OBJECTIVE To establish the ultra-high performance liquid chromatography （UPLC） fingerprint of Jingtian granule， and to evaluate its quality by chemical pattern recognition. METHODS Luna® Omega Polar C18 column （150 mm×2.1 mm， 1.6 μm） was used as the chromatographic column， and acetonitrile-0.2% phosphoric acid solution was used as the mobile phase for gradient elution. The flow rate was 0.2 mL/min， the column temperature was 30 ℃， and the detection wavelength was 265 nm. With peak 16 as the reference peak， the UPLC fingerprint of Jingtian granule was established by the Similarity Evaluation System of Chromatographic Fingerprint of Traditional Chinese Medicine （2012 edition）. The common peaks were identified， the similarity evaluation was carried out， and the ownership of each common peak was confirmed. Hierarchical cluster analysis （HCA） and principal component analysis （PCA） in chemical pattern recognition methods were used to classify 13 batches of samples （S1- S13）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） was used to identify the key components of the differences between different batches of samples. RESULTS RSDs of precision， repeatability and stability of the UPLC method were not more than 4.4%. A total of 25 common peaks were identified in the fingerprints of 13 batches of Jingtian granules. By comparing with the reference substance fingerprint， 10 common peaks were identified， namely peak 3 （hydroxymethyl-2-furaldehyde）， peak 5 （salidroside）， peak 8（chlorogenic acid）， peak 15 （cinnamic acid）， peak 19 （aloe-emodin）， peak 20 （ammonium glycyrrhizinate）， peak 21 （rhein）， peak 23 （emodin）， peak 24 （glycyrrhetinic acid）， peak 25 （chrysophanol）. The similarities of fingerprints of 13 batches of samples were 0.955-0.996. The results of HCA showed that 13 batches of samples could be divided into three categories， among which samples S1， S5， S7， S11-S13 were clustered in one category， S4 and S6 were clustered in one category， S2， S3 and S8-S10 were clustered in one category. PCA results showed that the cumulative variance contribution rate of principal components 1-7 was 92.666%. OPLS-DA further identified 13 differential components， which were mainly derived from Polygonati Rhizoma with wine steaming， Rhodiolae Crenulatae Radix Et Rhizoma， prepared Rhei Radix Et Rhizoma and Glycyrrhizae Radix Et Rhizome Praeparata Cum Melle. CONCLUSIONS The established UPLC fingerprint of Jingtian granule is simple， stable and reproducible. Combined with the chemical pattern recognition method， it can effectively reveal the overall quality difference between different batches of Jingtian granule. The quality of Polygonati Rhizoma with wine steaming， Rhodiolae Crenulatae Radix Et Rhizoma， prepared Rhei Radix Et Rhizoma， Dioscoreae Nipponicae Rhizoma， Polyporus， Cinnamomi Ramulus， Glycyrrhizae Radix Et Rhizome Praeparata Cum Melle is the key to the overall quality of Jingtian granule.

Objective:To retrospectively analyze the failure patterns and outcomes of patients with locally advanced hypopharyngeal squamous cell carcinoma (HPSCC) after undergoing induction chemotherapy (IC) followed by definitive radiotherapy.Methods:For patients with locally advanced HPSCC who were treated with IC and definitive radiotherapy from August 2008 to December 2019, their data were collected from the medical records system, and their clinical characteristics, failure patterns, and survival were retrospectively analyzed.Results:A total of 116 eligible patient with squamous cell carcinoma were included in this study. with a median age of 59 (39-79), and 3, 3, 60, and 50 of them had stage Ⅱ, Ⅲ, Ⅳ A, and Ⅳ B HPSCC, respectively. Among these patients, 81 received 1~2 cycles of IC, and 35 received 3-4 cycles of IC. After treatment with IC, 54, 13, and 49 patients received concurrent chemoradiotherapy, radiotherapy combined with targeted therapy, and radiotherapy alone, respectively. The median follow-up was 34.6 months (95% CI: 28.7-40.5 months). The 3-year local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), metastasis-free survival (MFS), progression-free survival (PFS), and overall survival (OS) of all the patients were 63.5%, 82.8%, 75.2%, 47.3%, and 43.1%, respectively. Median PFS and OS were 26.1 and 28.0 months, respectively. Treatment failure was reported in 59 patients, of whom 22, 5, 12, 10, 3, 6 and 1 experienced local, regional, distant only, local-regional, regional-distant, local-distant, and local-regional-distant failure, respectively. The objective response rate (CR+ PR) of patients after IC was 55.2% (64/116). The LRFS, RRFS, PFS, and OS of IC responders (CR+ PR) were better than those of IC non-responders (SD+ PD) ( χ2 = 12.52, 5.16, 13.19, 11.72, all P< 0.05). Conclusions:IC combined with radical radiotherapy has efficacy to a certain extent in the treatment of locally advanced HPSCC, and locoregional recurrence predominates the failure patterns. The prognosis of IC responders is significantly better than that of IC non-responders.

Objective:To assess plasma microfibrillar associated protein 5(MFAP5) level in patients with polycystic ovary syndrome(PCOS), and to explore its relationship with glucose and lipid metabolism as well as sex hormones.Methods:Fifty PCOS patients and 65 healthy female subjects were selected as PCOS group and control group, respectively. Clinical data and plasma MFAP5 levels between the two groups were compared.Results:The plasma MFAP5 level in PCOS group was significantly higher than that in control group( P<0.01), and the plasma MFAP5 level in PCOS overweight subgroup was higher than that in control subgroup( P<0.01). No difference was observed in plasma MFAP5 level between the two non-overweight subgroups( P>0.05). Correlation analysis showed that plasma MFAP5 level was positively correlated with waist circumference, low density lipoprotein-cholesterol, fasting insulin, homoeostasis model assessment of insulin resistance index(HOMA-IR), HbA 1C, testosterone, LH/FSH ratio, and leukocyte( P<0.05 or P<0.01). There was no significant correlation of MFAP5 with body weight, body mass index(BMI), hip circumference, waist hip ratio, high density lipoprotein-cholesterol(HDL-C), triglyceride, total cholesterol, and blood glucose( P>0.05). In PCOS group, plasma MFAP5 level was positively correlated with body weight, BMI, waist circumference, hip circumference, total cholesterol, and leukocyte( P<0.05 or P<0.01). There was no significant correlation of MFAP5 with waist hip ratio, HDL-C, triglyceride, blood glucose, fasting insulin, HOMA-IR, leukocyte, and sex hormones( P>0.05). Multivariate logistic regression analysis showed that MFAP5 was an independent risk factor for PCOS( P<0.05). Conclusion:Plasma MFAP5 level is increased in PCOS patients and is closely related to BMI, waist circumference, hip circumference, and total cholesterol. Plasma MFAP5 is an independent risk factor for PCOS, which may be involved in the pathogenesis of PCOS.

Objective:To evaluate the survival outcomes of radiotherapy in patients with newly-diagnosed metastatic head and neck squamous cell carcinoma (HNSCC) based on data from the Surveillance, Epidemiology and End Results (SEER) database.Methods:A total of 1226 patients newly-diagnosed with metastatic HNSCC between 2010 and 2015 were selected from the SEER database. There were 762 patients (62.1%) in the radiotherapy group and 464 patients (37.9%) in the non-radiotherapy group. Kaplan-Meier method was used to calculate the cancer-specific survival (CSS) and overall survival (OS). The effect of radiotherapy on survival was assessed by Cox multivariate regression and Propensity score-matched analyses (PSM). According to the results of multivariate analysis, the patients were further divided into low-, intermediate- and high-risk groups, and the effect of radiotherapy on survival was analyzed in different risk groups.Results:The median CSS and OS time of the whole group was 11.0 months and 10.0 months, respectively. For patients in the radiotherapy group and non-radiotherapy group, the median CSS time was 13.0 months and 6.0 months, and the median OS time was 12.0 months and 6.0 months, respectively. Multivariate analysis showed that age (CSS, P=0.045;OS, P=0.002), primary tumor site (CSS, P=0.021;OS, P<0.001), T stage (CSS, P=0.001;OS, P=0.002), N stage (CSS, P=0.002;OS, P<0.001), number of metastatic organs (CSS, P<0.001;OS, P<0.001), surgery (CSS, P<0.001;OS, P<0.001), radiotherapy (CSS, P<0.001;OS, P<0.001), and chemotherapy (CSS, P<0.001;OS, P<0.001)were the independent prognostic factors. After PSM, patients with and without radiotherapy in the low-,intermediate-,and high-risk groups, the 3-year CSS rates were 62.5% vs 23.5%( P=0.008), 22.4% vs 15.7%( P=0.001)and 10.5% vs 9.6%( P=0.203), respectively; the 3-year OS were 58.0% vs 20.8%( P=0.002), 19.8% vs 12.7%( P=0.001)and 7.0% vs 6.1%( P=0.166), respectively. Conclusion:Radiotherapy significantly improves CSS and OS in the low- and intermediate-risk groups, but patients in the high-risk group do not benefit from radiotherapy.

Objective:To assess the efficacy and toxicity of chemoradiotherapy in the treatment of early stage extranodal nasal-type NK/T-cell lymphoma (ENKTCL).Methods:Retrospective review was conducted for 174 patients with pathological proved early stage ENKTCL who were treated in the Department of Radiation Oncology, Peking University Cancer Hospital & Institute. The Kaplan-Meier survival analysis was adopted to calculate the local-regional control (LRC), overall survival (OS), and progression free survival (PFS), and the Log-rank test COX regression model were applied to univariate and multivariate analyses.Results:The patients in this study included 102 and 72 patients diagnosed with Ann Arbor stage-Ⅰ and stage-Ⅱ, respectively. Among them, two patients received radiotherapy alone and 172 patients were treated with combined chemoradiotherapy. The overall response rate of all the patients was 94.2%, with a complete response (CR) rate of 87.9% (153). Furthermore, the rates of 5-year OS, PFS, and LRC were 87.3%, 83.1%, and 91.9%, respectively. The most common toxicities during the chemotherapy and radiotherapy included myelosuppression and oral mucositis, with grade ≥ 3 myelosuppression and grade ≥ 3 oral mucositis accounting for 62.1% and 10.9% of all patients, respectively. As shown by multivariate analysis, the adverse prognostic factors for OS included age > 60, B symptoms, and stage Ⅱ, while the adverse prognostic factors for PFS included age > 60 and stage Ⅱ. Meanwhile, the PFS rate was significantly improved by increasing the radiation dose (≥ 50 Gy vs.<50 Gy), and the 5-year PFS rates of the two groups were 83.5% and 76.5%, respectively [hazard ratio ( HR) 0.374; 95% CI, 0.169-0.826; P=0.015]. Conclusions:A good therapeutic effect can be achieved for early stage NK/T-cell lymphoma and the toxicities after combined chemoradiotherapy can be tolerated.

Objective:To explore overall survival(OS) and prognostic factors of brainstem gliomas (BSG) after intensity modulated radiotherapy (IMRT) by a retrospective single-center analysis.Methods:A total of twenty-one patients with BSG were collected in the Department of Radiation Oncology, Peking University Cancer Hospital from January 2012 to September 2019. All patients underwent IMRT. OS and potential prognostic factors were analyzed, including gender, age, operation type, imaging classification, tumor location, WHO grade, chemotherapy, radiotherapy pattern, time interval between morbidity and the first treatment, and radiation dose.Results:Eighteen of twenty-one patients were followed up more than 3 months. The median follow-up time was 15.5 (5.3-25.6) months. The median overall survival (mOS) was 20 (14.1-25.8) months. The 1 and 2-year OS rates were 86.2% and 34.5% respectively. Operation type, imaging classification, tumor location, WHO grade and radiotherapy pattern were the prognosis factors ( χ2=4.829-20.261, P<0.05). Conclusions:Patients with maximal safe surgical resection, focal endogenesis / exogenesis, tumor located in mesencephalon, low-grade gliomas and/or received postoperative radiotherapy have a better prognosis. It has certain reference value for guiding the clinical practice.

OBJECTIVE: To observe the effect of integrated Chinese and Western medicine for the treatment of occupational noise-induced deafness( ONID). METHODS: A total of 80 ONID patients were selected and randomly divided into control group and treatment group by judgment sampling method,with 40 cases in each group. The control group received routine western medicine treatment using mecobalamin tablets,vitamin B complex,nerve growth factor and hyperbaric oxygen. The treatment group received routine western medicine as the control group,plus acupuncture,moxibustion and auricular point pressing. The patients in both groups were treated continuously for 30 days. The questionnaire of conscious,the selfconscious symptoms such as tinnitus,headache,dizziness and insomnia were recorded in these two groups before and after treatment. Pure tone audiometry was performed on the patients at the same time. RESULTS: After treatment,the binaural high frequency threshold average( BHFTA) and threshold of weighted value of the left and right ears in the treatment group were better than that in the same group before treatment( P < 0. 05). The difference of the BHFTA and threshold of weighted value of the right ear in the treatment group before and after treatment was higher than that in the control group( P < 0. 05). After treatment,the symptoms of tinnitus,headache,dizziness and insomnia in the two groups were better than those in the same group before treatment. The total improvement rate of tinnitus and dizziness symptoms in the treatment group was higher than that in the control group( P < 0. 05). CONCLUSION: The treatment with integrated traditional Chinese and Western medicine for ONID can improve the hearing level of patients,effectively alleviate the accompanying self-conscious symptoms,and is suitable for promotion in clinical use.

Objective: To investigate the current situation and influence factors of perceived professional benefits among nurses working in day-care unit. Methods: Convenience sampling method was adopted, totally 245 nurses working in day-care unit were investigated by nurses' perceived professional benefit questionnaire, psychological capital questionnaire, psychological sub-health questionnaire and a self-designed demographic questionnaire. The data were collected and analyzed statistically. Results: The scores of perceived professional benefit among nurses working in day-care unit were 117.96±14.06. Multiple regression analysis shows that working years, scores of psychological capital questionnaire and psychological sub-health questionnaire were positive factors to perceived professional benefit; while the education level was negative predictors to perceived professional benefit. The regression equation was: the scores of perceived professional benefit among nurses = 70.582-4.882 x the education level + 2.520 x working years+ 0.329 x scores of psychological capital questionnaire + 0.250 x psychological sub-health questionnaire. Conclusions It showed higher level of perceived professional benefit as tested in previous study. Managers can pay more attention to nurses with less working years and higher degree of education, and improve the level of psychological capital and mental health, so as to improve the level of perceived professional benefit.

Objective: To explore the effectiveness of modified internal fixation and fusion in treatment of type Ⅱ painful accessory navicular (PAN) in adults. Methods: Between January 2016 and December 2017, 29 patients (37 feet) with type Ⅱ PAN were treated with modified internal fixation and fusion. There were 12 males and 17 females with an average age of 41.4 years (range, 18-50 years). The injury caused by sprain in 24 cases and no obvious inducement occurred in 5 cases. All patients received conservative treatment for more than 6 months with no significant improvement. The effectiveness was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score before operation and at last follow-up. The inclination angle of calcaneus, the first metatarsal angle of talus, the inclusion angle of talonavicular joint, and the second metatarsal angle of talus were measured on X-ray films. Results: Superficial infection of incision occurred in 1 case after operation, and the incision healed after enhanced dressing change. The incisons of the other patients healed by first intention. There was no deep infection or osteomyelitis. All patients were followed up 12-33 months (mean, 25.1 months). X-ray films showed that the articular surfaces healed at 2-5 months after operation, with an average of 3.4 months. No loosening or rupture of internal fixator was found during the follow-up. At last follow-up, the pain, function, alignment scores, and total score of AOFAS were significantly improved when compared with those before operation (P<0.05). The inclusion angle of talonavicular joint, the first metatarsal angle of talus, and the second metatarsal angle of talus were also significantly improved when compared with those before operation (P<0.05). But there was no significant difference in the inclination angle of calcaneus between pre- and post-operation (t=1.097, P=0.276). Conclusion: Modified internal fixation and fusion in treatment of type Ⅱ PAN can effectively relieve the symptoms and obtain good recovery of feet function with less complications.

Objective? To evaluate the Chinese version of Glaucoma Quality of Life 17 (Glau-QoL17) by item analysis on each item using item response theory(IRT), so as to provide tools in life quality evaluation in patients with glaucoma in China. Methods? By convenience sampling, 198 glaucoma patients admitted in the outpatient department of Opthalmic Center affiliated to Sun Yat-Sen University from May 2017 to July 2018 were selected and their life quality were evaluated by using the Chinese version of Glau-QoL17. MULTILOG 7.0 was used to analyze the collected data in IRT and calculate the discrimination and difficulty parameters of each item. Results? The Chinese version of Glau-QoL17 had good discrimination. The discrimination parameter (α) ranged from 1.50 to 5.23, and the difficulty increased monotonously. Except for the entry "Are you afraid of surgeries?", the other items ranged from-3 to 3; the coverage area under the item information curve was relatively large except for item "Currently, I am very well-informed about my visual problems." Conclusions? The Chinese version of Glau-QoL17 can be used in the evaluation of the glaucoma patients' quality of life in our country, however, it still needs further modification on its content so as to improve the accuracy of the evaluation.