Objective:To investigate the efficacy of 125I seed implantation combined with programmed cell death 1 (PD-1) monoclonal antibody in the treatment of patients with stage Ⅳ non-small cell lung cancer. Methods:A retrospective analysis was performed on 106 patients with stage Ⅳ non-small cell lung cancer treated in Department of Radiology of the Sixth Medical Center of PLA General Hospital from February 2017 to January 2020. All patients were divided into the combination group, radiotherapy group and immunotherapy group according to treatment methods. Besides conventional chemotherapy in all three groups, 125I seed implantation combined with PD-1 monoclonal antibody therapy was given in the combination group, 125I seed implantation therapy was delivered in the radiotherapy, and PD-1 monoclonal antibody therapy was supplemented in the immunotherapy group, respectively. Differences in the general data, maximum tumor diameter, efficacy, progression-free survival (PFS) and safety among the three groups were analyzed. One-way ANOVA was used for comparison between groups, paired sample t-test was used for comparison before and after treatment. Kaplan-Meier method was used to calculate the survival rate, and log-rank test was used to compare the survival curve. Results:After treatment, the maximum tumor diameter in the three groups was decreased, and the data in the combination group was smaller than those in the radiotherapy and immunotherapy groups ( F=4.67, P=0.011). The objective response rate (ORR), disease control rate (DCR) and PFS rate in the combination group were higher than those in the radiotherapy and immunotherapy groups ( χ2=18.93, P<0.001; χ2=11.11, P=0.004; χ2=6.67, P=0.036), and the ORR in the immunoradiotherapy group was higher than that in the radiotherapy group ( χ2=4.23, P=0.040). There was no significant difference in the occurrence of adverse reactions among the three groups ( χ2=1.60, P=0.449). Conclusion:125I seed implantation combined with PD-1 monoclonal antibody may yield high efficacy in patients with stage Ⅳ non-small cell lung cancer, which can alleviate clinical symptoms and improve long-term survival rate with good safety.

Objective:To investigate the interactive effect of mismatch repair (MMR) protein status and adverse clinicopathological features on prognosis of stage Ⅰ-Ⅲ colon cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 1 650 patients with colon cancer of stage Ⅰ-Ⅲ who were admitted to 7 hospitals in China from January 2016 to December 2017 were collected. There were 963 males and 687 females, aged 62(53,71)years. Patients were classified as 230 cases of MMR deficiency (dMMR) and 1 420 cases of MMR proficiency (pMMR) based on their MMR protein status. Observation indicators: (1) comparison of clinicopathological characteristics between patients of different MMR protein status; (2) analysis of factors affecting the survival outcomes of patients of dMMR; (3) analysis of factors affecting the survival outcomes of patients of pMMR; (4) interaction analysis of MMR and adverse clinicopathological features on survival outcomes. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the Mann-Whitney U test. The random forest interpolation method was used for missing values in data interpolation. Univariate analysis was conducted using the COX proportional risk regression model, and multivariate analysis was conducted using the COX stepwise regression with forward method. The coefficient of multiplication interaction effect was obtained using the interaction term coefficient of COX proportional risk regression model. Evaluation of additive interaction effects was conducted using the relative excess risk due to interaction ( RERI). Results:(1) Comparison of clinicopathological characteristics between patients of different MMR protein status. There were significant differences in age, T staging, the number of lymph node harvest, the number of lymph node harvest <12, high grade tumor between patients of dMMR and pMMR ( P<0.05). (2) Analysis of factors affecting the survival outcomes of patients of dMMR. Results of multivariate analysis showed that T staging, N staging, the number of lymph node harvest <12 were independent factors affecting the disease-free survival (DFS) of colon cancer patients of dMMR ( hazard ratio=3.548, 2.589, 6.702, 95% confidence interval as 1.460-8.620, 1.064-6.301, 1.886-23.813, P<0.05). Age and N staging were independent factors affecting the overall survival (OS) of colon cancer patients of dMMR ( hazard ratio=1.073, 10.684, 95% confidence interval as 1.021-1.126, 2.311-49.404, P<0.05). (3) Analysis of factors affecting the survival outcomes of patients of pMMR. Results of multivariate analysis showed that age, T staging, N staging, vascular tumor thrombus were independent factors affecting the DFS of colon cancer patients of pMMR ( hazard ratio=1.018, 2.214, 2.598, 1.549, 95% confidence interval as 1.006-1.030, 1.618-3.030, 1.921-3.513, 1.118-2.147, P<0.05). Age, T staging, N staging, high grade tumor were independent factors affecting the OS of colon cancer patients of pMMR ( hazard ratio=1.036, 2.080, 2.591, 1.615, 95% confidence interval as 1.020-1.052, 1.407-3.075, 1.791-3.748, 1.114-2.341, P<0.05). (4) Interaction analysis of MMR and adverse clinicopathological features on survival outcomes. Results of interaction analysis showed that the multiplication interaction effect between the number of lymph node harvest <12 and MMR protein status was significant on DFS of colon cancer patients ( hazard ratio=3.923, 95% confidence interval as 1.057-14.555, P<0.05). The additive interaction effects between age and MMR protein status, between high grade tumor and MMR protein status were significant on OS of colon cancer patients ( RERI=-0.033, -1.304, 95% confidence interval as -0.049 to -0.018, -2.462 to -0.146). Conclusions:There is an interaction between the MMR protein status and the adverse clinicopathological features (the number of lymph node harvest <12, high grade tumor) on prognosis of colon cancer patients of stage Ⅰ-Ⅲ. In patients of dMMR, the number of lymph node harvest <12 has a stronger predictive effect on poor prognosis. In patients of pMMR, the high grade tumor has a stronger predictive effect on poor prognosis.

Objective:To produce 68Ga and automatically synthesize 68Ga-labeled drugs based on low-energy medical cyclotron solid target system. Methods:68Zn was electroplated on the surface of the target by electrodeposition. According to the principle of 68Zn(p, n) 68Ga nuclear reaction, 68Zn was irradiated by the 10 MeV medical cyclotron solid target system (30 μA, 30 min) to produce 68Ga, and the activity, nuclear purity, half-life and content of metal impurities of purified product were determined. 68Ga-prostate specific membrane antigen (PSMA)-11 and 68Ga-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) were synthesized automatically using 68Ga respectively, and the quality control analyses of drug properties, concentration, pH, radiochemical purity, sterility and bacterial endotoxin were carried out. Results:The electroplating mass of 68Zn was (43.71±0.87) mg ( n=35), the yield of 68Ga after irradiation was (10.96±0.67) GBq ( n=35), and the measured half-life was (67.64±0.06) min ( n=7). Only 511 keV energy peak was detected by the gamma spectrometer. After purification, (6.85±0.12) GBq ( n=35) of pure 68Ga was obtained, and the purification efficiency was (62.46±0.96)% (non-attenuated correction, n=35). The metal impurity contents of Zn and Fe were (0.18±0.06) and (1.25±0.43) μg/GBq ( n=5), which met the requirements of European Pharmacopoeia. Three batches of 68Ga-PSMA-11 and 68Ga-DOTATATE were automatically synthesized, with the yield, concentration and radiochemical purity of (3.54±0.14) and (2.74±0.20) GBq, (294.97±11.58) and (228.17±16.32) GBq/L, (99.73±0.11)% and (99.45±0.25)%, respectively. Both sterility and bacterial endotoxin were qualified. Conclusion:High-yield and qualified nuclide 68Ga and 68Ga-labeled drugs are successfully prepared through the low-energy medical cyclotron solid target system and the automated purification and synthesis module, which provide a strong guarantee for clinical practice.

Objective:To explore the efficacy and safety of FOLFOX4 regimen hepatic arterial infusion chemotherapy (HAIC) combined with 125I seed implantation or gamma knife in patients with primary liver cancer and type Ⅲ portal vein tumor thrombosis (PVTT). Methods:The clinical data of 116 patients with primary liver cancer and type Ⅲ PVTT from January 2016 to June 2018 in the Sixth Medical Center of PLA General Hospital were retrospectively analyzed. Among them, 56 patients were treated with FOLFOX4 regimen HAIC combined with 125I seed implantation in PVTT (observation group), and 56 patients were treated with FOLFOX4 regimen HAIC combined with gamma knife in PVTT (control group). The clinical efficacy, adverse reactions, liver function, tumor serum markers, quality of life and portal venous pressure were compared between 2 groups. The patients were followed up to June 2021, the progression-free survival (PFS) time, overall survival (OS) time and 1-, 3-year survival rate were recorded. Results:The objective response rate and disease control rate in observation group were significantly higher than those in control group: 21.43% (12/56) vs. 7.14% (4/56) and 50.00% (28/56) vs. 30.36% (17/56), and there were statistical differences ( P<0.05). The aspartate transaminase (AST), alanine transaminase (ALT), total bilirubin, alpha fetoprotein (AFP), carcinoembryonic antigen (CEA) and tumor supplied group of factor (TSG) after treatment in observation group were significantly lower than those in control group: (58.24 ± 7.16) U/L vs. (67.81 ± 8.39) U/L, (56.39 ± 5.42) U/L vs. (62.87 ± 6.83) U/L, (21.21 ± 4.32) μmol/L vs. (25.88 ± 4.71) μmol/L, (32.98 ± 6.15) μg/L vs. (45.06 ± 7.24) μg/L, (2.39 ± 0.22) μg/L vs. (3.17 ± 0.26) μg/L and (57.81 ± 5.67) kU/L vs. (66.19 ± 5.45) kU/L, and there were statistical differences ( P<0.01). The quality of life questionnaire core-30 (QLQ-C30) score after treatment in observation group was significantly higher than that in control group: (68.13 ± 6.95) scores vs. (64.49 ± 6.73) scores, the portal venous pressure after treatment in observation group was significantly lower than that in control group: (31.85 ± 3.89) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (35.37 ± 4.23) cmH 2O, and there were statistical differences ( P<0.01). There was no statistical difference in incidence of adverse reactions between 2 groups ( P>0.05). Two cases were lost in observation group and 3 cases in the control group; the PFS time and OS time in observation group were significantly longer than those in control group: (13.36 ± 2.85) months vs. (11.76 ± 2.60) months and (23.36 ± 4.37) months vs. (20.72 ± 3.96) months, and there were statistical differences ( P<0.01); the 1-year survival rate in observation group was significantly higher than that in control group: 70.37% (38/54) vs. 50.94% (27/53), and there was statistical difference ( P<0.05); there was no statistical difference in 3-year survival rate between 2 groups ( P>0.05). Conclusions:The anti-tumor effect and the improvement effect on liver function in patients with primary liver cancer and type Ⅲ PVTT treated with FOLFOX4 regimen HAIC combined with 125I seed implantation are better than combined gamma knife, and it has high safety and longer survival time.

Background::Although existing mycological tests (bronchoalveolar lavage [BAL] galactomannan [GM], serum GM, serum (1,3)-β-D-glucan [BDG], and fungal culture) are widely used for diagnosing invasive pulmonary aspergillosis (IPA) in non-hematological patients with respiratory diseases, their clinical utility in this large population is actually unclear. We aimed to resolve this clinical uncertainty by evaluating the diagnostic accuracy and utility of existing tests and explore the efficacy of novel sputum-based Aspergillus assays. Methods::Existing tests were assessed in a prospective and consecutive cohort of patients with respiratory diseases in West China Hospital between 2016 and 2019 while novel sputum assays (especially sputum GM and Aspergillus-specific lateral-flow device [LFD]) in a case-controlled subcohort. IPA was defined according to the modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity and specificity were computed for each test and receiver operating characteristic (ROC) curve analysis was performed. Results::The entire cohort included 3530 admissions (proven/probable IPA = 66, no IPA = 3464) and the subcohort included 127 admissions (proven/probable IPA = 38, no IPA = 89). Sensitivity of BAL GM (≥1.0 optical density index [ODI]: 86% [24/28]) was substantially higher than that of serum GM (≥0.5 ODI: 38% [39/102]) ( χ2 = 19.83, P < 0.001), serum BDG (≥70 pg/mL: 33% [31/95]) ( χ2 = 24.65, P < 0.001), and fungal culture (33% [84/253]) ( χ2 = 29.38, P < 0.001). Specificity varied between BAL GM (≥1.0 ODI: 94% [377/402]), serum GM (≥0.5 ODI: 95% [2130/2248]), BDG (89% [1878/2106]), and culture (98% [4936/5055]). Sputum GM (≥2.0 ODI) had similar sensitivity (84% [32/38]) (Fisher’s exact P = 1.000) to and slightly lower specificity (87% [77/89]) ( χ2 = 5.52, P = 0.019) than BAL GM (≥1.0 ODI). Area under the ROC curve values were comparable between sputum GM (0.883 [0.812-0.953]) and BAL GM (0.901 [0.824-0.977]) ( P = 0.734). Sputum LFD had similar specificity (91% [81/89]) ( χ2 = 0.89, P = 0.345) to and lower sensitivity (63% [24/38]) ( χ2 = 4.14, P = 0.042) than BAL GM (≥1.0 ODI), but significantly higher sensitivity than serum GM (≥0.5 ODI) ( χ2 = 6.95, P = 0.008), BDG ( χ2 = 10.43, P = 0.001), and fungal culture ( χ2 = 12.70, P < 0.001). Conclusions::Serum GM, serum BDG, and fungal culture lack sufficient sensitivity for diagnosing IPA in respiratory patients. Sputum GM and LFD assays hold promise as rapid, sensitive, and non-invasive alternatives to the BAL GM test.

Objective:To investigate the incidence and determinants of vaccine hesitancy towards national immunization program in China and understand the current status of parents' hesitancy to different vaccines used in national immunization program.Methods:A cross-sectional survey was conducted in Beijing, Sichuan and Gansu. The methods of proportional probability sampling and convenience sampling were used to select the eligible study subjects for questionnaire surveys.Results:A total of 3 592 parents were enrolled in the study, in whom 38.22% fully accepted all the vaccines, 59.35% agreed to let their children to receive all the vaccines but showed slight concern, and 2.42% had hesitancy to the vaccines. The vaccine with the most hesitancy was polio vaccine (0.89%), followed by diphtheria pertussis tetanus vaccine (0.70%) and hepatitis A vaccine (0.64%). The dominant reason for vaccine hesitancy was the risk-benefit perception of vaccination (31.03%), followed by the low awareness of the parents (21.84%) and the inconvenience caused by distance and time (21.84%).Conclusions:The incidence of vaccine hesitancy towards national immunization program was low in parents in China, but over 50% of the parents showed concern to the vaccines. It is essential to improve the service quality of national immunization program and strengthen the health education about the vaccination to reduce the incidence of vaccine hesitancy in parents.

Objective To investigate the effect and safety of venlafaxine augmented with amisulpride in the treatment of major depressive disorder. Methods Fifty patients with major depressive disorder were randomly divided into control group treated with venlafaxine (n=25) and study group treated by venlafaxine augmented with amisulpride (n=25). The treatment lasted 8 weeks. Hamilton Depression Rating Scale (HAMD) and Treatment Emergent Symptom Scale (TESS) were used to evaluate the effect and safety of therapy before and 1, 2, 4, and 8-week after treatment. The serum level of IL-18 was detected at each time points in two groups. Results After treatment for 2, 4 and 8 weeks, the serum levels of IL-18 were significantly decreased in study group than that of control group (P<0.05). The serum levels of IL-18 were gradually reduced with the extended treatment time in two groups. There was no interaction between two groups and different processing times. Scores of HAMD decreased gradually after treatment in two groups. Scores of HAMD were significantly lower after treatment than that before treatment in study group (P<0.05). Scores of HAMD were significantly lower after treatment than that before treatment except for one-week treatment in control group (P<0.05). There were no significant differences in HAMD scores before treatment and one-week treatment of two groups. Scores of HAMD were significantly lower 2,4 and 8 weeks after treatment in study group compared with those of control group (P<0.05). There was a interaction between groups and processing times (P<0.05). The effective rates increased in study group (96%) than control group (76.0%). The adverse effects were less in two groups. Conclusion The low dose of amisulpride helps to improve the efficacy of venlafaxine in the treatment of major depressive disorder, which has good security and can inhibit inflammatory reaction.

Objective To investigate the prevalence of tuberculosis (TB) in human immunodeficiency virus (HIV) positive population and explore its influencing factors.Methods Cluster sampling was used,continuous 205 cases who were diagnosed as HIV positive from December 16,2002 to June 30,2012 in Zhuhui district and Yanfeng district of Hunan province and could be followed up and traced were enrolled in the study.All patients were screened after informed content through questionnaire,sputum smear examination,chest X-ray examination,liquid culture (BACTECTM MGITTM 960 operating system),mycobacterium species identification (for liquid culture positive) and CD4 testing.Univariate and multivariate analyses were conducted to identify the impacts of different sex,age,and TB suspect syndromes,etc.Results Of 205 cases,19 were diagnosed as tuberculosis.The rate of TB/HIV was 9.3％.Univariate analysis showed that age,annual household net income,being acquired immunodeficiency syndrome (AIDS) patients and with TB suspect syndromes had significant impacts on tuberculosis combining (P ＜ 0.05).While multivariate analysis showed that age (OR =1.443) and TB suspect syndromes (OR =3.124) were risk factors influencing TB combining in people living with HIV (PLHIVs).Conclusions TB prevalence in HIV positive population was higher in Zhuhui district and Yanfeng,those aged and with TB suspect syndromes cases had higher risk to develop tuberculosis.TB screening should be reinforced in HIV positive population.

OBJECTIVETo realize propensity score matching in PS Matching module of SPSS and interpret the analysis results.

METHODSThe R software and plug-in that could link with the corresponding versions of SPSS and propensity score matching package were installed. A PS matching module was added in the SPSS interface, and its use was demonstrated with test data.

RESULTSScore estimation and nearest neighbor matching was achieved with the PS matching module, and the results of qualitative and quantitative statistical description and evaluation were presented in the form of a graph matching.

CONCLUSIONPropensity score matching can be accomplished conveniently using SPSS software.

Objective To observe the effects of combined surgeries for the correction of congenital ptosis accompanied by epicanthus.Methods 80 cases (105 eyes) of congenital ptosis were analyzed in this study.64 cases (80 eyes),with levator muscle strength more than 4 mm,were treated with suspension of frontal aponeurosis,and 16 cases (25 eyes),with levator muscle strength less than 4 mm,were treated with shorten operation of levator palpebrae superioris.Furthermore,all these patients were corrected the epicanthus at the same time.Results Except the under correction in 5 cases (8 eyes),the remaining patients were corrected satisfactorily.Postoperative palperbal fissure length was averagely increased by 2.0± 1.0 mm,inner canthic diameter was averagely decreased by 4.0± 2.0 mm,the eyelid height was increased by average 9.0±1.0 mm,the inclination of palpebral fissure was 12.0°±2.0°;64 cases (80 eyes) were treated with suspension of frontal aponeurosis,postoperative recurrence were 7.5％ (6/80),no postoperative recurrence were 92.5％ (74/80),complication were 5.0％ (4/80);16 cases (25 eyes) were treated with shorten operation of levator palpebrae superioris,postoperative recurrence were 8.0％ (2/25),and no postoperative recurrence were 8.0％ (2/25);complication rates were 4.0％ (1/25).Conclusions This procedure of combined surgeries can reduce the recurrence rate effectively.Moreover,the satisfactory,functional,and aesthetic results can be obtained simultaneously with this method.