Objective:The expression of serum free light chain(FLC)is abnormal in various diseases,but its role in lung cancer remains unclear.This study aims to investigate the expression and diagnostic value of serum FLC in lung cancer. Methods:A total of 80 lung cancer patients treated at Xiangdong Hospital,Hunan Normal University from January to December 2021 were selected as the lung cancer group.Another 80 healthy individuals undergoing routine physical examinations during the same period were chosen as the control group.General information and serum κFLC and λFLC levels were collected for all subjects.Clinical indicators such as serum carcinoembryonic antigen(CEA),cytokeratin fragment antigen 21-1(CYFRA21-1)levels,tumor diameter,histological type,TNM stage,and lymph node metastasis status were recorded for lung cancer patients.The expression levels of serum FLC[κFLC,λFLC,and FLC(κ+λ)]were compared between the lung cancer group and the control group.Lung cancer patients were grouped based on gender,age,smoking history,tumor diameter,TNM stage,histological type,and lymph node metastasis to compare differences in serum κFLC and λFLC levels.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic value of serum FLC alone and in combination with other indicators in lung cancer. Results:The expression levels of serum FLC(κ+λ)and κFLC were significantly higher in the lung cancer group than those in the control group(both P＜0.001),while there was no significant difference in serum λFLC levels between the 2 groups(P＞0.05).There were no significant differences in serum κFLC levels among lung cancer patients with different tumor diameters,histological types,or TNM stages(all P＞0.05);however,serum κFLC levels were higher in lung cancer patients with lymph node metastasis than in those without,with statistical significance(P=0.033).There were no significant differences in serum λFLC levels based on tumor diameter or histological type(both P＞0.05),but serumλFLC levels were higher in stage Ⅲ+Ⅳ and lymph node metastatic lung cancer patients compared to stage Ⅰ+Ⅱ and non-metastatic patients,with statistical significance(P=0.033 and P=0.019,respectively).The area under the curve(AUC)for κFLC and CEA in diagnosing lung cancer showed no significant difference(P=0.333).The combination ofκFLC+CYFRA21-1 had the highest diagnostic efficacy(AUC=0.875)and sensitivity(71.3％).The AUC for the combined diagnosis of κFLC+λFLC+CEA+CYFRA21-1 was 0.915(95％CI 0.860 to 0.953,P＜0.001). Conclusion:Serum FLC is highly expressed in lung cancer and is associated with its invasion and metastasis.Serum FLC,particularly κFLC,has diagnostic value for lung cancer,and the combined detection of FLC,CEA,and CYFRA21-1 offers the best diagnostic efficacy.

Bamboo leaf flavonoids(BLF)are compounds extracted from bamboo leaves,possessing properties including antioxidant,antimicrobial and anti-inflammatory properties.This study aimed to investigate the effects of BLF on liver damage,antioxidant function,and related gene expression in rats induced by diquat(DQ).Thirty-two 5-week-old male Sprague-Dawley(SD)rats were randomly divided into four experimental groups:the control group(Con),1 000 mg/kg BLF group(BLF),DQ stress group(DQ),and 1 000 mg/kg BLF+DQ stress group(BLF-DQ).The results showed that compared to the Con,the DQ group exhibited significantly decreased serum AST lev-els(P＜0.05),as well as decreased levels of T-AOC,GPX,SOD,and CAT in the liver(P＜0.05),and increased MDA levels in rats(P＜0.05).Additionally,the gene expression levels of HO-1,GPX,CAT,SOD1,and Nrf2 in the liver were significantly reduced(P＜0.05).In contrast,1 000 mg/kg BLF significantly decreased serum AST and ALT levels(P＜0.05),increased levels of T-AOC,GPX,CAT,and SOD in liver(P＜0.05),and significantly increased gene expression of HO-1,GPX,CAT,SOD1,Nrf2,and NQO1(P＜0.05).Compared to the DQ group,BLF-DQ significant-ly decreased liver index(P＜0.05),reduced serum AST and ALT levels(P＜0.05),increased lev-els of CAT,GPX,and T-AOC in liver(P＜0.05),decreased MDA levels(P＜0.05),and signifi-cantly upregulated gene expression levels of HO-1,GPX,CAT,SOD1,and Nrf2(P＜0.05).These findings indicated that BLF alleviate liver damage caused by DQ stress in rats,improve liver an-tioxidant function inhibition,activate the Nrf2 signaling pathway and PINK/Parkin mitophagy-re-lated gene expression.

Objective:To establish a high-performance liquid chromatography(HPLC)method for the simultaneous determination of 10 bacteriostatic agents in Kangfuxin solution.Methods:The HPLC method parameters were as follows,a Thermo AcclaimTM 120 column(4.6 mm × 250 mm,5 μm),a gradient mobile phase of 0.1％glacial acetic acid-0.02 mol·L-1 ammonium acetate solution and methanol at a flow rate of 1 mL·min-1,and the scan-ning wavelength of 200-700 nm.Results:In the corresponding concentration range,the linear relationship be-tween the mass concentration of the 10 bacteriostatic agents and the peak area was good(r≥0.999 8);the preci-sion was good with RSD of 0.33％-0.38％;The RSD values of the repeatability test and the stability test were＜0.5％,the recovery rate was 97.4％-101.1％,and the RSD was between 0.4％-1.8％.According to the pro-posed method,the content results of benzoic acid,sorbic acid,hydroxyphenyl ethyl ester and hydroxyphenyl propyl ester in the test sample were 0.15-0.34％,0-0.48％,0-0.02％,and 0-0.02％,respectively.Conclu-sion:This method is sensitive,rapid,specific and accurate,and can be used for the determination of the content of bacteriostatic agents in Kangfuxin solution.

The geometric bone model of patients is an important basis for individualized biomechanical modeling and analysis, formulation of surgical planning, design of surgical guide plate, and customization of artificial joint. In this study, a rapid three-dimensional (3D) reconstruction method based on statistical shape model was proposed for femur. Combined with the patient plain X-ray film data, rapid 3D modeling of individualized patient femur geometry was realized. The average error of 3D reconstruction was 1.597-1.842 mm, and the root mean square error was 1.453-2.341 mm. The average errors of femoral head diameter, cervical shaft angle, offset distance and anteversion angle of the reconstructed model were 0.597 mm, 1.163°, 1.389 mm and 1.354°, respectively. Compared with traditional modeling methods, the new method could achieve rapid 3D reconstruction of femur more accurately in a shorter time. This paper provides a new technology for rapid 3D modeling of bone geometry, which is helpful to promote rapid biomechanical analysis for patients, and provides a new idea for the selection of orthopedic implants and the rapid research and development of customized implants.
Humans ; Imaging, Three-Dimensional/methods* ; Tomography, X-Ray Computed/methods* ; Femur/surgery* ; Femur Head ; Lower Extremity

Objective To evaluate biomechanical properties of the personalized titanium alloy short femoral prosthesis by finite element analysis. Methods Based on the validated femoral finite element model, the base of the femoral neck was simulated, and by inserting different short femoral prostheses, four total hip replacement (THR) models, namely, the SMF stem model (Model A), BE1 stem model (Model B), MINI stem model (Model C) and personalized stem model (Model D) were established, respectively. The same loads and constraints were applied to four groups of models, and the von Mises stress distribution and deformation were calculated and analyzed, so as to compare mechanical stability of each model. Results The deformation of all THR models was smaller than that of the femur model under physiological state. The deformation of Model B was close to that of Model C, and the deformation of Model A was close to that of Model D. The peak stress of Model C was higher than that of the other 3 models, reaching 9555 MPa. The overall stress trend was Model C > Model B > Model D> Model A > Model under physiological state. Conclusions The peak stress, stress distribution of personalized short femoral stem were similar to that of SMF stem, with reasonable stress distribution, small stress shielding of the proximal femur, minimum overall deformation and shear stress of the prosthesis, and its effectiveness and stability could meet the requirements of human biomechanics, which could provide references for joint surgeons and prosthesis researchers.

For the safety problems of internal medicine intravenous infusion,we carry out meticulous management,establish quality control system of intravenous infusion safety management,and formulate quality control plan.We collect and analyse the potential unsafety factors in the various departments of internal medicine.We have revised the intravenous infusion system and procedures,formulated standards for safety inspection of intravenous fluids,and standardized the admission system for nurses.We carry out training on intravenous infusion related knowledge for nursing staff,carry out meticulous management of venous transfusion links,and actively carry out learning and communication.All these measures have greatly enhanced the safety awareness of the nursing staff.The safety index of intravenous infusion for liver diseases was preliminarily summarized.The use rate of the safe indwelling needle was increased from 30.60％ to 92.30％,the rate of appropriate rate of drop speed increased from 68.45％ to 93.20％,the three sign standard rate rose from 75.20％ to 95.10％,and the patient's satisfaction with infusion increased from 85.60％ to 96.82％.Meticulous management can improve the safety of the internal medicine intravenous infusion as a whole.

Objective Analyzing the construction process and application of health appropriate technology database in Zhejiang province and proposing related considerations and recommendations for the database construction.Methods To design and construct the technology database system,and using excel software to calculate statistic data.Results Established a health appropriate technology database,which contains 826 technologies that can be selected and promoted by the demonstration bases in the whole province.Conclusions The establishment of the technology database increased the efficiency of health appropriate technology transformation at the provincial level,and also provided a reference for the national-wide generalizing of health appropriate technology.

A study of the quality assurance system building made at the training bases in Zhejiang since 2011 found the following.Five management systems on training quality have been established, covering basic clinical conditions, training management, faculty management and training, training assessment,and training incentives.PDCA is called into play for continuous improvement and perfection to develop a training quality management system of local features and continuous improvement.

Objective To evaluate the application of job competence guided standardized training for new nurses. Methods A total of 28 nurses received traditional training ( experienced nurses trained new nurses) as control group for new recruited nurses in 2012, and 28 new entry nurses in 2013 underwent job competence guided standardized training as experimental group. We compared passed rates of bedside comprehensive ability and scores in two groups nurses before and after training. Results Before pre-service training, the passed rates of bedside comprehensive ability was 7. 14% in two groups, and increased to 92. 86%after training. After training, the score of experimental group was (83. 48 ± 9. 86) comparing with (79. 47 ± 8. 91) in the control group (t=4. 45,P<0. 01). Conclusions Pre-service training plays a important role in improving nurses′ bedside comprehensive ability, and job competence guided standardized training is more effective than traditional training for new entry nurses.

Objective To investigate the correlation between the insertion torque values and primary stability of dental implants using different insertion torque values ,and search for the best insertion torque values that can acquire good primary stability. Methods Six male pure beagles were selected, and the first molars and four premolars of bilateral mandibulars were extracted. Three months later, a total of 48 XIVE dental implants were inserted. All implants were divided into group A, group B, group C, and group D based on the insertion torque value (ITV): group A, 0 < ITV < 20Ncm; group B, 20 ≤ ITV < 40Ncm; group C,40Ncm ≤ ITV < 60Ncm;group D,ITV≥60Ncm The dental implant stability was measured by Resonance frequency analysis when implanrs were placed immediately. Results No complications occured.There was significant difference between group A and grop B (P=0.012), group A and grop C (P=0.037), group A and grop D (P=0.001). There are no ignificant difference among group B,group C and grop D(P>0.05). Conclusion With the limitations of the study, it was concluded the primary stability does not simply depend on the insertion torque;When the insertion torque value was no less than 20Ncm, the dental implant can acquire good primary stability.