Purpose: The interval between neoadjuvant chemotherapy (NAC) and surgery for locally advanced breast cancer (LABC) remains controversial. At the same time, the prognostic effect of delayed surgery in patients with poor responses is currently unclear. Methods: Data was collected from patients who had poor responses to NAC and underwent modified radical surgery from January 2013 to December 2018. The interval from completion of NAC to surgery was divided into two groups: a longer (greater than four weeks) or shorter (four weeks or less) interval. The associations of these interval groups with overall survival (OS) and recurrence-free survival (RFS) were evaluated by multivariable Cox models adjusting for the existing prognostic factors. Propensity score matching (PSM) was used to minimize election bias. Results: A total of 1,229 patients (mean age, 47.2 ± 8.9 years; median follow-up duration, 32.67 [6.57–52.63] months) were included. The 5-year OS rates were 73.2% and 60.8% in the shorter (n = 171) and longer interval group (n = 1,058), respectively, while the 3-year RFS rates were 80.8% and 71.7%, respectively. In multivariate Cox analysis, the longer interval was associated with an increased risk of mortality (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.01–2.02; p = 0.046) and recurrence (HR, 1.50; 95% CI, 1.12–1.99; p = 0.006).There was an interaction between the molecular subtype and the surgery interval for OS (pinteraction = 0.014) and RFS (pinteraction = 0.027). After PSM, no significant difference in OS (p = 0.180) and RFS (p = 0.069) was observed between the two groups. Conclusion Among LABC patients with a poor response, those with a longer interval between NAC and surgery had worse OS and RFS. The results indicate that these patients should receive modified radical surgery timely, which may in turn improve their prognosis.

OBJECTIVE: To investigate the clinical and radiographic outcomes of 3 years after partial pulpotomy with iRoot BP Plus in immature permanent teeth with complex crown fracture and to provide refe-rence for the clinical application. METHODS: The study was prospectively designed and 104 immature permanent teeth with complex crown fracture were randomly allocated into two groups (n=52). The experiment group received iRoot BP Plus as the pulp capping agent while the control group received calcium hydroxide as the pulp capping agent. After partial pulpotomy, all teeth were clinically and radiographically assessed at the end of 1, 3, 6, 12, 18, 24, 30, and 36 months. The success rate in the two groups was evaluated to see if there was significant difference. The root canal wall thickness in the treated teeth was compared both between the groups and within the groups with those of the corresponding healthy teeth on the opposite side, in the same patient. RESULTS: Excluding those lost to follow-up, there were 44 teeth in calcium hydroxide group (8 teeth accounting for 15.4% were lost to follow up) and 45 teeth in iRoot BP Plus group (7 teeth accounting for 13.5% were lost to follow up) in the end. There was no intergroup difference in the success rate between calcium hydroxide group and iRoot BP Plus group (per-protocol analysis: 80% vs. 87%; intent-to-treat analysis: 67% vs. 75%). The non-inferiority margin was -10%. The 95% confidence interval of the difference in success rate was -8% to 22%. There was no significant difference in root development between the experimental teeth and contralateral control teeth. The thickness of upper 1/3 root canal in the iRoot BP Plus group was thinner than that in the CH group [(1.82±0.21) mm vs. (1.91±0.20) mm, P=0.047]. CONCLUSION iRoot BP Plus used in pulpotomy can effectively preserve the living pulp and promote the development of root in the young permanent teeth with complex crown fracture.
Humans ; Tooth Fractures ; Calcium Hydroxide/therapeutic use* ; Female ; Male ; Child ; Pulp Capping and Pulpectomy Agents ; Pulpotomy/methods* ; Prospective Studies ; Dental Pulp Capping/methods* ; Adolescent ; Dentition, Permanent ; Drug Combinations ; Tooth Crown/injuries* ; Root Canal Filling Materials ; Silicones

Objective:To explore the value of linaclotide combined with compound polyethylene glycol electrolytes powder (PEG) for bowel preparation for colonoscopy.Methods:A randomized and single blind prospective clinical study was conducted in patients who intended to receive colonoscopy at the Department of Gastroenterology in Shenzhen Hospital, Southern Medical University from June 2021 to August 2021. One hundred and fifty-two patients in the experimental group were treated with 580 μg linaclotide + 2 L PEG, and 152 patients in the control group were treated with 3 L PEG. The bowel preparation effects including Boston bowel preparation scale (BBPS) score, bubble score and lesion detection rate, and safety (adverse events) were compared between the two groups.Results:The total BBPS scores were 9 (8, 9) in the experimental group, and 9 (9, 9) in the control group with no significant difference ( Z=0.141, P=0.888). The bubble scores were 1 (1, 2) in the experimental group, and 1 (1, 1) in the control group with no significant difference ( Z=1.788, P=0.074). There was no significant difference in detection rate of lesions between the experimental group and the control group [37.50% (57/152) VS 33.55% (51/152), χ2=0.517, P=0.472]. There was no significant difference in safety including incidence of nausea [7.24% (11/152) VS 13.16% (20/152), χ2=2.910, P=0.088], vomiting [2.63% (4/152) VS 7.24% (11/152), χ2=3.436, P=0.064], abdominal distension [7.89% (12/152) VS 11.84% (18/152), χ2=1.331, P=0.249] and abdominal pain [2.63% (4/152) VS 4.61% (7/152), χ2=0.849, P=0.357] between the experimental group and the control group. Conclusion:Linaclotide combined with PEG for colonoscopic bowel preparation reduces drinking water volume. The cleaning effect and safety are comparable to using 3 L PEG. It can be recommended for bowel preparation for colonoscopy.

Objective: To investigate the cleaning effects of biofilm cleaning agent and two kinds of multi-enzyme detergents on endoscopic biofilm. Methods: Endoscopic biofilm model was established using pseudomonas aeruginosa, and soaked with No. 1 multi-enzyme detergent, No. 2 multi-enzyme detergent, and biofilm cleaning agent respectively. The control group was cleaned with sterile water. After 5, 10, and 15 minutes at room temperature, the cleaning effects were evaluated by bacteria counting method and scanning electron microscope. Arova was used for the comparison of viable counts among groups. Results: At 5, 10, and 15 minutes of soak, the standard colony counts (CFU/cm²) of biofilm was 5.31±0.10, 5.04±0.08 and 4.90±0.16 in the No.1 multi-enzyme detergent group, 5.53±0.30, 5.39±0.21 and 5.03±0.42 in the No.2 multi-enzyme detergent group, and 3.53±0.30, 3.01±0.07 and 2.82±0.26 in the biofilm cleaning agent group, and 7.92±0.21 in the blank control group. There was no significant difference in the colony counts between the two multi-enzyme detergent groups (P>0.05). However, the colony counts of biofilm cleaning agent group was less than that of the two multi-enzyme detergent groups (P<0.05), and decreased with time (P<0.05). Under scanning electron microscope, the biofilm cleaning agent group had the least residual biofilm and bacteria. Conclusion Biofilm cleaning agent can significantly improve the quality of endoscopic cleaning, and is worthy of clinical promotion.

Objective To evaluate the diagnostic value of linked color imaging (LCI) technology on Helicobacter pylori (HP)-related gastritis. Methods Forty patients who were diagnosed as chronic gastritis using blue laser imaging endoscopy in Shenzhen Hospital of Southern Medical University during November 2016 to June 2017 were enrolled in this study. The appearance of gastric mucosa was observed using conventional white light imaging and LCI. Biopsies were taken under white light imaging according to biopsy pathological diagnosis consensus, and the ones from abnormal reddening area were taken under LCI. 13C-urea breath test (13C-UBT) was performed in all 40 patients. The consistency between the two observation methods and final pathological diagnosis was evaluated using Kappa test, and the diagnostic consistency of the two methods was compared using Mc Nemar paired Chi-square test.Results The positive predictive value of white light imaging and LCI for prediction of HP infection was 54. 5%(6/11) and 81. 5%(22/27), respectively.The consistency between white light imaging diagnosis and final pathological diagnosis was 0. 475 (19/40), Kappa＝0. 635; the consistency between LCI diagnosis and final pathological diagnosis was 0. 875 (35/40), Kappa＝0. 741. Mc Nemar paired Chi-square test showed that the consistency between the two methods had significant difference (P＜0. 01). 13C-UBT showed that 19 patients were positive and 21 negative. Among the 19 positive patients, 1 case was diagnosed as HP negative by pathology under LCI; and among the 21 negative patients, 4 cases were diagnosed as HP negative by pathology under LCI.The consistency between pathological diagnosis and 13C-UBT was good (Kappa＝0. 751). The red-white boundary and diffuse redness of gastric mucosa were observed in 15 and 11 cases under LCI, respectively, while unobserved under white light imaging.The Wilcoxon signed ranks test showed that there was a significant difference between white light imaging and LCI on the appearance of gastric mucosa (Z＝－4. 455, P＜0. 01). Conclusion LCI is more useful for diagnosis of HP-related chronic gastritis than white light imaging.

Objective To explore the nursing measures in blue laser endoscopy. Methods Endoscopy was performed in 102 patients. The nursing was done including preoperative preparation, nurse's coordination for different mode of endoscpy, postoperative nursing and so on. Result The endoscopy for the 102 patients was successfully done,the time ranging between 10~25 min,averaged 13.85 min.No complications were found. Conclusion The nursing measures including careful preoperative preparation,intraoperative cooperation and postoperative nursing are key to the successful detection and diagnosis of diseases by blue laser endoscopy.

Objective To investigate the effect of early pelvic floor muscle training on the recovery of urinary function in patients with radical prostatectomy.Methods A total of 62 patients with prostate cancer in our hospital were selected as the research objects.All patients were randomly divided into two groups according to the way of drawing,with 31 cases in each group.The control group received routine intervention,and the experimental group was given early pelvic floor muscle training on the basis of conventional intervention.The ICI-Q-SF score,clinical curative effect and life quality of prognosis of the two groups were analyzed before and after treatment.Results There was no significant difference in ICI-Q-SF scores between the two groups before treatment (P ＞ 0.05).After treatment,the ICI-Q-SF scores were significantly improved in the two groups,and the ICI-Q-SF score was better in the experimental group than in the control group (P ＜ 0.05).The clinical efficacy of the experimental group was 90.32％ (28/31),which was higher than 80.65％ (24/31) of the control group,and the difference was statistically significant (P ＜ 0.05).The quality of life of the experimental group was significantly higher than the control group (P ＜ 0.05).Conclusion Early pelvic floor muscle training can effectively improve the prevention and treatment of prostatic function after radical prostatectomy,improve the life quality of prognosis,so it is worthy of application and promotion.

Objective To investigate the effect of early pelvic floor muscle training on the recovery of urinary function in patients with radical prostatectomy.Methods A total of 62 patients with prostate cancer in our hospital were selected as the research objects.All patients were randomly divided into two groups according to the way of drawing,with 31 cases in each group.The control group received routine intervention,and the experimental group was given early pelvic floor muscle training on the basis of conventional intervention.The ICI-Q-SF score,clinical curative effect and life quality of prognosis of the two groups were analyzed before and after treatment.Results There was no significant difference in ICI-Q-SF scores between the two groups before treatment (P ＞ 0.05).After treatment,the ICI-Q-SF scores were significantly improved in the two groups,and the ICI-Q-SF score was better in the experimental group than in the control group (P ＜ 0.05).The clinical efficacy of the experimental group was 90.32％ (28/31),which was higher than 80.65％ (24/31) of the control group,and the difference was statistically significant (P ＜ 0.05).The quality of life of the experimental group was significantly higher than the control group (P ＜ 0.05).Conclusion Early pelvic floor muscle training can effectively improve the prevention and treatment of prostatic function after radical prostatectomy,improve the life quality of prognosis,so it is worthy of application and promotion.

OBJECTIVE:To develop the drug traceability management system in outpatients of medical institutions,and gradu-ally improve its traceability management. METHODS:Based on barcode technology,drug traceability management system in outpa-tients of medical institutions was independently developed,introducing it from system environment,framework design and system function,and the application results were evaluated in terms of differences in dispensing time,deployment error,drug withdrawal treatment and applicability investigation. RESULTS:The system was developed on hospital information system network environ-ment,which was designed by combination of client/server(C/S)network system(B/S)and set function modules as follows as role rights management,data extraction,information control,data acquisition and data query. The system can match with drug electron-ic surveillance code,commodity code and other traceable barcodes,achieve drug tracing from hospitals to users through software interaction,as well as the computer-aided calibration in dispensing to effectively reduce outpatient's dispensing error. The average time for each outpatient prescription prolonged 9 s after using the system;24 dispensing errors and 4 non-normal withdrawals were prevented within 1 month;100% surveyed pharmacists expressed approval for the system's applicability. CONCLUSIONS:The system can achieve the drug suitability management in outpatients,which has shown good applicability and further improved drug safety management and control capabilities in medical institutions.

Objective To investigate the expression of SOX4 and C/EBPα mRNA in chronic myeloid leukemia (CML) and their clinical significances. Methods Bone marrow samples from 68 cases of CML including 57 newly diagnosed patients and 11 patients treated with imatinib were collected, and peripheral blood mononuclear cells from 30 healthy people were collected as healthy control. The expression of SOX4 and C/EBPαmRNA and protein levels were detected by RT-PCR and Western blot, respectively. The relations between the expression of SOX4 and C/EBPα and the influences of imatinib on SOX4 and C/EBPα were analyzed. Results The expression level of SOX4 mRNA was increased in newly diagnosed CML patients compared with that of normal control group (6.545 5±1.495 2 vs. 0.059 6±0.018 8, t=3.139, P=0.002 3), but the expression level of C/EBPαmRNA was significantly decreased (0.238 8±0.033 8 vs. 0.810 5±0.056 2, t=9.240, P<0.000 1). The expression levels of SOX4 and C/EBPαmRNA had no significant correlation with age, gender, white blood cell count (WBC) and bcr-abl of newly diagnosed patients (all P>0.05). The expression level of SOX4 mRNA in 5 patients treated with imatinib was decreased (0.120 6 ±0.044 9 vs. 0.557 9±0.144 8, t=2.885, P=0.020 4), and the expression level of C/EBPαmRNA was increased (0.330 3±0.042 4 vs. 0.150 5±0.046 5, t=2.855, P=0.021 3). The expression level of SOX4 mRNA in 6 patients who developed blast phase during the treatment of imatinib was increased (0.469 9±0.123 0 vs. 0.050 2±0.036 6, t=2.370, P=0.039 3), and the expression level of C/EBPα mRNA was decreased (0.197 9 ±0.064 7 vs. 0.378 7±0.042 9, t=2.327, P=0.042 3). The expression of SOX4 mRNA was negatively correlated with C/EBPα mRNA (t=-0.554 6, P=0.002 8). Conclusions In newly diagnosed CML, the expression level of SOX4 is increased, C/EBPα is decreased compared with that of healthy control, and both have negative correlation. In the patients in blast phase after imatinib treatment, SOX4 gene is up-regulated, and C/EBPα is down-regulated. C/EBPα-SOX4 axis may play a role in the occurrence and development of CML. SOX4 may be a new molecular target for the treatment of CML.