Objective:To establish and evaluate a nomogram for long-term survival of patients with intrahepatic cholangiocarcinoma (ICC) after radical resection.Methods:The data of ICC patients who underwent radical resection for the first time at Zhongshan Hospital, Fudan University from January 2014 to December 2017 were retrospectively analyzed. Of 167 patients who were enrolled, there were 104 males and 63 females, with the age of (60.3±10.9) years. Tumor tissues were collected for immunohistochemical staining and interpretation. Univariate Cox regression, LASSO regression and multivariate Cox regression were used to analyze influencing factors of postoperative long-term survival after ICC. R software was used to construct a nomogram in predicting ICC prognosis.Results:Cox regression analysis showed that TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression to be independent risk factors associated with poor long-term survival after radical resection. The prognostic nomogram model of ICC was constructed based on these factors. The C-index was 0.821. The nomogram model consistency index had a high degree of prognostic differentiation. The 45° diagonal of the 3-year postoperative calibration curve which represented the actual survival fitted well with the segmented line which represented the predicted survival of the nomogram. The area under the receiver operating characteristic curve of the nomogram model was higher than that of AJCC TNM staging (0.894 vs. 0.803, z=4.10, P<0.001). The nomogram model was more effective in predicting postoperative survival of ICC patients than the TNM staging. Conclusion:TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression were independent risk factors for postoperative survival of ICC. The nomogram model could better evaluate long-term prognosis of ICC patients after radical resection than the traditional TNM staging system.

In this study, the virtual simulation tutoring system was applied to the teaching of dental residents in the standardized training stage for the first time, including the curriculum preparation, curriculum design and teaching practice. Through the practice of the preparation of class Ⅱ holes and the tooth preparation of PFM (porcelain fused to metal) by the dental residents in the virtual simulation teaching system, the teaching arrangement of three courses as one term was explored. Each course adopted the matching interactive teaching mode. Finally, the transcripts would be given by the virtual simulation teaching system to comment and summarize. This study has laid a foundation for future promotion of virtual simulation teaching system in the standardized training stage of stomatology residents and found a new direction for improving the proficiency and accuracy of residents' clinical operation skills.

Prostate cancer (PCa) patients who progress to metastatic castration-resistant PCa (mCRPC) mostly have poor outcomes due to the lack of effective therapies. Our recent study established the orphan nuclear receptor ROR

In February 2018, one 54-year-old male patient with severe scald complicated with pneumonia and sepsis was transferred to Qingdao Municipal Hospital from other hospital. Drugs including cephalosporin, vancomycin, and imipenem/cilastatin combined with ciprofloxacin were used successively for anti-infective treatment, with no obvious effect. Multiple bacterial culture results of sputum, blood, and wound exudate showed infection of extensively drug resistant Pseudomonas aeruginosa. On the 4th day of admission, the anti-infective treatment plan was adjusted, and plasma, red blood cell, and albumin were supplemented and nutritional support and symptomatic treatment were performed. At the same time, medication and drug-related adverse reaction were monitored. After treatment for more than 10 days, infection of the patient was effectively controlled and the condition gradually improved. The case suggests that severely burned patients are prone to have serious and fatal systemic infection, irregular use of antibiotics increases the risk of infection of extensively drug resistant bacteria, clear anti-infection idea and effective application of antibacterial drug can help to improve the success rate of infection treatment and are of important value in improving the prognosis of patients with severe burn.

Objective: To explore the relationship among osteopontin(OPN), Interleukin-17A(IL-17A), anti-MBP auto-antibody and autism spectrum disorder(ASD), and to provide the theoretical basis for the etiology and pathogenesis of ASD. Methods: Forty autistic children and forty matched healthy children were enrolled in this case-control study. The levels of OPN, IL-17A, anti-MBP autoantibody in serum were measured by enzyme-linked immunosorbent assay (ELISA). The associations between those metabolic levels and the severity and intelligence of ASD children were performed by Pearson or Spearman correlation. Results: Children with ASD had higher serum levels of OPN, IL-17A [(296.89±162.95),0.93] pg/mL compared to healthy control[(217.98±113.39), 0.62] pg/mL(P<0.05). Serum OPN, IL-17A, and anti-MBP auto-antibody levels in ASD group were not correlated with the scores of ABC, CARS, and PPVT(P>0.05). However, anti-MBP auto-antibodies level in children with ASD were positively correlated with OPN and IL-17A levels, respectively(r=0.35, 0.34, P<0.05). Conclusion It was obvious that the ASD children were found with neuroimmunologic abnormality, and the underlying mechanism needs to be further explored.

Objective: To investigate the level of human blood basic fibroblast growth factor (FGF2) among children with autism spectrum disorder (ASD) and its correlation with behavioral phenotypes, to provide a reference for etiological research of ASD. Methods: ASD Children were selected to get rehabitation training in reseach center of children development behavior in Harbin Medical University and the rehabitation constitution for ASD disabilities in Heilongjiang, 40 children were induded as ASD group, 41 healthy children in Harbin kindergarten was classified as control group. The Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS) and Peabody Picture Vocabulary Test (PPVT) were used to assess the severity and intelligence of ASD children, respectively. Results: No difference was found in FGF2 level between ASD children (4.95 pg/mL) and normal children(8.51 pg/mL)（P>0.05). However, difference in FGF2 level between the two groups were found in 4-year-old group(P<0.05). The level of FGF2 differed across different severity and intelligence of ASD children(P<0.05). Conclusion Abnormal levels of FGF2 in ASD children may correlate with severity of autistic traits and intelligence of children.

Objective To analyze the prevalence and risk factors of anemia in a general population in Kailuan.Methods Working and retired employees m Kailuan Company who had participated in biennial physical examination from 2006-2014 were investigated by questionnaire and blood test.Hemoglobin levels＜ 120 g/L in male and＜ 110 g/L in female are defined as anemia.The trend of prevalence of anemia was analyzed by chi square test.Multivariable logistic regression was used to analyze the factors associated with anemia.Results (1) The biennial prevalence of anemia in Kailuan during 2006-2014 were 3.7％,3.1％,2.4％,1.3％,1.5％.The corresponding proportion were 3.3％,2.3％,1.9％,0.8％,1.0％ in males and 5.3％,5.9％,4.2％,3.1％ and 3.3％ in females,respectively.The differences between males and females were statistically significant (all P＜0.05).The prevalence of anemia declined over time (P for trend＜0.05).(2) The results of multivariable logistic regression showed that aging and elevated hs-CRP were positively associated with anemia,with OR=1.01 (95％CI 1.01-1.02)and 1.03 (95％CI 1.02-1.03),respectively.While male,BMI,physical exercise,smoking,hyperlipidemia were negatively associated with anemia with OR=0.60(95％CI 0.55-0.65),0.99 (95％CI 0.98-0.99),0.91 (95％CI 0.82-0.98),0.87 (95％CI 0.81-0.95)and 0.87(95％CI0.81-0.94),respectively.Conclusions The prevalence of anemia in a large general population in Kailuan has been analyzed.Prevalence of anemia is higher in males than females and declines over time.Several demographic and clinical characteristics are associated with anemia.

OBJECTIVE:To compare the effects of dezocine and nalbuphine on patient-controlled intravenous analgesia(PCIA) in patients undergoing cesarean section. METHODS:A total of 97 patients undergoing selective cesarean section were selected from our hospital during Jun. 2015 to Mar. 2017. They were divided into dezocine group(52 cases)and nalbuphine group(45 cases) according to lottery. Both groups received cesarean section under combined spinal-epidural anesthesia,and then given PCIA pump immediately after surgery. The pump of dezocine group was Dezocine injection 0.5 mg/kg+Tropisetron hydrochloride injection 10 mg;that of nalbuphine group was Nalbuphine hydrochloride injection 2 mg/kg+Tropisetron hydrochloride injection 10 mg. Both groups of analgesic drugs were diluted 100 mL with 0.9% sodium chloride injection,constant infusion of liquid medicine at rate of 2 mL/h,adding 0.5 mL additionally each time,for consecutive 48 h. VAS score and Ramsay sedation score of resting pain, dynamic pain and uterine contraction pain were performed in 2 groups 4,8,12,24,48 h after surgery. The serum levels of PRL were determined 30 min before surgery and 24,48 h after surgery. The initial time of lactation and ADR were recorded in 2 groups. RESULTS:VAS score of resting pain and uterine contraction pain at 4,8,12 h after operation and that of dynamic pain at 4,8,12, 24 h after operation were significantly lower in dezocine group than nalbuphine group,with statistical significance (P＜0.05). There was no statistical significance in VAS score between 2 groups at other time points(P＞0.05). As time went on,the VAS scores of the two groups decreased significantly at each time point,and the difference was statistically significant(P＜0.05). The serum levels of PRL in 2 groups 24 and 48 h after operation were significantly higher than 30 min before operation,with statistical significance(P＜0.05). There was no statistical significance in serum level of PRL between 2 groups at same time point(P＞0.05). There was no statistical significance in Ramsay score, initial time of lactation or the incidence of ADR between dezocine group and nalbuphine group (P＞0.05). CONCLUSIONS:Both dezocine and nalbuphine are effective analgesia drugs of PCIA in patients undergoing cesarean section. Early postoperative analgesic effect of dezocine is superior to nalbuphine. They have similar effects on long-term analgesia and postoperative sedative,serum level of PRL,initial time of lactation,as well as safety.

Objective: To identify the prevalence of sleep problems in children with autism spectrum disorder (ASD) and to explore the association with the main melatonin metabolite, 6-sulfatoxymelatonin (6-SM). Method: This was a prospective case-control study. Children with ASD were recruited from Child Development and Behavioral Research Center (CDBRC) of the Harbin Medical University and Harbin Special Education School from October 2015 to April 2017 (ASD group) . Healthy controls were selected from five kindergartens and one primary school in Harbin by the stratified cluster random sampling (control group) . The Children's Sleep Habits Questionnaire (CSHQ) was used to investigate the sleep problems of the two groups. The patients were matched in a 1∶1 ratio for the age and sex, and the urine samples of case-control pairs were collected in the morning. The level of 6-SM was measured by the enzyme linked immunosorbent assay (ELISA). The student's t test was used for comparison between the ASD group and control group, and the Pearson correlation analysis was used to determine the correlation difference. Result: A total of 212 ASD children (mean (±SD) age was (6.0±2.7) years, and 181 patients (85.4%) were male), and a total of 334 healthy children(mean (±SD) age was (5.9±2.6) years, and 272 patients (81.4%) were male) were recruited. Among them, 101 matched case-control pairs completed the collection of urine samples. According to the statistical analysis, the scores of total CSHQ, bedtime resistance, sleep onset delay, sleep duration, night waking, parasomnia, sleep disordered breathing and daytime sleepiness in children with ASD were significantly higher than those in the control group (48.2±6.2 vs. 46.6±5.4, 11.4±2.5 vs. 10.7±2.8, 1.7±0.8 vs. 1.5±0.7, 4.1±1.4 vs. 3.7±1.1, 4.2±1.5 vs. 3.8±1.1, 8.5±1.5 vs. 8.3±1.4, 3.7±1.0 vs. 3.4±0.8, 11.7±2.5 vs. 12.4±2.7, t=3.16, 3.00, 3.23, 2.76, 3.19, 1.99, 3.45,-2.72, P=0.002, 0.003, 0.001, 0.006, 0.002, 0.048, 0.001, 0.007), the level of 6-SM was significantly lower in children with ASD than that of healthy controls ((1.24±0.50) vs. (1.68±0.63)μg/h, t=-5.50, P<0.01), and the total CSHQ score was negatively correlated with the level of 6-SM (r=-0.50, P<0.01). Conclusion The children with ASD were at high risk for sleep problems, and the melatonin metabolite of ASD group was abnormal compared with that of the control group. Moreover, there was a negative correlation between the severity of sleep problems and the level of 6-SM in ASD children. The results of our study indicate that the abnormal melatonin metabolism may be one of the causes of sleep problems in children with ASD.

OBJECTIVE:To explore hospital pharmacists service mode and the subject construction of hospital pharmacy. ME-THODS:Through reviewing the transformation process of hospital pharmacy and pharmacist's duty,the present structure,con-tent,working model and achievements of pharmacy in our hospital were introduced based onlarge pharmacyof taking clinical pharmacy as core,paying attention to personnel training,technical innovation,physican,pharmacist and nurse cooperation,multi-ple discipline integration,etc.;the direction of hospital pharmacy was explored. RESULTS:Many adjustments were made to facili-tate the smooth and orderly development of hospital pharmacy under the new situation,as that establish the rational drug use and quality safety system,drug supply and operation management system working mode;that the development strategy of pharmacy was identified asfocusing on the rational drug use,combining the management functionandproviding professional pharmaceuti-cal care for the clinic and patients,providing professional technical support for the hospital decision and medical management;that the construction of clinical pharmacy specialty/key discipline and drug clinical trial technology platform in accordance with the international standard and so on were lined in the project of pharmacy;that quality control circle was cited,pharmaceutical supervi-sion and pharmaceutical care were expanded to the public and the fine;that a fine,professional pharmacist team was cultured. CONCLUSIONS:The construction of future hospital pharmacy needs the concept oflarge pharmacywith multi-disciplinary inte-gration to develop towards standardization,refinement,specialization and modernization.