The relationship between plasma sCD163/sTWEAK ratio and prognosis in patients with spontaneous acute cerebral hemorrhage / 天津医药

Objective To investigate the relationship between the ratio of soluble hemoglobin scavenger receptor 163 protein(sCD163)/soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)in plasma and prognosis in patients with spontaneous acute cerebral hemorrhage(ACH).Methods From August 2020 to August 2022,90 patients with ACH admitted to the Department of Neurosurgery,Harison International Peace Hospital,Hengshui City were regarded as the research group.According to the Glasgow outcome scale,patients with ACH were separated into the poor prognosis group(n=38)and the good prognosis group(n=52).Another 45 healthy examinee who underwent physical examination were used as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect plasma sCD163 and sTWEAK levels,and the sCD163/sTWEAK ratio was calculated.Pearson method was applied to analyze the correlation between plasma sCD163,sTWEAK levels,sCD163/sTWEAK ratio and clinical data.Logistic regression was applied to analyze influencing factors of poor prognosis in patients with ACH.Receiver operating characteristic(ROC)was applied to analyze the predictive value of sCD163/sTWEAK ratio for poor prognosis of patients with ACH.Results The plasma levels of sCD163,sTWEAK and sCD163/sTWEAK ratio were obviously higher in the research group than those in the control group(P＜0.05).The plasma levels of sCD163,sTWEAK and sCD163/sTWEAK ratio were obviously lower in the good prognosis group than those in the poor prognosis group(P＜0.05).Hematoma volume,National Institutes of Health Stroke Scale(NIHSS)scores,hypertension and subtentorial hemorrhage were lower in the good prognosis group than those in the poor prognosis group,and low density lipoprotein cholesterol(LDL-C)was higher in the good prognosis group than that in the poor prognosis group(P＜0.05).Correlation analysis showed that plasma sCD163,and sTWEAK levels and the sCD163/sTWEAK ratio were positively correlated with bleeding site,hematoma volume,NIHSS score,white blood cell count,platelet count and neutrophil/lymphocyte ratio(NLR)(P＜0.05).Results of Logistic regression analysis showed that sCD163,sTWEAK,sCD163/sTWEAK ratio,hematoma volume,bleeding site and NIHSS score were influencing factors for poor prognosis in patients with ACH(P＜0.05).Results of receiver operating characteristic showed that the AUC of sCD163/sTWEAK ratio in evaluating poor prognosis of patients with ACH was 0.850,and the sensitivity and specificity were 86.84%and 69.23%.Conclusion The sCD163/sTWEAK ratio has a high level in the plasma of patients with ACH,which is associated with poor prognosis and has important value in predicting the prognosis of patients with ACH.

Repair effect of ephedrine on lipopolysaccharide-induced microglia function injury and its mechanism / 中国药房

OBJECTIVE To study the repair effect of ephedrine on lipopolysaccharide （LPS）-induced microglia function injury and its mechanism. METHODS Human microglia cells （HMC3） were used as research objects to investigate the effects of different concentrations of ephedrine （75， 150， 300， 600 μg/mL） on the viability and apoptosis of HMC3 cells. HMC3 cells were divided into control group （without drug intervention）， LPS group （1 μg/mL）， ephedrine group （1 μg/mL LPS+300 μg/mL ephedrine）， BAY11-7082 group [1 μg/mL LPS+5 μmol/L nuclear factor-κB （NF-κB） pathway inhibitor BAY11-7082]， inhibitor group （1 μg/mL LPS+300 μg/mL ephedrine+5 μmol/L BAY11-7082） and activator group （1 μg/mL LPS+300 μg/mL ephedrine+1 μmol/L NF-κB pathway activator Prostratin）. After 24 hours of drug treatment， cell migration， the levels of soluble interleukin-6（sIL-6）， interleukin-10（IL-10）， superoxide dismutase（SOD）and malondialdehyde（MDA）， and the expressions of NF-κB pathway-related proteins were all detected. RESULTS The viability of HMC3 cells could be increased significantly by 300 μg/mL ephedrine， while the apoptotic rate was decreased significantly （P＜0.05）. Compared with the control group， the number of migrating cells was increased significantly in the LPS group； the levels of sIL-6 and MDA， the phosphorylation of NF-κB protein were increased significantly， while the levels of IL-10 and SOD were decreased significantly （P＜0.05）. Compared with the LPS group， the above indexes were reversed significantly in the ephedrine group and BAY11-7082 group （P＜0.05）. Compared with the ephedrine group， the number of migrating cells was decreased significantly in the inhibitor group； the levels of sIL-6 and MDA， the phosphorylation of NF-κB protein were decreased significantly， while the levels of IL-10 and SOD were increased significantly （P＜0.05）. The above indexes were reversed significantly in the activator group （P＜0.05）can repair cell injury by inhibiting LPS induced apoptosis， migration， inflammation and oxidant stress of HMC3 cells， the mechanism of which may be associated with inhibiting the activity of the NF-κB signaling pathway.

Depressive symptoms are not associated with risks of rapid renal function decline or chronic kidney disease in middle-aged and elderly with normal kidney function: a longitudinal investigation / 南方医科大学学报

OBJECTIVE@#To explore the association between depressive symptoms and the risks of rapid decline in renal function and chronic kidney disease (CKD) in middle-aged and elderly with normal kidney function.@*METHODS@#The residents aged 40- 75 years with eGFR≥60 mL·min-1·1.73 m-2 without proteinuria in Lanzhou region, who participated in the "REACTION" study carried out in 2011, were selected and followed up in 2014. A total of 4961 individuals with complete and qualified data from the two surveys were included in the subsequent analysis. Based on PHQ-9 questionnaire scores, the baseline population was divided into two groups with and without depressive symptoms. Cox proportional hazard analysis was used to compare the incidences of rapid renal function decline and CKD between the two groups and study the association of depressive symptoms with the risk of these renal conditions.@*RESULTS@#PHQ-9 questionnaire scores were not found to correlate with baseline SCr, ALB, UACR or eGFR levels among the participarts (P>0.05). After a mean follow-up time of 3.4±0.6 years, 33.9% of the participants with depressive symptoms at baseline experienced a rapid decline in renal function and 3.6% progressed to CKD. During the follow-up, the incidence of rapid decline in renal function and the risk of developing CKD were not found to correlate with depressive symptoms in these participants (P>0.05) regardless of the type of the depressive syndromes.@*CONCLUSION@#Depressive symptoms are not associated with the risks of rapid renal function decline or progression to CKD in middle-aged and elderly with normal kidney function.

Research progress in medical imaging methods based on magnetoacoustic effect / 国际生物医学工程杂志

Electrical property imaging based on the magnetoacoustic effect has the advantages of non-invasiveness, high contrast, and high spatial resolution, making it a promising technique for early disease diagnosis. In this paper, the representative research progress of three magnetoacoustic multi-physical field coupled methods are reviewed, including magnetoacoustic tomography combined with magnetic induction (MAT-MI), magnetoacoustic tomography combined with current injection (MAT-CI), and magneto-acousto-electrical tomography (MAET). Additionally, the future development of these techniques is also discussed.

Research progress in removal methods of electroencephalography artifacts evoked by transcranial magnetic stimulation / 国际生物医学工程杂志

Transcranial magnetic stimulation (TMS) combined with electroencephalography (EEG) is a non-invasive technique for studying the excitability and connectivity of the brain cortex, which has been applied in basic scientific research and clinical disease assessment. However, the applicability of TMS-EEG is limited due to artifacts of both biological and abiotic nature induced by TMS pulse output. To address this issue, in the past decade, researchers have developed various TMS-EEG artifact removal methods from two perspectives, including online experimental design and offline data post-processing, and have achieved numerous valuable results. In this paper, the currently available TMS-EEG artifact removal methods are reviewed to facilitate the application of TMS-EEG in basic research and clinical disease diagnosis and treatment.

Analysis on the allocation and use of pediatric medical equipments and drugs commonly used in urban community health service centers / 中华医院管理杂志

Objective:To investigate and analyze the allocation and use of the common pediatric medical equipment and drugs in community health service centers, so as to provide decision-making reference for further strengthening the capacity-building of community children′s health services.Methods:Using multi-stage stratified random sampling method, 30 community health service centers in 14 cities were selected to investigate the basic situation of the sample centers, and the allocation and use of 21 kinds of commonly used pediatric medical equipment and 23 kinds of commonly used children′s drugs from April to August 2020.Results:The overall allocation rate of 21 commonly used pediatric medical equipment in the sample centers was 61.9%, and the overall utilization rate was 62.6%. The overall allocation rate of 23 commonly used drugs for children in the sample centers was 46.67%, and the overall utilization rate was 31.1%. There was a statistically significant difference in the utilization rate of equipment among different levels of urban community health service centers ( P<0.05); There were statistically significant differences in the allocation rate of commonly used children′s drugs among community health service centers under different regions, cities at different levels, types of jurisdictions, and institutional types ( P<0.05). Conclusions:The overall allocation and utilization rate of commonly used pediatirc medical equipment and drugs in urban community health service centers in China were relatively low, especially the drug utilization rate. The author suggested that the government should further strengthen the construction of grassroots pediatric diagnosis and treatment service capabilities, and reasonably equip commonly used pediatric medical equipment and drugs at the grassroots level.

Research progress on the effect mechanism of acupuncture-moxibustion for pressure injuries / 中国针灸

Evidence shows that acupuncture-moxibustion could promote the healing of pressure injuries (PI), but its action mechanism is not fully understood. This review summarizes the basic research literature of acupuncture-moxibustion for PI and identifies that the mechanism of acupuncture-moxibustion for PI is related with regulation of related signaling pathway target proteins, improvement of inflammatory response, modulation of vascular microenvironment, attenuation of oxidative stress damage, and inhibition of cell apoptosis. The review also points out the current limitations and future research directions. It emphasizes the need for further exploration of the upstream regulatory mechanism, specific cellular molecules, and the interactions among these molecules. A multi-level, multi-target, and multi-dimensional approach is required to fully understand the mechanism underlying the promotion of PI healing by acupuncture-moxibustion.

Research on magneto-acoustic-electrical tomography method based on liquid metal contrast agent and M sequence coded excitation / 生物医学工程学杂志

Magneto-acoustic-electric tomography (MAET) boasts high resolution in ultrasound imaging and high contrast in electrical impedance imaging, making it of significant research value in the fields of early tumor diagnosis and bioelectrical monitoring. In this study, a method was proposed that combined high conductivity liquid metal and maximum length sequence (M sequence) coded excitation to improve the signal-to-noise ratio. It was shown that, under rotational scanning, the liquid metal significantly improved the signal-to-noise ratio of the inter-tissue magneto-acoustic-electric signal and enhanced the quality of the reconstructed image. The signal-to-noise ratio of the signal was increased by 5.6, 11.1, 21.7, and 45.7 times under the excitation of 7-, 15-, 31-, and 63-bit M sequence code, respectively. The total usage time of 31-bit M sequence coded excitation imaging was shortened by 75.6% compared with single-pulse excitation when the same signal-to-noise ratio was improved. In conclusion, the imaging method combining liquid metal and M-sequence coding excitation has positive significance for improving MAET image quality.

Clinical efficacy of laparoscopic anatomical right posterior sector combined with anterior-dorsal segment resection for hepatocellular carcinoma / 中华消化外科杂志

Objective:To investigate the clinical efficacy of laparoscopic anatomical right posterior sector combined with anterior-dorsal segment resection for hepatocellular carcinoma.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 15 patients with hepatocellular carcinoma who underwent laparoscopic anatomical right posterior sector combined with anterior-dorsal segment resection in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University from September 2020 to August 2021 were collected. There were 9 males and 6 females, aged 66(range, 35?77)years. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect tumor recurrence and survival of patients in the postoperative 90 days. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. All the 15 patients underwent laparoscopic anatomical right posterior sector combined with anterior-dorsal segment resection successfully, without blood transfusion and conversion to laparotomy during the operation. The operation time, volume of intraoperative blood loss and occlusion time of first porta hepatis of the 15 patients were (155±17)minutes, (254±66)mL and (51±7)minutes, respectively. (2) Postoperative situations. The duration of postoperative hospital stay of the 15 patients was (7.4±2.1)days. Results of postoperative histopathological examination showed hepatocellular carcinoma and R 0 margins in all the 15 patients with a minimum distance from margin to tumor of (1.5±0.8)cm. There was none of the 15 patients transferred to intensive care unit, perioperative death or rehospitalization within 30 days after surgery. Of the 15 patients, 2 cases had postoperative complications, including 1 case with biliary fistula (grade Ⅰ of Clavien-Dindo classification) and 1 case with ascites (grade Ⅱ of Clavien-Dindo classification). Patients with complications were improved after washing and drainage, abdominal puncture and drainage. (3) Follow-up. All the 15 patients were followed up for the postoperative 90 days and none of them had tumor recurrence or death within postoperative 90 days. Conclusion:The laparoscopic anatomical right posterior sector and anterior-dorsal segment resec-tion for hepatocellular carcinoma is safe and feasible.

Effect of sling exercise therapy combined with Tuina on nerve conduction of upper extremities after radicular cervical spondylosis / 中国康复理论与实践

@#Objective To observe the effect sling exercise therapy (SET) and Tuina on radicular cervical spondylosis. Methods From August, 2015 to December, 2016, 72 patients with radicular cervical spondylosis were randomly divided into control group (n = 36) and trial group (n = 36), who accepted traction and SET+Tuina, respectively, for four weeks. They were measured F-wave conduction velocity with electromyogram from median nerve and ulnar nerve, somatosensory evoked potential (SEP), and current perception threshold (CPT) before and after treatment. The clinical ratio of improvement was calculated. Results The ratio of improvement was 83.33% in the trial group more than 58.33% in the control group (Z = 2.093, P < 0.05). F-wave conduction velocity increased in both groups after treatment (t > 12.059, P < 0.001), and increased more in the trial group than in the control group (t > 3.266, P < 0.01); while the latency of SEP decreased in N9 and N13 in both groups (t > 7.061, P < 0.001), and decreased more in the trial group than in the control group (t > 8.033, P < 0.001); the grade of CPT decreased in both groups (t > 8.895, P < 0.001), and decreased more in the trial group than in the control group (t = 8.913, P < 0.001). Conclusion The combination of SET and Tuina can promote the repair of nerve conduction of cervical spondylotic radiculopathy.

HIV nucleic acid results and follow-up of 73 WB negative and indeterminate samples in Dujiangyan area / 中华检验医学杂志

Objective:To test the HIV virus nucleic acid using immunoblot method (Western blotting, WB) and to follow-up with the negative and indeterminate samples in the Dujiangyan area, compare the WB and nucleic acid results before and after followed-up, and try to reduce the WB band′s false-negatives and false-positives.Methods:The 286 suspected HIV infection samples in the Dujiangyan region from January to October 2021 were confirmed by WB, the HIV virus load were tested for the samples that were WB negative and WB indeterminate, those patients were followed-up with epidemiological history and viral load results, and the results before and after tracking were compared.Results:In the 286 samples of suspected HIV infection included in this study, we reported 213 (74.48%) WB positive, 37 WB negative (12.94%), and 36 WB indeterminate (12.58%); 10 of 37 WB negative samples were followed-up; 18 of 36 WB indeterminate samples were followed-up. Among the followed-up WB negative and indeterminate samples, 17 of them had virus nucleic acid detection prior to the follow-up, and all of them turned positive after following-up. The others with no previous virus nucleic acid detection were confirmed to be negative.Conclusions:Among the followed-up samples, 2 samples were false-negative in WB negative results, and 3 were false-positive in WB indeterminate results. The viral nucleic acid must be tested and followed-up in WB negative and indeterminate samples.

Effects of Suspension Exercise Therapy Combined with Soft Tissue Manipulation on Upper Limb Sensory Function in Patients with Radicular Cervical Spondylosis / 医用生物力学

bjective To observe the changes of upper extremity sensory function in patients with radicular cervical spondylosis and evaluate the treatment effect, by using the method of suspension exercise therapy (SET) and soft tissue manipulation. Methods A total of 72 patients with cervical spondylosis were divided into observation group (treated by SET combined with manipulation)and control group (treated by purely cervical traction) by simple random method. Both groups received 4-week continuous treatment for 6 times per week. The somatosensory evoked potential(SEP), current perception threshold (CPT) before and after the treatment in two groups were separatedly tested, and changes in visual analogue scale (VAS) pain scores of the affected limbs were examined, so as to determine the effective rate of treatment. Results After treatment, the latency of SEP was shortened mainly in brachial plexus potential N9 and cervical spinal potential N13 in two groups (P<0.05). The CPT levels and the VAS pain scores of the affected limbs were reduced in two groups (P<0.01), and the treatment effect in observation group was better that in control group (P<0.01)．Conclusion SET combined with soft tissue manipulation can effectively promote the repair of nerve sense function of cervical spondylotic radiculopathy.

Study on Cep63 expression and apoptosis of thyroid papillary carcinoma cell lines TPC-1 / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the effect of centrosomal protein Cep63 on the apoptosis of papillary thyroid carcinoma (PTC) cell lines TPC-1 and underlying mechanism. Methods: With collected PTC tissues and adjacent tissues, Cep63 expression was detected by RT-qPCR and its relationship with clinicopathological factors was analyzed. The experiment included negative control group (NC), low expression group (Cep63(-)) and overexpression group (Cep63(+)), and wild-type TPC-1 cells were transfected with Cep63 lentivirus. The efficiency of Cep63 was detected by western blot (WB) and qRT-PCR. Cell proliferation ability was detected by plate cloning experiment and MTT assay. Cell apoptotic rate was detected by flow cytometry, and expression levels of apoptosis-related proteins were detected by immunohistochemistry and WB. The t-test was used to compare the differences in the means between the two groups, the one-way analysis of variance was used to compare multiple groups, and the chi-square test was used to analyze the association between gene expression levels and pathological factors. Results: Compared with NC group, cell proliferation ability was significantly decreased in Cep63(-) group (3.18±0.07 vs. 2.14±0.09, t=8.54, P<0.01) and significantly increased in Cep63(+) group (3.18±0.07 vs. 3.58±0.10, t=3.21, P<0.05). Apoptotic rates in NC, Cep63 (-) and Cep63 (+) groups were respectively 3.03%±0.24%, 8.66%±0.44% and 1.17%±0.44%, and the flow cytometry showed that the low expression of Cep63 significantly increased the apoptosis TPC-1 cells (F=157.7, P<0.001). Bcl-2 protein expression levels of NC, Cep63 (-) and Cep63 (+) groups were respectively 1.07±0.03, 0.49±0.01 and 1.99±0.09, and BAX protein expression levels of three groups were respectively 0.64±0.02, 1.06±0.01 and 0.21±0.03. WB showed that the expression level of Bcl-2 decreased (F=183.2, P<0.001), while the expression level of BAX was significantly up-regulated (F=283.7, P<0.001). Conclusion: Cep63 may regulate the apoptotic process of TPC-1 cells through Bcl-2/BAX pathway and Cep63 may be a potential oncogene of PTC.

Input-output efficiency analysis for children′s diagnosis and treatment service at 27 community health service centers in China / 中华医院管理杂志

Objective:To provide strategic suggestions for optimizing children′s diagnosis and treatment services in the communities, by means of analyzing the overall efficiency of children′s diagnosis and treatment services in the sample community health service centers, and learning the current input and output of children′s diagnosis and treatment resources.Methods:In April 2020, a total of 27 community health service centers in 14 cities were selected by random sampling. Data such as the number of medical visits by children aged 0 to 18 years and the area of pediatric diagnosis and treatment departments in the sample centers in 2019 were collected by self-filling questionnaires. Excel was used for data sorting. Data envelopment analysis(DEA) was used for data processing. The data processing tool was DEAP 2.1.Results:The average comprehensive efficiency, the average technical efficiency and the average scale efficiency of the 27 sample community health service centers were 0.445, 0.865 and 0.494 respectively. There were five DEA efficient centers, 4 DEA weak inefficiency centers and 18 inefficient centers. Six out of 18 DEA inefficient centers had redundant input of healthcare professionals capable pediatrics; 12 centers were short of children visits, and 15 were short of visits by children aged 0-6 years.The centers where DEA was inefficient were concentrated in the central region, the suburbs and " centers with independent pediatric clinics but without pediatric wards" .Conclusions:The comprehensive efficiency of children′s diagnosis and treatment services in the sample community health service centers is relatively low. Currently, the sample community health service centers are faced with such problems as small and insufficient input of children′s diagnosis and treatment resources in the community, unbalanced development of children′s diagnosis and treatment services in the region among others. It is suggested that on the basis of making full use of the existing resources to create the maximum output value, we should consider appropriately expanding the scale of resource input to improve the efficiency of children′s diagnosis and treatment services at the primary level and further give play to the value of the " gatekeepers" at the primary level in children′s diagnosis and treatment.

Treatment of pancreatic diseases and prevention of infection during outbreak of 2019 coronavirus disease / 中华外科杂志

Objective@#To explorethe proper protective measures for pancreaticdiseases treatment during theoutbreak of 2019 coronavirus disease(COVID-19).@*Method@#Clinical data of four cases of patients that suffered COVID-19from February 2nd, 2020 to February 9th, 2020 in pancreatic surgery were reviewed.After the first patientscuffednosocomial infection of COVID-19, the general protective measures in our department wereupdated.Only one patient was admitted to each room alone, with no more than one caregiver.The body temperature of care givers was measuredtwice a day.Primary protections were applied to all staff.The floor was sterilized using disinfectant with an effective chlorine concentration of 1000 mg/L.The protective measures for interventional procedures were as follow.Primary protection was applied to the operators ofcentral venipuncture catheter, percutaneous abdominal/pleural drainage, percutaneous retroperitoneal drainage, percutaneous transhepatic cholangial drainage and other surgical procedures with local anesthesiaand epidural anesthesia.Secondary protection was applied to the operators of endoscopic retrograde cholangiopancreatography and surgical procedures with general anesthesia.@*Results@#During Feb 2nd, 2020 to Feb 9th, 2020, four patients in our department were diagnosed with COVID-19, of which one was died of COVID-19, two were cured, and one is still in hospital for COVID-19.After the update ofprotective measures in our department, no more nosocomial infection of COVID-19occurred.Two central venipuncture catheter, three percutaneous abdominal/pleural drainage, one percutaneous retroperitoneal drainage, one percuteneous transhepatic cholecyst drainage and one open surgery with general anesthesia were performed with no infection of operators.@*Conclusions@#The caregivers of patients are potential infection source of COVID-19.Enhanced protective measures including the management measures of caregivers can decrease the risk of nosocomial infection of COVID-19.

Progress and prospect of machine learning in research of acupuncture and moxibustion / 中国针灸

The application progress of machine learning in research of acupuncture and moxibustion was reviewed from three aspects: mining of acupuncture and moxibustion prescription and indications, acupuncture efficacy prediction and its influencing factors, acupoint specificity and acupuncture manipulation research, and the existing problems in current research and future research trends were discussed. It is believed that the appropriate machine learning algorithm should be selected to build the model according to the research purpose and data characteristics in the future research; attention should be paid to feature design, feature selection and feature cleaning; sample data collection should be a priority, and data sharing platform and standardized data collection should be developed to improve the data quality.

Influence of policy support on the attitude of staff toward contracted service in community health service centers / 中华医院管理杂志

Objective To explore the influence of policy support on attitude of staff toward contracted service in community health service ( CHS) centers in different areas of China. Methods A multi-stage stratified cluster sampling method was used to select participants, and questionnaire survey was conducted among 192 staff (99 from Chengdu and 93 from Xiamen) from 4 community health service centers in Chengdu and Xiamen. In addition, documents on contracted service in CHS were collected and analyzed. EpiData software was used to establish database. Double input and cross-check were implemented. SAS version 9.4 was used for data analyses. Results Differences were found in goals, financial modes and insurances coverage in contracted service in the two areas. Among the 192 participants, 80.7% considered that contracted service was worth to carry out; 90.8% supported the implementation of contracted service in local settings and 78.1% were willing to take more work load on contracted service. In contrary, only 41.6% wished their child work as a family doctor. The main reasons for the negative attitudes were that the performance-based salary system had not been well established or implemented, and there was much more work load that resulted from contracted service. Conclusions The majority of the study subjects held positive attitude toward contracted service, but there were disparities between the four study sites. Relative policy and financial support, proper human resource distribution were critical determinants of contracted service.

Radiotherapy for thyroid cancer / 中国实用外科杂志

With the obvious improvement of the diagnosis and treatment level of thyroid cancer,the treatment methods of thyroid cancer have also been improved.The treatment of thyroid cancer is dominated by surgery,TSH inhibition therapy and radioactive iodine therapy. With the development of computer, imaging and radiotherapy equipment,radiotherapy has gradually become an important auxiliary treatment for thyroid cancer. For parts of the cases which operation could not thoroughly remove lesions or lost 131I treatment of thyroid cancer,external beam radiotherapy is increasingly being used for adjuvant therapy.Although external beam radiotherapy has gradually played a significant role,currently EBRT is not widely used in the clinic,and the therapeutic effect has been controversial yet in the treatment of thyroid cancer.

Analysis on the efficacy of hypertonic sugar local injection in the treatment of lymphatic leakage after cervical lymph node dissection for thyroid cancer / 中国实用外科杂志

OBJECTIVE: To investigate the effect of hypertonic glucose injection on patients with chylous leakage after neck dissection.METHODS: The clinical data of 9 patients with postoperative chylous fistula after the lymph node dissection of thyroid cancer from February 2017 to December 2018 in the Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University were collected and analyzed.RESULTS: As for 9 patients with intractable chylous fistula,8 patients were finally cured and had the drainage tube removed.Three patients decreased significantly by over 50% on next day after hypertonic glucose injection.Four patients decreased significantly by over 50% on next two daysafter hypertonic glucose injection.One patient had to have another one operation to cure chylous fistula.CONCLUSION: In patients with chylous fistula after thyroid cancer surgery,local injection of hypertonic glucose seems to be more effective in shortening time of drainage tube remining,which would promote wound healing and release pains.

Clinical Observation of Appatinib Combined with Systemic Chemotherapy for Liver Metastasis of Gastroenteropancreatic Neu- roendocrine Neoplasm / 中国药房

OBJECTIVE： To observe the efficacy and safety of apatinib combined with systemic chemotherapy for hepatic metastasis of gastroenteropancreatic neuroendocrine neoplasms （GEP-NEN）. METHODS： Totally 60 patients with GEP-NEN in Hubei Provincial Tumor Hospital from Jan. 2016 to Jan. 2018 were randomly divided into systemic chemotherapy group， apatinib group and combination group， with 20 patients in each group. Systemic chemotherapy group was given Etoposide injection 80 mg/m2，once a day d1-5， intravenously+Cisplatin for injection 20 mg/m2，once a day d1-5，intravenously， every 3 weeks for a cycle. Apatinib group was given Apatinib mesylate tablets 0.5 g， once a day. Combination group received treatment as systemic chemotherapy group+apatinib group. All three groups were treated continuously for 3 months. The clinical efficacies of 3 groups were observed. The serum levels of tumor markers （CEA， NSE， CgA and CA19-9） before and after treatment， survival situation after treatment and the occurrence of ADR during treatment were also observed. RESULTS： The objective remission rate， disease control rate， median overall survival and survival rate of combination group were significantly higher or longer than those of systemic chemotherapy group and apatinib group. Median progression-free survival and the incidence of ADR were significantly shorter or lower than systemic chemotherapy group and apatinib group （P＜0.05）. After treatment， the levels of CEA， NSE， CgA and CA19-9 in 3 groups were significantly lower than before treatment， and combination group was significantly lower than systemic chemotherapy group and apatinib group （P＜0.05）. There was no statistical significance in above indexes between systemic chemotherapy group and apatinib group （P＞0.05）. CONCLUSIONS： Apatinib combined with systemic chemotherapy for liver metastasis of GEP-NEN is effective and safe， which can improve the level of serum tumor markers， prolong the survival time of patients and improve survival rate.