Clinicopathological features of gastric carcinomas with NTRK-rearrangement/amplification: report of four cases / 中华病理学杂志

Objective: To investigate the clinicopathological, immunohistochemical and molecular genetic characteristics of gastric carcinoma with NTRK-rearrangement/amplification. Methods: The clinicopathological data of gastric carcinoma cases with NTRK-rearrangement/amplification diagnosed from January 2011 to September 2020 at the Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, China, were collected. The clinicopathological, immunophenotypic and molecular pathological features were analyzed. The relevant literature was reviewed. Results: There were 4 cases of gastric carcinoma with NTRK-rearrangement/amplification. All 4 patients were male, aged 57-67 years (average, 63 years). Tumor sizes ranged from 3.5 to 5.2 cm (average, 4.8 cm). All tumors were in the antrum. All 4 patients underwent radical gastrectomy and were followed up after the surgery. Morphologically, all tumors showed histological features with enteroblastic-differentiated gastric carcinoma. Tumor cells showed predominantly tubular/papillary architecture, with conspicuous vesicular nuclei and pale staining or transparent cytoplasm. Immunohistochemistry showed pan-TRK expression in all cases, with various degrees of positivity in the cytoplasm. All cases were subject to NTRK1/2/3 detection using fluorescence in situ hybridization. There were NTRK translocations in 2 cases and NTRK amplifications in 2 cases. These cases were further verified by RNAseq next generation sequencing which confirmed that NTRK1 gene translocation (TPM3-NTRK1) and NTRK2 gene translocation (NTRK2-SMCHD1) occurred in two cases, respectively. Conclusions: NTRK mutation occurs less frequently in gastric cancer. In this study, the cases mainly occur in the antrum. The morphology has the characteristics of enteroblastic differentiation. The tumors have unique histological, immunophenotypic and molecular characteristics, which require much attention from pathologists to effectively guide clinicians to choose the best treatment.

Correlation of NTRK genetic fusions with mismatch repair protein deletion in patients with colorectal cancer / 中华病理学杂志

Objective: To investigate the relationship between the expression of four mismatch repair proteins (MLH1, MSH2, MSH6 and PMS2) and NTRK genetic fusions in colorectal cancer. Methods: The paraffin-embedded tissue blocks of 830 cases of colorectal cancer were collected at the Affiliated Drum Tower Hospital, Nanjing University Medical School, China, from 2015 to 2019. Immunohistochemical and fluorescence in situ hybridization(FISH) method were used respectively to detect the expression of mismatch repair proteins and the break-apart of NTRKs; and the relationship between the expression of mismatch repair proteins and the NTRK genetic fusions was analyzed. Results: The overall mismatch repair protein deficiency (dMMR) rate was 9.88% (82/830), the mismatch repair proteins proficiency (pMMR) rate was 90.12%(748/830). The total deficiency rate of MLH1 protein was 9.04% (75/830), hPMS2 protein deficiency rate was 9.04% (75/830), MSH2 protein deficiency rate was 2.53% (21/830), MSH6 protein deficiency rate was 4.10% (34/830), the deficiency rate of synchronous MLH1 and PMS2 were 8.67% (72/830) and the deficiency rate of synchronous MSH2 and MSH6 were 2.17% (18/830). The dMMR group was associated with tumor location, different histological subgroups, tumor differentiation, AJCC stage and N stage (P<0.05). There were six cases (7.32%) carrying NTRK fusion by FISH among the 82 cases of dMMR, but only seven cases (0.94%) carrying NTRK fusion among the 748 cases of PMMR. The NTRKs translocation by FISH in all 13 cases were further confirmed by next generation sequencing. Among the clinicopathological characteristics, only differentiation showed significant difference between NTRK fusion positive and negative groups (P<0.05). More importantly, NTRK fusion was enriched in dMMR group (7.32% vs. 0.94%). Conclusion: In dMMR colorectal cancer group, the prevalence of NTRK fusion is higher than that in pMMR group.

Current advances in research of semaphorin 3A:a potential target for the treatment of nospecific low back pain / 中国骨伤

Nonspecific low back pain is closely associated with afferent nerve ingrowth into degenerated IVDs and increasing the inflammatory response. Members of the class 3 semaphorins signal their response through two prominent receptors; the NRP (Neuropilin-1) and the Plexin A. Sema3A (Semaphorin3A) is primarily known for their role in modulating neuronal survival as well as neurite outgrowth and guidance via regulation of Sema3A-NRP-1-plexinA signal pathway. Also, sema3A is shown to be conductive to innervate the inner painful degenerated IVDs (Intervertebral discs). Furthermore, sema3A is thought to act as a barrier to endothelial cells survival and migration on vascular endothelial growth factor (VEGF) and inhibition of KLF5-induced (Krüppel-like factor 5) inflammatory mediators within degenerated IVDs. Therefore, Sema3A produce a new perspective of dual-action therapeutic agent for attenuating the regulator of innervation and angiogenesis into degenerated IVDs and inhibition of KLF5-induced inflammation.

Potential predictors for mental stress-induced myocardial ischemia in patients with coronary artery disease / 中华医学杂志(英文版)

BACKGROUND@#Mental stress-induced myocardial ischemia (MSIMI) is closely associated with adverse cardiac events in patients with coronary artery disease (CAD) and we aimed to determine whether biomarkers and blood pressure could be potential predictors of MSIMI.@*METHODS@#This study enrolled 82 patients with documented CAD between June 1, 2017 and November 9, 2017. Patient blood samples were obtained at resting period and at the end of mental arithmetic. Then, patients were assigned to MSIMI positive group and MSIMI negative group. The main statistical methods included linear regression, receiver operating characteristic (ROC) curves, and logistic regression.@*RESULTS@#Patients with CAD with MSIMI had significantly greater median resting N-terminal pro-brain natriuretic peptide (NT-proBNP, 141.02 [45.85-202.76] pg/mL vs. 57.95 [27.06-117.64] pg/mL; Z = -2.23, P = 0.03) and mean systolic blood pressure (SBP) (145.56 ± 16.87 mmHg vs. 134.92 ± 18.16 mmHg, Z = -2.13, P = 0.04) when compared with those without MSIMI. After 5-min mental stress task, those who developed MSIMI presented higher elevation of median post-stressor high sensitivity cardiac troponin I (hs-cTnI, 0.020 [0.009-0.100] ng/mL vs. 0.009 [0.009-0.010] ng/mL; Z = -2.45, P = 0.01), post-stressor NT-proBNP (138.96 [39.93-201.56] pg/mL vs. 61.55 [25.66-86.50] pg/mL; Z = -2.15, P = 0.03) compared with those without MSIMI. Using the ROC curves, and after the adjustment for basic characteristics, the multiple logistic regression analysis showed that patients presenting a post-stressor hs-cTnI ≥ 0.015 ng/mL had seven-fold increase in the risk of developing MSIMI (odds ratio [OR]: 7.09; 95% confidence interval [CI]: 1.65-30.48; P = 0.009), a rest NT-proBNP ≥ 80.51 pg/mL had nearly eight-fold increase (OR: 7.85; 95% CI: 1.51-40.82; P = 0.014), a post-stressor NT-proBNP ≥ 98.80 pg/mL had 35-fold increase (OR: 34.96; 95% CI: 3.72-328.50; P = 0.002), a rest SBP ≥ 129.50 mmHg had 11-fold increase (OR: 11.42; 95% CI: 1.21-108.17; P = 0.034).@*CONCLUSIONS@#The present study shows that CAD patients with higher hs-cTnI level, and/or greater NT-proBNP and/or SBP are at higher risk of suffering from MSIMI when compared with those without MSIMI, indicating that hs-cTnI, NT-proBNP, SBP might be potential predictors of MSIMI.

Potential predictors for mental stress-induced myocardial ischemia in patients with coronary artery disease / 中华医学杂志(英文版)

Background@#Mental stress-induced myocardial ischemia (MSIMI) is closely associated with adverse cardiac events in patients with coronary artery disease (CAD) and we aimed to determine whether biomarkers and blood pressure could be potential predictors of MSIMI.@*Methods@#This study enrolled 82 patients with documented CAD between June 1, 2017 and November 9, 2017. Patient blood samples were obtained at resting period and at the end of mental arithmetic. Then, patients were assigned to MSIMI positive group and MSIMI negative group. The main statistical methods included linear regression, receiver operating characteristic (ROC) curves, and logistic regression.@*Results@#Patients with CAD with MSIMI had significantly greater median resting N-terminal pro-brain natriuretic peptide (NT-proBNP, 141.02 [45.85–202.76] pg/mL vs. 57.95 [27.06–117.64] pg/mL; Z = -2.23, P = 0.03) and mean systolic blood pressure (SBP) (145.56 ± 16.87 mmHg vs. 134.92 ± 18.16 mmHg, Z = -2.13, P = 0.04) when compared with those without MSIMI. After 5-min mental stress task, those who developed MSIMI presented higher elevation of median post-stressor high sensitivity cardiac troponin I (hs-cTnI, 0.020 [0.009–0.100] ng/mL vs. 0.009 [0.009–0.010] ng/mL; Z = -2.45, P = 0.01), post-stressor NT-proBNP (138.96 [39.93–201.56] pg/mL vs. 61.55 [25.66–86.50] pg/mL; Z = -2.15, P = 0.03) compared with those without MSIMI. Using the ROC curves, and after the adjustment for basic characteristics, the multiple logistic regression analysis showed that patients presenting a post-stressor hs-cTnI ≥ 0.015 ng/mL had seven-fold increase in the risk of developing MSIMI (odds ratio [OR]: 7.09; 95% confidence interval [CI]: 1.65–30.48; P = 0.009), a rest NT-proBNP ≥ 80.51 pg/mL had nearly eight-fold increase (OR: 7.85; 95% CI: 1.51–40.82; P = 0.014), a post-stressor NT-proBNP ≥ 98.80 pg/mL had 35-fold increase (OR: 34.96; 95% CI: 3.72– 328.50; P = 0.002), a rest SBP ≥ 129.50 mmHg had 11-fold increase (OR: 11.42; 95% CI: 1.21–108.17; P = 0.034).@*Conclusions@#The present study shows that CAD patients with higher hs-cTnI level, and/or greater NT-proBNP and/or SBP are at higher risk of suffering from MSIMI when compared with those without MSIMI, indicating that hs-cTnI, NT-proBNP, SBP might be potential predictors of MSIMI.

Survey of Anopheles vectors in Nanyang City from 2005 to 2017 / 中国血吸虫病防治杂志

Objective To investigate the malaria vectors in Nanyang City. Methods Two townships were selected as malaria vector surveillance sites in Nanyang City from 2005 to 2017, including Mazhenfu Township in Tanghe County and Huaiyuan Township in Tongbai County, and the malaria vectors were investigated using the semi-overnight human baiting trapping method and mosquito trapping in nets. Results The mean density of Anopheles sinensis was 0.65 to 22.30 mosquitos/(person · hour) in the two surveillance sites in Nanyang City using the human baiting trapping method from 2005 to 2017, and the peak density was detected in June and July. An. anthropophagus was captured only in Tongbai County during the period between 2008 and 2011, with a mean density of 0.03 to 1.10 mosquitos/(person · hour). The mean density of An. sinensis was 0.08 to 0.24 mosquitos/(net · night) using the mosquito trapping in nets from 2005 to 2011, and the peak density was detected in July and August, while few An. anthropophagus captured only in Tongbai County, with a mean density of 0.01 to 0.02 mosquitos/(net · night). Conclusions There are malaria vectors in Nanyang City, including An. sinensis and An. anthropophagus, and An. sinensis is the dominant mosquito species.

Apreliminarystudyofuseofintravoxelincoherentmotion MRItoassessplacentalperfusionin patientswithplacentaladhesiondisorderintheirthirdtrimester / 实用放射学杂志

Objective Toinvestigate MRIIVIM quantitativeassessmentoftheplacentalperfusioncanbeusedtodifferentiate womenwithandwithoutplacentaaccretaintheirthirdtrimester.Methods Thestudypopulationincluded17patientswithplacenta accreta,29patientswithplacentaincretaand16patientswithoutplacentaaccreta.Allwomenunderwentan MRIexaminationincluding anIVIMsequence.Theperfusionfraction(f),pseudodiffusioncoefficient(D?)andstandarddiffusioncoefficient(D)werecalculated. Results Womenwithplacentaaccretaandincretahadasmallerplacentalperfusionfraction (P＜0.05)thanpatientswithoutplacenta accreta,theplacentalperfusionfractiondidn’tdifferedbetweenplacentaaccretaandincreta(P＞0.05).DifferencesofDandD?between thethreegroupswerenotsignificant(P＞0.05).Conclusion Placentaaccretaandincretadifferinplacentalperfusionfractionfrom womenwithoutthedisease.Theperfusionfractioncanbeusedasafeasibleindextoevaluateplacentaperfusion.

Research Progress for Remote Medical Treatment of Basic Medical Insurance in China / 中国医院管理

Objective To find out research progress for remote medical treatment of basic medical insurance in China,in order to provide evidences for further research and policy-making.Methods Doing literature research.Results Research progress is summarized from five aspects,such as concepts and theoretical basis,causes of remote medical treatment and different social problems caused by it,the observation of domestic and foreign experiences,shift and continuity of basic medical insurance for rural residents,as well as instant reimbursement.Conclusion The enlightenment from the existing research is put forward,that is to solve the related problems of remote medical treatment.The most important thing is to classify the people who need remote medical treatment,and then to give solutions acording to different categories.

Association between Nonalcoholic Fatty Liver Disease and Carotid Artery Disease in a Community-Based Chinese Population: A Cross-Sectional Study / 中华医学杂志(英文版)

<p><b>Background</b>Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases with a high prevalence in the general population. The association between NAFLD and cardiovascular disease has been well addressed in previous studies. However, whether NAFLD is associated with carotid artery disease in a community-based Chinese population remained unclear. The aim of this study was to investigate the association between NAFLD and carotid artery disease.</p><p><b>Methods</b>A total of 2612 participants (1091 men and 1521 women) aged 40 years and older from Jidong of Tangshan city (China) were selected for this study. NAFLD was diagnosed by abdominal ultrasonography. The presence of carotid stenosis or plaque was evaluated by carotid artery ultrasonography. Logistic regression was used to analyze the association between NAFLD and carotid artery disease.</p><p><b>Results</b>Participants with NAFLD have a higher prevalence of carotid stenosis (12.9% vs. 4.6%) and carotid plaque (21.9% vs. 15.0%) than those without NAFLD. After adjusting for age, gender, smoking status, income, physical activity, diabetes, hypertension, triglyceride, waist-hip ratio, and high-density lipoprotein, NAFLD is significantly associated with carotid stenosis (odds ratio [OR]: 2.06, 95% confidence interval [CI]: 1.45-2.91), but the association between NAFLD and carotid plaque is not statistically significant (OR: 1.10, 95% CI: 0.8-1.40).</p><p><b>Conclusion</b>A significant association between NAFLD and carotid stenosis is found in a Chinese population.</p>

Hotspots and trend in research of wearable device / 中华医学图书情报杂志

Objective To study the hotspots and trend in research of wearable device. Methods The research hotspots and trend of wearable device were analyzed by literature investigation and bibliometrics. Results The pros-pect of wearable device is broad in the coming years. The powerful electronic and technological nations such as USA and South Korea were the major original places of new technologies for wearable device. The core competitive-ness, complete industry chain, main manufacture system and application of wearable device in our country still had a long way to go compared with those in USA and South Korea. Co-word and clustering analysis showed that the current research hotspots of wearable device were its design concept, new sensor technology and energy store device technology. Literature investigation revealed that independence, low endurance high integration technology, human-computer interaction technology, big data and cloud technology were the main trend of future wearable device. Conclusion Wearable device is still in its initial stage with a lot of problems to be solved in its design, function and management. However, its development prospect is broad.

Assessment of ischiofemoral impingement related image anatomy with MSCT / 中国医学影像技术

Objective To discuss the width of ischiofemoral space (IFS) in asymptomatic adults and the related influence of physiological parameters (including age,sex,height,body weight,intertuberous distance,femoral offset,lesser trochanter height,etc).Methods Pelvic MSCT data of 61 adults without hip pain symptom were analyzed retrospectively.The indexes were measured,including the width of IFS,intertuberous distance,femoral offset,lesser trochanter height,femoral neck long axis,femoral neck angle and ischial angle.The correlation between the width of IFS and the physiological parameters was analyzed.Results The height,body weight,width of IFS,femoral offset,lesser trochanter height and femoral neck long axis of male subjects were larger than those of female subjects (all P＜0.05),while the intertuberous distance and ischial angle of male subjects were smaller than those of female subjects (both P＜0.001).There was positive correlation between the width of IFS and femoral neck long axis (P＜0.001).Negative correlation was found between the width of IFS and the age,intertuberous distance,femoral neck angle,ischial angle,respectively (all P＜0.001).No correlation between IFS and the height,body weight,femoral offset,lesser trochanter height was found (all P＞0.05).Conclusion MSCT can be applied for measurement and evaluation of relative anatomy images of ischiofemoral impingement.The structure of pelvis is different between male and female,and this may be the reason of why female patients are more likely to suffer from ischiofemoral impingement.

Effects of New Rural Cooperative Medical Scheme on Medical Service Utilization and Medical Expense Control of Inpatients: A 3-year Empirical Study of Hainan Province in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The New Rural Cooperative Medical Scheme (NCMS) has been further adjusted and optimized to reduce the financial burden of rural residents and to achieve universal coverage for them. In this study, we aimed to explore the impact of NCMS on medical service utilization and medical expense of inpatients in recent years.</p><p><b>METHODS</b>The research data of Hainan Province were extracted from the Chinese NCMS platform from 2012 to 2014. Detailed information included total expenditure, average inpatients costs, average out-of-pocket payments, actual reimbursement rate, and average annual growth rate of the above indicators. Descriptive analysis was used to gauge the effects of NCMS.</p><p><b>RESULTS</b>In the utilization of medical services, NCMS inpatients in tertiary hospital decreased from 25.49% in 2012 to 20.39% in 2014, inpatients in county hospitals increased from 39.49% to 55.92%, simultaneously. The total expenditure in county hospitals rose steadily from 28.46% to 46.66%, meanwhile, the total expenditure in tertiary hospitals fell from 60.44% to 44.51%.The average out-of-pocket costs of rural inpatients remained stable over the years. Furthermore, the compensation fund of NCMS inpatients grew significantly. The actual inpatient reimbursement rate at township health centers increased from 76.93% to 84.04%. Meanwhile, the rate at county hospitals and tertiary hospitals increased slightly from 59.37% and 46.10% to 61.25% and 47.71%, respectively.</p><p><b>CONCLUSIONS</b>With the improvement of the reimbursement ability, especially after the new health care reform in 2009, the NCMS have been playing a prominent role in alleviating the economic burden of farmers' medical treatment. Meanwhile, more patients go to primary hospitals than tertiary hospitals, and the capability of primary hospitals has been greatly improved.</p>

Effect Observation of Entecavir Combined with Intervention in Liver Cancer Patients with HBV DNA-nega-tive Hepatitis B / 中国药房

OBJECTIVE:To observe the clinical efficacy of entecavir combined with intervention in the treatment of liver cancer patients with HBV DNA-negative hepatitis B. METHODS:100 liver cancer patients with HBV DNA-negative hepatitis B were random-ly divided into observation group and control group,50 cases in each group. Control group received intervention,percutaneous punc-ture of femoral artery,then injected Pirarubicin hydrochloride for injection + lipiodol in parent artery until blood stagnation,and also conventional liver protection therapy was conducted;observation group additionally received 1 mg Entecavir tablet,qd,for continuous 6 months. Clinical efficacy,HBV DNA quantification,Child-Pugh score and liver function indexes in 2 groups were compared. RE-SULTS:The total effective rate in observation group was 44.0%,which was significantly higher than control group(26.0%),the dif-ference was statistically significant(P0.05). After treatment,HBV DNA quantification,Child-Pugh score,fetoprotein,alanine aminotransferase, total bilirubin and aspartate aminotransferase significantly decreased in observation group,the differences were statis-tically significant compared with control group (P<0.05). CONCLUSIONS:Entecavir combined with intervention can obviously im-prove the clinical efficacy and liver function indexes of liver cancer patients with HBV DNA-negative hepatitis B.

Effect of recombinant human brain natriuretic peptide on sepsis induced myocardial dysfunction / 临床麻醉学杂志

Objective To explore the interventional effect of recombinant human brain natri-uretic peptide(rhBNP)on the patients with sepsis induced myocardial dysfunction by comparing N-terminal pro-B-type natriuretic peptide(Nt-proBNP),troponin and left ventricular ejection fraction (LVEF).Methods Forty septic patients were admitted into department of critical care medicine from February 2013 to May 201 5.They were randomly divided into control group and rhBNP group,with 20 patients in each group.Both groups received early goal directed therapy(EGDT),and rhBNP group re-ceived additional therapy of rhBNP 1.5 μg/kg bolus,and then 0.075 μg·kg-1 ·min-1 for 48 h.Con-trol group received saline in the same way.Vasoactive agents were used to maintain blood pressure. Concentration of plasma Nt-proBNP and troponin were determined at baseline,on days 1,3,and 7 day by point of care (POCT ).LVEF was also detected by transthoracic echocardiography. Results Concentrations of plasma Nt-proBNP and troponin in rhBNP group were lower than control group on days 1 and 3 (P <0.05).On day 3,levels of Nt-proBNP and troponin in both groups were higher than the days 1 and 7 (P <0.01).LVEF in the rhBNP group was higer than control group on days 3 and 7 (P <0.05 or P <0.01);On day 3,LVEF in both groups was significantly lower than the pre-therapy and day 7 (P < 0.05 or P < 0.01 ).Conclusion rhBNP can improve sepsis induced myocardial dysfunction by decreasing the Nt-proBNP and troponin levels with increased left ventricular ejection fraction.

Value of volume rendering technique of MSCT in the diagnosis of pediatric pectus carinatum / 实用放射学杂志

Objective To evaluate the value of volume rendering technique of MSCT in the diagnosis of pediatric pectus carinatum. Methods MSCT data of 36 children with pectus carinatum were collected.Volume rendering and multiplanar reformation recon-struction techniques were adopted at a postprocessing station.Results There were 35 cases of chondrogladiolar variant and 1 case of chondromanubrial variant,27 cases were symmetric and other 9 cases were asymmetric.VR technique clearly demonstrated the abnormal changes of sternum,costae and costal cartilages.Conclusion VR technique of MSCT can fully display the three-dimension morpho-logical changes of pediatric pectus carinatum,which can supply accurate information for minimally invasive treatment procedure.

Correlation between the volume of epicardial adipose tissue and SNYTAX score in patients with coronary artery atherosclerosis / 实用放射学杂志

Objective To explore the correlation between the epicaridal adipose tissue (EAT)volume and the SNYTAX score in patients with coronary artery diseases and to evaluate its clinical value.Methods Epicardial fat volume of 102 patients with coronary heart disease in our hospital were measured on dual-source CT angiography images,SNYTAX scores were calculated,and level of blood lipids,blood glucose (Glu),blood pressure,renal functional parameters and body mass index(BMI)were collected.Depending on SNYTAX scores,patients were divided into three groups (mild 0-22,moderate 23-32 and severe>33).The difference of EAT volume between groups and correlation with other indicators were analyzed.With indictors statistical significant in one-factor analysis,multi-ple regression equation was constructed to evaluate the risk factors of coronary artery diseases,particularly correlation between EAT volume and SNYTAX score.Results EAT,TC,TG,HDL,HbALc,GLu and BMI were significant different between three groups. Pearson regression showed that EAT,TC,GLu and BMI were independently risk factor in relation to the value of SNYTAX.Among them,standardized regressive coefficient of the EAT volume was the highest (β=0.52).Conclusion EAT volume is significantly positively correlated with the SNYTAX score in coronary heart disease,which can be as an effective predictor for its severity and prognosis.

Effect of Da Vinci robot-assisted laparoscopic radical prostatectomy on the respiratory system of elderly patients in intensive care units / 中国综合临床

Objective To explore the effect of Da Vinci robot?assisted laparoscopic radical prostatecto?my on the respiratory function of elderly in Intensive Care Units( ICU) . Methods Thirty?nine elderly patients received Da Vinci robot?assisted laparoscopic radical prostatectomy ( RARP ) from January 2015 to April 2016 and 25 cases received conventional laparoscopic radical prostatectomy from January 2014 to December 2014 ad?mitted into ICU were retrospectively analyzed. Their comorbidities,blood loss and transfusion during surgery,ate?rial blood gas(ABG) analysis and respiratory complications after operation,clinical outcomes between the two groups were compared. Results Compared with conventional laparoscopic radical prostatectomy,RARP group spent more time in surgery((4. 23±1. 44) h vs. (3. 25±1. 31) h,t=2. 783,P<0. 05),more patients need venti?lation(11 vs. 1,χ2=4. 378,P<0. 05) . ABG analysis showed respiratory and metabolic acidosis with lower pH (7. 29±0. 09 vs. 7. 35±0. 05,t=3. 886,P<0. 05),HCO3?((20. 05±2. 50) mmol/L vs. (22. 86±2. 53) mmol/L,t=3. 473,P<0. 05),BE(-5. 11±3. 94 vs.-3. 64±1. 17,t=5. 018,P<0. 05) and higher pCO2(46. 15±8. 31 vs. 40. 25±6. 57,t=2. 475,P<0. 05),Lac((3. 54±1. 99) mmol/L vs. (2. 91±1. 39) mmol/L,t=2. 254,P<0. 05) . Conclusion RARP may cause carbon dioxide retention and respiratory complications on elderly pa?tients. It may reduce postoperative respiratory complications by shortening surgery time,lowering pneumoperitone?um pressure,hyperventilation,recruitment maneuvers and chest physical therapy.

Study on the Doses of Oxaliplatin in Patients with Hepatocellular Carcinoma after Transcatheter Arterial Che-moembolization / 中国药房

OBJECTIVE:To investigate the effect of different doses of oxaliplatin on the efficacy and safety and related index-es of patients with hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE). METHODS:100 HCC patients were randomly divided into control group (50 cases) and observation group (50 cases). After TACE,control group re-ceived arterial infusion chemotherapy of 40 mg/m2 oxaliplatin,once a day+20 mg Epirubicin hydrochloride for injection,once a day,with little lipiodol. Observation group received arterial infusion chemotherapy of 80 mg/m2 oxaliplatin (the same usage with control group)+Epirubicin hydrochloride for injection(the same dosage with control group),with little lipiodol. Alanine aminotrans-ferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBIL),white blood cell count (WBC) and alpha-fetoprotein (AFP) in 2 groups after 3 d treatment were observed,and the total overall survival (OS) and the incidence of adverse reactions were followed-up. RESULTS:Abdominal pain,incidences of nausea and vomiting,ALT,AST and TBIL in observation group were significantly higher than control group,WBC was significantly lower than control group,the differences were statistically sig-nificant (P0.05). CONCLUSIONS:Compared with 40 mg/m2 oxaliplatin,80 mg/m2 can reduce the in-cidence of abdominal pain,nausea,vomiting,but other effects are poor than 40 mg/m2,and it can not prolong the survival time of patients.

Information system success mo del-based health information system construction effect evaluation model / 中华医学图书情报杂志

Objective To establish a general health information construction effect evaluation model for overall as-sessment of health information construction effect .Methods Domestic and foreign health information construction effect evaluation models were systematically analyzed by bibliometric analysis , comparative analysis , inductive and deductive method,repectively.The classic health information construction effect models were integrated.Results The health information construction effect evaluation model was established from the technique-organization man-agement-operation supportangle .Conclusion Thehealth information construction effects include technique effect, organization mangement effect, and operation effect.Thegeneral health information construction effect evaluation model is established, which includes 7 primary indexes and 20 secondaey indexes.

Application of Jintian'ge capsule in treatment of vertebral compression fracture in senile osteoporosis patients / 中国中药杂志

To study the clinical application of Jintian'ge capsule in treatment of vertebral compression fracture in senile osteoporosis patients. In the study, 69 senile osteoporotic vertebral compression fracture patients hospitalized in our hospital between January 2012 and June 2014 were selected and randomly divided into the control group and the treatment group. Patients in the control group were treated by percutaneous kyphoplasty (PKP), while those in the treatment group were given Jintian'ge capsule in addition to PKP. Efforts were made to visit the patients before the surgery and in three month after that, observe and compared the vertebral height, Cobb's angle, bone density, visual analogue scale (VAS) and Oswestry disability index between patients in the two groups. According to the findings, compared with before the treatment, patients in the two groups showed significant improvements in the vertebral height, Cobb's angle, bone density, VAS and Oswestry disability index three months after the surgery (P < 0.05); During the visit three months after the treatment, compared with the control group, the treatment group showed notable increases in all parameters (P < 0.05), particularly in the vertebral height, VAS and Oswestry disability index (P < 0.05). Based on the above findings, Jintian'ge capsule is applicable in adjuvant therapy after the osteoporotic vertebral compression facture PKP surgery.