevin staging and liver metastasis.CTCs could serve as a potential prognostic indicator in patients with gallbladder carcinoma.

Background:It was demonstrated that vitamin D has extensive biological effects,and evidence exists on association between vitamin D and a variety of immune mediated diseases such as inflammatory bowel disease. Aims:To investigate the relationship between serum level of 25-hydroxyvitamin D(25OHD)and disease activity and quality of life in patients with ulcerative colitis( UC). Methods:Serum level of 25OHD was detected by electrochemiluminescence in 50 outpatients/inpatients with UC from Oct. 2015 to Mar. 2016 at the Anhui Provincial Hospital;35 healthy subjects were served as normal controls. CRP,ESR and PLT were determined by routine laboratory tests in UC patients. Disease activity of UC was assessed by improved Mayo score,and Chinese version IBD questionnaire( IBDQ)was employed to assess quality of life. Results:Vitamin D deficiency defined as serum 25OHD ﹤20 ng/mL was detected in 68. 0% of the UC patients. The mean value of serum 25OHD was significantly lower in UC group than in normal control group[(16. 73 ± 8. 83)ng/mL vs.(19. 84 ± 4. 56)ng/mL,P﹤0. 05]. When patients were stratified with disease activity,serum level of 25OHD decreased in the order of remission,mild,moderate and severe active stage(P ﹤0. 05). In UC patients with vitamin D deficiency,the value of CRP,ESR and PLT were significantly increased(P all ﹤0. 05)and the overall score of IBDQ and scores of four dimensions of IBDQ referring to bowel symptom,systemic symptom,emotional function and social function were significantly decreased(P all ﹤0. 05). Spearman and Pearson correlation coefficients analyses showed that serum level of 25OHD was negatively correlated with Mayo score,CRP,ESR and PLT(P all ﹤0. 05),and positively correlated with scores of IBDQ,including overall score and four dimensional scores in UC group( P all ﹤0. 05 ). Conclusions:Vitamin D deficiency occurs frequently in patients with UC and might have a negative impact on disease activity and quality of life.

Objective To study the clinical effect of the secondary prevention of chronic ankle instability (CAI) for nursing staff.Methods From September 2014 to January 2015, we screened 100 nurse with functional ankle instability in Shandong Provincial Hospital .The subjects were divided into the intervention group ( n=51 ) and the control group ( n =49 ) by random number table .The nurses of intervention group accepted measures of the secondary prevention , including bundle health education , bracing and rehabilitation , while the nurses of control group received only routine health education .Before intervention and 4 months later , we evaluated the ankle instability by Chinese version Cumberland ankle instability tool ( CAIT) in two groups and compared the intervention effects and relevant knowledge of the two groups .Results Before the intervention, the CAIT score of intervention group was (19.0 ±4.8), and was (28.2 ±3.0) after intervention ( t=9.210,P<0.05);the CAIT score in the control group was (19.0 ±5.1) before intervention and (21.3 ± 5.2) after intervention (t=1.509,P>0.05); after intervention, the difference of two groups had statistical significance (t=9.317,P<0.05).Conclusions The secondary prevention of CAI can improve CAI nurse staff′s ankle stability and the recognition level of CAI prevention knowledge , and promote the clinical symptom prevention effectively , so it has significance for the improvement of nurse′s ankle function .

Objective To observe the role of cannabinoid receptor-2 (CB2) in acute experimental colitis in mice, and to explore its effect on the endoplasmic reticulum stress ( ERS ) in the intestinal mucosa . Methods 32 SPF mice were randomly divided into normal group,model group,CB2 agonist group and CB2 antagonist group. Disease activity index( DAI) and colon histopathological score( HS) were evaluatd. The levels of TNF-α and IL-10 in colon tissue were detected by ELISA. The expression of CB2 and ERS markers GRP78, CHOP in colon tissues were de-tected by immunohistochemical. The mRNA levels of GRP78 and CHOP were detected by RT-PCR. Results Com-pared with the normal group,the level of TNF-αwas significantly higher and the level of IL-10 was significantly low-er(P<0. 05) in the model group,the expressions of GRP78, CHOP and its mRNA were significantly higher(P<0. 05). Compared with the model group,the expression of CB2 in the CB2 agonist group was significantly higher(P<0. 05),the level of TNF-α dropped and the level of IL-10 increased(P<0. 05),and the expressions of GRP78, CHOP and its mRNA were significantly reduced(P<0. 05). The level of IL-10,TNF-α and ERS markers had no significant difference bewteen CB2 antagonist group and the model group ( P>0. 05 ) . Conclusion Severe endo-plasmic reticulum stress exists in intestinal mucosa of experimental colitis mice. The CB2 agonist activates CB2 ex-pression,reducing colitis in mice. Its mechanism may be related to inhibiting ERS in intestinal mucosa.

Objective To investigate the geographical distribution of plague host animals in residential areas and the association between plague and its distribution pattern in Yunnan Province.Methods A systematic investigation on fauna and community ecology of rodents was carried out in residential areas of 17 counties(cities) of Yunnan Province,southwestern China with different longitude,latitude and elevation from May 2007 to November 2012.The characteristics of the spatial distribution of flea communities along environmental gradients were analyzed using community structure indexes.Results A total of 390 small mammals were trapped in seventeen counties (cities),and the mammals were classified into 11 species and 7 genus in 4 families.Among all small host mammals,Rattus tanezumi,Rattus nitidus and Rattus norvegicus were dominant species of host animals in residential areas,accounting for 33.85％ (132/390),20.77％ (81/390) and 16.92％ (66/390),respectively.The horizontal distribution of rodents showed that Rattus tanezumi was the widest species in residential areas,which was found at the longitude 98°-105°,followed by Rattus norvegicus,Rattus yunnanensis and Mus musculus.The vertical and latitudinal distributions of rodents were similar in residential areas.Rattus tanezumi was also the widest distributed species,which was observed at the latitude 21°-＜ 28°N and at the altitude 500-＜ 3 500 m; the constituent of Rattus tanezumi showed similar trends of leaning peak curves,first gradually increasing and then decreasing with the increase of latitude and elevation; Rattus tanezumi gradually changed into Rattus nitidus and Apodemus chevrieri,et al.The richness spatial distribution patterns of host animals showed similar trends of leaning peak curves which gradually increased and then decreased with increasing of longitude and latitude; the highest richness was observed at the longitude 98°-＜ 101°E and at the latitude 23°-＜ 28°N.While,the richness spatial d istribution patterns of host animals were relatively poor in the low or the high altitude range.The highest richness was observed at the altitude between 1 000-＜ 1 500 m and 2 000-＜ 2 500 m.Conclusions All spatial patterns of indoor host animals have shown an aggregated spatial distribution in Yunnan Province.Moreover,important environmental factors such as longitude,latitude,and altitude play a substantial role on the distribution patterns of indoor host animals among various focus,therefore directly impact on the modes of prevalence and transmission of plague.