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Objective:To compare the clinical value of visual analogue scale （VAS）, Lebel scale and total nasal symptom scores （TNSS） in evaluating nasal allergen provocation test （NAPT）. Methods:A total of 151 patients suspected of allergic rhinitis admitted to the Department of Otolaryngology-Head and Neck Surgery of our hospital from April 2020 to September 2020 were included, of which 76 were positive for house dust mites and 75 were negative for allergens. Nasal airway resistance（NAR） was measured by active anterior nasal manometry. Nasal symptoms were evaluated by VAS, Lebel and TNSS. House dust mite allergen was used for NAPT by spray method. An increase≥40% in NAR was used as the gold standard for objective evaluation of NAPT. ROC curves of VAS, Lebel and TNSS were drawn to compare the evaluation effectiveness of different subjective evaluation methods, and the optimal critical point of each ROC curve was obtained. Results:With NAR increased by ≥40% as the gold standard, the area under ROC curve of VAS was 0.884, and the sensitivity and specificity were 97.75% and 80.65%, respectively. The area under ROC curve of Lebel was 0.773, and the sensitivity and specificity were 68.54% and 75.81%, respectively. The area under ROC curve of TNSS was 0.792, and the sensitivity and specificity were 68.54% and 79.03%, respectively. There was no significant difference between Lebel and TNSS（P>0.05）. The VAS differed significantly from Lebel and TNSS（P<0.05）. The Kappa values of VAS, Lebel, TNSS and NAR were 0.803, 0.432 and 0.459, respectively. Conclusion:The VAS, Lebel, TNSS subjective scale and NAR are consistent in evaluating the efficacy of NAPT, with the VAS assessment showing highest consistency with NAR. As objective assessment instruments are not widely used in China, subjective assessment method could be adopted to evaluate the efficacy of NAPT in clinical practice, and VAS scale is recommended as a priority.
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Animals , Humans , Allergens , Nasal Provocation Tests/methods , Rhinitis, Allergic/diagnosis , Nose , PyroglyphidaeABSTRACT
BACKGROUND@#Immune checkpoint inhibitors (ICIs) are increasingly used as first-line therapy for patients with advanced non-small cell lung cancer (NSCLC) harboring no actionable mutations; however, data on their efficacy among patients presenting with intracranial lesions are limited. This study aimed to explore the efficacy and safety of ICIs combined with chemotherapy in advanced NSCLC patients with measurable brain metastasis at initial diagnosis.@*METHODS@#Our study retrospectively analyzed clinical data of a total of 211 patients diagnosed with driver gene mutation-negative advanced NSCLC with measurable, asymptomatic brain metastasis at baseline from Hunan Cancer Hospital between January 1, 2019 and September 30, 2021. The patients were stratified into two groups according to the first-line treatment regimen received: ICI combined with chemotherapy ( n = 102) or chemotherapy ( n = 109). Systemic and intracranial objective response rates (ORRs) and progression-free survival (PFS) were analyzed. Adverse events were also compared between the groups.@*RESULTS@#Compared with the chemotherapy-based regimen, the ICI-containing regimen was associated with a significantly higher intracranial (44.1% [45/102] vs . 28.4% [31/109], χ2 = 5.620, P = 0.013) and systemic (49.0% [50/102] vs . 33.9% [37/109], χ2 = 4.942, P = 0.019) ORRs and longer intracranial (11.0 months vs . 7.0 months, P <0.001) and systemic (9.0 months vs . 5.0 months, P <0.001) PFS. Multivariable analysis consistently revealed an independent association between receiving ICI plus platinum-based chemotherapy as a first-line regimen and prolonged intracranial PFS (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.37-0.73, P <0.001) and systemic PFS (HR = 0.48, 95% CI: 0.35-0.66, P <0.001). No unexpected serious adverse effects were observed.@*CONCLUSION@#Our study provides real-world clinical evidence that ICI combined with chemotherapy is a promising first-line treatment option for driver gene mutation-negative advanced NSCLC patients who present with brain metastasis at initial diagnosis.@*CLINICAL TRIAL REGISTRATION@#https://www.clinicaltrials.gov/ , OMESIA, NCT05129202.
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Humans , Carcinoma, Non-Small-Cell Lung/genetics , Lung Neoplasms/genetics , Immune Checkpoint Inhibitors/therapeutic use , Retrospective Studies , Brain Neoplasms/geneticsABSTRACT
Leukemia is a common, multiple and dangerous blood disease, whose early diagnosis and treatment are very important. At present, the diagnosis of leukemia heavily relies on morphological examination of blood cell images by pathologists, which is tedious and time-consuming. Meanwhile, the diagnostic results are highly subjective, which may lead to misdiagnosis and missed diagnosis. To address the gap above, we proposed an improved Vision Transformer model for blood cell recognition. First, a faster R-CNN network was used to locate and extract individual blood cell slices from original images. Then, we split the single-cell image into multiple image patches and put them into the encoder layer for feature extraction. Based on the self-attention mechanism of the Transformer, we proposed a sparse attention module which could focus on the discriminative parts of blood cell images and improve the fine-grained feature representation ability of the model. Finally, a contrastive loss function was adopted to further increase the inter-class difference and intra-class consistency of the extracted features. Experimental results showed that the proposed module outperformed the other approaches and significantly improved the accuracy to 91.96% on the Munich single-cell morphological dataset of leukocytes, which is expected to provide a reference for physicians' clinical diagnosis.
Subject(s)
Humans , Blood Cells , Leukocytes , Leukemia , Electric Power Supplies , Recognition, PsychologyABSTRACT
Two-dimensional black phosphorus (BP) has unique layered structure, excellent photothermal properties, good biocompatibility and high biodegradability. In recent years, it has been found that BP has stable drug loading and light controlled sustained-release drug functions, excellent antibacterial properties and the ability to promote vascular and nerve regeneration in the medicine field, which has a broad application prospect in dentistry. This review elaborates the biological properties of two-dimensional BP and its application progress in dentistry, so as to provide new ideas for the further research and application of two-dimensional BP.
Subject(s)
Anti-Bacterial Agents , Dentistry , PhosphorusABSTRACT
Although several artificial nanotherapeutics have been approved for practical treatment of metastatic breast cancer, their inefficient therapeutic outcomes, serious adverse effects, and high cost of mass production remain crucial challenges. Herein, we developed an alternative strategy to specifically trigger apoptosis of breast tumors and inhibit their lung metastasis by using natural nanovehicles from tea flowers (TFENs). These nanovehicles had desirable particle sizes (131 nm), exosome-like morphology, and negative zeta potentials. Furthermore, TFENs were found to contain large amounts of polyphenols, flavonoids, functional proteins, and lipids. Cell experiments revealed that TFENs showed strong cytotoxicities against cancer cells due to the stimulation of reactive oxygen species (ROS) amplification. The increased intracellular ROS amounts could not only trigger mitochondrial damage, but also arrest cell cycle, resulting in the in vitro anti-proliferation, anti-migration, and anti-invasion activities against breast cancer cells. Further mice investigations demonstrated that TFENs after intravenous (i.v.) injection or oral administration could accumulate in breast tumors and lung metastatic sites, inhibit the growth and metastasis of breast cancer, and modulate gut microbiota. This study brings new insights to the green production of natural exosome-like nanoplatform for the inhibition of breast cancer and its lung metastasis via i.v. and oral routes.
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Objective: To observe the clinical efficacy of warm needling moxibustion plus spine subtle adjusting manipulation for cervical radiculopathy. Methods: A total of 70 patients with cervical radiculopathy were randomized into an observation group and a control group, with 35 cases in each group. The observation group was treated with warm needling moxibustion plus spine subtle adjusting manipulation, while the control group was treated with warm needling moxibustion alone. The treatments were performed three times a week, and for four weeks in total. The visual analog scale (VAS) was scored before and after treatment. And the clinical efficacy of the two groups was compared after treatment. Results: The total effective rate was 97.1％ in the observation group, versus 88.6％ in the control group. The difference between the two groups was statistically significant (P<0.05). After treatment, the VAS scores in both groups significantly decreased (P<0.01), and the score in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Warm needling moxibustion plus spine subtle adjusting manipulation has a better effect in the treatment of cervical radiculopathy than warm needling moxibustion alone.
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Radiotherapy is a vital treatment method for pancreatic cancer. However, the therapeutic effect of radiotherapy is significantly limited by the influence of pancreatic motion. More efficient radiotherapy for pancreatic cancer depends upon the improvement of motion management and high-quality image guidance. The emerging MR-guided radiotherapy (MRgRT) can perform functional imaging with high soft tissue resolution and no additional radiation. Multiple researches have demonstrated that MRgRT has significant advantages in terms of precise delineation of target area and organ at risk, motion management and adaptive radiotherapy, which assists radiotherapy to play a better role in the treatment of pancreatic cancer. In this paper, the application of MRgRT in pancreatic cancer was reviewed and prospected.
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Objective:To explore the application value of clinical case-based learning in medical imaging teaching.Methods:A total of 145 clinical medical students from three classes in the third year were enrolled and they were divided into three classes. One class took case-based learning, one class took traditional teaching, and one class took both. The teaching content was the preclinical medical professional course—Medical Imaging. Continuous variables were expressed in accordance with normal distribution (mean standard deviation). Differences in mean and median values were evaluated by using t test and the Mann-Whitney U test, respectively. Categorical data were compared using the chi-square test. Results:There was a significant difference between the combined teaching class and the case-based learning class or the traditional teaching class in the final exam ( P=0.002). There was also a significant difference between the combined teaching class and the traditional teaching class in the film reading quiz ( P=0.035). More than 70% of students recognized the case-based learning. Conclusion:Case-based learning is helpful to improve students' flexible application of relevant knowledge and skills of analysis and communication.
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Chronical hyperuricemia, a severe metabolic disease characterized by increased serum uric acid, urea nitrogen, and creatinine, has a positive correlation with the risks of gouty arthritis, diabetes, hypertension, and kidney damage. Abnormal purine metabolism and reduced uric acid excretion are the major causes of hyperuricemia, which, thus, points to a potential strategy of preventing from or delaying the progress of hyperuricemia-related diseases and its complications by effectively controlling the serum uric acid level. Increasing evidence has revealed that Chinese medicines alleviate hyperuricemia through regulating intestinal flora, which plays a pivotal role in regulating metabolites, including uric acid level. The disease treatment with traditional Chinese medicine is based on syndrome differentiation, and Chinese medicines often have multiple effects and a wide range of targets. In this review, we summarized the anti-hyperuricemia effects and mechanisms of active compounds in Chinese medicines, single Chinese medicinal herbs, and Chinese medicinal prescriptions in regulating the uric acid level via intestinal flora and metabolites, which will be helpful for further study and application of Chinese medicines in hyperuricemia treatment.
Subject(s)
Humans , Arthritis, Gouty , China , Gastrointestinal Microbiome , Hyperuricemia/drug therapy , Uric AcidABSTRACT
Blunt traumatic thoracic aortic injury (BTAI) is an extremely serious medical condition with a high rate of associated mortality. Recent advances in techniques such as thoracic endovascular repair offer new opportunities to manage the critical BTAI patients in an efficacious yet less invasive manner. A 65 year-old-male suffered from multiple injuries after a fall, including BTAI in the aortic arch, which resulted in dissection of the descending thoracic-abdominal aorta and iliac artery, development of an intimal flap in the left common carotid artery, and dissection of the left subclavian artery. Based on the imaging information of this patient and our clinical experience, the combined treatment of fenestrated thoracic endovascular repair and a chimney technique was immediately planned to fully repair these dissections and moreover prevent further dissection of the branching vessels, additionally to ensure sufficient blood flow in the left subclavian artery and left common carotid artery. The intervention yielded satisfactory early outcomes. Follow-up assessment at six months reported no symptoms or complications associated with the stent-graft. Computed tomography angiography further confirmed adequate stent-graft coverage of the aortic injury.
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OBJECTIVE@#To observe the difference in the therapeutic effects on rheumatoid arthritis (RA) between the combined -deep needling and bloodletting technique and the regular needling technique.@*METHODS@#A total of 70 patients were randomized into an observation group (35 cases) and a control group (35 cases, 4 cases dropped-out). Dazhui (GV 14), Shenzhu (GV 12), Zhiyang (GV 9), Jinsuo (GV 8), Ganshu (BL 18), Shenshu (BL 23), Zhibian (BL 54), Weizhong (BL 40), Taixi (KI 3) and Tianzong (SI 11), etc. were selected in the two groups. Additionally, in the observation group the -deep needling technique was adopted at Tianzong (SI 11) and Zhibian (BL 54), the bloodletting technique at the local swollen area and the even-needling technique at the rest acupoints. In the control group, the even-needling technique was applied to all of the acupoints. Acupuncture treatment was given once every two days, 3 times a week and for 12 weeks totally. The numbers of tender points at the knee joint, the numbers of swollen sites at the knee joint, the visual analogue scale (VAS) score and the American health assessment questionnaire (HAQ) score were observed in the two groups before and after treatment, as well as the changes in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The American College of Rheumatology (ACR) criteria was adopted to evaluate the therapeutic effects of the two groups.@*RESULTS@#After treatment, the numbers of tender points, the numbers of swollen sites, VAS score and HAQ score were all improved as compared with those before treatment in the two groups (all 0.05). The standard-reaching rates of ACR 20 and ACR 50 in the observation group were 94.3% (33/35) and 31.4% (11/35) respectively, which were better than 67.7% (21/31) and 6.5% (2/31) in the control group (<0.01, <0.05).@*CONCLUSION@#The acupuncture with the -deep and bloodletting techniques and the acupuncture with regular needling technique are all effective on RA. The therapeutic effects of the acupuncture treatment with the -deep and bloodletting techniques are better than that with regular needling technique.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Arthritis, Rheumatoid , Therapeutics , Bloodletting , Treatment OutcomeABSTRACT
Objective Sclerosing pneumocytoma (SP) is a rare benign tumor of the lung. This study investigates the CT and PET/CT features of 52 patients with sclerosing pneumocytoma (SP), summarizes their imaging features and provide reference for improving the accuracy of SP imaging diagnosis.Methods The clinical and imaging data of 52 patients with SP confirmed by operation and pathology in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine and the First Affiliated Hospital of Nanjing Medical University from January 2010 to March 2018 were analyzed retrospectively，and the imaging features of the disease were analyzed and summarized. Among 52 SP patients, 46 were female and 6 were male, with an average of 50.7±12.6 years old.Results ①Morphological characteristics: all were round or round-shaped solitary nodules or masses in the lung. The average diameter of the tumor was 22.2±15.4 mm. 39 lesions had smooth edges and 13 had shallow edge lobulation sign; ②Predilection sites: 33 of the cases were closely attached to or adjacent to the pleura, and there was no preponderant distribution of the lobe; ③Density: The density of the lesion was homogeneous. 8 cases had coarse calcifications at the edges or in the lesions; ④Enhancement features: 26 cases showed moderate to marked enhancement, only 6 cases were mild enhancement; ⑤Features around the tumor: "vascular adhering sign" in 21 cases, "tail sign" in 7 cases, "air crescent sign " in 5 cases, "localized emphysema" in 4 cases, "halo sign" in 11 cases, "bird egg-bird nest sign" in 5 cases, 4 cases of secondary bronchiectasis; ⑥Associated tumors: 3 cases of invasive lung adenocarcinoma, 3 cases of lung adenocarcinoma in situ, 2 cases of pulmonary atypical adenomatous hyperplasia, 1 case of pulmonary tiny inflammatory nodule; 2 cases of esophageal cancer associated, 1 case of invasive thymoma, 1 case of large mature ovarian cystic teratoma; ⑦PET/CT characteristics: 18F-FDG standard uptake value in tumor increased to different degrees, the average of SUV max value was 4.4±3.2.Conclusion The innovation of this research: SP is shown as solitary circular or circular-shaped blood-rich nodules in the lung, often under the pleura, especially the mediastinal pleura and lobar pleura. There is no lobar distribution advantage; SP calcification is uncommon, among which the calcification at the margin of the tumor was more common. "Air crescent sign", " Halo sign" and " Bird egg-bird nest sign" have high diagnostic value for SP.
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Objective To observe the change of dopamine receptor in ventral tegmental area (VTA), nucleus accumbens (NAc) and prefrontal cortex (PFC) in morphine-dependent rats, and the regulation effect of electroacupuncture (EA). Method Thirty male SD rats were randomized into a control group, a model group and an EA group, 10 rats each. Morphine-dependent rat models were induced by morphine self-administration. In the EA group, bilateral Jiaji points (EX-B2) of T5 and L2 were selected, and the EA intervention lasted 4 d. Western blotting method was adopted to observe the change of the contents of dopamine receptor D1 and D2 in VTA, NAc and PFC of the rats. Result After the intervention, compared to the model group, the morphine intake was reduced significantly in the EA group (P<0.05); the level of D2 declined significantly in VTA of rats in the model group (P<0.05); the level of D1 increased significantly and D2 declined significantly in NAc of rats in the model group (P<0.05); the level of D1 declined significantly and D2 increased significantly in PFC of rats in the model group (P<0.05); EA produced regulation effect on the altered contents of D1 and D2 in the cerebral areas mentioned above, approaching the normal level. Conclusion EA can inhibit the hunger of addiction rats for morphine to some extent; the contents of dopamine receptors in dopamine projection pathway will take adaptive changes after morphine addiction, while EA can regulate the abnormal expressions of dopamine receptors, producing a protective effect on dopamine receptors of morphine-dependent rats.
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<p><b>OBJECTIVE</b>To observe the clinical efficacy differences between different needling methods for dry eye syndrome.</p><p><b>METHODS</b>Sixty patients of dry eye syndrome were randomly divided into an observation group and a control group, 30 cases (60 eyes) in each group. Shangjingming (Extra), Xiajingming (Extra), Tongziliao (GB 1), Cuanzhu (BL 2), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) were selected in the two groups. The control group was treated with conventional acupuncture, while the observation group was treated with guiding-acupuncture. Electroacupuncture (EA) was used at bilateral Tongziliao (GB1) and Cuanzhu (BL 2), 30 min per treatment. The treatment was given three times per week. Totally 1-month treatment (12 treatments) was given. The eye symptom score, breakup time of tear film (BUT), Schirmer Ⅰ test (SⅠT) and visual analogue scale (VAS) score were compared before and after treatment in the two groups. The clinical efficacy was compared between the two groups.</p><p><b>RESULTS</b>Compared before treatment, the eye symptom score, BUT, SⅠT and VAS score were improved after treatment in the two groups (all<0.001); the improvements of eye symptom score and SⅠT in the observation group were superior to those in the control group (both<0.05). The differences of BUT and VSA score between the two groups were not significant (both>0.05). The total effective rate was 86.7% (52/60) in the observation group, which was superior to 73.3% (44/60) in the control group (<0.05). .</p><p><b>CONCLUSION</b>The conventional EA and guiding-acupuncture combined with EA are both effective for dry eye syndrome, and the efficacy of guiding-acupuncture combined with EA is superior to that of conventional EA.</p>
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BACKGROUND: Although the porcine small intestinal submucosa is very similar to the skin in the structure, its pore size and porosity are not beneficial to the growth of seed cells as the skin does. OBJECTIVE: To observe the morphological and cytocompatibility of porcine small intestinal submucosa after chemical modification using 1-ethyl-3-(3-dimethylaminopropyl) carbod imide (EDC). METHODS: A porcine small intestinal submucosa sample was immersed in 3% acetic acid solution containing 0.2% pepsin to make 1%, 2%, 3%, 4% small intestine submucosa solutions. After magnetic stirring and freeze-drying, small intestinal submucosa sponge was obtained and modified by cross-linking with 50, 100, 150 mmol/L EDC. Based on the detection of pore size and water absorption, we selected the best concentrations of small intestinal submucosa and EDC, which were further used for cell culture. Passage 2 bone marrow mesenchymal stem cells were cocultured with the small intestinal submucosa sponge, and observed under scanning electron microscope at 1, 2, 3 weeks after co-culture. RESULTS AND CONCLUSION: When cross-linked with 100 mmol/L EDC, the small intestinal submucosa sponge at a mass concentration of 1% showed a reasonable structure and good elasticity with no appearance of voids, and the pore size ranged 100-150 μm. Moreover, the small intestinal submucosa sponge at a mass concentration of 1% showed a 0.35-fold increase in the compared with that at a mass concentration of 2%, and its structure was more conducive to water flows and changes. The small intestinal submucosa sponges at a mass concentration of 3% and 4% showed no difference in the water absorbing capacity. After cross-linked with 100 mmol/L EDC, the small intestinal submucosa sponge at a mass concentration of 1% showed the best structure, pore size and water absorption, which were used for cell culture. At 3 weeks after cell culture, cell deformation was relatively intact and fast; there were many cells in the pores that were relatively large and approximately spindle-shaped, while there were less cells around the pores that were relatively small and disk-shaped. A paving stone-like alteration was observed in cells that covered the most of the scaffold surface with a large number of particle-like substances, especially in the site of cell concentration. All these findings indicate that EDC-modified small intestinal submucosa sponge has good cytocompatibility.
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Objective To investigate the expression and significance of epithelial cell adhesion molecule (Ep-CAM) in breast cancer.Methods Twenty-three cases of breast cancer tissue samples and paired lymph node metastases confirmed pathologically were collected.Isobaric tags for relative and absolute quantitation (iTRAQ) proteomics technology was used to screen and identify the differentially expressed proteins between primary tumor and lymph node metastasis of breast cancer.The expression of Ep-CAM was detected by Western blotting in 4 cases of primary breast cancer tissues and paired lymph node metastases.And the expressions of Ep-CAM in 252 cases of breast lesions were detected by immunohistochemical method.Results Quantitative proteomic examination results showed that differentially expressed proteins existed in breast cancer primary tumor and lymph node metastasis,and the expression of Ep-CAM in metastatic lesions was higher than that in primary tumor.Western blotting results showed that the expression of Ep-CAM in metastatic lesions (1.46 ± 0.22) was higher than that in primary tumor (1.16 ± 0.09),which was consistent with the results of proteomic.The immunohistochemical results showed that the positive expression rate of Ep-CAM in lymph node metastasis tissues (93.16％,109/117) was significantly higher than that in primary breast cancer without metastasis (72.73％,64/88),and the difference was statistically significant (x2 =15.921,P =0.000).The positive expression rate of Ep-CAM in primary breast cancer with lymphatic metastasis (72.65％,85/117) was lower than that in paired lymph node metastases (P =0.001).Conclusion Ep-CAM is differentially expressed in primary tumor and lymph node metastasis of breast cancer,which may be related to the lymphatic metastasis of breast cancer.
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Objective To study the anatomic characteristics and clinical values of the internal auditory artery via the neuroendoscope and microscope.Methods We observed the related microdissection of the internal auditory artery of 15 cadavers through retrosigmoid approach by operative microscope and neuroendoscope,in which 3 cadavers were fresh.Results The internal auditory arteries were observed bilaterally in all specimens (100％).Among them,17 sides (56.7％,17/30) were isolated branch type,9 sides were dual trunk (30％,9/30),and 4 sides were three branches type (13.3％,4/30).The diameter of the vessel at its origin was 0.12～0.28 mm,the average caliber of IAA was 0.22±0.04 mm,the length of IAA ranged from 7.12 to 14.82 mm,and the Mean 10.18± 2.63 mm.The starting-point of IAA was quite variable,13.3％ (4/30) of the IAA origined from the inferior segment of the basilar artery,and 86.7 ％(26/30) of the IAA origined from ACIA.Among them,17 sides (65.4％,17/26) of the IAA origined from the ansa of the inferior cerebellar artery,9 sides (34.6％,9/26) of the IAA origined from the anterior inferior cerebellar artery involved in the inner ear canal.We observed that 73.3 ％(22/30) of the IAA branches were along the ventral side of the vestibulocochlear nerve;26.7 ％(8/30) of the IAA branches were above the nerves.It's easy to identify the IAA and its adjacent structures by various neuroendoscope through various anatomic fissures.Conclusion Most of internal auditory arterys were located anterior and posterior to the facial nerve,the microscope was impossible to see it directly.A thorough identification of the internal auditory artery requires theuse of both surgical microscopy and neuroendoscope.
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Objective Typical carcinoma(TC), atypical carcinoma(AC) and large cellul neuroendocrine carcinoma (LC-NEC) are rare pulmonary neuroendocrine tumor (PNET) possessing different pathological features , biological behaviors and clinical prognosis .The paper aimed to investigate the characteristic CT findings of rare pulmonary neuroendocrine carcinoma in comparison with pathological diagnosis . Methods A retrospective analysis was conducted on clinical data , CT findings and pathological results of 22 patients admitted in the Affiliated Hospital of Nanjing University of TCM from 2010 to 2016, followed by statistical analysis . Results Among the 22 cases, there were 9 females and 13 males, 12 cases of central type and 10 cases of peripheral type , 7 cases with calcifi-cations, 10 cases with focal necrosis , 6 cases with combined bronchial obstruction sign , 5 cases with lymph node metastasis , and 1 case with distant metastasis.TC was presented with younger onset age , while AC and LCNEC with older onset age (P=0.003).TC ten-ded to be central type (P=0.044), mainly charaterized by bronchial lumen nodules (P=0.005) with smooth edges (P=0.000) and often accompanied with obstructive pneumonia and atelectasis ( P=0.019) without pleural involvement .AC mostly belonged to central type , charaterized by multilobulated soft tissue masses , elongated or"iceberg"in typical ones , with rare obstruction signs and no obvi-ous pleural involvement.LCNEC was mostly peripheral, with lobulated lesion margin (P=0.000), no obvious obstruction signs, and frequent pleura involvement ( P=0.000 ) . Conclusion Rare pulmonary neuroendocrine tumors have certain characteristic clinical features and CT findings .TC has the youngest onset age , mainly characterized by bronchial lumen nodules with smooth edges and often accompanied with obstruction signs , while LCNEC has the oldest on-set age and tends to be peripheral , mostly without obstruction signs and with frequent pleura involvement .
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AIDS has gradually changed from a fatal disease to a manageable chronic disease since the advent of antiretroviral drugs.In 2003,China initiated a national free antiretroviral treatment program for people living with HIV/AIDS,several death evaluation indicators have been used to evaluate public health effect of the program.Death evaluation indicators used frequently in domestic and overseas include mortality,case fatality rate,excess mortality,standard mortality ratio,years of potential life lost,disability-adjusted life year and life expectancy.This paper summarizes the different death indicators applied in effectiveness evaluation of HIV/AIDS prevention and treatment,elaborates the application range and significance of these indicators and suggests the research in related life expectancy and burden of disease which have not been conducted in China.
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AIDS has gradually changed from a fatal disease to a manageable chronic disease since the advent of antiretroviral drugs.In 2003,China initiated a national free antiretroviral treatment program for people living with HIV/AIDS,several death evaluation indicators have been used to evaluate public health effect of the program.Death evaluation indicators used frequently in domestic and overseas include mortality,case fatality rate,excess mortality,standard mortality ratio,years of potential life lost,disability-adjusted life year and life expectancy.This paper summarizes the different death indicators applied in effectiveness evaluation of HIV/AIDS prevention and treatment,elaborates the application range and significance of these indicators and suggests the research in related life expectancy and burden of disease which have not been conducted in China.