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Objective To compare biomechanical characteristics of external fixator, Kirschner’s wire, elastic stable intramedullary nailing (ESIN) for fixing proximal humeral fractures in children by finite element method.Methods The CT scanning data from the healthy humerus of an 8-year-old patient with proximal humeralfractures were collected, and the image data were imported in Mimics 21. 0 to establish the rough humeralmodel, which was imported in Geomagic 2013 to construct the three-dimensional (3D) model of cancellous and cortical bones of the humerus. After the model was assembled with 3 fixators ( external fixator, Kirschner’swire, ESIN), it was imported in ANSYS 2019 to simulate the upper limb under quiet, abduction, adduction, flexion, extension, external rotation, internal rotation working conditions. The maximum displacement of the distal humerus, the maximum stress of the fixture, and the maximum displacement of the distal fracture surface were analyzed. Results The minimum values of the maximum displacement of the distal humerus in models fixed by external fixator, Kirschner’s wire, ESIN appeared under extension (2. 406 mm), external rotation (0. 203 mm), external rotation (0. 185 mm) working conditions, respectively. Conclusions External fixator is the most unstable fixation of proximal humeral fractures in children, and the biomechanical performance of ESIN is better than that of external fixator and Kirschner’s wire fixation
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Objective To explore the relationship between serum levels of tyrosine hydroxylase (TH) and the risk of cerebral infarction in Parkinson's patients. Methods A total of 129 patients with confirmed Parkinson's disease who were hospitalized in our hospital were selected, among the 58 patients had Parkinson's disease complicated with cerebral infarction (complicated with cerebral infarction group), and the remaining 71 patients had Parkinson's disease alone (control group). Blood TH levels and other potential related information were collected retrospectively at the time of diagnosis. Comparative analysis of data was performed using SPSS software. Results Comparing the serum TH expression levels in patients with Parkinson's disease and patients with cerebral infarction at admission , the serum TH level in patients with cerebral infarction was lower. Results also showed that the levels of CRP, IL-6, MDA, and Hcy were higher in patients with cerebral infarction, while PON-1 level was lower. In addition, patients with cerebral infarction had lower motor ability (higher UPDRS Ⅲ score). Further regression analysis was carried out with the occurrence of Parkinson's disease complicated with cerebral infarction as the dependent variable and the potential influencing factors as the independent variable. The results indicated that factors such as low expression of TH, high expression of inflammatory factors, and high expression of oxidative stress factors were positively correlated with the risk of complications of the two diseases. Conclusion The low expression of TH, inflammatory state and high oxidative stress state are the potential risk factors for Parkinson's disease complicated with cerebral infarction, which deserves clinical attention.
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Objective:To explore the effects of frailty syndrome on activities of daily living and its associated risk for adverse outcomes among elderly residents in China.Methods:Using open data from "China Health and Retirement Longitudinal Survey", the 2011 baseline survey was conducted on general information, health risk factors, chronic disease, data obtained from various ability assessments and Fried frailty criteria assessments for community elderly aged 60 years and over.The follow-up data were used to analyze the adverse outcomes of frailty syndrome using a covariation-adjusted Logistic regression model.Results:Among the 5 630 people in the baseline population, 34.9%(1 963/5 630 cases)were non-frailty, 57.4%(3 236 cases)were pre-frailty, and 7.7%(431 cases)were frailty.The frailty group had higher rates of falls, hip fractures, hospitalizations, and death than the pre-frail and non-frail groups at the 3rd, 5th, and 8th years of follow-up.At follow up to 2015, the covariate-adjusted analysis of the study population showed that as compared with the non-frail group, the frail group had increased risks of falling( OR=1.738, 95% CI: 1.292-2.338, P<0.001), increased risks of hip fracture( OR=2.672, 95% CI: 1.365-5.233, P=0.004), increased risks of hospitalization( OR=1.670, 95% CI: 1.224-2.277, P=0.001), increased risk of death( OR=1.599, 95% CI: 1.256-2.035, P<0.001), increased risks of declined upper limb activity( OR=2.769, 95% CI: 2.101-3.650, P<0.001), of declined instrumental activity of daily living( OR=2.567, 95% CI: 1.941-3.395, P<0.001), and of declined basic activities of daily living( OR=2.790, 95% CI: 2.110-3.689, P<0.001). Conclusions:Frailty syndrome increases the risk of decreased ability to live, falls, hip fractures, hospitalization and death in older adults.Frailty screening is an effective tool for predicting the risk of adverse outcomes in elderly community populations.
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Objective:To analyze the risk factors of clinically-relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) and penetrating pancreaticojejunostomy (PPJ).Methods:The clinical data of 108 patients who underwent PD and PPJ in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Wannan Medical College from January 2017 to October 2022 were analyzed retrospectively, including 65 males and 43 females, aged 65.5 (54.2, 72.0) years. The incidences of POPF, biliary fistula, abdominal bleeding and other related complications were reviewed. The related factors of CR-POPF were analyzed by univariate analysis, and the statistically significant factors were included in multivariate logistic regression analysis.Results:A total of 108 patients were successfully treated with PD, including laparoscopic PD in 76 cases (70.4%) and open PD in 32 cases (29.6%). PPJ was performed in PD, including the continuous fashion in 39 cases (36.1%), intermittent fashion in 49 cases (45.4%) and modified continuous fashion in 20 cases (18.5%). The operation time was 390.0 (314.0, 480.0) min, the intraoperative blood loss was 200.0 (100.0, 384.0) ml, the postoperative hospital stay was 12.0 (10.0, 15.0) d, and the incidence of POPF (grade B + C) was 11.1% (12/108). Body mass index, pancreatic CT value and pancreatic duct size were the significant factors of CR-POPF (all P<0.05). Multivariate logistic regression analysis showed that age ( OR=0.895, 95% CI: 0.822-0.975), pancreatic CT value ( OR=0.812, 95% CI: 0.698-0.946) and pancreatic duct size ( OR=0.457, 95% CI: 0.220-0.952) were risk factors of CR-POPF after PPJ (all P<0.05). Conclusion:PPJ is a safe method of pancreaticoenterostomy, and CR-POPF may be related to younger patients, lower pancreatic CT value and the smaller pancreatic duct size.
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Objective:To learn about the prevalence of iodized salt in coastal counties (cities and districts, hereinafter referred to as counties) of Shandong Province, evaluate the iodine nutritional status of children and pregnant women, so as to provide data support for timely targeted prevention and control measures and scientific adjustment of intervention strategies.Methods:In 2021, in 37 coastal counties of Shandong Province, one township was selected from each of the five directions of the east, west, south, north, and middle of each county, one primary school was selected from each township, 40 non-boarding students aged 6 - 12 years old were selected from each primary school. In addition, 20 pregnant women were selected from each township. Children's and pregnant women's household salt samples and urine samples were collected to detect salt iodine and urinary iodine contents. The children from 19 counties selected from the 37 coastal counties of Shandong Province were examined by B-mode ultrasound, and the goiter rate of children was calculated.Results:Totally 7 736 household edible salt samples from the children were tested, and the coverage rate of iodized salt, iodized salt qualified rate and qualified iodized salt consumption rate was 74.3% (5 746/7 736), 74.3% (4 267/5 746) and 55.2% (4 267/7 736), respectively. A total of 7 740 urine samples were collected from the children, the median urinary iodine was 174.0 μg/L. A total of 4 344 children were selected for thyroid examination, and the goiter rate was 3.0% (131/4 344). Totally 4 513 household edible salt samples from the pregnant women were tested, and the coverage rate of iodized salt, iodized salt qualified rate and qualified iodized salt consumption rate was 83.7% (3 779/4 513), 77.6% (2 933/3 779) and 65.0% (2 933/4 513), respectively. A total of 7 740 urine samples were collected from the pregnant women, the median urinary iodine was 133.5 μg/L.Conclusions:Children in 37 coastal counties of Shandong Province are generally at the appropriate level of iodine, but pregnant women still have the risk of iodine deficiency. Comprehensive prevention and control measures for iodine deficiency disorders need to be continuously implemented to consolidate and deepen the achievements of iodine deficiency prevention and control.
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Objective:To investigate the impact of switching to low iodine drinking water in areas with high water iodine levels on the iodine nutritional status and thyroid function of pregnant women.Methods:A cross-sectional survey was conducted in Gaoqing County, Zibo City, Shandong Province. Pregnant women who underwent prenatal examinations at the Obstetrics Clinic of Gaoqing County People's Hospital from 2019 to 2021 were selected as the survey subjects. With reference to the Criteria for the Classification of Water Source High Iodine Areas and High Iodine Disease Areas (GB/T 19380-2016), pregnant women with drinking water iodine > 100 μg/L were considered as the high water iodine group and ≤100 μg/L was the non-high water iodine group. Basic information, one random urine sample, fasting blood sample, 24-hour urine sample and drinking water sample of pregnant women were collected, and thyroid ultrasound examination was performed on pregnant women. Urinary iodine (UI) concentration (UIC) and drinking water iodine concentration (WIC) were measured by inductively coupled plasma mass spectrometry, and 24-hour urinary iodine excretion (UIE) and daily iodine intake (TII) of pregnant women were calculated. Serum thyroid hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid peroxidase antibody (TPOAb) and anti-thyroid autoantibodies (TgAb) were determined by automatic chemiluminescence immunoassay. Creatinine (CR) was determined using deproteinized endpoint microplate method and UI/CR was calculate. Results:A total of 797 pregnant women were included, and the UIC was 150.2 (88.1, 281.3) μg/L, the iodine nutrition was generally at an appropriate level. Among them, 584 pregnant women in the non-high water iodine group had a UIC of 120.9 (74.9, 191.5) μg/L, which was at the iodine deficiency level; 213 pregnant women in the high water iodine group had a UIC of 321.1 (201.9, 569.1) μg/L, which was at the iodine super-appropriate level; the differences in WIC, UIC, UIE, TII, and UI/CR between the two groups were statistically significant ( Z = 21.63, 13.34, 15.14, 15.14, 11.81, P < 0.001). After stratification by different gestational periods, the differences were statistically significant when comparing WIC and TSH in pregnant women in the non-high water iodine group and UI/CR in pregnant women in the high water iodine group by gestational period ( H = 59.13, 7.30, 13.60, P < 0.05). A total of 744 pregnant women were tested for thyroid function, and 128 cases of TSH > 2.5 mU/L, 15 cases of hypothyroxemia, and 19 cases of subclinical hypothyroidism were detected, with detection rates of 17.2%, 2.0%, and 2.6%, respectively. The differences were statistically significant when comparing TSH and TPOAb levels and the proportion of pregnant women with TSH > 2.5 mU/L in the high water iodine and non-high water iodine groups ( Z = 3.04, - 2.17, χ 2 = 6.94, P = 0.002, 0.030, 0.008). The thyroid glands of pregnant women were examined in 720 cases, and 30 cases of goiter and 150 cases of thyroid nodules were detected, with detection rates of 4.2% and 20.8%, respectively. The median thyroid volume was 8.92 ml in the high water iodine group and 8.60 ml in the non-high water iodine group, which were both within the normal range, with no statistically significant difference between the groups ( Z = - 0.75, P = 0.455). Conclusions:After changing to low iodine water, the overall iodine nutrition of pregnant women in Gaoqing County is now at an appropriate level, and the reduction of water iodine effectively reduces the risk of TSH abnormalities in local pregnant women. However, pregnant women in the non-high water iodine group are iodine deficiency, and pregnant women in the high water iodine group are at iodine super-appropriate, and the iodine nutrition level of pregnant women in this area is highly variable, which causes the "illusion" that the overall iodine level of local pregnant women is suitable.
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Objective:To analyze the efficacy of quantitative parameters related to spectral CT iodine concentration (IC) values in evaluating regional lymph node metastasis in patients with gastric adenocarcinoma.Methods:The clinical data and CT images of 55 patients with gastric adenocarcinoma diagnosed by pathology from June 2021 to June 2022 were collected retrospectively at Shengjing Hospital of China Medical University. Patients were divided into lymph node metastatic lesion group (32 cases) and lymph node non-metastatic lesion group (23 cases) according to whether there were metastatic lymph nodes in all the lymph nodes examined in the pathological results. Then lymph nodes were taken as the research object, and all lymph nodes were divided into the metastatic lymph node group (25 lymph nodes) and the non-metastatic lymph node group (27 lymph nodes) according to the nature of lymph nodes recorded in the pathological report. The IC values and normalized IC (nIC) values of gastric cancer lesions and lymph nodes in the arterial and venous phases (ICa and ICp, nICa and nICp) were obtained. The difference of IC and nIC values between arterial and venous phases (?IC and ?nIC) were calculated, and the arterial enhancement fraction (AEF, ratio of ICa and ICp of lymph nodes ) was calculated. Student′s t test or Mann-Whitney U test was used to compare the differences of quantitative parameters between the two groups. The parameters with statistical differences were analyzed by the receiver operating characteristic curve to obtain the diagnostic efficacy of each parameter in evaluating lymph node metastasis of gastric cancer, and the Z test was used to compare the area under the curve (AUC) of each parameter. Results:The ICp, nICp, ?IC and ?nIC of the lymph node metastatic lesion group were higher than those of the lymph node non-metastatic lesion group (all P<0.05). The AUC were 0.738, 0.746, 0.811 and 0.821. The short diameter, ICa, nICa and AEF values of lymph nodes in the metastatic lymph node group were higher than those in the non-metastatic lymph node group (all P<0.05). The AUC were 0.821, 0.832, 0.734 and 0.863. There were significant differences in AUC between ICp and ?IC, ?nIC ( Z=2.41, 3.29, P=0.016, 0.001), and between nICp and ?IC, ?nIC ( Z=2.10, 3.09, P=0.036, 0.002) in gastric cancer lesions. There were statistically significant differences in AUC between nICa and ICa, AEF ( Z=2.09, 2.41, P=0.037, 0.016) in lymph nodes. Conclusions:The quantitative parameters related to IC values of spectral CT can be applied to evaluate the properties of regional lymph nodes in patients with gastric adenocarcinoma, where ?IC, ?nIC of lesions and AEF of lymph nodes have the best efficacy.
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Objective:To investigate the efficacy of internal fixation with common intramedullary nail versus bone cement reinforced antirotation intramedullary nail in the treatment of femoral intertrochanteric fracture. Methods:A total of 106 patients with femoral trochanteric fractures who were surgically treated in Weihaiwei People's Hospital from January 2018 to January 2019 were selected and divided into a control group and an observation group with 53 patients in each group. The control group received internal fixation with common intramedullary nails. The observation group was fixed with bone cement reinforced anti-rotation intramedullary nails. The therapeutic effects were compared between the two groups.Results:There were no significant differences in the amount of blood loss, postoperative Visual Analogue Scale score, amount of fluid drainage, postoperative time to get out of bed, and postoperative hospital stay between the two groups ( t = 1.33, 0.19, 0.34, 0.58, 0.37, all P > 0.05). Operative time in the observation group was significantly longer than that in the control group [(80.21 ± 6.52) minutes vs. (75.92 ± 8.15) minutes, t = 2.99, P < 0.05]. Time to fracture healing in the observation group was significantly shorter than that in the control group [(9.25 ± 1.12) weeks vs. (10.05 ± 1.31) weeks, t = 3.37, P < 0.05]. The incidence of complications in the observation group was significantly lower than that in the control group [3.77% (2/53) vs. 16.98% (9/53), χ2 = 4.97, P = 0.025]. At 6 and 12 months after surgery, Harris hip scores in the observation group were (82.84 ± 6.58) points and (85.55 ± 7.91) points, respectively, which were significantly higher than (78.35 ± 7.54) points and (79.92 ± 9.94) points in the control group ( t = 3.26, 3.22, both P < 0.05). Conclusion:Internal fixation with bone cement-reinforced anti-rotation intramedullary nails for treatment of femoral trochanteric fractures can shorten the time to fracture healing, reduce complications, and improve hip joint function.
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Objective:To improve training quality and to standardize the assessment procedures of radiology standardized residency training by analyzing the results of the clinical skills completion assessment for radiology standardized residency training in Liaoning Province in 2020.Methods:Totally 186 trainees participated the assessment with 6 exams in 3 days, including "Man-Machine interview" and "oral interview". Reliability and validity of the test were analyzed first. The accuracy were compared among the three parts of radiology, ultrasound and nuclear medicine, and also among the three portions of imaging description, diagnosis and relative question. Trainees of different type, gender and from different regions were further compared respectively. Scores of different examiners were also compared. SPSS 20.0 software was used for t-test and one-way ANOVA. Results:The Cronbach's α coefficient ranged from 0.65 to 0.87, and KMO values were nearly or higher than 0.7. Scores of both "Man-Machine interview" and "oral interview" parts were better relative to the total scores (relativity coefficient 0.698-0.969). The accuracy of radiology was relatively higher and more stable (nearly 80%), nuclear medicine had the lowest accuracy (nearly 50%), and that of ultrasound fluctuated obviously (56.2%-88.8%). The accuracy was the highest for imaging description, followed by diagnosis, and the lowest for relative question portion. There were significant differences between male and female residents in "Man-Machine interview" portion ( P=0.028), while there was not in "oral interview" ( P=0.050). There were significantly statistical differences in trainees' scores between different regions ( P=0.009 for "Man-Machine interview" and P<0.001 for "oral interview"). Trainees from Shenyang and Dalian got almost the same scores, which were significantly higher than those from other cities. Trainees with master's degree were scored higher than others trainees that were not (all P<0.001). Significant score differences were found between the two examiners in only one examiner group (1/18) ( P=0.011). Conclusion:By the analysis of test results, we find the shortage of both training and assessment process, which is beneficial to adjusting the training process, improving the training quality, and promoting the further standardization and development of the assessment system of radiology standardized residency training.
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Objective:To investigate the effect of lymphovascular invasion (LVI) on biochemical recurrence in patients treated with radical prostatectomy (RP).Methods:From June 2012 to November 2020, 403 cases treated with RP in the Second Hospital of Tianjin Medical University were analyzed retrospectively. Median age was 67 (range 47-81) years old. Median prostate specific antigen (PSA) was 18.0 (range 1.9-813.0) ng/ml. All patients received prostate biopsy and were confirmed with prostatic acinar adenocarcinoma according to pathology. The Gleason score of 44 (10.9%) cases were 6, 65 (16.1%) cases were 3+ 4, 62 (15.4%) cases were 4+ 3, and 232 (57.5%) cases were ≥8. 73 (18.1%) patients received neoadjuvant hormonal therapy. RP and pelvic lymph node dissection were carried out in all patients including 10 open surgery, 144 laparoscopic surgery and 249 robot-assisted laparoscopic surgery. The χ 2 test was used to analyze the correlation between LVI and clinicopathological characteristics. Kaplan-Meier method and log-rank test were used to summarize time-to-biochemical recurrence end point and compare biochemical recurrence-free survival between LVI positive and negative groups. Univariable and multivariable analyses were performed to test the possible factors of biochemical recurrence with Cox proportional-hazard model. Results:Of all 403 patients treated with RP, the final Gleason score of 68 (16.9%) cases were≤6, 87 (21.6%) cases were 3+ 4, 89 (22.1%) cases were 4+ 3, and 159 (39.5%) cases were≥8. 179 (44.4%) patients had positive surgical margins. The rate of seminal vesicle invasion was 23.6% (95 patients). There were 167 (41.4%) cases with T 1~2 and 236 (58.6%) cases with T 3~4 pathological stage. 39 (9.7%) patients had lymph node metastasis. 62 (15.4%) patients were LVI positive and 341 (84.6%) patients were LVI negative. There were statistically significant differences in biopsy and final Gleason score, pathological stage, rates of seminal vesicle invasion and rates of positive lymph node between LVI positive and negative patients ( P<0.05). 259 (64.3%) patients received adjuvant hormonal therapy and 70 (17.4%) patients received adjuvant hormonal plus radiation therapy. Median follow-up time was 22 (range 6-89) months. 23 (37.1%) occurred biochemical recurrence in LVI positive cases and median biochemical recurrence-free survival was 41 months. Meanwhile, 71 (20.8%) occurred biochemical recurrence in LVI negative cases and median biochemical recurrence-free survival was not reached, significantly longer than LVI positive cases ( P<0.001). Multivariable analysis showed that PSA level, biopsy gleason score, neoadjuvant hormonal therapy, pathological stage, positive surgical margins, seminal vesicle invasion, lymph node metastasis and LVI were significantly associated with prognostic prediction of biochemical recurrence. Conclusions:LVI implies shorter biochemical recurrence-free survival and could be an independent predictor on biochemical recurrence in patients treated with RP.
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Objective:To explore the application value of three-dimensional visualization technology in the analysis of anatomic variation of peripancreatic vessels in patients with pancreatic space occupation.Methods:A total of 98 cases in Yijishan Hospital of Wannan Medical College, the First Affiliated Hospital of University of Science and Technology of China, the First Affiliated Hospital of Anhui Medical University, the Second Affiliated Hospital of Anhui Medical University, the First Affiliated Hospital of Bengbu Medical College, Fuyang People's Hospital from June 2018 to December 2019 were retrospectively analyzed. Of 94 patients were enrolled, including 56 males and 38 females, aged (61.2±7.2) years. Abdominal organs and blood vessels were reconstructed by 3D visualization technology, and anatomic variation of peripancreatic vessels was analyzed, including abdominal trunk, hepatic artery system, portal vein system and dorsal pancreatic artery.Results:The three-dimensional reconstruction rate of celiac trunk vessels was 100.0% (94/94). The 60 cases of abnormal celiac trunk were as follows: liver and spleen trunk in 5 cases (5.3%), stomach and spleen trunk in 1 case (1.1%), liver, stomach and spleen mesentery trunk in 3 cases (3.2%), liver, stomach and spleen mesentery trunk in 17 cases (18.1%), celiac trunk with one or more inferior phrenic arteries in 34 cases (36.2%). There were 69 cases (73.4%) of Michels type Ⅰ, 2 cases (2.1%) of Michels type Ⅲ, 1 case (1.1%) of Michels Ⅴ, 2 cases (2.1%) of Ⅷ, and 1 case (1.1%) of type Ⅸ of hepatic artery system. There were 17 cases (18.1%) of accessory left hepatic artery from celiac trunk which did not belong to Michels classification. Left accessory hepatic artery originated from left gastric artery and left hepatic artery originated from superior mesenteric artery in 1 case (1.1%), right accessory hepatic artery originated from celiac trunk combined with proper hepatic artery and right anterior hepatic artery combined with gastroduodenal artery originated from right posterior hepatic artery in 1 case (1.1%). Abnormal walking of dorsal pancreatic artery in 3 cases. The inferior mesenteric vein flowed into the superior mesenteric vein in 38 cases (40.4%), and the inferior mesenteric vein flowed into the splenic vein and superior mesenteric vein in 4 cases (4.3%).Conclusion:Three-dimensional visualization technique is helpful to determine the variation of peripancreatic vessels, and has certain significance for accurate preoperative evaluation and surgical guidance of patients with pancreatic space occupation.
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Objective:To evaluate the efficacy and safety of docetaxel plus hormone therapy in metastatic prostate cancer.Methods:From April 2016 to April 2019, 204 cases with bone metastatic prostate cancer in the Second Hospital of Tianjin Medical University were analyzed retrospectively. There were 97 patients responded to hormone therapy including 92 cases with high-burden metastasis (more than 4 bone metastases with one or more beyond the axial skeleton) and 5 cases with low-burden metastasis, with average age of 70 years (range 42-87 years) and median prostate specific antigen (PSA) of 74.1 ng/ml (range 11.0-145.0 ng/ml). Among them, there were 35 patients (36.1%) with a Gleason score of 7 or lower, and 62 patients (63.9%) with a Gleason score of 8 or higher. There were 26 patients suffering from bone pain, with average numerical rating scales(NRS) score of 3.7. In addition, there were 107 patients being resistant to hormone therapy, with average age of 73 years (range 56-83 years), and median PSA of 84.5 ng/ml (range 12.4-490.2 ng/ml), including 32 patients (29.9%) with a Gleason score of 7 or lower, and 75 patients (70.1%) with a Gleason score of 8 or higher. Among them, there were 75 patients suffering from bone pain, with average NRS score of 5.4. All patients received continuous hormone therapy combined with docetaxel (at a dose of 75 mg per square meter of body-surface area every 3w, plus prednisone 5 mg twice a day), and PSA progression-free survival (PSA-PFS), NRS score, pain relief, and adverse events were analyzed. Additional analysis of the correlation between PSA-PFS and subgroups with age, PSA level and Gleason score were performed.Results:For patients with metastatic hormone sensitive prostate cancer (mHSPC), 6 (6.2%) cases only received 1-2 cycles of chemotherapy due to different reasons, and the others received 3-6 cycles(average 4.7)with the median follow-up of 15 months. Of patients who received ≥3 cycles, there were 36 cases presenting PSA progression, with the median PSA-PFS of 22 months, average NRS score decline from 3.9 to 3.0, and pain relief rate of 72.0%(18/25). For patients with metastatic castration-resistant prostate cancer (mCRPC), 9 (8.4%)cases only received 1-2 cycles of chemotherapy, and the others received 3-14 cycles (average 5.6). Of patients who received≥3 cycles, there were 51 cases with PSA progression, with the median PSA-PFS of 11 months, average NRS score decline from 5.6 to 4.4, and pain relief rate of 48.6%(35/72). Subgroup analysis showed a significant correlation between PSA level and PSA-PFS for patients with mCRPC( P=0.026). Age or Gleason score was not significantly correlated to PSA-PFS in mHSPC or mCRPC( P>0.05). For patients with mHSPC, grade 3 or 4 neutropenia occurred in 17 cases(17.5%), nausea and vomiting in 27 cases(27.8%), and fatigue in 25 cases(25.8%). For patients with mCRPC, grade 3 or 4 neutropenia occurred in 24 cases (22.4%), nausea and vomiting in 34 cases(31.8%), and fatigue in 26 cases(24.3%). Allergic reaction and sensory neuropathy toxicity were occasional. Conclusion:Efficacy of docetaxel plus hormone therapy was confirmed in metastatic prostate cancer and adverse events were tolerable.
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Sarcopenia is a geriatric syndrome characterized by loss of skeletal muscle mass and strength and functional decline due to aging.In recent years, with the increase of the aging population, the incidence of the disease continues to rise.It is associated with a variety of adverse events such as falls, frailty, increased mortality, and other adverse events.Therefore, as research continues to lead to improved understanding on risk factors, pathophysiological mechanisms and intervention of sarcopenia, rehabilitation has become an important means in clinical treatment.This paper systematically reviews the progress in rehabilitation therapy for patients with sarcopenia, in order to summarize evidence for clinical intervention of sarcopenia.
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Objective:To investigate the prevalence of sarcopenia among community-dwelling Chinese elderly and to explore the related factors.Methods:Data were obtained from the China Health and Retirement Longitudinal Survey(CHARLS)in 2015, an open national database.According to the criteria of the Asian Working Group(AWGS)on Sarcopenia in 2014, a cross-sectional survey was conducted on 7 584 Chinese residents aged 60 years and over who had undergone the standard sarcopenia test.General socio-demographic characteristics and living habits were compared between different gender groups.The prevalence of sarcopenia was analyzed with stratification.Multivariate Logistic regression analysis was used to analyze risk factors for sarcopenia.Results:The overall prevalence of sarcopenia was 6.4%(95% CI: 5.9-7.0)among the Chinese population aged 60 years or older.In the stratified analysis, the prevalence of sarcopenia was higher in males(9.9%, 95% CI: 9.0-10.9)than in females(3.0%, 95% CI: 2.4-3.5), in rural areas(7.2%, 95% CI: 6.5-7.9)than in urban areas(4.3%, 95% CI: 3.4-5.2), and in smokers(8.8%, 95% CI: 7.6-10.0)than in non-smokers(4.2%, 95% CI: 3.6-4.8). Multivariate Logistic regression showed that male gender( OR=5.368, 95% CI: 4.126-6.985)and old age( OR=1.191, 95% CI: 1.172-1.210)were risk factors for sarcopenia.In addition, the occurrence of sarcopenia was significantly associated with physical pain( OR=2.181, 95% CI: 1.695-2.673), alcohol consumption( OR=1.426, 95% CI: 1.057-1.923), low education level( OR=2.875, 95% CI: 1.577-5.241), increased waist circumference( OR=0.982, 95% CI: 0.973-0.990), decreased peak expiratory flow( OR=0.995, 95% CI: 0.994-0.997)and increased cystatin C levels( OR=2.088, 95% CI: 1.247-3.495)( P<0.05). Conclusions:The prevalence of sarcopenia is high among community-dwelling elderly in China, and the occurrence of sarcopenia is closely related to age, gender, education level, Waist circumference and alcohol consumption.
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Chronic refractory pain is an excruciating pain caused by various reasons, which is easily recurrent and barely responded to multiple drugs. It affects more than 10% of the global population and thus causes a huge burden on the society and the economy. With the development of neuroscience, neuromodulation technologies have been well concerned, which guide a novel direction in the treatment of chronic refractory pain. This review summarizes the research progresses on repetitive transcranial magnetic stimulation, transcranial direct current stimulation, transcranial focused ultrasound stimulation, optogenetics and other non-invasive neuromodulations in the treatment of chronic refractory pain.
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Drug-induced Parkinsonism (DIP) is a common complication of antipsychotic drugs, calcium channel antagonists, gastrointestinal prokinetic drugs, and antiepileptic drugs and the most common secondary Parkinsonism in the elderly. DIP caused by various drugs is not uncommon in clinic. However, it is easy to omit diagnosis and treatment. Withdrawal of offending drugs is the main treatment and lower risk drugs should be switched if the drug in use cannot be discontinued. The advances in definition, risk factors, pathogenesis, clinical features, diagnosis and treatment, and prognosis of DIP are reviewed in this paper, in order to improve cognition for this curable iatrogenic disease in clinical practice.
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Objective:To analyze the mean levels of skeletal muscle mass and strength in elderly patients with type 2 diabetes mellitus(T2DM), and to investigate the effects of chronic inflammatory factors and oxidative stress on them.Methods:A cross-sectional study was conducted on 120 patients with T2DM aged over 60 years and 126 elderly patients without diabetes(the control group). Skeletal muscle mass, strength and serum levels of chronic inflammatory factors interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and 8-hydroxy-2′-deoxyguanosine(8-OHdG)were determined, and their effects on skeletal muscle mass and strength in elderly patients with T2DM were analyzed.Results:Compared with the control group, grip strength decreased in elderly patients with T2DM(25.03±7.85)kg vs.(29.52±7.73)kg( P<0.01), and skeletal muscle mass decreased(21.36±5.46)kg vs.(22.01±5.22)kg with no significant difference( P>0.05). Serum levels of 8-OHdG were higher in elderly patients with T2DM than in the control group(3.08±0.26)ng/L vs.(2.59±0.16)ng/L( P<0.01). Correlation and regression analysis results showed that 8-OHdG was an influencing factor for muscle strength in elderly patients with T2DM( R2=0.457)and that height and weight could be influencing factors for skeletal muscle mass in elderly patients with T2DM( R2=0.822). Conclusions:Skeletal muscle mass and strength decline in elderly T2DM patients, probably as a result of increased levels of oxidative stress.These findings may serve as evidence for sarcopenia intervention in elderly T2DM patients.
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Normal mammalian secondary palate development undergoes a series of processes, including palatal shelf (PS) growth, elevation, adhesion and fusion, and palatal bone formation. It has been estimated that more than 90% of isolated cleft palate is caused by defects associated with the elevation process. However, because of the rapidly completed elevation process, the entire process of elevation will never be easy to clarify. In this article, we present a novel method for three-dimensional (3D) reconstruction of thick tissue blocks from two-dimensional (2D) histological sections. We established multiplanar sections of the palate and tongue in coronal and sagittal directions, and further performed 3D reconstruction to observe the morphological interaction and connection between the two components prior to and during elevation. The method completes an imaging system for simultaneous morphological analysis of thick tissue samples using both synthetic and real data. The new method will provide a comprehensive picture of reorientation morphology and gene expression pattern during the palatal elevation process.
ABSTRACT
Objective:To investigate the distribution of iodine in drinking water in Shandong Province, and to provide a basis for redefining different types of iodine in drinking water, adopting specific prevention measures and scientifically adjusting intervention strategies.Methods:In 2017, a survey on the distribution of water iodine in the whole province was carried out in townships (street offices, hereinafter referred to as townships). In addition, the administrative villages (neighborhood committees, hereinafter referred to as administrative villages) shall be taken as the units for the investigation of townships with a median water iodine of > 10 μg/L or more found in this or previous surveys. Arsenic-cerium catalytic spectrophotometry was used to detect water iodine.Results:A total of 1 844 townships were surveyed, with a median water iodine of 9.2 μg/L. Among them, there were 969 townships with water iodine of less than 10 μg/L, accounting for 52.55%. From 10 to 40 μg/L, 489 townships, accounting for 26.52%; There were 139 townships with > 40-100 μg/L, accounting for 7.54%; there were 247 townships of > 100 μg/L, accounting for 13.39%. A total of 37 073 administrative villages were surveyed in the townships with a median water iodine of > 10 μg/L, and 36 690 were collected with valid data. Among them, 5 531 villages with water iodine < 10 μg/L, accounting for 15.07%; there were 17 350 villages with 10-40 μg/L, accounting for 47.29%; there were 4 859 villages of > 40-100 μg/L, accounting for 13.24%; the number of villages > 100 μg/L was 8 950, accounting for 24.39%.Conclusions:In Shandong Province, most areas are iodine deficiency area (water iodine < 10 μg/L), waterborne high iodine areas (water iodine > 100 μg/L) and "optimal iodine" (water iodine 10-100 μg/L) regions exist, and there is the possibility of dynamic adjustment of water iodine. In the next step, the dynamic monitoring of iodine nutrition in water and population should be strengthened to provide data support for the adjustment of iodized salt supply strategy.
ABSTRACT
Objective:To investigate the iodine nutritional status of key population in waterbrone high iodine areas in Shandong Province and provide scientific basis for adjustment of control strategy.Methods:In 2018, the county (city, district, county for short) shall be the unit to carry out the monitoring work, and the administrative villages shall be the unit to determine the monitoring sites in the designated high-iodine areas. According to the results of the 2017 survey on drinking water iodine for residents of Shandong Province, each monitoring county sorted the administrative villages with a median water iodine above 100 μg/L according to the water iodine value and adopted a systematic sampling method. Each county took 5 administrative villages, and if there were less than 5 administrative villages, they were all extracted (if there were administrative villages with median water iodine above 300 μg/L, ensured at least one extraction). Among the monitoring sites, water iodine, children urinary iodine, salt iodine and thyroid volume, pregnant urinary iodine, and salt iodine were investigated. The "Arsenic Cerium Catalytic Spectrophotometry Method" (WS/T 107-2006) was used to detect the water iodine and urinary iodine contents; the B-ultrasound method was used to examine the thyroid volume of children; the semi-quantitative method was used to detect the salt iodine level of residents.Results:A total of 341 water samples were collected, the median water iodine was 131.15 μg/L, ranging from 7.10 to 1 054.00 μg/L. A total of 7 555 urine samples of children were tested and the median urinary iodine of children was 289.20 μg/L. The rate of goiter of children was 3.10% (234/7 555). A total of 1 996 urine samples of pregnant women were tested and the median urinary iodine of pregnant women was 179.90 μg/L. A total of 9 551 edible salt samples were collected from children and pregnant women, including 8 238 non-iodine salt samples and the consumption rate of non-iodine salt was 86.25% (8 238/9 551).Conclusions:The pregnant women are in a suitable state of iodine nutrition, the children's urinary iodine is at a higher than suitable level in waterbrone high iodine areas in Shandong Province. Therefore, it is still necessary to strengthen the efforts to improve water and reduce iodine, and strengthen the monitoring of iodine nutrition status of key populations.