Polyetheretherketone (PEEK) as a new type of thermoplastic engineering plastic, has good biological activity, elastic modulus close to human cortical bone and radiation permeability, and has been widely used in medical field. This study aims to explore the safety and clinical efficacy of using 3D printing personalized PEEK materials to repaire scapular bone defects after bone tumor resection. A total of 6 patients who underwent the implantation of 3D printed PEEK scapular prosthesis from January 2020 to December 2021 in Yunnan Cancer Hospital were retrospectively analyzed. There were 3 males and 3 females, with age ranged from 14 to 52 years. There were 1 case of synovial sarcoma, 1 of Ewing's sarcoma, and 4 of chondrosarcoma. PEEK prosthesis was designed and fabricated based on CT data before surgery. Tumor resection and prosthesis replacement were performed under the premise of ensuring safe surgical boundaries, including 2 cases of total scapular prosthesis replacement and 4 cases of partial scapular prosthesis replacement. The operation time was 90-170 min, and the intraoperative blood loss was 100-400 ml. All 6 patients received satisfactory follow-up, with a tumor progression free survival time of 16-28 months. No tumor recurrence or metastasis was observed, and all patients survived tumor free. At last follow-up, the Constant-Murley shoulder joint score was a minimum of 62 points and a maximum of 68 points. The Japanese Orthopaedic Association's shoulder joint score was 63 points minimum and 78 points maximum. Computer-aided design 3D printing PEEK material prosthesis has certain advantages in the treatment of scapular tumor limb salvage. It has light weight, well adapted, relatively simple installation, good histocompatibility, and can obtain a better appearance and function of the shoulder joint after operation. It can become one of the options for limb salvage treatment of scapular tumor.

Objective:To describe the characteristics and change trends of incidence, mortality and disease burden of acute myocardial infarction (AMI) in Qingdao from 2014 to 2020.Methods:We analyzed the incidence data of AMI retrieved from Qingdao Chronic Diseases Surveillance System. The average annual percent change (AAPC) of morbidity and mortality of AMI were evaluated by using Joinpoint log-linear regression model. Disability adjusted life year (DALY) was used to estimate disease burden of AMI in Qingdao.Results:A total of 70 491 AMI cases and 50 832 deaths of AMI occurred in Qingdao from 2014 to 2020. The age-standardized morbidity and mortality were 54.71/100 000 and 36.55/100 000, respectively. During 2014-2020, the AAPC of age-standardized morbidity was 2.86% (95% CI: 0.42%-5.35%), and 4.30% (95% CI: 1.24%-7.45%) in men and 0.78% (95% CI: -0.89%-2.47%) in women, respectively. The log-linear regression model showed that age-standardized morbidity in age groups 30-39, 40-49 years increased rapidly, with the AAPCs of 8.92% (95% CI: 2.23%-16.06%) and 6.32% (95% CI: 3.30%-9.44%), respectively. The trend was also observed in age groups 30-39, 40-49 and 50-59 years in men, with the AAPCs of 11.25% (95% CI: 3.54%-19.54%), 6.73% (95% CI: 2.63%-10.99%) and 6.72% (95% CI: 2.98%-10.60%), respectively. There was no significant change in age-standardized mortality. The DALY rate increased from 7.49/1 000 in 2014 to 8.61/1 000 in 2020, with the AAPC of 1.97% (95% CI: 0.36%-3.60%). Conclusions:The age-standardized morbidity of AMI in men increased in Qingdao, especially in those aged 30-49 years, while age-standardized mortality rate of AMI was relatively stable from 2014 to 2020. The burden of disease of AMI increased in both men and women.

Objective:To compare the short-term recovery and long-term prognosis of patients with colorectal cancer by laparoscopy and traditional open surgery.Methods:The clinical data of 86 patients with colon cancer treated by the Changshu NO.1 People′s Hospital from April 2017 to April 2019 were retrospectively analyzed. According to different surgical methods, they were divided into observation group (laparoscopic radical resection of colon cancer, 41 cases) and the control group (traditional laparotomy underwent radical resection of colon cancer, 45 cases). The surgical indicators, short-term recovery, complications, serum anti-inflammatory and pro-inflammatory factor levels, and 3-year tumor-free survival rate between two groups were compared.Results:Compared with the control group, the observation group had less intraoperative blood loss and shorter hospital stay: (120.32 ± 32.43) ml vs. (178.43 ± 39.98) ml, (9.65 ± 2.17) d vs. (12.35) ± 2.68) d; the time to get out of bed for the first time, the time of anal exhaust and the time of eating semiliquid in the observation group were earlier: (2.10 ± 0.23) d vs. (3.03 ± 0.54) d, (3.45 ± 1.02) d vs. (4.29 ± 1.03) d, (4.54 ± 1.09) d vs. (5.30 ± 1.05) d, the differences were statistically significant ( P<0.05). The incidence of complications in the observation group was lower than that in the control group: 12.20% (5/41) vs. 31.11% (14/45), the difference was statistically significant ( χ2 = 4.695, P<0.05). Serum interleukin (IL)-6 and tumor necrosis factor (TNF)-α levels in the observation group were lower than those in the control group: (23.12 ± 6.09) μg/L vs. (31.05 ± 5.3) μg/L, (57.87 ± 10.6) μg/L vs. (62.43 ± 6.8) μg/L; serum IL-4 and transforming growth factor (TGF)-β levels were higher than those in the control group: (155.03 ± 14.53) ng/L vs. (127.87 ± 12.09) ng/L, (26.32 ± 3.09) ng/L vs. (20.87 ± 3.87) ng/L, the differences were statistically significant ( P<0.05). There was no significant difference in the tumor-free survival rate between the two groups at 3-year after operation ( P>0.05). Conclusions:Laparoscopic treatment of colon cancer has the advantages of less trauma, fewer complications, and mild postoperative inflammatory reaction, and has a long-term prognosis comparable to traditional laparotomy.

Objective:To analysis the clinical characteristics of The clinical characteristics of using automated external defibrillation in the public place,To explore the feasibility and effectiveness of AED application in public places in China.Methods:From January 2014 to April 5, 2019, 54 cases of on-site emergency medical records of AED use in public places in China were analyzed retrospectively from three aspects: patient and AED user attributes, and AED clinical performance.Results:After field application of AED analysis, 54 patients did not have out of hospital cardiac arrest in 9 patients; cardiac arrest in 45 patients, cerebral resuscitation in 40 patients (88.9%), death in 5 patients (11.1%), one of them died in hospital. The accuracy of AED for defibrillation rhythm recognition and defibrillation recommendations was 100%. The success rate of shock to VF was 97.22%, and that of non pulse VT was 100%. The data shows that AEDs of different brands show clinical effectiveness in the core indicators of work. The operation level of the rescuer determines the critical time of AED shock, which is closely related to the prognosis of the patient ( P<0.05) . Conclusions:AED is reliable and effective in electric shock decision and performance.The overall efficiency of AED application can be improved by strengthening training, shortening the critical time of electric shock, rational configuration and effective management.

Objective:To analyze consistency between histopathological and reflectance confocal microscopy (RCM) characteristics of early-stage mycosis fungoides (MF) , and to evaluate the value of RCM in assisting the pathological diagnosis of early-stage MF and the feasibility of dynamic monitoring of treatment response with RCM.Methods:From January 2014 to January 2018, 40 cases of clinically suspected MF were collected from Department of Dermatology, Third People′s Hospital of Hangzhou, including 26 males and 14 females, and their age was 47.0 ± 17.6 years. According to the summarized RCM characteristics of early-stage MF, biopsy sites were preliminarily located, and then a histopathological examination was performed. The RCM and pathological features of MF were compared. In addition, a combination therapy with narrowband ultraviolet B and interferon was performed in patients with confirmed MF. Targeted lesions were followed up with RCM for 9 months, and then therapeutic efficacy was evaluated.Results:Among the 40 cases of clinically suspected MF, 8 were preliminarily diagnosed as typical MF, 18 as suspected MF, and 14 were excluded according to the RCM characteristics; according to the pathological features, 12 could be diagnosed as typical MF, 14 as suspected MF, and 14 were excluded. Consistency analysis showed that the kappa coefficient between RCM classification and pathological diagnosis was 0.848 ( P < 0.01) . The consistency of epidermal infiltration of mildly refractive cells was the highest between RCM and pathological findings (kappa coefficient = 1, P = 0.005) , followed by dermal fibrosis at the erythema stage (kappa coefficient = 0.714, P = 0.035) . The RCM characteristics of MF gradually returned to normal during treatment, but atypical lymphocytes still existed when clinical lesions completely regressed. Conclusion:RCM can be used for pathological localization of suspected MF lesions in the early stage, and for dynamic monitoring of therapeutic efficacy in MF.

Objective To determine the expression of ubiquitin-conjugating enzyme E2S (UBE2S) in malignant melanoma (MM),and to evaluate its effect on the biological behavior of melanoma cells.Methods Immunohistochemical study was performed to determine the UBE2S expression in 128 primary MM tissue chips,64 metastatic MM tissue chips,16 non-tumor tissue chips (8 paralesional normal skin tissues and 8 normal epidermal tissues).Real-time quantitative RCR was conducted to determine the UBE2S mRNA expression in the melanoma cell lines A375,MUM-2B and MUM-2C.The melanoma cell lines A375 and MUM-2B were divided into 2 groups separately:interference group transfected with a lentiviral vector carrying UBE2S RNA interference sequence,and control group transfected with a lentiviral vector carrying control sequence.After 72 hours,real-time quantitative RCR was performed to determine the UBE2S mRNA expression in the melanoma cell lines A375 and MUM-2B.Caspase-3/7 activity in the groups was assessed by using kits,and cell apoptosis and cell cycle distribution were detected by flow cytometry.The effect of UBE2S knockdown on the migratory and invasive abilities of and N-cadherin expression in A375 cells were evaluated by Transwell assay and Western blot analysis respectively.Statistical analysis was carried out with SPSS 22.0 software by using independent sample t-test for the comparison of normally distributed data between two groups,chi-square test for enumeration data,MannWhitney U test for the comparison of non-normally distributed data,and Spearman's coefficient for assessment of the correlation of UBE2S expression with T staging of melanoma.Results UBE2S was highly expressed in 98 (51.0％) MM tissues,but lowly expressed in 16 non-tumor tissues,and the UBE2Sexpression rate significantly differed between the above two kinds of tissues (x2 =11.905,P ＜ 0.01).UBE2S expression was negatively correlated with T staging of melanoma (ρ =-0.210,P =0.043).The relative mRNA expression of UBE2S significantly differed among the A375,MUM-2B,and MUM-2C cells (F =817.228,P ＜ 0.01).After UBE2S knockdown,the caspase-3/7 activity was significantly up-regulated in the A375 interference group (t =17.572,P ＜ 0.01) and MUM-2B interference group (t =24.552,P ＜0.01) compared with the A375 and MUM-2B control groups respectively.Compared with the control group,the A375 interference group showed significantly increased proportion of A375 cells at G1 phase (t =7.365,P ＜ 0.01),decreased proportion at S phase (t =-9.190,P ＜ 0.01),and no change in the proportion of A375 cells at G2/M phase (t =-0.227,P ＞ 0.05).The MUM-2B interference group showed significantly increased proportions of MUM-2B cells at G1 (t =12.676,P ＜ 0.01) and G2/M phases (t =13.045,P ＜0.01),but significantly decreased proportion at S phase (t =-15.718,P ＜ 0.01) compared with the control group.Transwell assay revealed decreased migratory and invasive abilities of A375 cells in the interference group compared with the control group (t =-35.727,-125.000,P ＜ 0.05,＜ 0.01,respectively).Western blot analysis showed down-regulated expression of N-cadherin protein in A375 cells in the interference group compared with the control group.Conclusions UBE2S is over-expressed in melanoma tissues,whose expression is associated with the T staging of melanoma.Knockdown of UBE2S affects the apoptosis,cell cycle,migration and invasion of melanoma cells,and may promote the metastasis of MM cells by regulating N-cadherin expression.

Objective To investigate the effect of micro-incision phacoemul-sification on cataract patients and its effect on interleukin (IL)-6, tumor necrosis factor-α (TNF-α), and epidermal growth factor (EGF) expressions in cataract patients.Methods With forward-looking research, 284 cataract patients were randomly included in the control (coaxial conventional incision phacoemulsification) or observation (coaxial micro-incision phacoemulsification) groups, with 142 cases per group.The effective phacoemulsification time and mean ultrasonic energy difference were compared between two groups, and the uncorrected vision recovery, Ocular Surface Disease Index (OSDI), tear break-up time (BUT), schirmer I test (SIt), corneal fluorescence stain (FL), and the expressionsIL-6, TNF-α and EGF were measured in two groups on preoperative (T0), 1 week after operation (T1), 2 weeks after operation (T2), 4 weeks after operation (T3), and the above indicators of Spearman correlation analysis.Results There was no significant difference in effective phacoemulsification time and mean ultrasonic energy between two groups (P ＞ 0.05).The improvement of uncorrected visual acuity in observation group was significantly better than that in the control group (F=6.116, P =0.032).In addition, OSDI, FL,IL-6,TNF-α, and EGF showed the first increase and then decreased at different time points, and the observation group was superior to the control group with statistically significant difference.At the same time, BUT and SIt showed a trend of increasing first and then decreased, and the observation group was superior to the control group with statistically significant difference.In addition, IL-6, TNF-α, and EGF expressions were positively correlated with OSDI and FL scores (P ＞ 0.05).Conclusions Micro-incision phacoemulsification can help reduce the expressions of IL-6 and TNF-α, improve the expression levels of EGF in cataract patients, and reduce the incidence of adverse symptoms such as dry eye after operation.It might improve the clinical therapeutic effect.

Objective:To study the effects of insulin and berberine on osseointegration of titanium implant in type Ⅱ diabetic rats.Methods:10 out of 53 SD rats were randomly selected and selected into H group(healthy group)(n =10).The remaining rats were treated with high glucose diet plus low dose of streptozotocin(STZ) and 40 rats were induced into the models of type Ⅱ diabeties.The 40 dibetic rats were randomly divided into group B(berberine),group Ⅰ(insulin),group IB(insulin + berberine) and group N(without treatment).2 pure titanium implants were implanted into the bilateral femoral metaphysis of each rat.Mter 7,32,38,66 and 101 d,the body weight(BW) and fasting blood glucose(GLU) were measured.After 10 week,the rats were sacrifice,femoral metaphysis samples were subjected to Micro-CT scan,VG staining and implant pull-out test.Hard tissue slices were observed;bone volume fraction(BV/TV),Liang Houdu (Tb.Th),trabecular bone trabecular number(Tb.N),Liang Jianxi (Tb.Sp),trabecular bone trabecular bone volume (TBV),bone contact ratio(BIC) and the maximum pull-out strength (MPF) were measured.Results:There was no significant difference of BW and GLU between IB group and H group(P ＞ 0.05),but the BW and GLU of IB group was better than those of Ⅰ group and B group,Ⅰ group and B group were better than those of group N (P ＜ 0.05).BV/TV,Tb.Th,Tb.N,Tb.Sp,TBV,BIC and MPF of IB group were not statistically different from those of H group(P ＞0.05);but the indexes of IB group were higher than those of Ⅰ group and B group,those of Ⅰ group and B group were higher than those of N group (P ＜ 0.05).Conclusion:The combination of insulin and berberine can effectively reduce blood glucose and can promote osseointegration of titanium implants in type Ⅱ diabetic rats.

Objective To explore the effect of contract learning on rehabilitation training to patients with stroke . Methods According to the random number table, 120 stroke patients were randomly divided in equal number into control group and observation group. The patients in the control group were treated with conventional nursing during hospitalization and health guidance during follow-up. The patients in the observation group were given rehabilitation training according to contracted learning during the period of hospitalization and follow-up. The time was 6 months. The quality of life was compared between the two groups of patients before and after the intervention, 1 months after discharge, 6 months after discharge. Results After six months of intervention, the 7 dimensions of quality of life, including daily life ability, hand function, mobility, strength, emotion, communication and participation in the intervention group were significantly better than those of the control group (P<0.001). The 6 dimensions of quality of life, including daily life ability, hand function, mobility, strength, emotion, and communication of the control group were significantly better than before the intervention (P<0.001). Conclusion For stroke patients, the rehabilitation training under the learning contract can improve the effect of rehabilitation training so as to improve the quality of life and the prognosis.

OBJECTIVETo investigate the epidemiological characteristics of lymphoma in Jiangsu province.

METHODSA total of 5 147 consecutive lymphoma samples collected from 18 hospitals in Jiangsu province from January 2007 to December 2013 and diagnosed according to the WHO classification were enrolled in this study. Basic epidemiological information including age, gender and lymphoma subtypes was analyzed.

RESULTSThe median age of all lymphoma cases was 59(2-96) years, and gender ratio (M/F) was 1.6:1. The subtypes distribution analysis revealed that Hodgkin lymphoma (HL) accounted for 5.19% (n=241), whereas non-Hodgkin's lymphoma (NHL) accounted for 94.81% (n=4 400). Further analysis displayed B-NHL formed 75.44% (n=3 501) of all cases and T/NK-NHL 16.51% (n=766), diffuse large B-cell lymphoma and NK/T-cell lymphoma were the major subtypes of B-NHL and T/NK-NHL (53.50%, 1 873/3 501 and 31.85%, 244/766), respectively.

CONCLUSIONUnique epidemiological characteristics of lymphoma in Jiangsu province was different from other regions in China and western country, which can provide strong theoretical basis for public health, clinical and basic research.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Lymphoma ; classification ; epidemiology ; pathology ; Male ; Middle Aged ; World Health Organization