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In patients with medullary thyroid carcinoma (MTC), calcitonin (Ctn) and carcinoembryonic antigen (CEA) were the most important serum biomarkers for diagnosis, evaluation and follow-up. Approximately 0.3% to 5.9% of the thyroid nodule population could present with elevated Ctn on screening, and a diagnosis of MTC can be basically confirmed when serum Ctn > 100 pg/ml.. Ctn and CEA levels could reflect tumor burden and help determine the extent and timing of surgery. When preoperative serum Ctn >200 pg/mL or CEA >30 ng/mL, nearly more than one-third of patients had lateral neck lymph node metastasis. Few patients developed distant metastasis when Ctn<500 pg/mL, however the proportion of distant metastasis could reach 75% when CEA>100 ng/mL. In inherited MTC patients, tumors with Ctn<30 pg/mL were usually localized in the gland without metastasis. The time to normalization of serum Ctn and CEA postoperatively was one month in most patients. According to the response to initial therapy, patients with undetectable Ctn and normal CEA had a low risk of relapse and death in the follow-up period. The risk of local recurrence, LNM and distant metastasis increased as Ctn levels rose. The Ctn/CEA doubling time could predict the disease prognosis, and when it was less than 0.5 years, most patients would die.
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Objective: To analyze the status of occupational medical examination (OME) institutions in Guangdong Province and the critical control points affecting their future development. Methods: A total of 211 OME institutions registered in Guangdong Province were selected as the research subjects. Their current statue was investigated, and the risk assessment of their future development was carried out based on hazard analysis and critical control point theory. Results: The OME institutions were mainly concentrated in the Pearl River Delta, accounting for 72.0%. The public and private medical and health institutions accounted for 70.6% and 29.4% respectively. The filing rates of different OME categories from high to low in the order were physical factors, chemical factors, dust, other, radiation factors, biological factors (P<0.01), and the filing rates were 89.6%, 88.6%, 84.8%, 63.0%, 7.1% and 1.0%, respectively. The rates of excellence in the field assessment from high to low in the order were hearing atlas analysis personnel, lung function examination operators, chest film reading personnel, chief examination physician, technical director, quality director (P<0.01), and the rates of excellence were 49.4%, 26.2%, 20.6%, 10.8%, 8.2% and 4.6%, respectively. A total of 37 institutions did not submit OME information, of which 23 institutions did not carry out OME work after filing. The required diagnosis rate and confirmed diagnosis rate of suspected occupational diseases in 2020 were 34.3% and 55.3%, respectively. In 2021, the detection rate of suspected occupational diseases was only 1.1‰. Among the institutions with biological monitoring records, 64.1% did not participate in external quality assessment program in laboratory, and the unqualified rate of 38 participating institutions was 55.3%. The risk assessment results show that the future development of OME institutions needs to focus on private institutions, institutions that have not reported OME information, institutions that have missed diagnosis and missed reporting of suspected occupational diseases, institutions that have not participated in external quality assessment program in laboratory and core personnel such as quality managers, technical leaders, and main inspection physicians. Conclusion: OME institutions in Guangdong Province show the characteristics of centralized filing category, centralized filing region and centralized filing institution nature. Combined with the potential risks of OME institutional capacity building, it is necessary to implement classified management, strengthen information construction, supervision and management, implement post responsibilities, and promote the high-quality development of OME institutions.
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@#Objective To evaluate the early clinical outcomes of the Renatus® balloon-expandable valve in the treatment of severe aortic stenosis. Methods From November 2021 to April 2022, a total of 38 patients who received Renatus® balloon-expandable valve for severe aortic stenosis in Guangdong Provincial People's Hospital were included. There were 22 males and 16 females, with an average age of 73.7±5.3 years. Mean aortic gradient and peak aortic jet velocity at baseline, post-procedure, and follow-up were compared. Clinical outcomes including all-cause mortality, perivalvular leakage, serious adverse cardiovascular events and the occurrence of permanent pacemaker implantation were assessed. Results All patients completed the procedure successfully without conversion to thoracotomy or perioperative death. The post-implant mean aortic pressure gradient was decreased from 41.5 (27.8, 58.8) mm Hg to 6.0 (3.0, 8.0) mm Hg, and the peak aortic jet velocity was also decreased from 4.1±0.9 m/s to 1.7±0.4 m/s (P<0.001). Pacemakers were required in 2 (5.3%) patients. The median follow-up time was 27.5 (23.0, 87.5) d, with a follow-up rate of 100.0%. The mean aortic gradient was 8.0 (7.0, 10.8) mm Hg and peak aortic jet velocity was 2.0±0.3 m/s, showing significant improvement compared with those in the preoperative period (P<0.001). No severe aortic regurgitation or paravalvular leak was observed. There was no serious cardiovascular adverse event or reoperative event during the study period. Conclusion Transcatheter aortic valve replacement with the domestic Renatus® balloon-expandable valve system is a safe and effective procedure for selected patients with severe aortic stenosis who are at high risk or not candidates for surgical aortic valve replacement.
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ObjectiveTo investigate the regulatory effects of Xuanfu Daizhetang on a mouse model of allergic asthma induced by ovalbumin （OVA）. MethodSixty female BALB/c mice （6-8 weeks old， SPF） were randomly divided into groups. Ten mice were assigned to the normal group and given 0.2 mL of saline， while the remaining groups received intraperitoneal injections of Al（OH）3 at 5 g·L-1 and OVA at 1 g·L-1. The mice were divided into normal group （10 mL·kg-1 saline）， OVA model group （10 mL·kg-1 saline）， dexamethasone group （OVA+DEX， 1 mg·kg-1）， OVA+ low-dose Xuanfu Daizhetang group （OVA+XL， 7.065 g·kg-1）， OVA+ medium-dose Xuanfu Daizhetang group （OVA+XM， 14.13 g·kg-1）， and OVA+ high-dose Xuanfu Daizhetang group （OVA+XH， 28.26 g·kg-1）. An OVA-induced asthma model was established in mice. Hematoxylin-eosin （HE） and periodic acid-Schiff （PAS） staining methods were used to observe bronchial tissue pathological changes. Enzyme-linked immunosorbent assay （ELISA） was performed to measure the levels of immunoglobulin E （IgE）， interleukin-4 （IL-4）， IL-5， IL-13， IL-17A， and γ interferon （IFN-γ） in bronchoalveolar lavage fluid. Western blot was used to detect the phosphorylation of extracellular signal-regulated kinase （ERK）， p38 mitogen-activated protein kinase （MAPK）， and c-Jun N-terminal kinase （JNK） proteins in lung tissue. ResultCompared with the normal group， the OVA model group showed increased inflammatory cell infiltration in mouse alveoli， elevated levels of IL-4， IL-5， IL-13， IL-17A， IFN-γ in bronchoalveolar lavage fluid， and IgE in serum （P<0.05， P<0.01）， and promoted phosphorylation of MAPK signaling pathway-related proteins. Compared with the model group， the OVA+XL， OVA+XM， and OVA+XH groups showed reduced inflammatory cell infiltration in mouse alveoli， decreased levels of IL-4， IL-5， IL-13， IL-17A， IFN-γ in bronchoalveolar lavage fluid， and IgE in serum （P<0.05， P<0.01）， and inhibited phosphorylation of MAPK signaling pathway-related proteins. ConclusionThe results of this study suggest that Xuanfu Daizhetang has potential anti-allergic asthma activity， providing a theoretical basis for its future clinical application.
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Objective To analyze the distribution features of newly reported cases of occupational welder′s pneumoconiosis (OWP) in Guangdong Province from 2013 to 2022. Methods Data of newly reported cases of OWP from National Occupational Disease Network Direct Reporting System of Guangdong Province from 2013 to 2022 was analyzed using conventional data analyzing Methods. Results A total of 294 cases of OWP were reported in Guangdong Province from 2013 to 2022 with an overall downward trend. The average age at diagnosis for new OWP cases was 44±6 years old, and the median of dust exposure duration was 11 years. Males accounted for 99.3% of the cases, and 94.2% of the cases were phase Ⅰ OWP. Guangzhou City had the highest regional distribution with 74.8% of the cases. The industry distribution was mainly manufacturing, accounting for 86.7% of the cases. The scale of enterprises was most common in small enterprises, followed by large and medium-sized enterprises, accounting for 38.4%, 30.6% and 24.5% of the cases respectively. The economic types of enterprises were mostly private enterprises, followed by state-owned enterprises, accounting for 54.1% and 32.0% of the cases respectively. Conclusion In Guangdong Province, the newly reported OWP cases were clustered in terms of disease stage, regional distribution, industry, enterprise scale and enterprise economic type. There was a tendency of younger age at diagnosis and shorter dust exposure duration.
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Objective To explore the effects and influencing factors of traditional occupational health training on occupational health literacy (OHL) of employees in micro-, small- and medium-sized enterprises. Methods A total of 540 employees from 154 micro-, small- and medium-sized enterprises, who participated (347 employees) and not-participated (193 employees) in traditional occupational health training, and 171 community residents/students (not-participated in occupational health training) were selected as the research subjects using the convenient sampling method. The OHL level was investigated using Occupational Health Literacy Questionnaire of National Key Populations. Results The overall OHL level of employees was 43.3% (234/540). Among them, the overall OHL level of untrained and trained employees was 38.9% and 45.8%, respectively, and the overall OHL level of community residents/students was 43.3%. The results of multivariate logistic regression analysis showed that the higher the educational level, the higher the OHL level (all P<0.01). The OHL level of untrained and trained employees was higher than that of untrained community residents/students (all P<0.05). The interaction of education level and training status had no statistical difference on the OHL level of the research subjects (P>0.05). The results of factorial design analysis of variance showed that the overall OHL score rate of untrained employees and trained employees was higher than that of untrained community residents/students (all P<0.05). However, there was no significant difference in overall OHL score rate between untrained and trained employees (P>0.05). Conclusion The role of traditional occupational health training in improving the OHL level of employees in micro-, small- and medium-sized enterprises needs to be improved. The responsibility of enterprise occupational health training should be implemented, and multiple measures should be taken to enrich the ways and approaches of occupational health education for enterprise employees, to effectively improve the OHL of workers.
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@#We reported a 26-year-old male who was diagnosed with apical hypertrophic cardiomyopathy with left ventricular aneurysm. The location of the hypertrophic myocardium and the extent of resection were accurately assessed preoperatively using 3D modeling and printing technology. Myectomy was performed via transapical approach, and the intraoperative exploration was consistent with the description of the preoperative 3D modeling. The patient underwent the surgery successfully without any complications during the hospitalization, and the cardiopulmonary bypass time was 117 min, the aortic cross-clamping time was 57 min, and the hospital stay time was 7 d. The postoperative echocardiography demonstrated left ventricular cavity flow patency. This case provides a reference for the management of patients with apical hypertrophic cardiomyopathy.
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Objective:To analyze the diagnostic value of preoperative electromyography and spasticity assessment for patients with hemifacial spasm, and to define a relationship between intraoperative electrophysiological examination and prognosis in order to provide help for clinical diagnosis and treatment.Methods:Thirty-one patients with hemifacial spasm were selected for the clinical spasticity scoring and divided into a general spasm group ( n=27) and a severe spasm group ( n=4). All received preoperative neurophysiological examination to record their twitch discharge, facial nerve conduction velocity (MCV), lateral spread (LSR) of the spasm, brainstem auditory evoked potential (BAEP), and blink reflex. Electrophysiological monitoring then recorded intraoperative LSR. According to whether the LSR disappeared or not, the patients were divided into the LSR disappearance group (of 15) and the LSR residual group (of 16), and facial muscle activity was recorded again one, three and six months after the operation. Results:Preoperative EMG examination of both groups showed positive LSR and that facial nerve MCV was within the normal range. There were, though, significant differences between the two groups in the twitching discharge by needle electromyography, blink reflex and preoperative BAEP. One week after the operation, one member of the residual group and 3 from the disappearance patients of the former and latter group had recovered in terms of LSR, with 3 and 7 cases significantly relieved, respectively. Two months later, the corresponding figures were 5 and 7, 3 and 6, respectively. Half of a year after the surgery, 5 from the residual group and 12 from the disappearance group had fully recovered in terms of LSR, while 9 and 2 cases were significantly relieved. Altogether, there were significant differences within the two groups in terms of recovery among all the time points, with significantly better recovery in the LSR disappearance group than the LSR residual group at 1 week after operation, while there were no significant differences between the two groups in recovery 3 and 6 months after their operation.Conclusions:Preoperative electromyography can provide objective assessments of the scope, severity, and facial nerve excitability of patients with hemifacial spasm. Real-time intraoperative electrophysiology monitoring can help surgeons to objectively assess the effect of decompression and to find and avoid nerve traction injury in surrounding areas quickly.
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Objective:To evaluate the efficacy by using domestic recombinant human thyroid-stimulating hormone (rhTSH) in patients with differentiated thyroid cancer (DTC) before or after 131I therapy. Methods:From May 2019 to November 2020, a total of 24 patients with DTC (5 males, 19 females, median age 41 years) in Peking Union Medical College Hospital and Affiliated Tumor Hospital of Zhengzhou University were enrolled into the open-label, dose escalation phase Ⅰ study. All patients were divided into 4 domestic rhTSH dose groups: 0.9 mg×1 d (group A), 0.9 mg×2 d (group B), 1.8 mg×1 d (group C), 1.8 mg×2 d (group D) in succession, with 6 patients in each group. Each patient underwent rhTSH phase and thyroid hormone withdrawal (THW) phase. The end point included safety, tolerability, the quality of life (hypothyroidism symptom and sign score (Billewicz score), profile of mood states (POMS)), effectiveness (thyroid-stimulating hormone (TSH) and thyroglobulin (Tg) levels, diagnostic whole-body scan (Dx-WBS)) and pharmacokinetic characteristics (peak time, peak concentration) of rhTSH. Paired t test and Wilcoxon signed rank test were used for statistical analysis. Results:There were no dose-limiting toxicities, serious adverse events, or no grade ≥3 adverse events reported. The quality of life in rhTSH phase was significantly better than those in THW phase, including the lower Billewicz score (-53.00(-53.00, -53.00) vs -39.50(-47.00, -23.00); S=119.50, P<0.001) and the lower POMS score (91.92±12.06 vs 99.67±19.13; t=0.95, P=0.025). Serum TSH level was increased from 0.04(0.02, 0.11) mU/L (baseline) to 150.00(105.20, 173.31) mU/L 24 h after the last rhTSH administration, which was increased along with the elevation of rhTSH doses. In the THW phase, patients′ TSH levels were≥30 mU/L after 23 d (median) of THW, with the median of 73.51(57.22, 106.22) mU/L. Median Tg level of baseline was 0.10(0.10, 0.41) μg/L, which reached a peak of 0.85(0.12, 3.01) μg/L at 48 h after rhTSH administration. The peak Tg level in the THW phase was 0.88(0.15, 8.04) μg/L. The Dx-WBS consistency rate between rhTSH and THW phase was 95.8%(23/24). Conclusion:rhTSH is a safe and effective method to stimulate the serum Tg level and radioiodine uptake in patients undergoing post-operation or post- 131I assessment for DTC, as well as maintain a higher quality of life in comparison to THW phase.
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Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder associated with both genetic and environmental risks. Neuroimaging approaches have been widely employed to parse the neurophysiological mechanisms underlying ASD, and provide critical insights into the anatomical, functional, and neurochemical changes. We reviewed recent advances in neuroimaging studies that focused on ASD by using magnetic resonance imaging (MRI), positron emission tomography (PET), or single-positron emission tomography (SPECT). Longitudinal structural MRI has delineated an abnormal developmental trajectory of ASD that is associated with cascading neurobiological processes, and functional MRI has pointed to disrupted functional neural networks. Meanwhile, PET and SPECT imaging have revealed that metabolic and neurotransmitter abnormalities may contribute to shaping the aberrant neural circuits of ASD. Future large-scale, multi-center, multimodal investigations are essential to elucidate the neurophysiological underpinnings of ASD, and facilitate the development of novel diagnostic biomarkers and better-targeted therapy.
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Objective@#To explore the intervention effect of multiple nutritional health guidelines for school-aged children on the knowledge, attitudes and practices (KAP) of primary school students in Chengdu.@*Methods@#A primary school in Chengdu, which had a school canteen, was selected as the intervention school, and another similar primary school was selected as the control school. Students from the intervention school received nutritional education for six months, while the control school did not provide such intervention measures. A total of 589 students from grades 3 to 5 were selected to participate in the questionnaire survey(eligible 558, missing 31).@*Results@#Before the intervention, no significant difference was found in the rate of awareness regarding nutritional knowledge, including dietary attitudes and dietary behavior. After the intervention, the rate of awareness of nutritional knowledge and the overall awareness rate reached more than 80% in the intervention group, which was significantly higher than that observed in the control group(P<0.05). The intervention group consumed less than one type of breakfast food(26.6%), which was less than the control group(49.4%). The frequency of weekly egg and milk consumption was higher in the experimental group than in the control group. The proportion of students who consumed three or more types of vegetables daily was higher in the intervention group than in the control group. The proportion of leftovers was lower in the intervention group (15.8%) than in the control group(57.9%).@*Conclusion@#The comprehensive nutritional education based on a variety of nutritional health guidelines for school-age children can enhance students awareness of nutritional knowledge and healthier dietary behaviors.
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Objective@#To evaluate snack consumption and the influencing factors associated with student participation in the Nutrition Improvement Program, and to provide a scientific basis for improving the program.@*Methods@#Among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns (i.e., school, company, and mix). This study randomly selected one or two classes from each grade, which ranged from grade 3 to grade 9. A questionnaire, which addressed snack consumption and choice, was distributed to 27 374 students.@*Results@#The findings revealed that 14.0% of students from poor rural areas in central and western regions consumed snacks two or more times per day, and 21.6% of students spent 3 yuan or more on snacks each day. The top three choices of snacks included fruit and vegetables (50.6%), biscuits and bread (50.1%), and puffed food (40.0%). Students who had mothers who worked outside the home, parents who worked outside the home, who consumed corporate meals, and who had access to a small shop on campus were more likely to consume snacks one or more times per day(OR=1.35，1.19，1.11，1.51，P<0.05).@*Conclusion@#The phenomenon of snack consumption among primary and middle school students from poor rural areas in central and western regions is common, and the selection of unhealthy snacks was identified as a problem. A health education system with comprehensive support and guidance from individuals, families, schools, and society should be established to guide students to opt for healthier snacks.
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OBJECTIVE: To analyze the research status and developmental trend of open-access patents at home and abroad of radioactive decontamination technology for human body surface. METHODS: The basic information of open-access patents related to human body radioactive decontamination was searched and collected from the IncoPat Global Patent Database. Based on patent analysis method, the number of patent application, legal status, patent types, application trends, applicants, functional application fields, and citations were analyzed and compared, with focus on their research and development capabilities in domestic and foreign patent application status.RESULTS: A total of 981 patents of radioactive decontamination technology for human body surface were retrieved. Among them, 144 were domestic(14.7%) and 837 were from abroad(85.3%). After merge, 207 patents were confirmed, 88 were from domestic(42.5%) and 119 from abroad(57.5%). The top 5 countries with the most patents were China, Japan, the United States, France and Germany with patent amount of 88, 47, 20, 14 and 13 respectively,accounting for 87.9%(182/207) of all patents. Japan had a large number of patents with a stable growth; France and Germany started patent research very early; the United States focused on technology inheritance; Chinese patent applications are developing rapidly, followed by South Korea, and Russia had few open-access patents. Chinese patent applicants were mainly from Beijing with major enterprises and government organizations. Patents in China had few patent family, foreign patents had a wide distribution, 35.3% of which had more than five of the same family. The proportions of valid patents, utility model patents and patents of integrated device & technology in China were higher than that from abroad(35.2% vs 17.6%, 53.4% vs 3.4%, 62.5% vs 26.9%, P<0.01). The proportion of domestic patents citing other patents in China was lower than that from abroad(13.6% vs 52.1%, P<0.01), but the proportion of Chinese patents cited by other patents showed no statistical significance compared with that of abroad(27.3% vs 39.5%, P>0.05). CONCLUSION: Patents of radioactive decontamination technology for human body surface in China have developed rapidly in recent years. Patent emphasis is placed on integration and multifunctionality. However, the awareness of patent protection and regional layout is not strong enough, and the technical level needs to be improved. It is suggested to propose strategic deployment as soon as possible and strengthen technological research, development and innovation.
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The development of new proton-pump inhibitors (PPIs) with less adverse effects by lowering the pKa values of nitrogen atoms in pyrimidine rings has been previously suggested by our group. In this work, we proposed that new PPIs should have the following features: (1) number of ring II = number of ring I + 1; (2) preferably five, six, or seven-membered heteroatomic ring for stability; and (3) 1 < pKa1 < 4. Six molecular scaffolds based on the aforementioned criteria were constructed, and R groups were extracted from compounds in extensive data sources. A virtual molecule dataset was established, and the pKa values of specific atoms on the molecules in the dataset were calculated to select the molecules with required pKa values. Drug-likeness screening was further conducted to obtain the candidates that significantly reduced the adverse effects of long-term PPI use. This study provided insights and tools for designing targeted molecules in silico that are suitable for practical applications.
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Humans , Computer Simulation , Drug Design , Proton Pump Inhibitors , Toxicity , Toxicological PhenomenaABSTRACT
Objective To explore the expression of tiny RNA-25 (microRNA-25, miR-25) in the plasma、tissues of triple-negative breast cancer(TNBC) patients and cell lines, to investigate the potential molecular mechanisms of miR-25 on migration and invasion of TNBC. Methods Real-time fluorescent quantitative PCR was used to detect the expression of miR-25 in the plasma of TNBC patients. Linked omics web platform was used to analyse miR-25 level in samples of TNBC and non-TNBC. Real-time fluorescent quantitative PCR was also used to detect the miR-25 level in TNBC cell lines. The wound healing and transwell assay was applied to assess the effects on migration and invasion of TNBC cell lines which transfected with miR-25 inhibitor or the negative control. The luciferase reporter assay was used to validate the relationship between miR-25 and the sphingosine-1-phosphate phosphatase 1 (SGPP1) in HEK293T cell. The wound healing and transwell assay was used to detect the migration and invasion ability of TNBC cell lines when cotransfected with pCMV6-SGPP1 and miR-25. Furthermore, Western blot was performed to detect the SGPP1 level in TNBC cell lines. Results The expression of miR-25 was significantly elevated in the plasma of 86 TNBC patients compared with the healthy controls (P value was 0.031). LinkedOmics web platform analysis showed that miR-25 expression was significantly higher in TNBC samples than in non-TNBC samples with Luminal A or Luminal B (P value was<0.001 and 0.006). The level of miR-25 was also elevated in TNBC cell lines HS578T, HCC1806, MDA-MB-231 and BT549(P value was 0.006, 0.01, 0.029 and 0.046). The MDA-MB-231 and HS578T cells which transfected with miR-25 inhibitor exhibited a significant slower wound healing rate than control (P value was 0.035 and 0.001). At the same time, when transfected with miR-25 inhibitor, MDA-MB-231 and HS578T both exhibited a decreased invasion ability compared with the control group(P value was 0.002 and 0.001). LinkedOmics web platform analysis showed that sphingosine-1-phosphate phosphatase 1 (SGPP1) gene level was negatively correlated with miR-25 in the tissues of TNBC patients (P value was 0.037). The luciferase reporter assay validated that SGPP1 was a directed target of miR-25. The western blot assay indicated that the SGPP1 level was increased in MDA-MB-231 and HS578T after transfection with miR-25 inhibitor. Over-expression of SGPP1 could abrogate the positive effects of miR-25 on migration and invasion when pCMV6-SGPP1 was cotransfected with miR-25 (P value was all 0.002). Conclusions MiR-25 was elevated in both plasma and tissues of TNBC patients and also increased in TNBC cell lines. Transfection of MDA-MB-231 and HS578T cells with miR-25 inhibitor resulted in reduced migration and invasion. Moreover, SGPP1 was identified as a novel target of miR-25. The ability of miR-25 to promote TNBC cell migration and invasion is attributable to its effect on SGPP1 suppression.
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Objective To summarize clinicopathologic features of papillary thyroid carcinoma (PTC) coexistent with chronic lymphocytic thyroiditis (CLT) and investigate risk factors for lymph node metastasis.Methods The medical records of 4 264 consecutive papillary thyroid carcinoma patients who received surgical treatment from Oct 2013 to Oct 2015 in Peking Union Medical College Hospital were reviewed.The diagnoses was confirmed by histopathological tests.Univariate analysis was performed to identify specific clinicopathologic features of PTC with CLT.Univariate and multivariate analysis were performed to determine whether each clinicopathologic feature was an independent risk factor for lymph node metastasis.Results In all 4 265 cases,there were 3 059 papillary thyroid microcarcinoma (PTMC) (71.7％),1 010 PTC patients (23.7％) with CLT.909 female patients (90％),624 cases with multifocal lesions (61.8％),422 cases with extra-thyroid extension (41.8％),429 cases with lymph node metastasis (42.5％),and 133 cases with metastatic lymph nodes(LNs) ≥6 (13.2％).The median age was 43 years old and median tumor size was 0.8 cm.Patients with CLT were more females (90.0％ vs.70.2％;P ＜ 0.001),younger median age (43 vs.44 years;P =0.001),and lower incidence of lymph node metastasis (42.5％ vs.50.9％;P ＜0.001).CLT was not associated with tumor size,multifocal lesions,extra-thyroid extension and metastatic LNs≥6 (0.8 cm vs.0.7 cm,61.8％ vs.62.9％,41.8％ vs.42.1％ and 13.2％ vs.14.8％,respectively,all P ＞ 0.05).In multivariate analysis,CLT was an independent protective factor for lymph node metastasis (OR =0.713,95％ CI 0.609-0.835,P ＜0.001).In PTC patients with lymph node metastasis,CLT was not associated with lymph node metastasis number (3 vs.3,P =0.300).Conclusions Chronic lymphocytic thyroiditis was an independent protective factor for papillary thyroid carcinoma patients with lymph node metastasis.But in patients with lymph node metastasis,the metastatic number didn't decrease.
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OBJECTIVE: To analyze the newly diagnosed occupational disease spectrum of female workers in Guangdong Province from 2009 to 2018. METHODS: The data of occupational diseases of female workers reported to the National Occupational Diseases Network Direct Reporting System during 2009 to 2018 in Guangdong Province were collected, and analyzed by descriptive epidemiological method. RESULTS: A total of 1 191 female workers with new occupational diseases were reported in Guangdong Province from 2009 to 2018, involving 40 occupational diseases in 8 categories. The number of new occupational disease cases generally showed an increased trend in a zigzag pattern, with the lowest number in 2009(44 cases). The new case number increased from 2015 to 2018, and reached a peak in 2017(176 cases), which was four times higher than that in 2009. The top four classifications of occupational diseases were occupational chemical poisoning(59.7%), occupational ear-nose-throat-oral diseases(19.7%), occupational tumor(7.8%), and occupational pneumoconiosis and other respiratory diseases(6.1%). The top four entities of occupational diseases were occupational chronic benzene poisoning(35.0%), occupational noise deafness(19.6%), occupational chronic n-hexane poisoning(14.5%) and occupational benzene induced leukemia(7.7%). The new occupational diseases mainly concentrated in Pearl River Delta Region, accounting for 96.6%. The new cases mainly distributed in manufacturing industry(95.1%), private economic enterprises(41.6%), and medium and small enterprises(68.3%). Totally 64.2% of the cases were seen in operating workers. CONCLUSION: The newly diagnosed occupational disease spectrum of female workers in Guangdong Province shows aggregation in both categories and varieties. It also shows aggregation in certain area, enterprise industry, enterprise economic type, enterprise scale and type of work.
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OBJECTIVE: To summarize and analyze the diagnostic ideas of new occupational lung tumors in Guangdong Province.METHODS: According to the Law of the People′s Republic of China on the Prevention and Control of Occupational Disease and the GBZ 94-2002 Diagnostic Criteria of Occupational Cancer, the key diagnostic points of 6 new occupational lung tumors diagnosed in Guangdong Province from 2010 to 2011 were analyzed. RESULTS: There were 9 cases of 6 new kinds of new occupational tumors were diagnosed in Guangdong Province in 2010-2011. The cases included 3 occupational lung cancer of coke oven workers, 2 occupational lung cancer caused by asbestos, 1 occupational mesothelioma caused by asbestos, 1 occupational lung cancer caused by arsenate, 1 occupational lung cancer caused by chromate salt, and 1 occupational lung cancer caused by asphalt. During the process, the diagnosis was based on the principles of the comprehensive analysis and the attribution diagnosis, combined with occupational history, occupational disease hazard exposure history, clinical data and auxiliary examination results. If the patients were diagnosed with a primary tumor, the patients′ exposure history to occupational carcinogens should be tracked, traced and confirmed, and the diagnosis should be confirmed by referring to the list of occupational carcinogens and literature reports of the International Labor Organization, and not limited to only the personnel in a particular industry. CONCLUSION: During the diagnostic process of occupational tumors, attention should be paid to confirm the exposure history of occupational carcinogen. The key is to determine the exposure of corresponding occupational carcinogen, the route and the time of exposure and the incubation period.
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Objective@#To compare the distribution characteristics of left ventricular configuration in Chinese adult patients with hypertension under Chinese and international standard using echocardiography.@*Methods@#A total of 201 patients with primary hypertension were included in the study.Left ventricular end systolic left atrial diameter (LAD), ascending aortic diameter (AO), left ventricular end diastolic diameter (LVDd), left ventricular posterior wall thickness (PWTd) and ventricular septal thickness (IVSd) were measured and then relative wall thickness (RWT), left ventricular mass (LVM), left ventricular mass index (LVMI) were calculated. Left ventricular systolic left atrial volume (LAV) was measured by Simpson′s biplane method and left atrial volume index (LAVI) was then calculated. Ganau classification was done according to Chinese and international standard respectively. The differences of left ventricular configuration in hypertension were compared.@*Results@#According to the Chinese standard, the analytic results of left ventricular configuration showed that there were 103 cases (51.2%) in normal configuration (NG) group, 28 cases (13.9%) in concentric remodeling (CR) group, 52 cases (25.9%) in eccentric hypertrophy (EH) group and 18 patients (9.0%) in hypertrophic (CH) group, respectively. Whereas, according to the international standard, there were 47 cases (23.4%) in NG group, 93 cases (46.3%) in CR group, 18 cases (8.9%) in EH group and 43 cases (21.4%) in CH group.Each group in the configuration analysis had significant difference between Chinese and international standard (P<0.01). Patients with left atrial enlargement according to the Chinese and international standard had statistical difference in the EH and CH groups (P<0.05).@*Conclusions@#Analysis of left ventricular configuration according to the Chinese and international standard has significant difference. According to Chinese standard, it may be more accurate to reflect the changes of left ventricular configuration in Chinese hypertensive population, so as to evaluate the changes of left heart structure and function more accurately.
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Objective To explore the influence of collateral circulation on the cognition of persons with severe unilateral carotid artery stenosis or occlusion using transcranial Doppler (TCD) imaging combined with P300.Methods A total of 185 patients with stenosis or occlusion of the carotid artery were enrolled and randomly divided into a monocollateral group (n=83),a multicollateral group (n=79) and a noncollateral group (n=23).The monocollateral group was further divided into an anterior communicating artery (AcoA) group,an ophthalmic artery (OA)group and a post communicating artery (PcoA) group according to their collateral circulation.All patients and 40 normal controls (NC) were tested using the Montreal cognitive assessment (MoCA) and P300,and the correlation between the MoCA and P300 scores was analyzed.Results Compared with the NC group,all the other three groups had significantly lower average MoCA scores and P300 amplitudes.They also had significantly longer average P300 latency periods.Compared with the multicollateral group,both the monocollateral and noncollateral groups had significantly lower average MoCA scores and P300 amplitudes and longer P300 latencies.Comparing the monocollateral group with the noncoilateral group revealed the same trends.Among the monocollateral patients the average MoCA score of the AcoA group was significantly higher than the PcoA and OA group averages,while their average P300 latency period was significantly shorter and the amplitude significantly greater than the PcoA group's average.Correlation analyses showed that the MoCA score was negatively correlated with the P300 latency,but positively correlated with the P300 amplitude.Conclusions Collateral circulation can protect the cognitive function of patients with unilateral stenosis or occlusion of the internal carotid artery to some extent,with multicollateral circulation being more effective than monocollateral and AcoA circulation superior to both PcoA and OA circulation.The MoCA score is significantly correlated with the latency period of P300 in such cases.