Chronic disease management approaches for fundus disease to be explored and established / 中华眼底病杂志

Chronic disease is a major threat to human health. Fundus disease has become a major ophthalmic disease affecting daily life. Although great breakthroughs have been made in the treatment, compared with other chronic disease management, the management of patients with fundus disease is still in its infancy. To strengthen the management exploration of patients with fundus diseases, establish a management model of fundus diseases and strive to improve patients' awareness of fundus diseases and adherence to treatment and follow-up are the great challenges at present. All ophthalmic centers should strengthen patient education, establish a regional cooperation network, support the construction of grassroots medical capacity, cultivate talents, enhance training, promote the standardized treatment of fundus diseases, standardize fundus imaging inspection and diagnosis, and promote the homogeneous construction of diagnosis and treatment of chronic fundus diseases. We will accelerate the construction of a hierarchical diagnosis and treatment system and the ability to link consultation and referral. Through systematic management and intervention of fundus diseases, a large number of patients with fundus diseases will receive early screening, diagnosis, standardized continuous treatment and systematic management, and improve the quality of life of patients with fundus diseases.

Study on F9 gene expression downregulation and its clinical value in hepatocellular carcinoma / 中华肝脏病杂志

Objective: To analyze the expression levels of the F9 gene and F9 protein in hepatocellular carcinoma by combining multiple gene chip data, real-time fluorescence quantitative PCR (RT qPCR), and immunohistochemistry. Additionally, explore their correlation with the occurrence and development of hepatocellular carcinoma, as well as with various clinical indicators and prognosis. Methods: The mRNA microarray dataset from the GEO database was analyzed to identify the F9 gene with significant expression differences associated with hepatocellular carcinoma. Liver cancer and adjacent tissues were collected from 18 cases of hepatocellular carcinoma. RT-qPCR method was used to detect the F9 gene expression level. Immunohistochemistry was used to detect the F9 protein level. Combined with the TCGA database information, the correlation between F9 gene expression level and prognostic and clinicopathological parameters was analyzed. The biological function of F9 co-expressed genes associated with hepatocellular carcinoma was analyzed by the Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG). Statistical analysis was performed using Graphpad Prism software. Results: Meta-analysis results showed that the expression of the F9 gene was lower in HCC tissues than in non-cancerous tissues. Immunohistochemistry results were basically consistent with those of RT-qPCR. The data obtained from TCGA showed that the F9 gene had lower expression values in stages III-IV, T3-T4, and patients with vascular invasion. A total of 127 genes were selected for bioinformatics analysis as co-expressed genes of F9, which were highly enriched in redox processes and metabolic pathways. Conclusion: This study validates that the F9 gene and F9 protein are lower in HCC. The down-regulation of the F9 gene predicts adverse outcomes, which may provide a new therapeutic target for HCC.

Identification of latent class of sleep quality among breast cancer patients during chemotherapy and differences on quality of life based on latent profile analysis / 中国实用护理杂志

Objective:To identify the classification characteristics and quality of life (QOL) of breast cancer (BC) patients during chemotherapy, so as to provide basis for improving the sleep and QOL of this group.Methods:A cross-sectional investigation was completed among 421 BC patients in 5 tertiary hospitals in Shanghai, Wuhan, Tangshan and Nanning in 1-12 months of 2016 using validated instruments including self-made general information questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Functional Assessment of Cancer Therapy-Breast (FACT-B).Results:Four latent class of patients were identified through latent profile analysis (LPA), named by badly worse sleep quality(SQ) (C1, n=23), medium-SQ with difficulty to fall asleep (C2, n=127), medium-SQ with worse sleeping process (C3, n=30), none sleep disorders (C4, n=241). Total points of SQ among C1-C4 had significant difference ( χ2 value was 309.28, P<0.05). Age, BMI, job status, whether had surgery and course of chemotherapy between classes had statistically significant differences ( χ2 values were 9.57-25.28, all P<0.05). It had significant difference between C2 and C3, C2 and C4, C3 and C1, C3 and C4 on QOL ( χ2 values were 5.96-52.73, all P<0.05). Conclusion:SQ of BC patients during chemotherapy has heterogeneity among population. Different features of SQ of BC patients have different performance on QOL. Health professionals should keep an eye on patients with features of older age, high BMI, in job status, already received surgery and during early-stage chemotherapy, provide personal nursing intervention to improve SQ and QOL.

Effect of prenatal taurine supplementation on sensorimotor ability and hippocampal synaptophysin expression of juvenile rats with intrauterine growth restriction / 中华实用儿科临床杂志

Objective:To investigate the effect of prenatal taurine supplementation on sensorimotor ability and synaptophysin (Syn) expression in the hippocampus of juvenile rats with intrauterine growth restriction (IUGR).Methods:The IUGR rat model was induced by food restriction throughout pregnancy.Pregnant rats were randomly divided into normal control group, IUGR group and IUGR+ taurine group.Sensorimotor ability was tested in 2-week-old juvenile rats via grading the tail suspension scores and beam balance test scores, followed by detecting Syn expression in the hippocampus of juvenile rats by immunohistochemistry and Western blot.The correlation between sensorimotor ability scores and Syn expression was assessed.Results:Tail suspension time[(14.62±3.46) s vs.(25.38±5.92) s, P<0.001] and beam balance test scores [(9.08±1.38) scores vs.(12.08±1.16) scores, P<0.001] in the IUGR group were significant lower than those of normal control group.Tail suspension time (22.77±5.16) s and beam balance test scores (11.08±1.38) scores in IUGR+ taurine group were significantly higher than those in IUGR group (all P<0.05), but there was no significant difference comparable to those in normal control group ( P>0.05). The average optical density ( A) value [(53.96±2.37)% vs.(61.68±3.07)%, P<0.001] and protein expression of Syn (1.82±0.23 vs.2.23±0.17, P<0.001) in rat hippocampus of IUGR group were all signi-ficantly lower than those in normal control group.The A value [(60.27±2.59)%] and expression of Syn protein (2.07±0.17) in IUGR+ taurine group were significantly higher than those in IUGR group (all P<0.05), but there was no significant difference comparable to those in normal control group ( P>0.05). The expression of Syn in rat hippocampus was positively correlated with the tail suspension test time and beam balance test scores (all P<0.05). Conclusions:Prenatal taurine supplementation can improve the sensorimotor ability of juvenile rats with IUGR by upregulating Syn in the hippocampus.

Timeliness of health science popularization in local media of Shanghai during the outbreak of coronavirus disease 2019 / 上海预防医学

ObjectiveTo analyze the timeliness of health science popularization during the outbreak of coronavirus disease 2019 （COVID-19） and its correlation with the epidemic situation and policies. MethodsThe original reports of health science popularization by 26 major media in Shanghai during the COVID19 outbreak between January 19 and March 25 of 2020 were retrieved， and the timeliness of the number of reports， media sources and categories， and contents were analyzed. ResultsDuring the epidemic of COVID-19， public media reported timely. Online media accounted for 63.35%， and text-based reports accounted for 85.90%. There was a correlation between the trend of the number of reports and the development of COVID-19 and the prevention and control policy issued by the government. After the change in the epidemic or the release of policy， the number of reports increased. The top four topics were personal protection， disease treatment， healthy lifestyle and psychological health， accounting for 18.62%， 18.54%， 12.96% and 11.74%， respectively. Reports focused on different aspects at different stages of COVID-19 epidemic， and the number of reports tended to increase one week after the occurrence of major events. ConclusionDuring the COVID-19 epidemic， the coverage of health science on media is timely and targeted. For future similar public health emergencies， it is suggested to respond quickly to major events according to the trend， to carry out publicity timely， to innovate the report forms， and thus make it easy for the public to accept and implement.

Timeliness of health science popularization in local media of Shanghai during the outbreak of coronavirus disease 2019 / 上海预防医学

ObjectiveTo analyze the timeliness of health science popularization during the outbreak of coronavirus disease 2019 （COVID-19） and its correlation with the epidemic situation and policies. MethodsThe original reports of health science popularization by 26 major media in Shanghai during the COVID19 outbreak between January 19 and March 25 of 2020 were retrieved， and the timeliness of the number of reports， media sources and categories， and contents were analyzed. ResultsDuring the epidemic of COVID-19， public media reported timely. Online media accounted for 63.35%， and text-based reports accounted for 85.90%. There was a correlation between the trend of the number of reports and the development of COVID-19 and the prevention and control policy issued by the government. After the change in the epidemic or the release of policy， the number of reports increased. The top four topics were personal protection， disease treatment， healthy lifestyle and psychological health， accounting for 18.62%， 18.54%， 12.96% and 11.74%， respectively. Reports focused on different aspects at different stages of COVID-19 epidemic， and the number of reports tended to increase one week after the occurrence of major events. ConclusionDuring the COVID-19 epidemic， the coverage of health science on media is timely and targeted. For future similar public health emergencies， it is suggested to respond quickly to major events according to the trend， to carry out publicity timely， to innovate the report forms， and thus make it easy for the public to accept and implement.

Protection Mechanism of Addition and Subtraction Therapy of Danshenyin Combined with Wendantang for Myocardial Ischemia in Patients with Stable Angina / 中国实验方剂学杂志

Objective:To observe the efficacy of addition and subtraction therapy of Danshenyin combined with Wendantang in the treatment to stable angina pectoris （SAP） with stagnation of phlegm and blood stasis， and to explore its protection mechanism for myocardial ischemia. Method:One hundred and thirty-two patients were randomly divided into control group and observation group equally. Finished the 63 cases study both in control group and observation group after dropout， loss of follow-up and withdrawal. Patients in control group and observation group got antianginal drugs and the treatment of drug therapy to control the risk factors. All patients were treated with anti-angina drugs and risk factors control drugs. Patients in control group got Danlou Tablets by oral administration， 5 tablets/time， 3 times/day. Patients in observation group got dispensing decoction pieces of Danshenyin and Wendantang 1 dose/day. The treatment continued for 3 months in both groups. Scores of angina attack were graded every week. Before and after treatment， electrocardiogram treadmill exercise test was made to evaluate myocardial ischemia of coronary heart disease， and scores of phlegm stasis block syndrome and Seattle Angina questionnaire （SAQ） were graded for TCM symptoms and quality of life. Levels of hemorheology index， interleukin-6 （IL-6）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， intercellular adhesion molecule-1 （ICAM-1）， Cystatin C （CysC）， homocysteine （Hcy）， ischemic modified albumin （IMA） and macrophage migration inhibitory factor were detected. In addition， safety was evaluated. Result:After treatment， scores of times， duration， degree of angina pectoris， nitroglycerin dosage of angina pectoris and nitroglycerin dosage in the observation group were lower than those in the control group （<italic>P</italic><0.01）. Total exercise time， duration of ST depression for 1.0 mm， occurrence time of stable angina pectoris， metabolic equivalent and scores of Duke in the observation group were more than those in the control group （<italic>P</italic><0.01）. Score of stagnation of phlegm and blood stasis in the observation group was lower than that in the control group （<italic>P</italic><0.01）， while score of SAQ was higher than that in the control group （<italic>P</italic><0.01）. Levels of IL-6， TNF-<italic>α</italic>， ICAM-1， CysC， IMA， Hcy， MIF， whole blood viscosity （low cut， high cut）， whole blood reducing viscosity， plasma viscosity， platelet aggregation rate and fibrinogen （FIB） in the observation group were lower than those in the control group （<italic>P</italic><0.01）. Effect of angina pectoris in observation group was superior to that in control group （<italic>Z</italic>=2.091， <italic>P</italic><0.01）. No adverse reactions related to Danshenyin combined with Wendantang were found. Conclusion:Addition and subtraction therapy of Danshenyin combined with Wendantang based on the routine western medicine treatment can control the attack of angina pectoris， relieve the symptoms of phlegm and stasis block syndrome， and improve the quality of life for patients with SAP， showing superior clinical efficacy and safety. In addition， it can improve the hemorheology of patients， inhibit the inflammatory reaction， reduce the stenosis or obstruction of lumen in order to improve the degree of myocardial ischemia.

Comprehensive Evaluation of Rehabilitation Medical Service Quality in Tertiary General Hospitals in Gansu, China / 中国康复理论与实践

Objective:To investigate the quality of rehabilitation medical service in tertiary general hospitals in Gansu Province. Methods:Stratified sampling was used to sample tertiary general hospitals in Gansu Province for on-site surveys in 2017. A quality evaluation index system was established in the view of medical service providers, including 17 indicators, based on Donabedian model and experts' opinions. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Rank-sum Ratio were applied to make a comprehensive evaluation on the overall service quality of the hospital rehabilitation medical service. Results:A total of 27 tertiary general hospitals were sampled, in 13 cities/prefectures of Gansu Province. For the structure quality, the compliance rate of the business operation area and the number of beds in the rehabilitation medicine department were 77.78% and 51.85% respectively; while the compliance rates of the physicians, therapists and nurses were all less than 50%. For the process and results quality, the compliance rates were all more than 85%. For the overall quality of rehabilitation medical service, five hospitals were classified as Good, located in Lanzhou, Tianshui and Jiayuguan; 18 hospitals were classified as Medium, located in Longnan, Longdong, Lanzhou and surround, Linxia and Hexi regions; four hospitals classified as Poor, located in Lanzhou and Tianshui. Conclusion:The overall quality of rehabilitation services in the tertiary general hospitals of Gansu Province needs to be improved, and the development of rehabilitation services is uneven in various regions. Comprehensive evaluation provides an important reference to promote the rational distribution of rehabilitation medical resources and improve the quality of rehabilitation medical services.

Burkholderia pseudomallei infection manifests as mediastinal/hilar lymphadenopathy: A case report

Rationale: This case report presents the diagnosis and etiology of hilar/mediastinal lymphadenopathy in a male patient. Patient concerns: A 49-year-old man presented with fever and dyspnea after physical exertion. Diagnosis: The patient was diagnosed with melioidosis by cultivation of lymph node aspirate on blood agar using the VITEK 2 compact system. Interventions: The patient was treated with ceftazidime intravenously, combined with trimethoprim/sulfamethoxazole orally for 1 week. Once the patient was discharged, he began a 12-week course of trimethoprim/sulfamethoxazole. Outcomes: The patient recovered after treatment with ceftazidime and trimethoprim/sulfamethoxazole. Conclusions: Melioidosis is an infectious disease that mainly occurs in tropical regions. It can cause severe sepsis and pneumonia, and the infection in some patients may become chronic. Endobronchial ultrasound-transbronchial needle aspiration is a useful technique in the diagnosis of patients with hilar/mediastinal lymphadenopathy.

Research progress of interaction between coronavirus disease 2019 and cardiovascular system / 上海交通大学学报（医学版）

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2), has been spreading rapidly internationally. On the one hand, there is a certain correlation between the basic cardiovascular disease and the severity of COVID-19; on the other hand, the patients with severe and critical COVID-19 often have cardiovascular system-related clinical manifestations. This article reviews the interaction between COVID-19 and cardiovascular system, and the cardiovascular problems that may be encountered in the diagnosis and treatment of COVID-19.

Weight Gain during Neoadjuvant Chemotherapy is Associated with Worse Outcome among the Patients with Operable Breast Cancer / 한국유방암학회지

PURPOSE: This study was aimed at identifying the influence of initial weight and weight change during neoadjuvant chemotherapy (NAC) on pathologic complete response (pCR) and long-term survival in Chinese patients with operable breast cancer. METHODS: We conducted a retrospective study using data from 409 female patients who received NAC for stage II or III breast cancer and had complete record of body mass index (BMI) before and after NAC. BMI of 2 kg/m² following NAC was considered to be significant, else was considered stable. The study end points included pCR rates, disease-free survival (DFS), and overall survival (OS). RESULTS: The median follow-up time was 43.2 (8.9–93.6) months. The average BMI was 23.40 ± 3.04 kg/m² before NAC and 23.66 ± 3.02 kg/m² after NAC (t = −3.604, p < 0.001). The pCR rate was 25.3% in the NW/UW group and 24.1% in the OW/OB group (p = 0.811), and was similar between the BMI-gain (23.3%) and the BMI-stable/loss (25.1%) groups (p = 0.787). Initial BMI was an independent prognostic factor for DFS (hazard ratio, 1.69; 95% confidence interval [CI], 1.13–2.53; p = 0.011) but not for OS, while BMI-gain was an independent prognostic factor for both DFS (hazard ratio, 2.09; 95% CI, 1.28–3.42; p = 0.003) and OS (hazard ratio, 1.97; 95% CI, 1.04–3.74; p = 0.039). CONCLUSION: BMI increased after NAC in Chinese breast cancer patients. Initial BMI and BMI change during NAC were not associated with pCR but were reversely associated with survival.

Plasma citrulline concentration as a biomarker for bowel absorptive function in neonates with enterostomy / 中华实用儿科临床杂志

Objective To investigate the clinical significance of serum citrulline levels in evaluating the remnant bowel absorptive function with enterostomy in the neonatal period by means of tandem mass spectrum so as to guide clinical treatment with parenteral nutrition(PN) or not.Methods The serum amino acid profiles of 30 enterostomy infants including small intestinal enterostomy 17 cases of enterostomy and 13 cases of colon enterostomy and 20 cases of control infants in Wuhan Children's Hospital,Tongji Medical College University of Science & Technology from January 2016 to June 2018 were performed by using tandem mass spectrum,and the related amino acid with the bowel absorbing ability-citrulline was screened out.The Pearson correlation of the serum citrulline levels with the gain weight of the infants was studied.Results The weight of small intestinal enterostomy was significantly lower than colon enterostomy and control infants [(3.22 ± 1.00) kg vs.(5.63 ± 0.66) kg and (6.09 ± 0.85) kg],and there was statistical significance (F =57.23,P ＜ 0.05).Serum citrulline levels were significantly lower in small intestinal enterostomy compared with colon enterostomy and controls [(10.65 ± 5.82) μmol/L vs.(16.57 ± 4.33) μmol/L and (16.52 ± 4.20) μmol/L],and there was statistical significance (F =8.29,P ＜ 0.05).In enterostomy infants serum citrulline was positively correlated with gain weight everyday(r =0.65,P ＜ 0.05).Serum citrulline level ＜ 12 μmol/L had 81.3％ sensitivity and 71.4％ specificity for underweight.Conclusions Serum citrulline is a simple and accurate biomarker for evaluation of the absorptive function and adaptation of the enterostomy infants.Serum citrulline level ＜ 12 μmol/L is a strong predictor of PN-dependence in infants with temporary enterostomy.

Impact of body weight and physical activity on quality of life among breast cancer patients receiving adjuvant chemotherapy / 上海交通大学学报（医学版）

Objective • To investigate the impact of body weight and physical activity during different stages of adjuvant chemotherapy on the quality of life after chemotherapy among breast cancer patients. Methods • In a convenient sample of breast cancer patients with no prior history of systemic therapy, physical activity and quality of life were measured with anthropometric measurements, international physical activity evaluation questionnaire and Chinese version of functional assessment of cancer therapy-breast (FACT-B) scale before, during and after chemotherapy. Data was processed using repetitive measurement variance analysis and correlation analysis. Results • Among the 140 breast cancer patients, the average incidence of obesity during chemotherapy was 30.24%. An increase of body mass index (BMI) was observed throughout the treatment course. During adjuvant chemotherapy, the median physical activity was 844.50 (MET•min)/week. Obesity before chemotherapy was significantly negatively correlated with quality of life among patients receiving adjuvant chemotherapy (r=-0.21, P=0.014), while physical activity energy consumption was positively correlated with quality of life (r=0.20, P=0.019). Conclusion • Obesity and insufficient physical activity are rather common during adjuvant chemotherapy treatment in breast cancer patients, and they are strongly correlated with patients' quality of life after chemotherapy.

Antibiotic Resistance Analysis of Haemophilus Influenzae and Moraxella Catarrhalis Strains Isolated from Children in Sichuan Province from 2013 To 2016 / 现代检验医学杂志

Objective To investigate the changing antibiotic resistance profile of Haemophilus influenzae and Moraxella catarrhalis strains collected from children in Sichuan province from 2013 to 2016,provide some reference for rational utilization of clinical antimicrobial agents.Methods Collected the infection data of Haemophilus influenzae and Moraxella catarrhalis strains isolated from children which reported in Sichuan Province Drug Resistance Monitoring Report from 2013 to 2016.The experimental results were analyzed by WHONET5.6 software.Results The prevalence of H.influenzae increased with time from 8.95％ in 2013 to 16.6％ in 2016.The prevalence of M.catarrrhalis increased with time from 4.16％ in 2013 to 6.34％ in 2016.Among the 15 896 clinical strains of H.influenzae,the highest resistance rate was to ampicillin,which was 71.6％ in 2016.The resistance rate to cefaclor also increased from 26.1％ in 2013 to 59.5％ in 2016 for increase of 33.4％.The insensitivity rate to azithromycin increased from 8.3％ in 2013 to 25％ in 2016.However,the insensitivity rate to ceftriaxone and moxifloxacin decreased in recent years and the susceptibility rate to ceftriaxone,cefotaxime,levofloxacin and moxifloxacin were higher than 90％ in each year.The resistance rate of H.influenzae strains from children were higher than the stains from all patients.The insensitivity rate to azithromycin in strains from children and all patients increased from 8.3％,10.2％ in 2013 to 25％,22.1 ％ in 2016,respectively.The 5 625 clinical strains of M.catarrrhalis re mained highly susceptible to the amoxicillin-clavulanic acid,ceftriaxone,cefotaxime,levofloxacin,ciprofloxacin (greater than 90％).The resistance rate to cotrimoxazole increased from 15.1 ％ in 2013 to 59.1 ％ in 2016.Conclusion H.influenzae are still susceptible to the third generation cephalosporins (greater than 90 ％),which can be used as the first choice in clinical practice.Nearly 70 ％ of these strains were resistant to ampicillin and cotrimoxazole,which is inappropriate for clinical therapy.The resistance rate to cotrimoxazole in the M.catarrrhalis strains from children increased from 15.1％ in 2013 to 59.1 ％ in 2016,and the resistance rate to the other test drug in M.catarrrhalis did not change much in the-year period.

Effect of germacrone in alleviating HUVECs damaged by H2O2-induced oxidative stress / 中国中药杂志

This study focuses on the protective effect of germacrone on human umbilical vein endothelial cells(HUVECs) damaged by H2O2-induced oxidative stress and its possible mechanisms. The oxidative damage model was established by using 500 μmol•L⁻¹ H2O2 to treat HUVECs for 3 hours, and then protected with different concentrations of germacrone for 24 hours. The effect of germacrone on cell viability of HUVECs damaged by H2O2 was detected by MTT. The contents of PGI2, TXB2, ET-1, t-PA, PAI-1, TNF-α and IL-6 were detected by ELISA. The content of NO was detected by using nitrate reductase method. Colorimetry was used to detect NOS and GSH-Px. The contents of MDA, SOD and LDH were detected by TBA, WST-1 and microplate respectively. Apoptosis was observed by Hoechst 33258 fluorescent staining. The mRNA expressions of Bax, Bcl-2 and Caspase-3 in cells were detected by RT-PCR. The results showed that the cell damage rate was 52% after treated with 500 μmol•L⁻¹ H2O2 for 3 hours. The cell activity was increasing with the rise of germacrone concentration within the range of 20-200 mol•L⁻¹. Compared with normal group, the contents of PGI2, NO, T-NOS, t-PA, SOD, GSH-Px and Bcl-2 mRNA expressions were lower after damaged with H2O2. The contents of PAI-1, ET-1, IL-6, TNF-α, TXB2, LDH, MDA, Bax mRNA and Caspase-3 mRNA expressions were increased. Compared with model group, the contents of PGI2, NO, T-NOS, t-PA, SOD, GSH-Px and Bcl-2 mRNA expressions were increased after treated with germacrone. The contents of PAI-1, ET-1, IL-6, TNF-α, TXB2, LDH, MDA, Bax mRNA and Caspase-3 mRNA expressions were lower after treated with germacrone. According to Hoechst 33258 fluorescence staining, compared with normal group, the cell membrane and the nucleus showed strong dense blue fluorescence, and the number of cells significantly decreased in model group. Compared with model group, blue fluorescence intensity decreased in drug group. The above findings demonstrate that germacrone may improve the effect on HUVECs damaged by H2O2-induced oxidative stress by resisting oxidation and inhibiting cell apoptosis.

Effect of 21-gene recurrence score on chemotherapy decisions for patients with estrogen receptor-positive, epidermal growth factor receptor 2-negative and lymph node-negative early stage-breast cancer / 中华肿瘤杂志

Objective@#To investigate the effect of 21-gene recurrence score on adjuvant chemotherapy decisions for patients with estrogen receptor (ER)-positive, epidermal growth factor receptor 2 (HER-2)-negative and lymph node (LN)-negative early stage-breast cancer.@*Methods@#One hundred and forty-eight patients with ER+ , HER-2- and LN- early stage breast cancer were recruited in the Ruijin hospital, Shanghai Jiao Tong University School of Medicine. The 21-gene recurrence score (RS)assay was performed and systemic therapeutic decisions were made before and after knowing the RS results under multidisciplinary discussion. The effects of RS assay and the other influential factors on adjuvant chemotherapy decision were further analyzed.@*Results@#After knowing the RS results, treatment decisions were changed in 26 out of 148 patients(17.6%). Among them, 9 out of 26 patients were not recommended for chemotherapy; 16 of 26 had treatment recommendation changed to chemotherapy, and chemotherapy regimen was changed in the last one patient. Multivariate analysis showed that RS, age and histological grade were independent factors of decision-making for adjuvant chemotherapy.@*Conclusion@#Our results suggest that 21-gene recurrence score significantly influences decision making for adjuvant chemotherapy in patients with ER+ , HER-2- and LN- early stage breast cancer.

Analysis of the factors influencing adjuvant chemotherapy decisions for triple negative breast cancer / 中华肿瘤杂志

Objective@#To analyze adjuvant chemotherapy decisions for triple negative breast cancer (TNBC), and explore the influencing factors in the multidisciplinary treatment (MDT) modality.@*Methods@#A retrospective analysis was performed. The cases with invasive TNBC who underwent surgery and MDT discussion for adjuvant treatment in Ruijin Hospital, from April 2013 to June 2015, were recruited. The patients′ clinicopathological characteristics were analyzed and adjuvant treatment suggestions from MDT were obtained. Here the chemotherapy decision alteration was defined as a disagreement in chemotherapy or not, or inconsistence in regimens between the attending doctor and the multidisciplinary team.@*Results@#A total of 194 patients aged ≤70 years old were enrolled in the multidisciplinary discussion, and 187 patients (96.4%) were suggested to receive chemotherapy. When compared the opinions of the attending doctor to suggestions of the multidisciplinary team, we found that the percentage of chemotherapy decision alteration reached 22.7% (39/172), of which 94.9% (37/39) were inconsistence in chemotherapy regimens. There were 119 patients who were recommended to receive epirubicin plus cyclophosphamide (EC) followed by docetaxel (T) or weekly paclitaxel (wP) regimens. Before the announcement of results for the E1199 trial, EC-T accounted for 62.5% (55/88), and EC-wP accounted for 37.5% (33/88) for this group of patients. After that, the proportion of EC-T was decreased to 22.6% (7/31) and proportion of EC-wP increased to 77.4%(24/31) (P<0.001). In addition, a total of 20 patients were suggested to receive platinum based chemotherapy. The proportions were 9.3% in cases with invasive ductal carcinoma, and 33.3% in cases with metaplastic carcinoma, respectively (P=0.016).@*Conclusions@#The adjuvant chemotherapy decision for TNBC patients is altered in 22.7% of the patients after MDT discussion. After the announcement of SABCS E1199 results, more patients are suggested to receive EC followed by weekly paclitaxel. There is a lack of detailed evidence for platinum based adjuvant chemotherapy for TNBC, and more patients with metaplastic carcinoma receive platinum based adjuvant chemotherapy.

Sexual satisfaction and its associated factors among individuals with hearing disability / 中华男科学杂志

<p><b>Objective</b>To investigate sexual satisfaction (SS) and the factors associated with decreased SS among individuals with hearing disability.</p><p><b>METHODS</b>We conducted an investigation on SS among 439 individuals (268 males and 171 females, aged ≥18 yr) with hearing disability using a general information questionnaire, Center for Epidemiologic Studies Depression Scale, Social Support Rating Scale, and a self-report on SS. We identified the factors of decreased SS by multivariate ordinal logistic regression analysis.</p><p><b>RESULTS</b>Totally 76 (17.3%) of the hearing-disability individuals investigated were dissatisfied with their sexual life. SS reduction was significantly correlated with the status of being single (OR=1.72), grade-1 or -2 disability (OR=1.78), physical diseases (OR=2.46), depression (OR=6.61), or inadequate subjective social support (OR=3.28).</p><p><b>CONCLUSIONS</b>SS of hearing-disability persons is relatively low, which can be improved by treating physical diseases, promoting mental health, and providing psycho-social support.</p>

Efficacy and safety of aripiprazole in the treatment of childhood tic disorders: a Meta analysis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of aripiprazole in the treatment of childhood tic disorders (TD) by a meta analysis.</p><p><b>METHODS</b>A systematic search for randomized controlled trials (RCTs) on the efficacy and safety of aripiprazole in the treatment of childhood TD that were published between January 2000 and August 2014 was conducted. A Meta analysis on the selected RCTs was conducted using Review Manager 5.2 software.</p><p><b>RESULTS</b>Six RCTs involving 551 TD patients were enrolled. There were no significant differences in the efficacy between aripiprazole and traditional drugs for treatment of TD either by the end of follow-up visit or at 2 weeks, 4 weeks and 8 weeks after treatment. The subgroup analysis results indicated that aripiprazole had the same efficacy for the treatment of TD as traditional drug haloperidol. Aripiprazole had a lower incidence of extrapyramidal reactions than haloperidol (P<0.05), but the overall incidence of side effects of aripiprazole was not lower than traditional drugs for treatment of TD.</p><p><b>CONCLUSIONS</b>The available evidence suggests that aripiprazole has the same curative effect in the treatment of childhood TD compared with the traditional drugs. However, it is difficult to draw a firm conclusion that aripiprazole is a safer drug in the treatment of childhood TD.</p>

Role of mitomycin C in interventional therapy for tuberculous cicatricial stenosis of the central airway / 实用医学杂志

Objective To investigate the clinical efficacy of bronchoscopic MMC topical spraying for the treatment of tuberculous cicatricial stenosis of the central airway. Methods 45 patients with t tuberculous cicatricial stenosis of the central airway were randomly divided into a control group (14 patients), treatment group 1 (group1, 15 patients), or treatment group 2 (group 2, 16 patients), who received bronchial balloon dilatation alone, bronchial balloon dilatation combined with topical MMC spraying for one time, and for twice, respectively . The clinical efficacy was observed by using the MRC score and measuring airway diameter at the time points before treatment, end of treatment, and 3, 6, and 12 months after treatment, respectively. Results For the MRC scores at different time points, the MRC scores in group 2 (0.06 ± 0.25) and group 1 (0.33 ± 0.617) were significantly lower than those in the control group at 3 months after treatment (P 0.05). Conclusions Bronchial balloon dilatation combined with topical MMC spraying has certain short-term and long-term efficacy for improving dyspnea and maintaining the airway diameter after dilatation.