ABSTRACT
Objective: Using propensity score matching method(PSM) to investigate the clinical effect of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma. Methods: A retrospective analysis was conducted on the clinical data of 324 patients diagnosed with advanced tonsillar squamous cell carcinoma and treated in Peking Union Medical College Hospital from 2000 to 2018, confirmed by pathology and without distant metastasis. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching(PSM). Results: Of the 324 patients, 102 were treated with non-surgery chemoradiotherapy treatment strategies and 222 with surgical plus radio(chemo)therapy treatment. Cox multivariate analysis showed that the non-surgery treatment group had a favorable prognosis than the surgical treatment group, however, these outcomes were not significantly different [overall survival(OS): adjusted Hazard Ratios(aHR): 0.92, 95% confidence interval(CI): 0.60-1.42; disease-specific survival(DSS): aHR: 0.71, 95%CI: 0.43-1.20; disease-free survival(DFS): aHR: 0.82, 95%CI: 0.53-1.28]. The new patient cohort consisted of 102 subpairs after PSM. There were no significant differences between two groups(OS: aHR: 0.85, 95%CI: 0.51-1.40; DSS: aHR: 0.62, 95%CI: 0.35-1.11; DFS: aHR: 0.80, 95%CI: 0.49-1.33). Conclusion: Our findings indicate that patients with non-surgical treatment do not have significantly better survival outcomes compared to surgical treatment group, while non-surgical treatment has advantages in improving the quality of life of patients, so comprehensive treatment based on radiotherapy and chemotherapy may be recommended for advanced tonsillar squamous cell carcinoma.
Subject(s)
Humans , Carcinoma, Squamous Cell/therapy , Chemoradiotherapy , Quality of Life , Retrospective Studies , Tonsillar Neoplasms/therapyABSTRACT
Objective:Objective To investigate the role of radiotherapy in the treatment of refractory keloids, evaluate the self-assessment degree of satisfaction of patients and compare with the objective outcomes.Methods:A total of 144 patients (290 lesions) with refractory keloids admitted to Peking Union Medical College Hospital from 2013 to 2018 were included in this study. The median age was 28 years old (range: 15-81 years old). All lesions were subjected to electronic radiation at postoperative 24h. The regime of 5 to 7MeV electron beam radiation therapy was adopted. The total dose was ranged from 16 to 18 Gy/2f (at 1-week interval). The median follow-up time was 48 months (range: 35-91 months). Patient and Observer Scar Assessment Scale (POSAS) was used to evaluate the degree of satisfaction. Multivariate analysis was performed by Cox proportional hazards model.Results:Among 290 keloids, 52 keloids (17.9%) relapsed in 3 to 42 months from the end of radiotherapy (median 12 months). The main side effects were hyperpigmentation and local incisional extension. Univariate analysis showed that local incisional color darker than skin, pruritus, pain and young age were associated with recurrence. Multivariate analysis indicated that local incisional color darker than skin and pain were the independent prognostic factors for scar recurrence. Recurrence, hyperpigmentation and local incisional extension were the main reasons for patients′ dissatisfaction.Conclusions:Postoperative electronic radiation can achieve satisfactory efficacy in the treatment of refractory keloids. Local incisional color darker than skin and pain are the independent prognostic factors of keloid recurrence. Patient self-assessment results are not fully consistent with the objective clinical outcomes and recurrence status.
ABSTRACT
Objective:To introduce the usefulness and advantages of needle-type choledochotomy in laparoscopic common bile duct exploration.Methods:A retrospective analysis for the data of 1 107 patients who successfully implemented laparoscopic common bile duct exploration in Subei People′s Hospital of Jiangsu Province from January 1, 2013 to December 31, 2020 were applied. All cases were divided into the study group 662 cases with needle-type choledochotomy) and the control group (445 cases with non-needle-type choledochotomy) according to the manipulation of common bile duct incision. The time-cost, incidences of bleeding and bile leakage, as well as the recurrence rate of bile duct stone and the incidence of bile duct stenosis were observed and compared between the two groups. Normally distributed data were expressed as mean±standard deviation ( Mean± SD) and compared by t test while count data were expressed as frequency or percentage and compared by chi-square test or Fisher′s exact test. Results:The bile duct incision time and bleeding rate were (14.45±2.46) s and 25.1% in the study group, (104.48±15.32) s and 68.1% in the control group, respectively. The differences between the two groups were statistically significant ( P<0.001). The incidence of stone recurrence, biliary leakage, and bile duct stricture were 3.0%, 3.6% and 0.3% in the study group, 4.9%, 5.6% and 0.4% in the control group, respectively. There were no statistically significant differences between the two groups ( P>0.05). Conclusion:Needle-type bile duct incision can be used as a routine manipulation in laparoscopic common bile duct exploration for its time-saving, less bleeding, safe and easy to handling.
ABSTRACT
Objective:To investigate the effect of Huayu Jiedu prescription （HYJDP） on gut microbiota and fecal metabolites in mice with endometriosis. Method:Normal female C57BL/6J mice were divided into normal control group （CO）， endometriosis group （EM） and Chinese medicine Huayu Jiedu decocotion group （CM）. CO and EM groups received normal saline and CM group received HYJDP by intragastric administration. Untargeted metabolomics method was used to detect metabolites in fecal supernatant of mice， and receiver operating characteristic （ROC） analysis was used to screen the differential metabolites， 16S rRNA high-throughput sequencing was used to detect the gut microbiota， and Spearman correlation coefficient was used to represent the degree of correlation between differential metabolites and intestinal flora. Lipopolysaccharides （LPSs） in intestinal wall tissue， serum and peritoneal lavage fluid were detected by enzyme-linked immunosorbent assay （ELISA）. The expression of Vimentin and E-cadherin in ectopic lesions was detected by immunohistochemistry. Result:HYJDP alleviated the disorders of fecal metabolites and gut microbiota in EMS mice， especially with the recovered levels of homoveratric acid， melilotoside C and physapubescin in fecal supernatant. In the comparison of these three factors between EM group and CO group as well as between EM group and CM group， the variable important in projection （VIP） value was both above 2， and AUC in ROC analysis was both >0.9. As compared with EM group， HYJDP restored the abundance of species such as <italic>Lachnospiraceae_NK4A136_group</italic>， <italic>Lactobacillus</italic> and <italic>Blautia </italic>（<italic>P</italic><0.05）. In addition， the level of LPS in peritoneal fluid supernatant of EM group was significantly higher than that of CO group （<italic>P</italic><0.05） and CM group （<italic>P</italic><0.05）. The protein expression of vimentin and E-cadherin in endometriosis decreased significantly （<italic>P</italic><0.05）. Conclusion:HYJDP which can improve the intestinal environment and reduce the level of LPS in mice with endometriosis， is an effective drug for the treatment of endometriosis.
ABSTRACT
Objective:To evaluate the effect of leptin on pyroptosis in hippocampal cells during brain injury in a rat model of orthotopic liver transplantation (OLT).Methods:Fifty-four clean-grade male Sprague-Dawley rats, aged 12 weeks, weighing 200-250 g, were divided into 3 groups( n=18 each)by a random number table method: sham operation group (S group), OLT-induced brain injury group (Liver group) and leptin group (Lep group). The model of OLT was established according to the " two-cuff" technique in anesthetized rats in Liver and Lep groups.The perihepatic ligament was only isolated and freed in S group.Leptin 1 mg/kg was intraperitoneally injected immediately after portal vein occlusion in Lep group.The equal volume of normal saline was intraperitoneally injected at the same time point in S group and Liver group.Twelve rats in each group were selected on day 3 after surgery and sacrificed, and the hippocampal tissues were obtained for examination of the pathological changes (with a light microscope) and for determination of the expression of NOD-like receptor protein 3 (NLRP3), caspase-1, interleukin-1beta (IL-1β), IL-18 and gasdermin D (GSDMD) mRNA (by real-time polymerase chain reaction) and expression of NLRP3, caspase-1, IL-1β, IL-18 and GSDMD (by Western blot). Morris water maze test was performed in the remaining 6 rats in each group on day 30 after surgery. Results:Compared with S group, the count of viable neurons in hippocampi was significantly decreased, the expression of NLRP3, caspase-1, IL-1β, IL-18 and GSDMD protein and mRNA was up-regulated, the time of staying at the platform quadrant was shortened, and the escape latency was prolonged in Liver and Lep groups ( P<0.05). Compared with Liver group, the count of viable neurons in hippocampi was significantly increased, the expression of NLRP3, caspase-1, IL-1β, IL-18 and GSDMD protein and mRNA was down-regulated, the time of staying at the platform quadrant was prolonged, and the escape latency was shortened in Lep group ( P<0.05). The pathological changes of hippocampal tissues were significantly attenuated in Liver group when compared with Lep group. Conclusion:The mechanism by which leptin reduces brain injury is related to inhibiting pyroptosis in hippocampal cells in a rat model of OLT.
ABSTRACT
ObjectiveThere are few reports on the correlation between blood glucose fluctuation and body mass index(BMI) in patients with type 2 diabetes mellitus (T2DM). This study aims to evaluate the correlation between the two by comparing the differences of glucose fluctuation in T2DM patients with different BMI.MethodsA total of 672 patients with T2DM admitted to the General Hospital of Eastern Theater Command from June 2017 to October 2018 were selected as subjects. They were divided into 4 groups according to the quartile of BMI. The age, height, weight, course of diabetes, hemoglobin, uric acid, glycosylated hemoglobin, HOMA-IR (insulin resistance index) and HOMA-β (islet β cell function index) were collected. The blood glucose of the patients was continuously monitored within 3 days by wearing a continuous glucose monitor (CGMS). The standard deviation of daily blood glucose (SBDG), the mean of daily differences (MODD) and the mean amplitude of glycemic excursion(MAGE) were calculated to analyze the effect of BMI on blood glucose fluctuation.ResultsThe index of blood glucose fluctuation was negatively correlated with BMI, HbA1c and HOMA-β, but positively with HOMA-IR. Compared with the 1st and 2nd quartiles of BMI, the fluctuation level of patients in the 3rd and 4th quartiles was lower. Multivariate logistic regression analysis showed that after adjustment of age, sex, cholesterol, triglyceride and hemoglobin, the risk of hyperglycemia fluctuation in the fourth quartile group was lower than that in the first quartile group (OR=0.594, 95%CI: 1.825~2.062).ConclusionThe fluctuation of blood glucose in patients with higher BMI is lower than that in patients with lower BMI.
ABSTRACT
Objective The alterations of gut microbiota is closely related to metabolic diseases. The aim of this study was to analyze the effects of antibiotics on glucose metabolism and gut microbiota in mice, and to further explore the mechanism of gut microbiota in reducing blood glucose in db/db diabetic mice by broad-spectrum antibiotics. Methods 16 C57BL/KsJ-db/db mice were randomly divided into antibiotic group and control group with 8 mice in each group. Antibiotic group: broad-spectrum antibiotics(vancomycin 10mg/(kg·d), carbenicillin 50mg/(kg·d), metronidazole 50mg/(kg·d), neomycin 30mg/(kg·d)); Control group: 1% cellulose sodium solution as placebo treatment. Fasting blood glucose and body weights were recorded once a week during the study. At the same time, feces were collected for 16S rDNA gene sequencing analysis. The changes of fasting blood glucose, body weight, the relative abundance of microbiota, Shannon index, Simpson index and GLP-1 were compared between the two groups. Results After 5 weeks of treatment with broad-spectrum antibiotics (Vancomycin , Carbenicillin , Metronidazole , and Neomycin ), fasting blood glucose levels in db/db diabetic mice were significantly decreased (9.59±4.49mmol/L vs 19.71±8.74mmol/L,P=0.016). At the same time, antibiotics can also affect the gut microbiota of mice. The relative abundance of Proteobacteria in mice treated with antibiotics was significantly higher than that in control group (0.471±0.12 vs 0.177±0.12, P<0.05), and the OTUs of Proteobacteria, Enterobacteriaceae, Gamma-proteobacteria, and Enterobacteriales increased in mice treated with antibiotics compared with controls. In addition, we also showed antibiotics could change the diversity of gut microbiota, and the diversity of gut microbiota in antibiotic treated mice decreased significantly (Shannon index 3.135 vs 5.359, P<0.01); Simpson index 0.794 vs 0.946, P<0.01). Conclusion Broad-spectrum antibiotics can significantly reduce the fasting blood glucose level and the diversity of gut microbiota of db / db diabetic mice, and the alterations of gut microbiota may play an essential role in the process of reducing blood glucose by broad-spectrum antibiotics.
ABSTRACT
Objective@#To investigate the clinical features and prognosis of primitive neuroectodermal tumor (PNET).@*Methods@#The clinical data of 99 patients with PNET from February 1, 1998 to February 1, 2017 were retrospectively analyzed. Univariate analysis was performed using Kaplan-Meier and Log rank test. Multiviate Cox regression was applied to analyzed independent prognostic factor for patient survival.@*Results@#Among the 99 patients, 81 were peripheral PNET(pPNET) and 18 were central PNET (cPNET) . Biopsy was performed exclusively in 16 cases, with R0 resection in 61 cases, with R1 resection in 4 cases, and with R2 resection in 18 cases. Twelve patients underwent surgery only, nine had chemotherapy only, and one received radiotherapy only. There were 72 patients who had combined treatment including chemotherapy, and 48 patients had combined therapy including radiotherapy. The one-year, three-year and five-year overall survival(OS) rates of the 99 PNET patients were 79.2%, 63.9% and 56.1% respectively, and median OS time was 14.0 months. The one-year, three-year and five-year progression free survival (PFS) rates of these patients were 42.7%, 25.7% and 19.8% respectively, and median PFS time was 8.0 months. The univariate analysis revealed that lymph node metastasis, surgical resection, numbers of cycles of chemotherapy and radiotherapy dose were the main factors affecting the OS (all P<0.05). Gender, age, lymph node metastasis, staging, and chemotherapy cycles were related to PFS in PNET patients (P<0.05). Multivariate analysis showed that the degree of surgical resection, chemotherapy cycle, and radiotherapy dosage were independent influencing factors of OS in PNET patients (risk ratio=1.856, 0.398, and 0.408, respectively, all P<0.05), and gender was an independent factor influencing PFS in PNET patients (risk ratio=0.494, P<0.05).@*Conclusions@#Comprehensive therapy is the main therapy for PNET patients. The surgical resection, cycles of chemotherapy and radiotherapy dosage are independent prognostic factors for patient′s OS.
ABSTRACT
Objective To validate the analysis capability of RapidHITTM 200 system for four kinds of routine forensic samples and the recyclable capability of template, template DNA and PCR products in the process of twice duplicate detection. Methods The buccal swabs underwent the test twice by RapidHITTM 200 system, and the template DNA and PCR products that arose in the system were also tested for two times. After four kinds of routine forensic samples were detected by RapidHITTM 200 system, the follow-up tests of the template, template DNA and PCR products that arose in the system were performed. Re-sults The STR loci could be detected in the buccal swabs by the system for the first time. However, part of the STR loci lost during the second test. And the peak value obtained in the second test was significantly reduced than the one in the first time. The average STR loci detection rates of the template DNA and PCR products were both less than 50％ in the second test, which were significantly reduced than that in the first test. In addition, the analysis capability of the system for the tissues and buccal swabs was better than that for the blood and cigarette butts. Compared with the first test, the STR loci detection rate of the tested items, template DNA and PCR products decreased with the numbers of tests. Conclusion RapidHITTM 200 system is more effective in retesting buccal swabs than other samples, whereas the items, DNA template, PCR products obtained in the first and second time cannot be directly used for the further application and study of forensic medicine.
ABSTRACT
<p><b>Objective</b>To investigate the effect of finasteride on the microvascular density (MVD) and the expression of the vascular endothelial growth factor (VEGF) in the seminal vesicle of rats.</p><p><b>METHODS</b>Forty male SD rats were randomly and equally divided into groups A, B, C and D, those in groups A and B fed with normal saline as the control and those in C and D with finasteride at 40 mg per kg of the body weight per day, A and C for 14 days and B and D for 28 days. Then the seminal vesicles of the animals were harvested for HE staining, measurement of MVD, determination of the expressions of CD34 and VEGF by immunohistochemistry, and observation of histomorphological changes in the seminal vesicle.</p><p><b>RESULTS</b>The expressions of CD34 in groups C and D were decreased by 6.7% and 15.8% as compared with those in A and B (P<0.01), and that in group D decreased by 9.3% in comparison with that in C (P<0.01). The expression indexes of VEGF in groups C and D were decreased by 6.9% and 14.1% as compared with those in A and B (P<0.01), and that in group D decreased by 9.0% in comparison with that in C (P<0.01).</p><p><b>CONCLUSIONS</b>Finasteride can inhibit the expression of VEGF in the seminal vesicle tissue of the rat and hence suppress the angiogenesis of microvessels of the seminal vesicle.</p>
Subject(s)
Animals , Male , Rats , Angiogenesis Inhibitors , Pharmacology , Antigens, CD34 , Metabolism , Finasteride , Pharmacology , Immunohistochemistry , Neovascularization, Physiologic , Random Allocation , Rats, Sprague-Dawley , Seminal Vesicles , Metabolism , Vascular Endothelial Growth Factor A , MetabolismABSTRACT
Objectives To conduct a research on the possibility and effect factors of latent fingerprints development in clothing objects after vacuum coating, and extracting fingerprints DNA and to probe in the relation among DNA template quantity and genetic loci numbers tested, and the rfu value after coating. Methods To select two groups that are free sweat hands and sweat hands and have them press their fingerprints on the cloth, after coating, and to analyze the effect of time, to quantify and test the targeted fingerprints DNA, to compare the locus numbers tested between white and black cloth. Results As the time is prolonged, the locus numbers tested decrease. The locus numbers tested on the group of sweat hands using the same method after the same placed time are lager than the free sweat hands. When the value of rfu is 600 above, the ratio of the locus numbers tested is more than 90% and the threshold of templates is 0.013ng. The locus numbers tested of white cloth is larger, comparing with black cloth when using the same method. What is more, there exists an prohibitive influence of pigments of the dyed cloth over the PCR amplification, to put it further, the loci numbers tested will be trimmed. Conclusion The technology of vacuum coating can be well used in the area of detecting fingerprint DNA.
ABSTRACT
Objective To examine the incidence of radiation-induced lung injury(RILI)after involved-field intensity-modulated radiation therapy(IMRT)in patients with locally advanced non-small cell lung cancer(NSCLC),and to evaluate the predictability of different models.Methods The clinical data of 242 inoperable or unresectable stage Ⅲ NSCLC patients treated in our hospital from 2007 to 2011 were reviewed. Grade 2 and grade 3 RILI that occurred within 6 months after IMRT were selected as outcome events in this study. The principal component analysis(PCA)model,Lyman-Kutcher-Burman(LKB)model,and mean lung dose(MLD)model were each used to establish a predictive model of normal tissue complication probability (NTCP)for evaluating the dosimetric parameters of IMRT. Results Four principal components were used in the PCA model. The areas under the receiver operating characteristic curve(AUCs)of grade 2 and grade 3 RILI were 0.652 and 0.611,respectively. For the LKB model, the fitted parameters were m=0.46, n=1.35, and D50=23.59 Gy for grade 2 RILI,and m=0.36,n=0.27,and D50=72.67 Gy for grade 3 RILI. The AUCs of grade 2 and grade 3 RILI in the LKB model were 0.607 and 0.585, respectively. For the MLD model, the estimated parameters were γ50=1.073 and D50=24.66 Gy for grade 2 RILI,and γ50=0.97 and D50=48.45 Gy for grade 3 RILI.The AUCs of grade 2 and grade 3 RILI in the MLD model were 0.604 and 0.569,respectively. Conclusions The use of large data set from a single patient population with the same mode of treatment is very important for improving model predictability and stability. Both the LKB model and PCA model can predict the probability of RILI,whereas the MLD model is less effective in predicting grade 3 RILI.
ABSTRACT
A quantitative method for epimedin A, B, C and icariin in rat plasma was established using LC-MS/MS after intermuscular administration of Chuankezhi injection to rat. Chromatographic separation was performed on an Agilent Eclipse XDB-C18 column (150 mm×2.1 mm, 5.0 μm) at 40℃. Mobile phase consisted of acetonitrile -0.1% formic acid in water (35:65), and the flow rate was 0.22 mL·min-1. The LC effluent was detected and analyzed using an ESI-triple quadrupole tandem mass spectrometer under the multiple reaction monitoring (MRM) in the negative ion mode. The plasma samples were treated with solid phase extraction prior to LC-MS/MS analysis. As a result, all of the four analytes displayed a good linearity over the concentration of 1-1000 ng·mL-1. The RSDs of intra-day and inter-day assays were less than 5.99% and 10.16%, respectively. The relative recovery of each analyte was between 88.1%-101.1% with RSD<7.9% and the absolute recovery was between 72.0%-86.6% (RSD<6.3%). In conclusion, the established method shows good specificity, sensitivity and efficiency for quantifying the four flavonoid glycosides contained in rat plasma.
ABSTRACT
To establish an UPLC method for the simultaneous determination of 8 compounds in Eclipta Herba, such as isoquercitrin, luteoloside, demethylwedelolactone, isochlorogenic acid A, isochlorogenic acid C, luteolin, wedelolactone and apigenin. The experiment was performed with a Waters Acquity UPLC BEH C₁₈ (2.1 mm×100 mm, 1.7 μm) column by gradient elution of 0.1% formic acid in water and acetonitrile: 0-4 min,10%-13% A; 4-10 min, 13%-16% A; 10-13 min, 16%-25% A; 13-17 min, 25%-28% A; 17-20 min,28%-40% A;20-25 min,40%-95% A. The flow rate was 0.3 mL•min⁻¹.. The condition of was the colum temperature was maintained at 35 ℃ and the detected wavelength was set at 350 mm. 8 components were separated clearly by this method. Also a good linearity was obtained between the chosen concentration(r≥0.999 0). The measured data showed that the recovery rate range from 96.60%-103.4% (n=6) and their RSD values were 0.86%-2.4%. The method has high recovery rate, good reproducibility and stability. It provides a scientific basis for the identification and quality evaluation of Eclipta Herba.
ABSTRACT
To study pharmacokinetic characteristics of epimedin A, B, C and icariin after intermuscular administration of Chuankezhi injection to rat. The established RRLC-MS/MS method was applied for simultaneous determination of four analytes in rat plasma and calculating their pharmacokinetic parameters. As a result, each analyte showed a good linear relationship in the concentration range of 1-1 000 μg•L⁻¹.The intra-day precise was 96.9%-107.5% with RSD<5.99%, inter-day precise was 92.3%-105.0% with RSD<10.16%. The relative recovery of four analytes was 88.1%-101.1% with RSD<7.9% and their absolute recovery was 72.0%-86.6% with RSD<6.3%. After intermuscular administration of Chuankezhi injection, the plasma concentration of four flavonoid glycosides rapidly arose to peaks at about 10 min, and then quickly declined in rat. Tmax of epimedin A, B, C and icariin was 0.21, 0.19, 0.16 and 0.49 h, respectively, and their mean elimination half-life(t1/2z) was 0.60, 0.62, 0.47 and 0.49 h. The established method was validated to be sensitive, rapid and specific for determination of the four analytes. Serum concentration of 4 species of epimedium flavonoids in Chuankezhi injection was low, and their absorption and elimination seem quickly, displaying similar pharmacokinetic characteristics in this study.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the association of VKORC1 gene -1639G/A polymorphism with atrial fibrillation (AF) in ethnic Uygurs and Hans from Xinjiang.</p><p><b>METHODS</b>The above polymorphism was detected among 100 Uygur and 102 Han AF patients and 103 Uygur and 111 Han subjects that have no AF with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.</p><p><b>RESULTS</b>A statistically significant difference was detected between the patient and control groups of Uygur origin in terms of genotypic and allelic frequencies (P<0.05). Logistic regression analysis also indicated the -1639G/A polymorphism as an independent risk factor for AF in Uygur population (OR=2.085, 95% CI: 1.067-4.072, P=0.031). No similar statistical difference was found between the patient and control groups of Han origin (P>0.05).</p><p><b>CONCLUSION</b>The -1639G/A polymorphism of VKORC1 gene is associated with AF in the Uygur population but not in Hans.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Asian People , Ethnology , Genetics , Atrial Fibrillation , Ethnology , Genetics , Base Sequence , China , Ethnology , Molecular Sequence Data , Polymorphism, Single Nucleotide , Vitamin K Epoxide Reductases , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To analyze the status of maternal health behaviors and it's risk factors for Yi-nationality women in poor rural areas of Sichuan province.</p><p><b>METHODS</b>In 2012, multi-stage stratified cluster sampling method was used to select 14 villages of two poor counties in Liangshan Yi-nationality autonomous prefecture Sichuan province. At least 10 women who have infants aged 0-12 months were selected in each simple villages, a total of 284. The structured questionnaire was developed on the basis of the theory of reasoned action. Yi-nationality female college students were trained as investigators. Research indicators included prenatal care rate, hospital delivery rate, postpartum examination rate, socio-demographic characteristics, maternal health care knowledge. χ² test was used to compare the differences of above indicators among different groups. The structural equation model were used to statistical analyze.</p><p><b>RESULTS</b>In the 284 subject women, 51.7% (147/284) women owned more than 2 children, 41.6% (118/284) women were more than 30 years old, 87.3% (248/284) women were illiteracy. The prenatal care rate was 69.7% (197/284), the hospital delivery rate was 26.8% (76/284), and the postnatal check rate was 22.9% (65/284). The influence factors of maternal health behaviors included the number of children, age and education (χ² were 10.92, 13.24, 9.58; P values were 0.027, 0.004, 0.008, respectively).The structural equation model analysis results showed that the maternal health behaviors were directly or indirectly affected by subjective norms (β = 0.236, P < 0.001), women's cognition (β = 0.226, P = 0.020) and women's attitudes on maternal health behavior (β = 0.157, P = 0.001). Among subjective norms, women have high compliance to their husbands (β = 0.850, P < 0.001), their peers (β = 0.708, P < 0.001), and their mothers-in-law (β = 0.636, P < 0.001).</p><p><b>CONCLUSION</b>There were still serious problems in maternal health behaviors for Yi-nationality women in poor rural areas. The main factors included not only the women's cognition and attitudes for maternal health, but also the attitudes of important social relationships.</p>
Subject(s)
Child , Female , Humans , Infant , Pregnancy , China , Ethnicity , Family , Health Behavior , Ethnology , Maternal Health , Ethnology , Maternal Health Services , Postpartum Period , Prenatal Care , Risk Factors , Rural PopulationABSTRACT
Objective To explore the incidence and related predictive factors for acute symptomatic esophagitis in patients with locally advanced non?small cell lung cancer ( NSCLC ) treated with intensity?modulated radiation therapy ( IMRT) . Methods Data were collected retrospectively from 256 patients with inoperable or unresectable stage Ⅲ NSCLC treated in our hospital between January 2007 and December 2011. The radiotherapy target volume included primary lung cancer and lymphatic drainage area involved,with a median dose of 60 Gy in 30 fractions (50-70 Gy).Of all the patients,109 patients (42.6%) received concurrent chemotherapy. Grade ≥2 acute esophagitis ( AE ) ( symptomatic esophagitis ) which occurred during radiotherapy and within 3 months after completion of radiotherapy served as the outcome event. National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0( NCI?CTCAE3.0) was used to evaluate the grade of AE. The logistic regression model was used to analyze the predictive factors. Results A total of 174 patients ( 68%) had treatment?related grade ≥2 AE;154 patients ( 60. 2%) had grade 2 AE and 20 patients (7.8%) had grade 3 AE.The median dose when grade≥2 AE occurred was 30 Gy (11?68 Gy).For grade≥2 AE,multivariate analysis showed that esophageal V5?V60,mean dose,and age were independent predictive factors (P=0.021,0,0.010).For grade ≥3 AE,multivariate analysis showed that esophageal V50?V60 ,concurrent chemotherapy,and body mass index ( BMI) were independent predictive factors ( P= 0.010,0.003,0.019 ) . Old age and higher BMI were the protective factors for grade≥2 and ≥3 AE, respectively. Conclusions For patients with locally advanced NSCLC treated with IMRT, esophageal V50—V60 and concurrent chemotherapy are predictive factors for grade ≥3 AE,and esophageal V50 has a high predictive value for both grade ≥2 and ≥3 AE.
ABSTRACT
Objective To investigate the incidence of radiation?induced lung injury ( RILI ) in patients with locally advanced non?small cell lung cancer ( LA?NSCLC ) after involved?field intensity?modulated radiotherapy ( IMRT) and concurrent chemotherapy, and to figure out the predictive factors for RILI. Methods Two hundred and fifty?six patients with stage Ⅲ NSCLC who were treated without surgery in our hospital from January 2007 to December 2011 were enrolled as subjects. All patients received involved?field IMRT with a median dose of 60 Gy ( 50?70 Gy) in 30 fractions. In all patients, 109 patients (42.6%) received concurrent chemotherapy. The National Cancer Institute Common Terminology Criteria for Adverse Events Version 3. 0 was used to evaluate the RILI grade. The incidence of grade ≥2 RILI ( symptomatic RILI, SRILI ) within 6 months after radiotherapy served as the end point. The predictive factors for RILI were analyzed using logistic regression model. Results In all patients, 215 ( 84%) were male, and 41(16%) were female. The mean age at diagnosis was 59.2 years. Forty?three (16.7%) patients had grade ≥2 RILI. The mean duration between the incidence of RILI and the beginning of radiotherapy was 64 days ( 20?169 days) . Univariate analysis showed that smoking, peripheral or central tumor location, mean lung dose ( MLD) for both lungs, and V5?V20 for both lungs were suspected to be associated with the development of SRILI (P=0.108,0.106,0.030,0.049). Multivariate analysis showed the MLD and V5?V20 for both lungs were independent predictive factors for SRILI P=(0.048). Conclusions For patients with LA?NSCLC treated with involved?field IMRT, the MLD and the volume of low?dose region in dose volume histogram for both lungs are significantly correlated with the incidence of SRILI.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effects of wrist-ankle acupuncture combined with ginger moxibustion against gastrointestinal tract reactions (nausea, vomiting, and constipation) to chemotherapy in cancer patients.</p><p><b>METHODS</b>A total of 60 patients with gynecological tumors treated by chemotherapy were randomly divided into two groups. The treatment group (30 cases) underwent wrist-ankle acupuncture and ginger moxibustion, whereas tropisetron hydrochloride and dexamethasone were intravenously administered to the control group (30 cases) during chemotherapy.</p><p><b>RESULTS</b>The frequency of nausea in the treatment group was significantly less than that of the control group from the 2nd to the 5th day of chemotherapy (P<0.01). The anti-emetic effect in the treatment group was significantly better than that in the control group on the 3rd day of therapy (P<0.05). The incidence rate of constipation was significantly lower in the treatment group than that in the control group (P<0.01). Furthermore, the cost of therapy for the treatment group was significantly lower than that of the control group (P<0.01). Only 1 patient manifested a post-acupuncture side effect in the form of subcutaneous blood stasis.</p><p><b>CONCLUSION</b>Wrist-ankle acupuncture combined with ginger moxibustion could prevent gastrointestinal tract reactions to chemotherapy in cancer patients. In addition, the proposed method had fewer side effects, lower cost, and less risk.</p>