Objective:To investigate the impact of malnutrition diagnosed with Global Leadership Initiative on Malnutrition (GLIM) criteria on the outcomes of patients with primary gastrointestinal lymphoma (PGIL).Methods:Patients with PGIL admitted into Gansu Provincial People's Hospital from January 2014 to July 2022 were retrospectively enrolled. Nutritional risk screening was conducted using Nutritional Risk Screening 2002 (NRS 2002) scale, and malnutrition was diagnosed as per GLIM criteria. Kaplan-Meier survival analysis and multivariate Cox regression analysis were performed to investigate the effect of malnutrition as per GLIM criteria on the outcomes of PGIL patients.Results:A total of 82 patients were included. The phenotypic parameters, including body mass index (BMI), arm circumference, leg circumference and grip strength, were at significantly lower levels in the 28 malnourished patients, compared with the other non-malnourished patients. The median overall survival of patients with malnutrition as per GLIM criteria was 10 months, while that of patients without malnutrition was 41 months, showing significant differences between groups. The univariate analysis revealed that age, loss of muscle mass, tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the impacting factors for survival in patients with PGIL. The multivariate analysis further demonstrated that tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the independent impacting factors for survival in patients with PGIL.Conclusion:Malnutrition based on GLIM criteria is an independent risk factor for unfavorable outcomes in patients with PGIL and could be utilized as a prognostic indicator.

Objective:To investigate the early efficacy and safety of pomalidomide-based regimen in relapsed/refractory multiple myeloma (MM) in the real world.Methods:The clinical data of 15 patients with relapsed/refractory MM treated with pomalidomide-based regimen who were admitted to Gansu Provincial Hospital from January 2021 to July 2021 were retrospectively analyzed, and the early efficacy and safety were also evaluated.Results:There were 8 males and 7 females, and the median age of onset of 15 patients was 60 years (43-83 years); the median time for the diagnosis of relapse and refractory was 15 months (4-84 months). All 15 patients previously received bortezomib-based treatment regimens, 9 patients previously received lenalidomide treatment, and 7 cases received autologous hematopoietic stem cell transplantation. All patients received pomalidomide-based regimen combined with two-drug or three-drug regimen (pomalidomide combined with bortezomib,daratumumab,bendamustine, dexamethasone, cyclophosphamide or lenalidomide). The median treatment cycle was 2 cycles (2-4 cycles). After 2 cycles of treatment, the therapeutic efficacy was evaluated; the overall response rate was 73% (11/15), including 3 cases of complete remission, 3 cases of very good partial remission, and 5 cases of partial remission. Hematological toxicity occurred in 9 patients, of which 5 cases had grade 3-4 hematological toxicity, 4 cases had grade 1-2 hematological toxicity, and other adverse reactions were mild and tolerable.Conclusion:Pomalidomide-based regimen is effective and safe for relapsed/refractory MM patients.

Objective:To investigate the efficacy and safety of BeEAM (bendamustine+cytarabine+etoposide+melphalan) regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma.Methods:The clinical data of 15 patients with lymphoma who underwent autologous hematopoietic stem cell transplantation after pretreatment with BeEAM regimen from January 2020 to February 2021 in Gansu Provincial Hospital were retrospectively analyzed. The transplant-related adverse reactions and hematopoietic reconstitution were evaluated.Results:During the pretreatment process of 15 patients, 13 patients had gastrointestinal adverse reactions such as nausea, vomiting and diarrhea, 2 patients had hypokalemia, and 1 patient had abnormal liver function, but all of them were grade 1-2, and no grade 3-4 adverse reactions occurred. One patient had poor platelet implantation, and the remaining 14 patients all achieved hematopoietic reconstruction. After transplantation, the median time of peripheral blood neutrophils and platelets good implantation in patients was 10 d (9-14 d) and 11 d (9-17 d), respectively. Until March 2021, all patients were alive during follow-up.Conclusions:The efficacy of BeEAM regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma is good, and the adverse reactions are tolerable.

Clinical data of 62 patients with gastrointestinal submucosal tumors (diameter ≥1 cm) who were treated with kissing suture by single-channel endoscope after endoscopic full-thickness resection (EFR) in the First Affiliated Hospital of Zhengzhou University from February 2017 to May 2019 were analyzed retrospectively to evaluate the clinical value of kissing suture technique by single-channel endoscope in defect closure after EFR. All the post-EFR defects were successfully closed (100%). No postoperative anastomotic leakage or other serious complications occurred. The mean maximum diameter of lesions was 3 cm (ranged 1-7 cm), and 13 (21%) of them were greater than or equal to 5 cm.The mean number of clips used was 25.7 (ranged 7-78). The mean procedure time was 168 min (ranged 44-300 min), and the mean suture time was 63 min (ranged 13-211 min). The mean postoperative hospital stay was 7 days (ranged 4-12 days). Endoscopic reexamination 3-6 months after operation showed that all wounds healed well. Kissing suture method by single-channel endoscope is a safe, effective, easy and feasible for closing gastrointestinal defect after EFR.

Objective To analyze the status quo and existing problems of radiation protection for veterinary X-ray facilitiesin Beijing-Tianjin region, China, and to provide a basis for improving radiation protection management level. Methods According to the requirements of the Technical guidelines for status quo assessment of occupational hazard of the employing unit (AQ/T 4270—2015), the study performed status quo assessment on the workplaces of veterinary X-ray facilities in 16 pet hospitals in Beijing-Tianjin region, and comprehensively analyzed the impact of the workplaces on the health of radiation workers and the public. Results In terms of personnel management, the pass rates of occupational health management post setting, personnel training, personal protective equipment, individual monitoring of occupational external exposure, notification of occupational hazards, and occupational health surveillance were 100%, 81.3%, 100%, 75%, 37.5%, and 25%, respectively. In terms of workplace management, most workplaces had reasonable layout and zoning and complete protection and emergency devices. However, there were some problems in some places, such as non-standard radiation warning signs, no notice board of occupational hazards, and no radiation protection testing. In terms of document management, all institutions had imperfect system documents. Conclusion The workplaces of veterinary X-ray facilities in 16 institutions basically meet the requirements for radiation protection, but there are also some problems, such as inadequate management of personnel and workplace radiation protection, and imperfect system documents. Institutions should strengthen the study of radiation protection knowledge. The competent authorities should strengthen supervision, formulate corresponding standards for radiation protection, enhance training, and improve the professional level of staff.

Objective To evaluate the current status of radioactive occupational hazards in the construction of some medical institutions in Tianjin, discover existingproblems and deficiencies, and provide a technical basis for radiation protection management. Methods Based on the requirements of relevant regulations and standards, we comprehensivelyevaluated the results of the pre-evaluation and control effect evaluation of 81 radioactive occupational hazards in Tianjin. Results Among the 35 proposed protective measures for pre-evaluation of radiation occupational hazards constructionprojects, the lowest compliance rate is warning signs and personal protective equipment. Among the 46 construction projects of radioactive occupational hazard control evaluation, the pass rate of protective measures was between 73.9% and 100%, with the lowest pass rate for personal protective equipment. Besides, the pass rate of radiation protectionmanagement evaluation was 95.7% ～ 100%, with the lowest pass rate for the protection management system.The initial inspectionpass rateof the equipment quality control acceptancewas 98.6%, while the pass rate was 97.1% for the relevant workplace radiation protection during the initial inspection. Conclusion The pre-evaluation completion rate of radiological occupational hazard evaluation in Tianjin medical institution construction project, unilateral and area of construction room, workplace layout and zoning, ventilation, shielding measures, personal dose management and occupational health inspection all meet the requirements of regulations and standards. However, there are still some deficiencies in the personal protective equipment, warning signs and the radiation protection management system. Therefore, the regulatory department should further strengthen the evaluation of medical institutions, especially the key supervision and management of non-conformities.

Objective:To understand the current status of quality control of medical X-ray diagnostic equipment in Tianjin, discuss the problems existing in the process of quality control, and provide technical basis for the relevant regulatory agencies.Methods:Using stratified random sampling, a total of 401 pieces of medical X-ray diagnostic equipment distributed over 111 medical institutions in Tianjin was used for this study. X-ray multifunctional dosimeters and other types of equipment were used to perform quality control testing and evaluation under the relevant health industry standards.Results:The initial testing pass rate of these equipment was 90.0%, with the pass rates of X-ray imaging equipment lower than those of X-ray fluoroscopy equipment, digital subtraction angiography (DSA) and X-ray computed tomography (CT) ( χ2=9.203, 3.383, 5.754, P<0.05). Among the imaging equipment, the screen X-ray equipment had the lowest pass rate, followed by the breast X-ray equipment and medical digital radiography (DR). The main unqualified items were output repeatability, deviation of tube voltage indication and limit spatial resolution. DR accounted for the highest percentage of X-ray equipment that were below testing condition. The unqualified proportion of X-ray imaging equipment was higher than that of X-ray fluoroscopy equipment ( χ2=8.216, P <0.05). Among the imaging equipment, the screen X-ray equipment was seen to have the highest unaqualified proportion, followed by computed radiography (CR). Among the 401 devices in this study, the initial testing pass rates of private medical institutions was not statistically different from those of public medical institutions ( P>0.05). The initial pass rates of domestic equipment was lower than those of imported equipment ( χ2=4.576, P<0.05). Conclusions:The performance of medical X-ray diagnostic equipment in Tianjin needs to be further improved. Medical institutions should pay attention to the quality control testing of medical X-ray diagnostic equipment. The relevant regulatory agencies should strengthen oversight and management of equipment that contains unqualified items, no baseline values and below the testing conditions.

Objective: To observe the expression of miR-488-5p in cervical cancer tissues and to explore its effect on the proliferation and migration of cervical cancer C33Acells. Methods: 12 pairs of cervical cancer tissues and corresponding paracancer tissues from patients, who underwent total hysterectomy at the Luoyang Central Hospital of Zhengzhou University from March 2017 to September 2017, were collected for this study; and the expression of miR-488-5p was detected by fluorescence quantitative and real-time polymerase chain reaction (qRT-PCR). Lipofectamine 3000 was used to transfect miR-488-5p (experiment group) and miR-NC (control group) into cervical cancer C33Acells. Cell cycle distribution was detected by Flow cytometry. Cell proliferation was assessed by CCK8 assay and Transwell assay was used to detect cell migration. Bioinformatics software was used to predict the possible target genes of miR-488-5p, and luciferase activity assay was used to verify the binding of miR-488-5p to target genes. The expressions of tumor endothelial marker 8 (TEM8) and downstream EGFR signaling pathway related proteins in two groups were detected by qRT-PCR and Western blotting. Results: The relative expression level of miR-488-5p in cervical cancer tissues (1.33±0.20) was significantly lower than that in paracancer tissues (3.68±0.45) (P<0.01). The relative expression level of miR-488-5p in the experimental group (25.23±3.11) was significantly higher than that in the control group (1.02±0.10) (P<0.01). The percentage of C33A cells at G0/G1 phase in experimental group (53.39±2.48)% was significantly higher than that in control group (39.57±1.21)% (P<0.01). When the culture time extended to 96 h and 120 h, the proliferation ability of C33Acells in experimental group was significantly lower than that in control group (P<0.05), and the number of migrated cells in the experimental group (117.90±18.86) was significantly less than that in the control group (295.10±19.33) (P <0.01). Luciferase activity assay confirmed that miR-488-5p could directly bind with TEM8 and inhibit its expression (P<0.01). The relative expression of TEM8 mRNAin experimental group (0.42±0.06) was significantly lower than that in control group (1.00 ± 0.06) (P<0.01).After transfection with miR-488-5p for 48h, the protein expressions of TEM8, p-EGFR, p-ERK and pAKT were significantly lower than those in control group (P <0.01). Conclusion: The expression of miR-488-5p in cervical cancer tissues was decreased. Over-expression of miR-488-5p could inhibit the cell cycle progression of cervical cancer cells and reduce the proliferation and migration of cervical cancer cells. The mechanism may be related to the interference of TEM8 gene expression.

Objective To investigate the current situation of perioperative pain treatment and management using questionnaire survey.Methods A questionnaire was designed by ourselves and sent to anesthesiologists in each hospital all over China via the WeChat platform within 1 month.The system automatically recorded the situation of questionnaires.Results A total of 8 447 anesthesiologists involved in the investigation,the number of valid questionnaires retrieved was 6 778,anesthesiologists in the survey came from 847 hospitals in China,distributing across China 31 provinces and cities,and there were 526 tertiary hospitals (62.1％) and 321 hospitals under tertiary grade (37.9％).Among the medication for perioperative analgesia (not including medication for anesthesia),the following analgesics (applied alone or in combination) were used by anesthesiologists,and the application rate was as follows:opioids 79.74％,nonsteroidal anti-inflammatory drugs 53.78％,paracetamol 25.76％,local analgesics for analgesia (for nerve blockade) 25.44％,other drugs (such as ketamine,gabapentin) 12.39％;combination of two or more drugs 63.65％.Six hundred forty-nine hospitals (76.6％) carried out therapy with analgesic pump after operation,and the constituent ratio of hospitals using patient-controlled analgesia (PCA) pump was 43.8％.Four hundred seventy-five hospitals (56.1％) established Acute Pain Service (APS),the organizing rate of APS was significantly higher in tertiary hospitals than in hospitals under tertiary grade (P＜ 0.01),and the majority of APS personnel was anesthesiologists (72.4％).Conclusion Multimodal analgesia and PCA technique are not widely adopted and the requirement for non-steroidal anti-inflammatory drugs and nerve blockade is lower in perioperative pain treatment in China;analgesic pump is widely used after operation,but the application rate of PCA technique is not high;APS establishment is relatively weak in pain management and anesthesiologists play a leading role in APS.

OBJECTIVE:To optimize the dry granulation technology conditions for Yinqiao baidu tablet. METHODS:Using granulating difficulty degree and disintegration time as investigation indexes,ratio and amount of accessories microcrystalline cellu-lose and compressible starch in Yinqiao baidu tablet,moisture content of the sprayed powder were screened. Using yield of particle and angle of repose as indexes,L9(34)orthogonal test was used to optimize the wheel pressure,rotating speed and feeding speed in dry granulation technology,and verification test was conducted. RESULTS:The ratio of microcrystalline cellulose and compress-ible starch was 7:3,and mixing ratio of the two with spray powder+inclusion compound was 1:5. The moisture content of spray powder was controlled in 1％-2％. The optimal technology was as follow as wheel pressure of 3.5 MPa,roller speed of 4 r/min and feeding speed of 10 r/min. In verification test,average yield of particle was 69.2％ and angle of repose was 31.5 °. Transfer rate of chlorogenic acid had reached over 92％,and RSD of each index was below 2.53％(n=3). CONCLUSIONS:Each index of parti-cle prepared by optimized accessories formulation and technology shows good reproducibility and feasibility,and the technology is stable and suitable for production.