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Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.
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This article gives a review on domestic and foreign researches on the non-drug intervention for patients with perimenopausal depression published from 2012 to 2022， so as to provide a reference for clinical treatment and nursing. Currently， pharmacotherapy is the mainstay of treatment for perimenopausal depression， while many existing problems remain to be solved such as the variation in treatment effect and the difficulty in maintaining emotional stability. however，high safety and relatively low cost are the characteristics of non-drug intervention， so this article expounds on the non-drug intervention measures for perimenopausal depression， such as music therapy， dietary therapy， exercise therapy， acupuncture therapy and repetitive transcranial magnetic stimulation （rTMS）.
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Objective@#This study explored the relationship between childhood maltreatment and adolescent suicide provides a scientific basis for suicide prevention strategies.@*Methods@#A total of 16 271 middle and high school students from rural areas in Anhui, Guangdong, Yunnan, Heilongjiang and Hubei provinces were enrolled through multi stage stratified cluster random sampling. Structured questionnaires were used to collect information on participants general information, childhood neglect, abuse, suicide ideation, suicide plans and suicide attempts in the 12 months prior to the survey. Multivariate Logistic regression models were used to analyze the associations of childhood neglect and childhood maltreatment with suicide ideation, suicide plans and suicide attempts.@*Results@#The number of suicide ideations, suicide plans and suicide attempts among rural adolescents were 2 453( 15.1 %), 1 164(7.2%) and 572(3.5%), respectively. The number of cases of childhood neglect, moderate physical abuse and severe physical abuse were 10 756(66.1%), 4 311(26.5%) and 703(4.3%), respectively. Univariate analysis showed that childhood neglect and abuse were significantly associated with suicide ideation, suicide plans and suicide attempts( P <0.05). After controlling for age, gender, only children, parental education level, income, emotional management and social support, childhood neglect and abuse remained significantly correlated with suicide ideation, suicide plans and suicide attempts( OR =1.62-5.14, P <0.05); the OR(OR 95%CI) for severe physical abuse were 3.00(2.49-3.62), 3.52(2.81-4.40),5.14(3.87-6.83) respectively.@*Conclusion@#Childhood neglect and abuse may increase the risk of suicide among adolescents in rural China, and effective measures should be taken to reduce childhood neglect and abuse and prevent suicide.
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Objective:To investigate the effect of montelukast sodium tablets combined with pulmicort aerosol in the treatment of children with asthma, and its influence on eosinophil (EOS), interleukin-4 (IL-4), immunoglobulin E (IgE), tumor necrosis factor-α (TNF-α).Methods:From March 2018 to March 2019, 142 children with asthma admitted to Hangzhou Dajiangdong Hospita were randomly divided into observation group (71 cases) and control group (71 cases) according to the digital table.The patients in the observation group were treated with montelukast sodium tablets combined with pulmicort aerosol, while patients in the control group were treated with pulmicort aerosol.Both two groups were treated for 2 weeks.The levels of EOS, IL-4, IgE and TNF-α, day and night asthma symptom scores and blood gas analysis indicators before and after treatment were compared between the two groups.Results:The total effective rate of the observation group (91.55%) was higher than that of the control group (74.65%) (χ 2=7.220, P<0.05). After treatment, the scores of asthma symptoms in day[(0.38±0.12)points] and night[(0.42±0.14)points] in the observation group were lower than those in the control group[(0.87±0.19)points and (0.93±0.25)ponts]( t=18.373, 14.998, all P<0.05). After treatment, the levels of EOS[(0.38±0.09)×10 9/L], IL-4[(13.89±3.25)ng/L], IgE[(109.35±16.57)kU/L] and TNF-α[(1.25±0.12)ng/L] in the observation group were lower than those in the control group[(0.73±0.13)×10 9/L, (18.36±2.70)ng/L, (164.53±23.51)kU/L and (1.49±0.15)ng/L]( t=18.652, 8.914, 16.165, 10.528, all P<0.05). Conclusion:Montelukast sodium tablets combined with pulmicort aerosol is effective in the treatment of children with asthma.It can reduce the levels of EOS, IL-4, IgE and TNF-α, alleviate the symptoms of daytime and night asthma.
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The occurrence rate of colorectal cancer is increasing. Metastasis and recurrence are the leading causes of death in colorec-tal cancer. Tumor cells in the circulation have the ability to proliferate or to migrate, thereby providing a reliable means for neoplasm staging and assessment of recurrence or metastasis, and evaluation of efficacy by detecting circulating tumor cells (CTC). Optimizing the development of detection technology will provide better support for clinical applications. This review mainly discusses CTC detec-tion and advances in colorectal cancer relapse or metastasis.
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Objective To investigate the effects of subthreshold micropulse yellow laser (577 nm) on vascular endothelial growth factor (VEGF),nerve growth factor (NGF) and Chemerin expressions in retina of early stage diabetic rats.Methods A total of 40 Brown Norway rats were treated with streptozocin (65 mg · kg-1) to establish the diabetic model.20 diabetic BN rats' right eyes were received subthreshold micropulse yellow laser (577 run) therapy after 2 weeks.The left eyes were used as control group.At 3 days,7 days,14 days,28 days after laser therapy,5 BN rats were randomly chosen to perform RT-PCR and Weston-blot.The expressions of mRNA and protein of VEGF,NGF and Chemerin were analyzed.Results The expression of VEGF mRNA and protein increased in control group at 3 days,7 days,14 days and 28 days (all P ＜ 0.05).Compared with the control group,VEGF mRNA and protein decreased in the subthreshold micropulse yellow laser (577 nm) group (all P ＜ 0.05).The expression of NGF mRNA and protein decreased in the control group at 3 days,7 days,14 days and 28 days (all P ＜ 0.05),however,the difference was not statistically significant between 3 days and 7 days(P ＞0.05).Compared with control group,NGF mRNA and protein increased in the subthreshold micropulse yellow laser (577 nm) group (all P ＜ 0.05),with maximum expression at 14 days.The expression of chemerin mRNA and protein increased at 3 days,7 days,14 days and 28 days in the control group (all P ＜0.05).Compared with the control group,chemerin mRNA and protein decreased in the subthreshold micropulse yellow laser (577 urn) group (all P ＜ 0.05).Conclusion Subthreshold micropulse yellow laser (577 urn) can suppress VEGF,Chemerin expression and upregulate NGF expression in early stage diabetic rats.
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Objective To explore the relations of the doctor-patient relationship to psychological security and stress.Methods Totally 430 operation patients were selected and followed-up.A survey was performed using the Security Questionnaire (SQ),the Patient Doctor Relationship Questionnaire 13-Item Version (PDRQ-13),the Hospital Stress Rating Scale (HSRS) Results The average score of SQ was lower than medium value in operation patients.The SQ scores of operation patients with emergency operation were 39.50±10.51,lower than those of selective operation which were 49.02±10.37 and limited operation which were 47.67±10.29 (P ＜ 0.05).The SQ scores of operation patients who didn't provided themselves were 37.33±10.10,lower than those of basically which were 40.10±10.83 and partly provided for themselves which were 43.50±10.51 (P＜ 0.05).The SQ scores of operation patients in severe group according severity of illness were 37.13±10.40,lower than those of them in mild group which were 39.19±10.24 and moderate group which were 41.38±10.01 (P＜ 0.01).The SQ scores of post-operation patients were 44.32±9.96,higher than post-operation patients which were 40.36±10.81 (P ＜ 0.01).The lack of comforts (LC),lack of information (LI) and risks of serious disease (RSD) scores of post-operation patients were 49.23±30.62,30.46±21.42,52.84±31.22,lower than those of post-operation patients which were 52.37±32.06,35.25±20.14,80.12±33.18 (P ＜ 0.05).The path analysis showed that the regression relationship between SQ scores and PDRQ scores,RSD scores was established (β=0.40,-0.26,P ＜ 0.01),and the PDRQ-13 scores was a mediator between the scores of LC,LI,RSD and the SQ scores (β=0.40,P＜0.01).The PDRQ-13 scores was a adjustor between the RSD scores and the SQ scores (β=-0.34,P ＜ 0.01).Conclusions The operation patients have a low level of the sense of security which is statistically significant with surgical types,the ability to care for themselves and severity of illness.The sense of security of post-operation patients were higher than those of pre-operation patients.The recognition of physician-patient relationship may be play a mediating and adjusting role between the sense of security and stress.The surgical stress affect patient security and physician-patient relationship.
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<p><b>OBJECTIVE</b>To investigate the predictive value of P53, Ki-67, HER2 protein detection in neoadjuvant chemotherapy for adenocarcinoma of gastroesophageal junction (AGEJ).</p><p><b>METHODS</b>Preoperative biopsy specimens and clinical data of 72 patients of locally advanced Siewert II AGEJ between June 2010 and December 2013 were reviewed. All the patients received SOX scheme neoadjuvant chemotherapy, and were divided into effective group (complete response plus partial response) and ineffective group (stable disease plus progressive disease). Expressions of above 3 proteins were detected by immunohistochemistry in all the patients before neoadjuvant chemotherapy. The relationship between various proteins and efficacy of chemotherapy was analyzed by univariate and logistic multivariate regression analyses.</p><p><b>RESULTS</b>All the 72 patients successfully completed 2 cycles of SOX neoadjuvant chemotherapy, among them, 5 cases (6.9%) with complete response, 30 cases (41.7%) with partial response, 31 cases (43.1%) with stable disease, 6 cases (8.3%) with progressive disease, including 35 cases in effective group and 37 cases in ineffective group. Compared with ineffective group, the positive expression rate of P53 was significantly reduced (25.0% vs. 45.9%, P=0.020), and that of Ki-67 significantly increased (77.1% vs. 43.2%, P=0.003), however, there was no significant difference in the expression rate of HER2 between the two groups (P>0.05). Multivariate analysis showed that Ki-67 was the independent predictive factor for the efficacy of neoadjuvant chemotherapy (P=0.015). Spearman rank correlation showed that Ki-67 expression was positively correlated with HER2 expression (r=0.259, P=0.028), but P53 expression was not correlated with Ki-67 or HER2 (r=0.140, 0.042, P=0.240, 0.725, respectively).</p><p><b>CONCLUSIONS</b>SOX neoadjuvant chemotherapy is safe and effective for AGEJ, especially for patients with depressed expression of P53 and elevated expression of Ki-67, which both may be used as reference for the prediction of chemotherapy efficacy. There is no correlation between P53 and Ki67 proteins, so combined detection may improve the predictive value.</p>
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Humans , Adenocarcinoma , Diagnosis , Drug Therapy , Esophageal Neoplasms , Diagnosis , Drug Therapy , Esophagogastric Junction , Pathology , Immunohistochemistry , Ki-67 Antigen , Metabolism , Neoadjuvant Therapy , Receptor, ErbB-2 , Metabolism , Remission Induction , Tumor Suppressor Protein p53 , MetabolismABSTRACT
Termite nests is rarely seen in the clinical applications of traditional Chinese medicine, generally used for the treatment of the bone injuries and internal medical diseases. According to the recent research on termite nests, this article makes a summarize of its distribution, types, pharmacognosy characteristics, chemical composition, pharmacological effects and its application research aspects, so as to provide reference for the further development and utilization of termite nests.
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<p><b>OBJECTIVE</b>To investigate the effects of Qili Qiangxin capsules on the amino-terminal pro-brain natriuretic peptide (NT-proBNP) level and cardiac function in patients with silicosis.</p><p><b>METHODS</b>Hospitalized silicosis patients with heart failure were divided into treatment group (41 cases) and control group (30 cases) according to their own will. Both groups received comprehensive symptomatic treatment; in addition, the treatment group received Qili Qiangxin capsules. The treatment lasted 6 months. The observed items included NT-proBNP level, 6-minute walk test, ultrasonic cardiogram, and NYHA classification before and after treatment.</p><p><b>RESULTS</b>According to NYHA classification, the response rate was 29.27%in the treatment group and 10.00%in the control group; there was a significant difference between the two groups (P < 0.05). The average walk distance in the treatment group was increased from 150.96±73.12 m before treatment to 169.32±77.04 m after treatment, and the improvement was statistically significant (P < 0.05). The average NT-proBNP level in the treatment group was reduced from 1154.44 ± 480.79 ng/L before treatment to 494.49 ± 342.61 ng/L after treatment, and the reduction was statistically significant (P < 0.01). Left ventricular ejection fraction was significantly improved in the treatment group (P < 0.05).</p><p><b>CONCLUSION</b>Qili Qiangxin capsules in addition to comprehensive symptomatic treatment can significantly reduce NT-proBNP level and improve cardiac function in silicosis patients, and thereby improve patients' quality of life.</p>
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Humans , Capsules , Drugs, Chinese Herbal , Pharmacology , Echocardiography , Heart Failure , Natriuretic Peptide, Brain , Metabolism , Peptide Fragments , Metabolism , Quality of Life , Silicosis , Drug TherapyABSTRACT
Objective To explore the clinicopathological characteristics in young women with breast cancer.Methods The clinicopathological data of 201 cases of breast cancer with age below 35 years from Apr.1997 to Apr.2010 in Anyang Tumor Hospital were retrospectively analyzed and compared with those of 251 cases of breast cancer patients selected randomly with age more than 60 years during the same period.All these cases had undergone surgical treatment and been confirmed by pathologist.Results In the young group,the percentage of patients with the course of disease less than six months was higher than that of the old-aged group [82.09 ％ (165/201),72.11％ (181/251)] (x2 =6.19,P ＜ 0.05).The incidence of the tumor size ≤ 2 cm in the young group was less than that of the old-aged group [19.90 ％ (40/201),30.28 ％ (76/ 251)] (x2 =6.302,P ＜ 0.05).The incidence rate of metastasis of lymph nodes in the young group was less than that of the old-aged group [63.68 ％ (128/201),54.19 ％ (136/251)] (x2 =4.145,P ＜ 0.05).The incidence rate of stage 0～ Ⅰ in the young group was more than that of the old-aged group [11.94 ％ (24/201),17.53 ％ (44/251)] (x2 =2.729,P ＞ 0.05).Conclusion The tumor size in the young group is larger than that in the old-aged group,pTNM classification in the young group is later than that in the latter group and the incidence rate of metastasis of lymph nodes in the young group is higher than that in the latter group.In young patients with breast cancer the percentage of tumors with advanced tumor stage and poor prognosis are more than that in elder breast cancer patients.In addition,these young patients have lower awareness to mammary adenocarcinoma.Young ladies should examine breast cancer by themselves and go to hospital for regular inspections in order to discovere,diagnose and treat cancer earlier.
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Objective To analyze health status and characters of health service demand and utilization among farmers and herdsmen in Kangxiwa and Saitula border areas from the altitude of 3700m to 4300m for offered scientific advices to the health management institutions for optimizing the allocation of health resources.Methods A total of 51 families in the Kangxiwa and Saitula areas in Karakorum-Kunlun Mountains were randomly chosen with stratified sampling method for the family health survey.Physical and biochemical examination were carried out for each herdsman.Results Among the participants,the most disease the two-week medical consultation rate was 1.74％.the hospitalization rate was 0.98％.The two-week medical consultation and hospitalization rate of herds were lower than the national and Xinjiang level for rural area.Herdsmen's doctor poor accessibility and low-income may be the main reasons for the underutilization of health services ;The difficult situation of herdsmen has been initially improved after participating in the new rural cooperative medical care.Conclusion The health status of native herdsmen in Kara Kunlun mountains was poor,and the provision of health services cannot meet the demand for health service of native herdsmen.It's necessary to improve efficiency of utilization of health service and optimize the allocation of health resources.