Diagnostic value of optic disc retinal nerve fiber layer thickness for diabetic peripheral neuropathy / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#To investigate the value of optic disc retinal nerve fiber layer (RNFL) thickness in the diagnosis of diabetic peripheral neuropathy (DPN).@*METHODS@#Ninety patients with type 2 diabetes, including 60 patients without DPN (NDPN group) and 30 patients with DPN (DPN group), and 30 healthy participants (normal group) were enrolled. Optical coherence tomography (OCT) was used to measure the four quadrants and the overall average RNFL thickness of the optic disc. The receiver operator characteristic curve was drawn and the area under the curve (AUC) was calculated to evaluate the diagnostic value of RNFL thickness in the optic disc area for DPN.@*RESULTS@#The RNFL thickness of the DPN group was thinner than those of the normal and NDPN groups in the overall average ((101.07± 12.40) µm vs. (111.07±6.99) µm and (109.25±6.90) µm), superior quadrant ((123.00±19.04) µm vs. (138.93±14.16) µm and (134.47±14.34) µm), and inferior quadrant ((129.37±17.50) µm vs. (143.60±12.22) µm and (144.48±14.10) µm), and the differences were statistically significant. The diagnostic efficiencies of the overall average, superior quadrant, and inferior quadrant RNFL thicknesses, and a combined index of superior and inferior quadrant RNFL thicknesses were similar, and the AUCs were 0.739 (95% confidence interval (CI) 0.635-0.826), 0.683 (95% CI 0.576-0.778), 0.755 (95% CI 0.652-0.840), and 0.773 (95% CI 0.672-0.854), respectively. The diagnostic sensitivity of RNFL thickness in the superior quadrant reached 93.33%.@*CONCLUSIONS@#The thickness of the RNFL in the optic disc can be used as a diagnostic method for DPN.

Diagnostic value of optic disc retinal nerve fiber layer thickness for diabetic peripheral neuropathy / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Objective: To investigate the value of optic disc retinal nerve fiber layer (RNFL) thickness in the diagnosis of diabetic peripheral neuropathy (DPN). Methods: Ninety patients with type 2 diabetes, including 60 patients without DPN (NDPN group) and 30 patients with DPN (DPN group), and 30 healthy participants (normal group) were enrolled. Optical coherence tomography (OCT) was used to measure the four quadrants and the overall average RNFL thickness of the optic disc. The receiver operator characteristic curve was drawn and the area under the curve (AUC) was calculated to evaluate the diagnostic value of RNFL thickness in the optic disc area for DPN. Results: The RNFL thickness of the DPN group was thinner than those of the normal and NDPN groups in the overall average ((101.07± 12.40) µm vs. (111.07±6.99) µm and (109.25±6.90) µm), superior quadrant ((123.00±19.04) µm vs. (138.93±14.16) µm and (134.47±14.34) µm), and inferior quadrant ((129.37±17.50) µm vs. (143.60±12.22) µm and (144.48±14.10) µm), and the differences were statistically significant. The diagnostic efficiencies of the overall average, superior quadrant, and inferior quadrant RNFL thicknesses, and a combined index of superior and inferior quadrant RNFL thicknesses were similar, and the AUCs were 0.739 (95% confidence interval (CI) 0.635–0.826), 0.683 (95% CI 0.576–0.778), 0.755 (95% CI 0.652–0.840), and 0.773 (95% CI 0.672–0.854), respectively. The diagnostic sensitivity of RNFL thickness in the superior quadrant reached 93.33%. Conclusions: The thickness of the RNFL in the optic disc can be used as a diagnostic method for DPN.

Parental confidence in immunization and its influential factors / 上海预防医学

Objective To explore parental confidence on immunization and its influential factors and provide scientific basis for immunization management and confidence enhancement strategy in Jinhua. Methods A questionnaire survey was conducted among 1 865 parents in the district, and the cumulative Logit regression model was used to analyze the influential factors of parental confidence on immunization. Results It was found that 96.41% of the children′s parents believed immunization was necessary, 70.03% believed immunization was safe, 93.51% was willing to be vaccinated, and parental confidence on immunization was 90.89%.The sequence of influential factors of confidence was satisfaction of immunization services, cognitive level of immunization knowledge, immunization about route and age obtained through medical staff. Conclusion By strengthening health education and health promotion, improving the cognitive level of parents′ immunization knowledge and elevating the quality of daily immunization service, the parental confidence can be improved effectively in immunization.

Effect of Different Nitrogen Forms and Concentrations on Yield and Quality of Fritillaria thunbergii / 中国实验方剂学杂志

Objective:To investigate the effect of different nitrogen forms and concentrations on yield and quality in Fritillaria thunbergii，and provide basis for improving scientific utilization of nitrogenous fertilizer and its introduction to Chongqing area. Method:The pot culture experiment was conducted to investigate the changes in growth，physiological and biochemical characteristics，soil factors，alkaloid content and yield of Fritillaria thunbergii under the ratio of nitrate nitrogen（NO3--N） to ammonium nitrogen（NH4+-N）of 15∶0（N1），12∶3（N2），7.5∶7.5（N3），3∶12（N4） and 0∶15（N5）. Result:As compared with no-nitrogen（CK） treatment group，the growth and quality of F. thunbergii were significantly improved by different nitrogen nutrition treatments，with differences among them.With the increase of ammonium nitrogen concentration：①plant height and the activity of superoxide dismutase（SOD） reached the maximum when the ratio of NO3--N to NH4+-N was 3∶12，increased by 9.27% and 206.62% respectively compared with the CK group，② the length and width of leaf，stem diameter，chlorophyll a，chlorophyll b，total chlorophyll content，the content of available P and organic matter，total alkaloid content and yield reach the maximum when the ratio of NO3--N to NH4+-N was 0∶15，increased by 14.02%，16.44%，13.68%，40.75%，45.31%，41.72%，77.70%，14.70%，24.61%/47.39% respectively compared with the CK group，with the increase of nitrate nitrogen concentration，③the leaf index，soluble protein content，peimisine content/yield，yield of peiminine and dry weight of bulbs reached the maximum when the ratio of NO3--N to NH4+-N was 7.5∶7.5，increased by 2.54%，5.92%，21.76%/54.55%，60.61% and 26.93%，respectively compared with the CK group，④the content of carotenoids，pigment and peiminine，the activity of peroxidase（POD） and catalase（CAT），the content/yield of peimine，both peimine and peiminine，both peimine，peiminine and peimisine，dry weight of bulbs reached the maximum when the ratio of NO3--N to NH4+-N was 12∶3，increased by 45.39%，45.31%，36.01%，271.38%，67.45%，39.82%/64.87%，38.90%/63.80%，37.03%/61.57%，20.29% respectively compared with the CK group. Conclusion:All the results indicated that a higher proportion of NH4+-N is beneficial to the growth of F. thunbergii，while NO3--N is beneficial to the accumulation of alkaloids and the growth of bulbs.Therefore，the combined application of ammonium and nitrate（NO3--N to NH4+-N ratio of 12∶3） is more effective than pure nitrate or pure ammonium applications to improve the yield and quality of F. thunbergii．

Status of Health Resource Allocation of Medical Institutions in Poverty-stricken Areas / 昆明医科大学学报

Objective To understand the status quo of health resource allocation of medical institutions in poverty-stricken areas, and to provide decision-making basis for rationalizing health and poverty alleviation policies and improving the overall service capacity of medical institutions in poverty-stricken areas. Me thods The overall institutions, bed capacity and staffs in medical institutions in 680 poor counties were analyzed. Re s ults The proportion of government health expenditure in 14 concentrated areas was lower than 15％. The largest number of health institutions was 349 in the Dabie Mountains and 70 in Tibet, and the number of beds was lower than the national average level of 5.11.The largest number of health technical staff for 1 000 people of the four provinces is 4.42 people, the smallest number is 2.72 in Wumeng mountain area;the registered nurses (number) for 1 000 people is up to 1.56 people in the Luo Xia mountain area, the lowest Tibet, only 0.39 people. Thousands of population practice (assistant) physician number of Tibetans is up to 2.98 people, the lowest is 1.07 for the Xinjiang Southern Xinjiang three states; health care than the lowest in Tibet 1:0.54. Conclus ion At present, China's centralized contiguous poverty-stricken areas of county-level medical institutions is extremely short of resources, and the health resource allocation is uneven.

Effects of inhibitory concentration minocycline on the proliferation, differentiation, and mineralization of osteoblasts / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the effect of the inhibitory concentration minocycline on the proliferation, differentiation, and expression of Runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP) and osteopontin (OPN) mRNA of osteoblasts.</p><p><b>METHODS</b>Primary osteoblasts were cultured in osteogenic induction medium containing 0, 0.1, 0.5, 1, 10 μg·mL⁻¹ minocycline. Cell counting kit-8 was used to observe cell proliferation. ALP activity assay, alizarin red S staining, and real-time quantitative polymerase chain reaction (PCR) were used to determine cell differentiation and mineralization.</p><p><b>RESULTS</b>The groups with 0.1, 0.5, 1 μg·mL⁻¹ minocycline promoted cell proliferation. The mRNA expression levels of ALP and Runx2 were up-regulated. Osteoblast-mediated mineralization was increased. The group with 1 μg·mL⁻¹ showed maximal promotion effect (P<0.05). When the concentration increased to 10 μg·mL⁻¹, the promoting effect began to decline, and the ALP activity and OPN expression were significantly inhibited (P<0.01).</p><p><b>CONCLUSIONS</b>Appropriate concentration of minocycline can promote osteoblasts proliferation, up-regulate the expression levels of Runx2, ALP and OPN, and increase the differentiation and mineralization of osteoblasts.</p>

Laboratory detection of imported Plasmodium ovale wallikeri in Sichuan Province / 中国血吸虫病防治杂志

Objective To identify 10 imported cases of Plasmodium ovale wallikeri infection in Sichuan Province from January to April in 2018, and to analyze the P. ovale wallikeri infection status of 1 079 malaria cases reported in this area from 2013 to 2017. Methods The 10 cases collected in 2018 were examined by microscopy, RDT, nested PCR and sequencing. Meanwhile, the retrospective detections of P. ovale wallikeri of the 1 079 blood samples from past 5 years were conducted by nested PCR using wallikeri-specific primers. Results For the 10 cases, the microscopic examinations were all positive for P. ovale, of which 2 were mixed infection with P. falciparum, and the results of RDT were all positive for Plasmodium. Except for 2 cases of P. falciparum infection, the routine nested PCR showed negative results for rest of the samples. The nested PCR for the specific detection of P. ovale wallikeri showed the 10 cases were all positive, and the following sequencing confirmed that the 10 cases were all infected with P. ovale wallikeri. The retrospective tests discovered 2 cases both reported in 2017 and recorded as simple P. falciparum infection tuned out to be mixed infection with P. falciparum and P. ovale wallikeri. Conclusion This is the first time that imported P. ovale wallikeri infection is founded in Sichuan Province.

Laboratory detection of imported Plasmodium ovale wallikeri in Sichuan Province / 中国血吸虫病防治杂志

Objective To identify 10 imported cases of Plasmodium ovale wallikeri infection in Sichuan Province from January to April in 2018, and to analyze the P. ovale wallikeri infection status of 1 079 malaria cases reported in this area from 2013 to 2017. Methods The 10 cases collected in 2018 were examined by microscopy, RDT, nested PCR and sequencing. Meanwhile, the retrospective detections of P. ovale wallikeri of the 1 079 blood samples from past 5 years were conducted by nested PCR using wallikeri-specific primers. Results For the 10 cases, the microscopic examinations were all positive for P. ovale, of which 2 were mixed infection with P. falciparum, and the results of RDT were all positive for Plasmodium. Except for 2 cases of P. falciparum infection, the routine nested PCR showed negative results for rest of the samples. The nested PCR for the specific detection of P. ovale wallikeri showed the 10 cases were all positive, and the following sequencing confirmed that the 10 cases were all infected with P. ovale wallikeri. The retrospective tests discovered 2 cases both reported in 2017 and recorded as simple P. falciparum infection tuned out to be mixed infection with P. falciparum and P. ovale wallikeri. Conclusion This is the first time that imported P. ovale wallikeri infection is founded in Sichuan Province.

A comparison study on the effect of different propaganda mode of charge vaccines on community residents / 预防医学

Objective Toevaluatetheeffectof3differentkindsofpropagandamodesofchargevaccinesonchanging knowledge,attitude and behavior of community residents,and to explore the effective propaganda mode of vaccination. Methods Sanjiang,JiangnanandSumengwereselectedaspilotstreets,respectively.And"motherclass"(A)mode, vaccination clinics "inform-booking"(B)mode and the community responsible doctor recommended mode (C)mode were used to carry out intervention.Intervention time was from March to September,2014.Awareness rate,necessity awareness rate,compliance rate and vaccination rate of the children of school age were used to evaluate effect of 3 propagandamodes.Results Therewerenosignificantdifferencesindemographiccharacteristicsamongthreemodes(P>0.05).Through intervention of A,B mode,the awareness knowledge,necessity awareness and willingness to vaccination were improved (P<0.05),while the other indicators were not improved through C mode intervention except for 4 vaccine related knowledge (P<0.05).After controlling for the time factor,the improving effect of related knowledge,attitude and behaviorofchargevaccinethroughAandBmodeswerebetterthanthosethroughCmode(P<0.05).Conclusion The effect of"mother class"mode,the vaccination clinics"inform-booking"mode to carry out the charge vaccine propaganda is significant,but the community responsible doctor recommended mode needs to be improved.

Intracranial Artery Calcification and Its Clinical Significance

Intracranial arterial calcification (IAC) is an easily identifiable entity on plain head computed tomography scans. Recent studies have found high prevalence rates for IAC worldwide, and this may be associated with ischemic stroke and cognitive decline. Aging, traditional cardiovascular risk factors, and chronic kidney disease have been found to be associated with IAC. The severity of IAC can be assessed using different visual grading scales or various quantitative methods (by measuring volume or intensity). An objective method for assessing IAC using consistent criteria is urgently required to facilitate comparisons between multiple studies involving diverse populations. There is accumulating evidence from clinical studies that IAC could be utilized as an indicator of intracranial atherosclerosis. However, the pathophysiology underlying the potential correlation between IAC and ischemic stroke-through direct arterial stenosis or plaque stability-remains to be determined. More well-designed clinical studies are needed to explore the predictive values of IAC in vascular events and the underlying pathophysiological mechanisms.

Intracranial Artery Calcification and Its Clinical Significance

Intracranial arterial calcification (IAC) is an easily identifiable entity on plain head computed tomography scans. Recent studies have found high prevalence rates for IAC worldwide, and this may be associated with ischemic stroke and cognitive decline. Aging, traditional cardiovascular risk factors, and chronic kidney disease have been found to be associated with IAC. The severity of IAC can be assessed using different visual grading scales or various quantitative methods (by measuring volume or intensity). An objective method for assessing IAC using consistent criteria is urgently required to facilitate comparisons between multiple studies involving diverse populations. There is accumulating evidence from clinical studies that IAC could be utilized as an indicator of intracranial atherosclerosis. However, the pathophysiology underlying the potential correlation between IAC and ischemic stroke-through direct arterial stenosis or plaque stability-remains to be determined. More well-designed clinical studies are needed to explore the predictive values of IAC in vascular events and the underlying pathophysiological mechanisms.

Effects of scalp acupuncture combined with auricular point sticking on cognitive behavior ability in patients with vascular dementia / 中国针灸

<p><b>OBJECTIVE</b>To compare the therapeutic differences among scalp acupuncture combined with auricular point sticking, body acupuncture and western medication for treatment of vascular dementia (VD).</p><p><b>METHODS</b>Ninety cases were randomly divided into a combined therapy group (31 cases), a body acupuncture group (29 cases) and a western medication group (30 cases). The combined therapy group was treated with scalp acupuncture at forehead middle line, parieral middle line, temporal front line and temporal rear line as well as auricular point sticking at naogan (AT3,41), shen (CO10), shenmen (TF4), zhen (AT3), once a day; the body acupuncture group was treated with acupuncture at Baihui (GV 20), Fengchi (GB 20), Zusanli (ST 36) and so on, once a day; the western medication group was treated with oral administration of aniracetam tablets, 0.2 g per time, twice a day. Fourteen days were considered as a treatment course, and totally 3 courses were required. The mini-mental state examination (MMSE) and activities of daily living (ADL) were applied to assess the changes of cognitive behavior ability before and after treatment among three groups. Also the efficacy among three groups were compared.</p><p><b>RESULTS</b>One case dropped out in the body acupuncture group and western medication group, respectively. The total effective rate was 90.334 (28/31) in the combined therapy group, which was superior to 85.734 (24/28) in the body acupuncture group and 79.3% (23/29) in the western medication group (both P < 0.05). After the treatment, the scores of MMSE and ADL were all improved among three groups, which was the most significant in the combined therapy group (MMSE: 23.32 +/- 4.45 vs 21.23 +/- 4.13, P < 0.05; 23.32 +/- 4.45 vs 20.41 +/- 4. 01, P < 0.01; ADL: 53.18 +/- 21.55 vs 51.92 +/- 20.42, P < 0.05; 53.18 +/- 21.55 vs 49.42 +/- 19.43, P < 0.01).</p><p><b>CONCLUSION</b>The scalp acupuncture combined with auricular point sticking could improve the clinical symptoms and cognitive behavior ability in patients with vascular dementia, which has superior total efficacy to body acupuncture and western medication aniracetam tablets.</p>

An experimental study of the wear behavior of dental feldspathic glass-ceramic and lithium disilicate glass-ceramic / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the tribology characteristics of two ceramic materials in vitro:feldspathic glass-ceramic (veneer porcelain) and lithium disilicate glass-ceramic (heat-pressed ceramic), and to evaluate the wear resistance of different ceramic materials from the dynamic chewing perspective.</p><p><b>METHODS</b>Wear tests were performed in simulated oral environment with stainless steel ball antagonists (r = 3 mm), veneer porcelain (CERAMCO 3) and heat-pressed ceramic (IPS e.max Press HT type) in the chewing simulator. The tribological tests were carried out under artificial saliva lubrication condition in room temperature with a vertical load of 10 N for 1.2×10(6) cycles (f = 1.5 Hz, uniform circular motion, revolving speed = 90 r/min, radius = 0.5 mm). The wear volumes were measured using three-dimensional profiling, and surface microscopic morphology were observed using scanning electron microscopy at time point of 200 000, 400 000, 600 000, 800 000, 1 000 000, and 1 200 000 cycles.</p><p><b>RESULTS</b>In a simulated oral environment, the wear rates of veneer porcelain were (0.001 20 ± 0.00 018) , (0.000 10 ± 0.000 03) , (0.000 50 ± 0.000 05), (0.000 10 ± 0.000 02) , (0.004 10 ± 0.000 38) , and (0.019 00 ± 0.003 53) (×10(-4) mm(3)/cycles) at 200 000, 400 000, 600 000, 800 000, 1 000 000, 1 200 000 cycles. The wear rates of heat-pressed ceramic were (0.139 50 ± 0.030 94), (0.124 40 ± 0.031 20), (0.054 80 ± 0.005 38), (0.038 80 ± 0.006 10), (0.011 10 ± 0.003 75), (0.198 90 ± 0.045 80) (×10(-4) mm(3)/cycles) at 200 000, 400 000, 600 000, 800 000, 1 000 000, 1 200 000 cycles. Three stages were observed in the wear loss process of the two materials: running-in stage, steady wear stage and severe wear stage. In running-in and steady wear stage, the shallow wear tracks of veneer porcelain were produced by the fatigue effect.While in severe wear stage, the wear tracks turned into ploughing. In running-in stage, the surface of heat-pressed ceramic was characterized by dense and shallow ploughing. In steady wear stage, the wear tracks turned into flake peeling produced by fatigue effect. At last, the whole layer was worn off by the effects of ploughing.</p><p><b>CONCLUSIONS</b>In a simulated oral environment, the wear rate and wear loss of heat-pressed ceramic are greater than that of veneer porcelain.</p>

Synergistic effect of beta-elemene injection combined paclitaxel injection on human breast cancer MB-468 cells: an in vitro study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the synergistic effect of beta-elemene Injection (betaI) combined Paclitaxel Injection (PI) on breast cancer MB-468 cells and to study possible mechanisms.</p><p><b>METHODS</b>Breast cancer MB-468 cells were treated with betaI (2.5, 5.0, 10.0, 20.0, 40.0, 80.0, 160.0, 320.0, and 640.0 microg/mL), PI (0.00100, 0.00200, 0.00400, 0.00800, 0.01600, 0.03125, 0.06250, 0.12500, and 0.25000 microg/mL), and betaI combined PI for 24 h and 48 h respectively. Cell proliferation was determined using SRB assay. Cell apoptosis and cell cycle phase distribution were detected using flow cytometry. The post-intervention expressions of cell cycle proteins [cyclin-dependent kinase (CDK1), cyclin-B1, P21(cip1), and P27(kip1)] were detected by Western blot.</p><p><b>RESULTS</b>Beta-elemene or paclitaxel inhibited the growth of MB-468 cell line. The IC50 and IC20 values treated with beta-elemene for 24 h were 34.20 and 52.59 microg/mL and for 48 h were 10.15 and 17.81 microg/mL respectively, while the IC50 values treated with paclitaxel for 24 h and 48 h were 2.449 and 1.698 microg/mL respectively. Beta-elemene (20 and 40 microg/mL respectively) and Paclitaxel (0.016 and 0.008 microg/mL respectively) synergistically inhibited cell proliferation of MB-468 cells, with Q value > 1.15. Beta-elemene alone (52.59 microg/mL) apparently decreased the expression of cyclin-B1 protein. The expression of cyclin-B1 protein in the combined group was also lower than that in the PI group (1.698 microg/mL). The expression of P27(kip1) was up-regulated when compared with that in the betaI group or the PI group.</p><p><b>CONCLUSION</b>Beta-elemene had synergistic effect with Paclitaxel, and its possible mechanism might be correlated with down-regulating the cell cycle protein cyclin-B1 expression and up-regulating the P27(kip1) expression.</p>

Analysis of full-length gene sequence of rabies vaccine virus aG strain / 病毒学报

To sequence and analyze the full-length gene sequence of rabies vaccine virus aG strain. The full-length gene sequence of aG strain was amplified by RT-PCR by 8 fragments,each PCR product was cloned into vector pGEM-T respectively, sequenced and assemblied; The 5' leader sequence was sequenced with method of 5' RACE. The homology between aG and other rabies vaccine virus was analyzed by using DNAstar and Mega4. 0 software. aG strain was 11 925nt(GenBank accession number: JN234411) in length and belonged to the genotype I . The Bioinformatics revealed that the homology showed disparation form different rabies vaccine virus. the full-length gene sequence of rabies vaccine virus aG strain provided a support for perfecting the standard for quality control of virus strains for production of rabies vaccine for human use in China.

Efficacy and safety of docetaxol, pemetrexed and EGFR-TKIs as second-line treatment for patients with advanced non-small-cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the efficacy and safety of docetaxol, pemetrexed and EGFR-TKIs in the second-line treatment for patients with advanced non-small cell lung cancer.</p><p><b>METHODS</b>The clinical data of 170 patients with advanced non-small cell lung cancer who failed standard first-line chemotherapy were reviewed. Those who received docetaxol as second-line therapy were designated as group A (n = 60), those who received pemetrexed as second-line therapy were designated as group B (n = 49), and those who received EGFR-TKIs as second-line therapy were designated as group C (n = 61). PFS and MST were estimated by Kaplan-Meier method and the differences between groups were compared by log-rank test.</p><p><b>RESULTS</b>The response rate in the groups A, B and C group was 15.0% (9/60), 24.5% (12/49) and 36.1% (22/61), respectively. The PFS after second-line therapy in the groups A, B and C was 5.49 months (95%CI: 4.03 - 6.95 months), 5.42 months (95%CI: 4.23 - 6.60 months) and 9.31 months (95%CI: 6.88 - 11.73 months), respectively (P = 0.045). The MST after second-line therapy in the groups A, B and C was 14.89 months (95%CI: 11.23 - 18.55 months), 15.81 months (95%CI: 12.11 - 19.52 months) and 17.47 months (95%CI: 13.38 - 21.56 months), respectively (P = 0.574). Regression analysis showed that the performance status score (PS) and response for second-line treatment are independent prognostic factors in each sub-group, and pathological type is an independent prognostic factor in the group C (P = 0.003).</p><p><b>CONCLUSIONS</b>The safety of the three drugs used as second-line treatment for patients with advanced non-small-cell lung cancer, who failed standard first-line chemotherapy, is comparable, but the EGFR-TKIs group has the highest response rate, and the EGFR-TKIs group has the longest PFS with a statistically significant difference, while there is no significant difference in MST among the three groups. When patients receive second-line treatment, the performance status < 2 and the response rate for second-line treatment are independent prognostic factors. Furthermore, pathological type (adenocarcinoma) is also an independent prognostic factor for EGFR-TKIs as second-line treatment.</p>

Urticaria as the initial presentation of early stage bronchioloalveolar carcinoma: a case report / 中华医学杂志(英文版)

Bronchioloalveolar carcinoma is a subtype of the lung adenocarcinoma. Early stage bronchioloalveolar carcinoma is usually asymptomatic, especially in the peripheral lung. Rarely, urticaria has been described occurring with lung cancer, usually small-cell lung cancer, but no case has been reported of the bronchioloalveolar carcinoma yet. We report here a unique and initial urticaria on a patient, lasting for 6 months, who finally was diagnosed as early stage bronchioloalveolar carcinoma (T1aN0M0). After treatment of surgery, the symptom of urticaria disappeared and did not recur. Therefore, we consider that utricaria is a possibly clinical manifestation in early stage bronchioloalveolar carcinoma.

Comparison of the efficacy of second line EGFR TKIs followed by third line pemetrexed or the reverse sequence in the treatment of advanced lung adenocarcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the efficacy of second-line EGFR-TKIs followed by third-line pemetrexed with second-line pemetrexed followed by third-line EGFR-TKIs in patients with advanced lung adenocarcinoma.</p><p><b>METHODS</b>From March 2007 to August 2008, 83 patients with advanced lung adenocarcinoma who failed standard first-line chemotherapy were included in this study. The patients who received EGFR-TKIs as second-line therapy followed by third-line pemetrexed were designated as group A (n = 45). The patients who received pemetrexed as second-line therapy followed by third-line EGFR-TKIs were designated as group B (n = 38). PFS and MST were estimated with Kaplan-Meier analysis and the difference between groups were compared with Log-rank test.</p><p><b>RESULTS</b>The progression-free survival (PFS) after second-line therapy in the groups A and B was 8.05 months (95% CI, 5.90 to 10.20) and 4.20 months (95% CI, 3.33 to 5.06), respectively (P = 0.001). The PFS after second-line therapy in smokers and non-smokers was 3.69 months (95% CI, 5.00 to 7.59) and 7.12 months (95% CI, 5.51 to 8.38), respectively (P = 0.007). The PFS of male and female patients was 5.56 months (95% CI, 4.02 to 7.10) and 6.85 months (95% CI, 4.98 to 7.58), respectively (P = 0.279). The PFS after third-line therapy in groups A and B was 6.88 months (95% CI, 5.07 to 8.69) and 7.60 months (95% CI, 5.59 to 9.12) respectively, (P = 0.899). The PFS after third-line therapy in smokers and non-smokers was 4.95 months (95% CI, 2.83 to 7.05) and 8.49 months (95% CI, 6.27 to 10.76), respectively (P = 0.050). The PFS after third-line therapy in male and female patients was 5. 96 months (95% CI, 4.02 to 7.91) amd 8.38 months (95% CI, 5.68 to 11.07), respectively (P = 0.176). The MST in groups A and B was 23.60 months (95% CI, 19.23 to 28.00) and 15.58 months (95% CI, 11.85 to 19.32), respectively (P = 0.021). The MST in smokers and non-smokers was 11.99 months (95% CI, 8.55 to 15.49) and 23.18 months (95% CI, 19.33 to 27.02), respectively (P = 0.001). The MST in male and female patients was 17.40 months (95% CI, 13. 19 to 21.61) and 22.74 months (95% CI, 18.29 to 27.19), respectively (P = 0.111).</p><p><b>CONCLUSIONS</b>Second line EGFR TKIs followed by third line pemetrexed regimen improves the PFS and MST compared with the regimen second line pemetrexed followed by third line EGFR TKIs in patients with advanced lung adenocarcinoma. Smoking status is an independent prognostic factor. Survival is not influenced by gender. Prospective clinical trials are needed to confirm these findings.</p>

Relation between eardrum flap area and healing outcome of traumatic eardrum perforation / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To retrospectively study the clinical effects of eardrum flap area on the healing outcome following traumatic perforation.</p><p><b>METHODS</b>Totally 291 traumatic eardrum perforations with in-/everted edges were included in this study. They were randomly divided into three groups and received conservative treatment, epidermal growth factor (EGF) via Gelfoam patching, or edge-approximation plus Gelfoam patching respectively. Patients in each group were further divided into two subgroups according to the eardrum flap area less than or equal to 1/2 or >1/2 of the perforation size. The healing rate and mean closure time after tympanic membrane perforation were evaluated at three months.</p><p><b>RESULTS</b>Of the total 291 participants, 281 were included in the final statistical analysis. The area of curled edge did not affect the healing outcome significantly in any groups (P>0.05). The healing rate varied slightly: 90.7% vs 92.3% in spontaneous healing group, 98.2% vs 97.4% in EGF via Gelfoam patching group, and 96.5% vs 100% in edge-approximation plus Gelfoam patching group. In addition, in all groups the area of curled edge did not affect the mean closure time significantly (P>0.05). The closure time was (32.3+/-2.4) d vs (30.6+/-3.1) d in sponaneous healing group, (13.4+/-2.5) d vs (13.1+/-1.9) d in EGF via Gelfoam patching group, and (11.9+/-3.1) d vs (12.2+/-2.1) d in edge-approximation plus Gelfoam patching group.</p><p><b>CONCLUSION</b>The eardrum flap area of traumatic eardrum perforation does not significantly affect the clinical outcomes.</p>

Prevalence of asymptomatic intracranial artery stenosis in middle-aged and elderly population in the community of Foshan city, Guangdong province: a cross-sectional study / 中华流行病学杂志

Objective To investigate the prevalence and risk factors of asymptomatic intracranial artery stenosis in middle-aged and elderly population in the community of Foshan city,Guangdong province. Methods Subjects from residential communities were chosen through Cluster sampling method. Physical data and history were collected. Serum fasting glucose, total cholesterol and triglycerides concentrations were tested with venous blood samples. Intracranial artery stenosis was diagnosed by transcranial Doppler(TCD). Data was analyzed by the software SPSS 18.0.Results 1405 subjects met the inclusive criteria, among which 163(11.6%)were found one(7.4%)or more(4.2%)stenotic arteries, and the standardized rate was 10.3%. 9.89% of the SICA, and 3.05%, 2.29%, 1.59%, 1.38%, 0.89% of basilar artery, middle cerebral artery, anterior lerebral artery,vertebral artery, posterior cerebral artery were found stenotic respectively. Data from the age-stratified analysis showed that the prevalence in these above 70(27.8%)was significantly higher than that under age 70(7.5%)(P=0.000). Single factor and logistic regression analysis demonstrated the history of diabetes mellitus and elevated systolic pressure present were significantly different between stenofic group and the non-stenotic group(P=0.000, P=0.000), which were the independent risk factors of asymptomatic stenosis of intracranial arteries(OR= 2.362,95%CI:1.194-4.674; OR= 1.024,95%CI:1.016-1.031). Conclusion Comparatively high prevalence of asymptomatic intracranial artery stenosis in middle-aged and aged community population was found in the Southern part of China,especially among the age group above 70. History of diabetes and elevated systolic pressure seemed to be the independent risk factors of asymptomatic stenosis of intracranial arteries.