Objective To explore the advantages and safety of laparoscopic operation compared with open surgery for the treatment of acute appendicitis in pregnancy.Methods The clinical data of 22 patients with early,middle and late pregnancy acute appendicitis from November 2004 to April 2023 were retrospectively analyzed.They were divided into laparoscopic operation group(n=9)and open group(n=13)according to the operation method.The infection indicators and fetal outcome indicators were compared between the two groups.Results Comparison of hospitalization time,intraoperative bleeding,drain placement rate,C-reactive protein,procalcitonin,antibiotic use time,incision infection rate,abdominal infection rate,fertility preservation treatment time,pathological manifestations,preterm delivery rate,delivery mode,fetal survival rate between the two groups,the differences were not statistically significant(P＞0.05);the operation time of laparoscopic group was longer than that of open group,postoperative analgesic use time,postoperative time of first feeding and postoperative anal defecation time were shorter than those of open group,postoperative leukocyte count was lower than that of open group,the differences were all statistically significant(P＜0.05),and anesthesia mode was statistically significant(P＜0.05).Conclusion Laparoscopic surgery is safe and feasible for the treatment of appendicitis in pregnancy.Compared with laparotomy,it has the advantages of small incision,beautiful incision,fast intestinal recovery,early feeding,less infection,good maternal-fetal outcome and high fetal safety.

Objective:To prepare a recombinant hemagglutinin trimer (HA-Tri) vaccine against influenza viruses and to study its immunogenicity in a mouse model.Methods:A stable CHO cell line that could express HA-Tri was constructed. Western blot, single radial immunodiffusion, protein particle size detection and N-glycosylation site analysis were performed for qualitative and quantitative analysis of the recombinant protein. According to the different treatment conditions such as dosage and adjuvant, BALB/c mice were divided into 11 groups and subjected to consistent immunization procedures. Serum neutralizing antibody titers were measured on 56 d after the first immunization to evaluate the immunogenicity of HA-Tri.Results:The constructed CHO cells could secret and express HA-Tri proteins. The HA-Tri proteins were biologically active and capable of forming precipitation rings in the single radial immunodiffusion. The particle size of HA-Tri was approximately 18.79 nm and 10 N-glycosylation sites were detected, including high mannose, complex glycoforms and heterozygous glycoforms. After prime-boost immunization, there was no statistically significant difference in the titers of neutralizing antibodies induced in mice by 3.75 μg of HA-Tri in combination with RFH01 adjuvant and 15 μg of monovalent vaccine stock solution ( P=0.431 2, U=36). Serum antibody titers in the HA-Tri+ RFH01 groups were higher than those in the corresponding HA-Tri groups without RFH01 adjuvant, and the highest titer was induced in the 15 μg HA-Tri+ RFH01 group, which was 1 280. Conclusions:The recombinant HA-Tri protein was successfully prepared. HA-Tri in combination with RFH01 adjuvant could induce humoral immune responses against influenza viruses in BALB/c mice, which would provide reference for the development of influenza virus recombinant subunit vaccines.

Objective:To evaluate the immunogenicity of a quadrivalent subunit vaccine combined with RFH01 adjuvant in a mouse model.Methods:Identification tests were performed on four monovalent influenza virus subunit vaccine stock solutions according to the methods described in Part 3 of the Chinese Pharmacopoeia 2020 Edition. In the study of the quadrivalent subunit vaccine combined with RFH01 adjuvant, 460 female BALB/c mice (6-8 weeks old) were randomly divided into 46 groups including experimental groups, vaccine control group, negative control group and blank group with 10 mice in each group. In the study of the quadrivalent subunit vaccine in old and young mice, 80 female 10-month-old and 80 female 10-week-old BALB/c mice were randomly divided into 16 groups ( n=10) including monovalent influenza virus vaccine group, quadrivalent subunit vaccine group, quadrivalent subunit vaccine+ RFH01 adjuvant group, chicken embryo quadrivalent split vaccine control group and PBS group. All mice were immunized by intramuscular injection. At 21 d after the primary immunization, a booster immunization was conducted using the same strategy. Blood samples were collected at 21 d and 42 d after the primary immunization for serum separation. Haemagglutination inhibition (HI) test was performed to detect the antibody levels in mouse serum samples. Results:After the booster immunization, the positive conversion rates in all vaccine+ RFH01 adjuvant groups reached 100%, and the geometric mean titers (GMTs) of serum antibodies were significantly higher than those of the vaccine groups without RFH01 adjuvant. There were significant differences in serum antibody titers between the monovalent/quadrivalent subunit vaccine groups with and without RFH01 adjuvant. After the booster immunization, the titers of serum antibodies against H1N1, H3N2, B/Victoria and B/Yamagata in the 10-week-old mice were significantly higher than those in the 10-month-old mice.Conclusions:The monovalent and quadrivalent influenza virus vaccines in combination with RFH01 adjuvant could elicit higher antibody titers in young (6-10 weeks old) and old (10 months old) mice, showing good immunogenicity.

Objective:To explore the mediating effect of social support and exercise self-efficacy on the intrinsic capacity of community-dwelling older adults and healthy aging, so to provide a basis for improving the healthy aging of community-dwelling older adults.Methods:From January to July 2022, cluster random sampling was used to select 1 303 community-dwelling older adults from Urumqi City as the research subject. The survey was conducted using the General Information Questionnaire, Healthy Aging Instrument, Intrinsic Capacity Questionnaire, Social Support Rating Scale, and Exercise Self Efficacy Scale for Aged People in Community. The conceptual model was used to explore the relationship among social support, exercise self-efficacy, intrinsic capacity, and healthy aging in community-dwelling older adults. A total of 1 303 questionnaires were distributed, and 1 042 valid questionnaires were collected, with an effective response rate of 80%.Results:Among 1 042 community-dwelling older adults, the scores of the Intrinsic Capacity Questionnaire, Healthy Aging Instrument, Social Support Rating Scale, and Exercise Self Efficacy Scale for Aged People in Community were [1.00 (0, 2.00) ] , [146.00 (133.75, 155.00) ] , [41.00 (36.00, 46.00) ] and [51.00 (39.00, 61.00) ] , respectively. The intrinsic capacity of community-dwelling older adults was negatively correlated with social support, exercise self-efficacy, and healthy aging ( r=-0.112, -0.121, -0.120, P<0.01) , and social support and exercise self-efficacy were positively correlated with healthy aging (r=0.129, 0.113, P<0.01) . Bootstrap mediating effect test showed that the mediating effect of social support and exercise self-efficacy between the intrinsic capacity of community-dwelling older adults and healthy aging was established, with a mediating effect value of -0.477, accounting for 24.75% of the total effect. The path effect value of intrinsic capacity→ social support→ healthy aging was -0.262, accounting for 54.93% of the mediating effect value. The path effect value of intrinsic capacity → exercise self-efficacy→ healthy aging was -0.214, accounting for 44.86% of the mediating effect value. Conclusions:In the community elderly population, social support and exercise self-efficacy can play a mediating role between intrinsic capacity and healthy aging. Community health care providers should pay attention to the internal capacity of the older adults, improve social support and exercise self-efficacy, and thus promote the realization of healthy aging of the older adults.

Objective:To express the head domain of influenza A virus hemagglutinin (HA) in a prokaryotic expression system and to evaluate its immunogenicity.Methods:The genes encoding the HA head domains of H1N1 and H3N2 influenza viruses were cloned into pET-22b(+ ) prokaryotic expression plasmid. After the induction with IPTG, the fusion proteins rH1N1-HA and rH3N2-HA containing HA head domain and His-tag were expressed and obtained from E. coli BL21. SDS-PAGE and Western blot was used to verify the expression of the recombinant proteins. Rabbits were immunized with multiple doses of the purified recombinant proteins to obtain polyclonal antibodies against the HA head domains of H1N1 and H3N2. The immunogenicity of the recombinant proteins was evaluated in BALB/c mice. Results:rH1N1-HA and rH3N2-HA induced protective antibodies (geometric mean titer ≥40) in mice and could be used as protective antigens. Polyclonal antibodies against rH1N1-HA and rH3N2-HA could be used as important materials for Western blot, ELISA and other immunological assays.Conclusions:The HA head domains prepared in this study could be used as protective antigens to induce protective antibodies in mice. Polyclonal antibodies against the HA head domains could be used for immunological and serological studies of influenza A viruses.

Objective:To explore the impact of mentors' behaviors on the professional identity of medical students during the internship.Methods:Based on the data of the China Medical Students Survey in 2020, a research was conducted on 25 557 medical graduates from 104 universities in China. The Wilcoxon rank-sum test and multiple linear regression were used to analyze the impact of mentors' behaviors on the professional identity of medical students during the internship.Results:More than 70% of medical students believed that the clinical mentors they met during their internship had positive medical and teaching behaviors. If students believed that clinical mentors were enthusiastic, responsible for their work, highlighted role modeling and paid attention to their behaviors in teaching, the scores of professional identity would be 3.027, 0.445, 0.840 and 1.234 points greater than if they did not respectively (all P<0.001). Conclusion:The students have generally good evaluation on mentors' behavior during the internship. The positive medical and teaching behaviors of mentors have a positive impact on the professional identity of medical students and the impact of enthusiasm is the greatest. Medical institutions should provide complete institutional support and standardize the behavior of clinical teachers in order to enhance the professional identity of medical students.

Objective: To investigate the clinical effects of first generation epithelial growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) compared with platinum-based chemotherapy as first-line therapy in advanced lung adenocarcinoma patients with uncommon EGFR mutations. Methods: Clinical data of 4 276 patients diagnosed as advanced lung adenocarcinoma (ⅢB/Ⅳ) underwent EGFR gene detection at the Affiliated Cancer Hospital of Zhengzhou University from January 2012 to February 2018 were collected and 99 cases with uncommon EGFR mutations were selected. The clinical pathological features, treatment outcomes, treatment options and prognosis after first-line treatment of the 99 cases were analysed and compared with other patients with common EGFR mutations. Results: The objective response rates of patients with uncommon EGFR mutations receiving EGFR-TKIs or platinum-based chemotherapy were 33.0% and 27.1%, respectively. The disease control rates were 76.5% and 87.5%, respectively. The progression-free survival (PFS) of patients treated with EGFR-TKIs was 7.2 months, significantly superior than 4.9 months of patients receiving chemotherapy (P=0.009). The overall survival of patients treated with EGFR-TKIs was 14.3 months, significantly worse than 20.7 months of patients receiving chemotherapy (P=0.034). Multivariate analysis showed that distant metastases (P=0.001) and smoking history (P=0.013) were independent prognostic factors for OS of lung adenocarcinoma patients with EGFR uncommon mutations. Conclusions Compared with chemotherapy, the usage of first generation of EGFR-TKIs as first-line therapy can improve the short-term efficacy of advanced lung adenocarcinoma patients with EGFR uncommon mutations. However, platinum-based chemotherapy shows a longer overall survival.

Objective To investigate the clinical effects of first generation epithelial growth factor receptor tyrosine kinase inhibitors ( EGFR?TKIs) compared with platinum?based chemotherapy as first?line therapy in advanced lung adenocarcinoma patients with uncommon EGFR mutations. Methods Clinical data of 4 276 patients diagnosed as advanced lung adenocarcinoma (ⅢB／Ⅳ) underwent EGFR gene detection at the Affiliated Cancer Hospital of Zhengzhou University from January 2012 to February 2018 were collected and 99 cases with uncommon EGFR mutations were selected. The clinical pathological features, treatment outcomes, treatment options and prognosis after first?line treatment of the 99 cases were analysed and compared with other patients with common EGFR mutations. Results The objective response rates of patients with uncommon EGFR mutations receiving EGFR?TKIs or platinum?based chemotherapy were 33.0%and 27.1%, respectively. The disease control rates were 76.5% and 87.5%, respectively. The progression?free survival (PFS) of patients treated with EGFR?TKIs was 7.2 months, significantly superior than 4.9 months of patients receiving chemotherapy (P＝0.009). The overall survival of patients treated with EGFR?TKIs was 14.3 months, significantly worse than 20.7 months of patients receiving chemotherapy (P＝0.034). Multivariate analysis showed that distant metastases ( P＝0.001) and smoking history ( P＝0.013) were independent prognostic factors for OS of lung adenocarcinoma patients with EGFR uncommon mutations. Conclusions Compared with chemotherapy, the usage of first generation of EGFR?TKIs as first?line therapy can improve the short?term efficacy of advanced lung adenocarcinoma patients with EGFR uncommon mutations. However, platinum?based chemotherapy shows a longer overall survival.

Objective To investigate the clinical effects of first generation epithelial growth factor receptor tyrosine kinase inhibitors ( EGFR?TKIs) compared with platinum?based chemotherapy as first?line therapy in advanced lung adenocarcinoma patients with uncommon EGFR mutations. Methods Clinical data of 4 276 patients diagnosed as advanced lung adenocarcinoma (ⅢB／Ⅳ) underwent EGFR gene detection at the Affiliated Cancer Hospital of Zhengzhou University from January 2012 to February 2018 were collected and 99 cases with uncommon EGFR mutations were selected. The clinical pathological features, treatment outcomes, treatment options and prognosis after first?line treatment of the 99 cases were analysed and compared with other patients with common EGFR mutations. Results The objective response rates of patients with uncommon EGFR mutations receiving EGFR?TKIs or platinum?based chemotherapy were 33.0%and 27.1%, respectively. The disease control rates were 76.5% and 87.5%, respectively. The progression?free survival (PFS) of patients treated with EGFR?TKIs was 7.2 months, significantly superior than 4.9 months of patients receiving chemotherapy (P＝0.009). The overall survival of patients treated with EGFR?TKIs was 14.3 months, significantly worse than 20.7 months of patients receiving chemotherapy (P＝0.034). Multivariate analysis showed that distant metastases ( P＝0.001) and smoking history ( P＝0.013) were independent prognostic factors for OS of lung adenocarcinoma patients with EGFR uncommon mutations. Conclusions Compared with chemotherapy, the usage of first generation of EGFR?TKIs as first?line therapy can improve the short?term efficacy of advanced lung adenocarcinoma patients with EGFR uncommon mutations. However, platinum?based chemotherapy shows a longer overall survival.

BACKGROUND: Bevacizumab combined with platinum-based chemotherapy has been recommended as the first-line agent in advanced nonsquamous non-small cell lung cancer (NSCLC) without driven gene, but this regimen is not common in the second-line or later-line treatment of non-squamous NSCLC. The aim of this study is to investigate the efficacy and safety of bevacizumab combined with chemotherapy as second-line or later-line treatment in advanced non-squamous NSCLC. METHODS: We retrospectively reviewed the clinical data of advanced nonsquamous NSCLC patients who were treated with bevacizumab after first-line treatment failure and they were hospitalized in the Affiliated Cancer Hospital of Zhengzhou University from January 2014 to June 2017, and Kaplan-Meier method, Log-rank test and Cox model were used for analysis. RESULTS: A total of 62 patients were included in the analysis. The total objective response rate (ORR) was 32.2%, and the disease control rate (DCR) was 96.8%. The median progression-free survival (PFS) was 6.4 months (95%CI: 6.05-6.83), and the median overall survival (OS) was 20.4 months (95%CI: 12.98-27.76). In the subgroup analysis, there was no significant difference in median PFS between patients with brain metastases and those without brain metastases (6.2 months vs 6.4 months, P=0.052). Cycles of bevacizumab (>6 or ≤6 cycles) was an independent influencing factor of PFS (P=0.004). The most common adverse events were leukopenia, fatigue, nausea, thrombocytopenia and hypertension. CONCLUSIONS In the second-line or later-line treatment, bevacizumab combined with chemotherapy is an effective and safe regimen for advanced non-squamous NSCLC.
Aged ; Bevacizumab ; adverse effects ; therapeutic use ; Brain Neoplasms ; secondary ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Safety ; Treatment Outcome