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Objective To retrospectively evaluate the clinical efficacy and safety of brentuximab vedotin(BV) combined with chemotherapy in the treatment of malignant lymphoma. Methods We collected the data of 32 lymphoma patients with CD30-positive status, including 14 cases of Hodgkin's lymphomas, 2 cases of diffuse large B-cell lymphomas, and 16 cases of mature T/NK cell lymphomas. Chemotherapy combined with BV was administered to all patients for a minimum of two cycles. The efficacy of the treatment was evaluated according to Lugano criteria every two cycles. Results Complete response rate and overall response rate after four cycles of treatment were 22% and 50%, respectively. Sixteen cases (50.0%) had grades 1 and 2 toxicity, and 16 cases (50.0%) had grade 3 toxicity or higher. The most common adverse events were neutropenia (50.0%), pneumonia (46.9%), and anemia (43.8%). The most common grade 3 or higher adverse events were pneumonia (18.8%) and febrile neutropenia (12.5%). Four patients discontinued brentuximab vedotin because of severe adverse events. Conclusion BV is effective in treating relapsed and refractory CD30- positive Hodgkin's lymphoma and peripheral T-cell lymphoma, and its overall safety is acceptable.
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【Objective】 To evaluate the dietary quality with the dietary balance index (DBI_16) and the association between dietary quality and bone mass among middle-aged and elderly people in Gansu Province so as to provide evidence for improving dietary quality and bone health status of Gansu population. 【Methods】 Based on the information of the type and quantity of food intake and the bone mass of middle-aged and elderly people aged 35 years and above collected by the Gansu Project in the Regional Ethnic Cohort Study in Northwest China, DBI_16 was used to evaluate the intake level of cereals, vegetables, fruits, milk, beans, fish and shrimp, eggs and other foods, and the degree of inadequate, excessive and unbalanced dietary intake of the participants. Multiple linear regression was used to evaluate the associations of three component indexes of DBI_16, high bound score (DBI_HBS), low bound score (DBI_LBS), diet quality distance (DBI_DQD), and seven single indexes of DBI_16 with bone mass. 【Results】 Analyses of the dietary and bone mass data of 11,840 participants showed that 44.8% of participants consumed excessive amounts of cereals compared to the dietary recommendation. 96.3%, 90.6%, 90.1%, 71.9%, 95.1% and 60.3% of participants’ intake of vegetables, fruits, milk, soybeans, fish and shrimp, and eggs, respectively, were inadequate. 47.7% participants consumed less than 10 types of food. 2.3% participants’ DBI_LBS levels were appropriate. 54.7% participants’ DBI_HBS levels were appropriate. Only 1.2% participants’ DBI_DQD reached a balanced level. The bone mass level in the study population was (2.5±0.6) kg [(2.8±0.5) kg for men and (2.3±0.5) kg for women]. After adjusting for sociodemographic characteristics, lifestyle, total dietary energy intake and body mass index, DBI_LBS and DBI_DQD were negatively associated with bone mass [β and 95% CI was -0.002 01 (-0.003 62--0.000 40) and -0.001 76 (-0.003 09--0.000 43), respectively]. 【Conclusion】 Dietary intake imbalance is common among middle-aged and elderly people in Gansu Province, and the more severe the dietary intake imbalance, the lower the bone mass level.
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【Objective:】 To explore the individual needs and the willingness to actively participate in treatment decision-making and communication among school-age children during hospitalization. 【Methods:】 Using the interview outline containing 11 questions summarized based on literature review, face-to-face interviews were conducted with patients of school-age children, and the contents of the interview feedback were summarized. Guided by Bronfenbrenner’s bioecological model and child-centered care methods, the subjects’ individual needs and willingness to actively participate in treatment decision-making and communication during hospitalization were analyzed. 【Results:】 A total of 40 hospitalized school-age children from January to April 2022 were selected, including 27 males (67.5%) and 13 females (32.5%), with a mean age of (11.8±3.2) years old. Face-to-face interviews were conducted and the results were summarized. The main contents summarized from the interview results included children’s needs for their parents, medical staff, and the hospitalization environment. 【Conclusion:】 School-age children were able to express their various needs and willingness to actively participate in treatment decision-making and communication during hospitalization. School-age children need to be provided age-appropriate opportunities to participate in decision-making to support their reasonable needs.
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Objective:To analyze the interaction between obesity and diabetes, obesity and central obesity, central obesity and diabetes on hypertension.Methods:A questionnaire survey on 7 622 residents of Han Chinese ethnicity, aged 35-75 years, of Liangzhou district of Wuwei city were performed using multi-stage random sampling method in September to December 2018. Relative excess risk due to interaction, attributable proportion, synergy index, and 95% CI of the three were used to evaluate the additive interaction. Logistic regression analysis was used to analyze the multiplicative interaction. Results:Among the 7 622 residents, hypertension was detected in 3 212 residents, with a crude prevalence rate of 42.14% and a standardized incidence of 33.81%. There was a significant difference in incidence of hypertension between residents of different sexes, between residents at different ages, between obese residents and normal weight residents, between residents who had central obesity and those who had no central obesity, between residents who smoked and those who did not, between residents of different family economic situations, between residents who had different occupations, and between residents who had diabetes and those who had no diabetes (all P < 0.05). Getting primary, middle, and high school education was a protective factor against hypertension, while obesity, central obesity, diabetes, male gender, age greater than 45 years were the risk factors for hypertension. Multivariate logistic regression analysis showed that there was no additive interaction between obesity and diabetes, obesity and central obesity, central obesity and diabetes on hypertension. There was a multiplicative interaction between obesity and central obesity on hypertension ( P = 0.031, 95% CI: 0.53-0.97) and the interaction was antagonistic, but there were no multiplicative interaction between obesity and diabetes, central obesity and diabetes on hypertension. Conclusion:There was a negative multiplicative interaction between obesity and central obesity on hypertension.
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Objective:To summarize the clinical features of childhood opsoclonus-myoclonus syndrome (OMS), evaluate severity degree and prognosis using OMS Symptom Severity Standard Rating Scale.Methods:The clinical features,diagnosis, therapeutic regimen and follow-up of 9 children with OMS in Department of Neurology and Oncology Department of Children's Hospital of Fudan University between 2011 and 2019 were retrospectively reviewed. Severity degree and prognosis were evaluated using OMS Symptom Severity Standard Rating Scale.Results:Among the 9 children with OMS, 4 were males and 5 were females. The onset age ranged from 14 months to 5 years, with a median of 17 months. Main symptoms were opsoclonus, myoclonus, ataxia, motor function regression, behavior and mood changes and sleep disorders. Eghit patients were combined with tumor. Seven of them with neuroblastoma were confirmed by surgical pathology, the other one showed spontaneous regression and symptom remission without treatment. Eight patients received hormone combined with intravenous immunoglobulin, of which 3 cases received adrenocorticotropic hormone, while 5 cases received methylprednisolone pulse therapy, with prednisone sequential therapy, decreasing dose gradually. Rituximab was administrated in 3 patients whose annual recurrent time was≥2. Nine patients were divided into 3 groups according to OMS Symptom Severity Standard Rating Scale, 1 of mild degree, 3 of moderate degree, 5 of severe degree. There was no recurrence and sequelae in the mild-degree patient after 3 years follow-up. There was no recurrence and sequelae in 2 of the moderate-degree patients after 1-2 years follow-up. Different degrees of motor, cognitive sequelae were found in 1 of moderate-degree patients and all of severe-degree patients after 1-8 years follow-up.Conclusions:Childhood OMS patients have early onset age. Bad symptom severity before treatment and multiphase course are associated with poor prognosis. OMS Symptom Severity Standard Rating Scale is suitable for estimations of long-term prognosis.
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Objective@#To examine the effects of obesity and central obesity on hypertension, so as to provide insights into the prevention and control measures of hypertension.@*Methods@#From September to December 2018, residents at ages of 35 to 75 years were sampled using the multi-stage random sampling method in Baiyin District, Baiyin City, Gansu Province, and subjected to questionnaire surveys and physical examinations. The interaction between obesity/central obesity and hypertension was evaluated using logistic regression analysis. The synergy index ( SI ), relative excess risk due to interaction ( RERI ) and attributable proportion due to interaction ( AP ) were calculated using Excel compiled by Andersson et al.@*Results@#A total of 6 246 questionnaires were allocated and 6 169 valid questionnaires were recovered, with an effective recovery rate of 98.77%. The respondents included 3 038 men ( 49.25% ) and 3 131 women (50.75%), with a mean age of ( 52.05±8.78 ) years. There were 832 respondents with obesity ( 13.49% ) and 2 278 with central obesity ( 36.93% ). The crude and standardized prevalence rates of hypertension were 35.89% and 33.05%, respectively. Multivariable logistic regression analysis showed that obesity ( OR=2.020, 95%CI: 1.705-2.393 ) and central obesity ( OR=1.622, 95%CI: 1.433-1.836 ) were statistically associated with hypertension. There was no multiplicative interaction between obesity or central obesity and hypertension ( OR=1.011, 95%CI: 0.655-1.560 ), and no additive interaction was detected between obesity or central obesityand hypertension ( SI=1.405, 95%CI: 0.815-2.424; RERI=0.658, 95%CI: -0.298 to 1.614; AP=0.201, 95%CI: -0.075 to 0.476 ).@*Conclusions@#Obesity and central obesity increase the risk of hypertension; however, no interaction is detected between obesity or central obesity and hypertension.
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In order to provide efficient medical care to atrial fibrillation patients in the community, the Huamu Community Health Service Center in association with its medical consortium, Renji Hospital have developed a novel atrial fibrillation management system. With the collaboration of general practitioners and specialist team from the tertiary hospital, a special clinic for atrial fibrillation has been set up in the community health service center, which is based on the internet technology and the medical consortium platform. This article introduces the development of this novel system and the initial outcome of the measures, to provide a reference for the management of atrial fibrillation patients in the community.
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Purpose@#There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. @*Materials and Methods@#Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. @*Results@#The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). @*Conclusion@#Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.
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Purpose@#There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. @*Materials and Methods@#Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. @*Results@#The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). @*Conclusion@#Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.
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Objective:To discuss the impact and practicability of pluralistic management when puerpera with hepatitis B virus (HBV) in hospital.Methods:By review researching and convenient sampling, two groups of puerpera with HBV were studied comparatively by the index of the time of breast milk, the breastfeeding rate and the satisfaction rate in hospital.The control group (411 cases, January to December, 2017) carried on the normal regulations nursing and the observation group (411 cases, January to October, 2018) carried on the pluralistic management in the Obstetrics and Gynecology Department of the Fifth Medical Center of PLA General Hospital.Results:The rate of the starting time of milk secretion (<24, 24-48, 49-72, >72 h) was 29.4%(121/411), 36.0%(148/411), 24.6%(101/411), 1.0%(41/411) in the observation group, and 13.6%(56/411), 21.7%(89/411), 33.3%(137/411), 31.4%(129/411) in the control group. The differences between the two groups were significant ( χ2 value was 7.66-57.43, all P<0.01). Postpartum hospital stay in 3 days and 6 days, the breastfeeding rate and average rate was 90.4%(198/219), 95.3%(183/192), 92.7%(381/411) in the observation group, and 79.0%(180/228), 84.2%(154/183), 81.3%(334/411) in the control group, the differences between the two groups were significant ( χ2 value was 11.13, 12.7, 23.61, all P<0.01). The total satisfaction rate in hospital was 99.5%(409/411) in the observation group, and 91.2%(375/411) in the control group, the difference between the two groups was significant ( χ2 value was 31.93, P<0.01). Conclusions:Pluralistic management can raise the rate of breastfeeding of puerpera with HBV and the satisfaction of puerpera with HBV and her family.
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Objective@#To discuss the impact and practicability of pluralistic management when puerpera with hepatitis B virus (HBV) in hospital.@*Methods@#By review researching and convenient sampling, two groups of puerpera with HBV were studied comparatively by the index of the time of breast milk, the breastfeeding rate and the satisfaction rate in hospital.The control group (411 cases, January to December, 2017) carried on the normal regulations nursing and the observation group (411 cases, January to October, 2018) carried on the pluralistic management in the Obstetrics and Gynecology Department of the Fifth Medical Center of PLA General Hospital.@*Results@#The rate of the starting time of milk secretion (<24, 24-48, 49-72, >72 h) was 29.4%(121/411), 36.0%(148/411), 24.6%(101/411), 1.0%(41/411) in the observation group, and 13.6%(56/411), 21.7%(89/411), 33.3%(137/411), 31.4%(129/411) in the control group. The differences between the two groups were significant (χ2 value was 7.66-57.43, all P<0.01). Postpartum hospital stay in 3 days and 6 days, the breastfeeding rate and average rate was 90.4%(198/219), 95.3%(183/192), 92.7%(381/411) in the observation group, and 79.0%(180/228), 84.2%(154/183), 81.3%(334/411) in the control group, the differences between the two groups were significant (χ2 value was 11.13, 12.7, 23.61, all P<0.01). The total satisfaction rate in hospital was 99.5%(409/411) in the observation group, and 91.2%(375/411) in the control group, the difference between the two groups was significant (χ2 value was 31.93, P<0.01).@*Conclusions@#Pluralistic management can raise the rate of breastfeeding of puerpera with HBV and the satisfaction of puerpera with HBV and her family.
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Idiopathic pulmonary fibrosis(IPF)is a progressive lung disease characterized by pulmonary interstitial fibrosis and pulmonary dysfunction.Cell microenvironment is mainly composed of cell components,extracellular matrix,extracellular regulators,and liquid substances.Changes in microenvironment components are closely related to IPF.This article elaborates the roles of cell microenvironments including cytokines,mesenchymal cells,extracellular matrix,and unfolded proteins in the pathogenesis of IPF.
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Humans , Cellular Microenvironment , Extracellular Matrix , Idiopathic Pulmonary Fibrosis , LungABSTRACT
Objective@#To investigate the correlation between hyperuricemia and non-frozen cold wounds (chilblains) in agricultural workers of a township for prevention measures.@*Methods@#From October 2016 to September 2017, a cross sectional study was applied to 3107 agricultural workers of a township in kaihua county, zhejiang province, of which 371 people with hyperuricemia were observed as the objective group and of which 2 736 people without hyperuricemia as the control group. The data of the occurrence of non-frozen cold wounds (chilblains) in winter among the objective group and the control group were gathered. The descriptive statistics was carried out with the prevalence ratio (PR) of chilblains and 95% confidence intervals of those agricultural workers with hyperuricemia.@*Results@#The prevalence rate was 11.94% and 371 cases with hyperuricemia among 3107 agricultural workers of a township. The total number of cases of non-frozen cold wounds (chilblains) was 195 cases and the prevalence rate was 6.28% with Chilblains among 3 107 agricultural workers of a township. The total of 55 cases with chilblains (14.82%) among the objective group, and 140 cases with chilblains (5.12%) were found among the control group (χ2=52.342, P<0.05) . The objective group had a high prevalence of chilblains. The prevalence ratio (PR) of chilblains was 2.897 (95%CI 2.163-3.881) .@*Conclusion@#Hyperuricemia may be a risk factor for non-frozen cold wounds (chilblains) . Those agricultural workers with hyperuricemia should pay more attention to keep warm and prevent non-frozen cold wounds (chilblains) in winter.
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Objective@#To understand the status of iodine nutrition of children aged 8-10 years and pregnant women in Shizuishan City.@*Methods@#In 2017, five sampling districts were divided into east, west, south, north and middle districts in three counties (Dawukou District, Huinong District and Pingluo County) of Shizuishan City, one township (town, street) was selected in each district, one primary school was selected in each township (town, street), 40 children aged 8-10 years were selected in each primary school, and 20 pregnant women were selected in each township (town, street). In Dawukou District and Huinong District of Shizuishan City, 50 g of edible salt and 10 ml of urine samples were collected from the homes of children and pregnant women; in Pingluo County 50 g of edible salt samples were collected from the homes of children and pregnant women. Iodine in edible iodized salt was measured by redox titration and urinary iodine content was measured by arsenic-cerium catalytic spectrophotometer.@*Results@#A total of 900 edible salt samples were collected, the median iodine content in salt was 24.50 mg/kg, the coverage rate of iodized salt was 97.67% (879/900), the qualified rate of iodized salt was 86.92% (764/879), and the edible rate of qualified iodized salt was 84.89% (764/900). A total of 400 urine samples of children were tested, the median urinary iodine was 213 μg/L. There was statistically significant difference in urinary iodine among children between Dawukou District and Huinong District (the median urinary iodine was 246 and 194 μg/L, respectively, Z=-4.827, P < 0.05), but no statistically significant differences in urinary iodine among children in different gender and age groups (P > 0.05). A total of 200 urine samples of pregnant women were tested, and the median urinary iodine was 173 μg/L. There were no significant differences in urinary iodine content between pregnant women in different counties(districts), and between pregnant women at different pregnancy stages (P > 0.05).@*Conclusion@#The iodine nutrition status of the children aged 8-10 years and pregnant women in Shizuishan City is generally at the appropriate level.
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Objective To investigate the situation and the causes of neonatal death in Henan Province.Methods This study retrospectively analyzed the clinical data of 277 neonates who died at 18 hospitals in Henan Province in 2017.Distribution and causes of neonatal deaths,differences between perinatal conditions of premature and term/post-term infants,causes of early (＜ 7 d) and late (7-28 d) neonatal deaths and the differences in neonatal death cases between Maternal and Child Health Care Hospitals and General/Children's Hospitals were analyzed.We used t,rank-sum and Chi-square test (or corrected Chi-square test,or Fisher's exact test) for statistical analysis.Results (1) A total of 50 993 newboms were admitted to the 18 hospitals in 2017,297 of which died with a mortality of 5.82‰.After excluding 20 cases with uncertain birth or maternal pregnancy history or clinical data,277 cases with complete data were analyzed.Among them,168 (60.6％) were preterm neonates and 109 (39.4％) were term/post-term ones.Early and late neonatal deaths accounted for 74.0％ (205 cases) and 26.0％ (72 cases),respectively.(2) The top five causes of neonatal deaths were infection (78 cases,28.2％),asphyxia (54 cases,19.5％),neonatal respiratory distress syndrome (NRDS,33 cases,11.9％),severe congenital malformations (26 cases,9.4％) including cyanotic congenital heart diseases,digestive malformations,airway malformations and neural tube defects and pulmonary hemorrhage (23 cases,8.3％).Among them,the top three causes of early neonatal deaths were asphyxia (48 cases,23.4％),infection (43 cases,21.0％) and NRDS (33 cases,16.1％),while the main causes of late neonatal deaths were infection (35 cases,48.6％),major congenital malformations (9 cases,12.5％) and chromosome abnormities/inherited metabolic diseases (7 cases,9.7％).(3) Maternal complications during pregnancy accounted for 79.1％ (219 cases) and the predominant types were pregnancy-induced hypertension (43 cases,19.6％),followed by infection (36 cases,16.4％),placental-related conditions (32 cases,14.6％),gestational diabetes mellitus (23 cases,10.5％),hypothyroidism (20 cases,9.1％),fetal distress (18,8.2％),twin-twin transfusion syndrome (10 cases,4.6％) and cholestasis syndrome (9 cases,4.1％).(4) Compared with the term/post-term cases,the preterm cases had higher proportions of multiple births [27.4％ (46/168) vs 6.4％ (9/109),x2=14.016,P ＜ 0.05],assisted reproduction [7.1％ (12/168) vs 0.9％ (1/109),x2=4.421,P ＜ 0.05] and maternal hypertensive disorders of pregnancy [21.4％ (36/1 68) vs 6.4％ (7/109),x2=11.353,P ＜ 0.05],infection [16.7％ (28/168) vs 7.3％ (8/109),x2=4.295,P ＜ 0.05] and twin-to-twin transfusion syndrome [6.0％ (10/168) vs 0.0％ (0/109),x2=6.707,P ＜ 0.05].(5) Among all the early neonatal deaths,preterm cases had a higher incidence of NRDS than term/post-term neonates [20.3％ (27/133) vs 8.3％ (6/72),x2=1 1.937,P ＜ 0.05],but lower incidence of meconium aspiration syndrome (MAS),severe congenital malformations and chromosome abnormalities/inherited metabolic diseases [0.8％ (1/133) vs 5.6％ (4/72),x2=4.508;3.8％ (5/133) vs 16.7％ (12/72),x2=10.233;1.5％ (2/133) vs 6.9％ (5/72),~=4.172;all P ＜ 0.05].Among the late neonatal deaths,the incidence of severe intracranial hemorrhage in preterm infants was higher than that in term/post-term neonates [7.1％ (3/42) vs 0.0％ (0/30),x2=2.205,P ＜ 0.05].(6) Compared with the cases in General/Children's Hospitals,those in Maternal and Child Health Care Hospitals showed a higher proportion of preterm neonatal deaths [67.3％ (105/156) vs 52.1％ (63/121),x2=6.010,P ＜ 0.05],younger gestational age [(32.8±5.3) weeks vs (34.6±4.9) weeks,t=3.072,P ＜ 0.05],lower birth weight [(2 132.6± 1 014.5) g vs (2 409.4±987.3) g,t=-2.513,P ＜ 0.05],and higher average age of death [M(P25-P75),3 (1-8) d vs 2 (1-4) d,Z=3.710,P ＜ 0.05].Conclusions Neonatal death occurs mainly within one week after birth in those with maternal complications.Late preterm deaths and term/post-term cases account for nearly half of total neonatal deaths.The causes of death for preterm and term/post-term newborns vary with postnatal age.Infection,asphyxia and severe congenital malformations are important causes of neonatal deaths.
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Objective To understand the status of iodine nutrition of children aged 8-10 years and pregnant women in Shizuishan City.Methods In 2017,five sampling districts were divided into east,west,south,north and middle districts in three counties (Dawukou District,Huinong District and Pingluo County) of Shizuishan City,one township (town,street) was selected in each district,one primary school was selected in each township (town,street),40 children aged 8-10 years were selected in each primary school,and 20 pregnant women were selected in each township (town,street).In Dawukou District and Huinong District of Shizuishan City,50 g of edible salt and 10 ml of urine samples were collected from the homes of children and pregnant women;in Pingluo County 50 g of edible salt samples were collected from the homes of children and pregnant women.Iodine in edibl eiodized salt was measured by redox titration and urinary iodine content was measured by arsenic-cerium catalytic spectrophotometer.Results A total of 900 edible salt samples were collected,the median iodine content in salt was 24.50 mg/kg,the coverage rate of iodized salt was 97.67％ (879/900),the qualified rate of iodized salt was 86.92％ (764/879),and the edible rate of qualified iodized salt was 84.89％ (764/900).A total of 400 urine samples of children were tested,the median urinary iodine was 213 μg/L.There was statistically significant difference in urinary iodine among children between Dawukou District and Huinong District (the median urinary iodine was 246 and 194 μg/L,respectively,Z =-4.827,P ＜ 0.05),but no statistically significant differences in urinary iodine among children in different gender and age groups (P ＞ 0.05).A total of 200 urine samples of pregnant women were tested,and the median urinary iodine was 173 μg/L.There were no significant differences in urinary iodine content between pregnant women in different counties (districts),and between pregnant women at different pregnancy stages (P ＞ 0.05).Conclusion The iodine nutrition status of the children aged 8-10 years and pregnant women in Shizuishan City is generally at the appropriate level.
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Objective To evaluate the association between V-raf murine sarcoma viral oncogene homolog B1 (BRAF)V600E mutation and biological behaviors of papillary thyroid microcarcinoma (PTMC).Methods Published papers about the association between BRAFV600E mutation and aggressiveness of PTMC from January 2011 to January 2016 were collected using databases of Wanfang,VIP,China National Knowl-edge Infrastructure (CNKI),PubMed,Embase and Cochrane library.The key words were "PTMC","papillary thyroid microcarcinoma"," thyroid microcarcinoma"," micropapillary thyroid carcinoma"," BRAF".The languages were restricted to English and Chinese.Meta-analysis was performed with RevMan 5.3 software.Results Eighteen studies involving 2 938 patients were included.A total of 1 536 patients showed BRAFV600E mutation-positive results,and 1 402 patients were with wild type.The average prevalence of the BRAFV600E mutation was 52.3％.The BRAFV600E mutation was associated with the multifocality (odds ratio (OR)=1.37,95％ CI:1.11-1.67),extrathyroid extension(OR=2.25,95％ CI:1.31-3.86),lymph node metastases (OR =3.05,95％ CI:1.60-5.79),advanced stage (TNM Ⅲ + Ⅳ;OR =1.99,95％ CI:1.54-2.57),recurrence(OR=2.92,95％ CI:1.84-4.65),male patients(OR=1.70,95％ CI:1.35-2.14) and tumor diameter ＞5 mm(OR=1.62,95％ CI:1.29～2.04)of PTMC.There was no significant association between BRAFV600E mutation and age or distant metastases.Conclusion BRAFV600E mutation is a risk factor for aggressive behaviors of PTMC.
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Objective To investigate the clinical characteristics, pathogenesis, diagnosis, treatment and prognosis of acute myeloid leukemia secondary to angioimmunoblastic T-cell lymphoma. Methods The clinical data of 3 patients with acute myeloid leukemia secondary to angioimmunoblastic T-cell lymphoma including immunohistochemistry and flow cytometer analysis were analyzed retrospectively, then the literature was reviewed. Results All the 3 patients were elderly men and the initial diagnosis was angioimmunoblastic T-cell lymphoma. The 3 cases developed secondary acute myeloid leukemia in 8 months, 14 months and 34 months after treating primary neoplasms respectively. After diagnosed acute myeloid leukemia, one case died 10 months later without treatment, one case died 13 months later despite aggressive treatment and one case lost follow-up. Conclusion Angioimmunoblastic T-cell lymphoma has risk to developing acute myeloid leukemia, and there is a poor survival and the pathogenesis is unclear.
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<p><b>OBJECTIVE</b>To investigate the value of MRI with CUBE sequence in early evaluation of the efficacy of neoadjuvant therapy (NAT) for locally advanced rectal cancer.</p><p><b>METHODS</b>Inclusion criteria: (1) rectal cancer proven by biopsy; (2) locally advanced rectal cancer (T3-4 or positive lymph nodes) with distance from lower edge of tumor to anal verge within 12 cm diagnosed by MRI before NAT; (3) acceptance of NAT treatment regulations and completion of NAT; (4) completion of routine MRI scan and CUBE scan before and after 2-course NAT chemotherapy (including new neoadjuvant chemotherapy and chemoradiotherapy); (5) completion of surgery 6-8 weeks after NAT; (6) exclusion of any previous NAT due to rectal malignant tumor or other tumors; (7) exclusion of poor image quality of preoperative routine MRI insufficient for rectal cancer staging or of CUBE image insufficient for tumor volume measurement. Fifty patients with advanced local rectal cancer were recruited in our hospital from February 2014 to January 2016. All the patients underwent MRI before and after 2-course neoadjuvent therapy. Tumor volume on CUBE were measured and the volume changes were calculated: volume difference= pre-treatment volume-post-treatment volume, volume change rate= (pre-treatment volume-post-treatment volume)/ pre-treatment volume. All the patients were categorized into sensitive and non-sensitive group according to postsurgical pathology. Comparisons were made between both groups before and after therapy. ROC curve was used to evaluate the value of CUBE-associated parameters in predicting the efficacy of rectal cancer.</p><p><b>RESULTS</b>Among enrolled 50 patients with rectal cancer, 31 were male and 19 were female, with mean age of 49.1 years (range 21 to 70 years). T-staging by MRI before NAT was T2N1-2 in 1 case, T3 in 43 cases, T4 in 6 cases. The number of patients after NAT from tumor regression grading (TRG) 0 to TRG3 was 14, 13, 18, 5, respectively. The sensitive group and insensitive group were 45 cases and 5 cases. Mean tumor volume before and after preoperative 2-course NAT was 18.70 (4.14 to 91.77) cmand 9.26 (1.02 to 52.58) cm, respectively, whose difference was significant (U=-5.826, P<0.001). Both measure values of overall tumor volume before and after preoperative NAT between sensitive group and insensitive group did not show significant differences(all P>0.05). While sensitivity group had significantly higher volume difference and change rate compared to insensitive group [ (11.90±10.01) cmvs. (0.65±3.93) cm, P=0.005; 0.45±0.28 vs. 0.09±0.36, P=0.010]. ROC curve revealed that the optimal cutoff value of accurate identification of patients with NAT sensitive was 1.96 cmfor volume difference with sensitivity 86.7% and specificity 80%, and 0.06 for volume change rate with sensitivity 93.3% and specificity 60%.</p><p><b>CONCLUSION</b>MRI CUBE can predict the efficacy of NAT for early rectal cancer patients accurately and sensitively through the detection of tumor volume change before and after NAT.</p>
ABSTRACT
OBJECTIVE@#To explore the diagnostic value of magnetic resonance imaging(MRI) in anal fistula.@*METHODS@#A total of 2160 patients were clinically diagnosed with anal fistula at the Sixth Affiliated Hospital of Sun Yat-sen University from March 2010 to September 2015. Among them, 232 cases with operative history at other hospital, 218 with Crohn's disease, 6 with rectum cancer and 8 with other disease were excluded, and 1696 patients were finally enrolled and retrospectively analyzed. The saggital FSE T2WI imaging was confirmed based on the midline of body, and then the coronal and axial scanning line were confirmed. The key point was that the coronal scanning line must parallel and the axial scanning line must be perpendicular to the major axis of anal canal. The characteristics of anal fistula were recorded, and anal fistula were classified as five types, including intersphincteric, transphincteric, suprasphincteric, extrasphincteric and superficial fistula according to the Parks classification and our experience. The distribution of internal opening was described by using lithotomy position clock method.@*RESULTS@#Of 1696 patients, 1456 were males and 240 females with median age of 26.5 (0.2 to 87.0) years. Age of 8.4% (143/1696) cases was under 20 years old, of 57.4%(973/1696) cases was between 20 to 40, of 28.4%(482/1696) cases was between 40 to 60, of 5.8%(98/1696) cases was over 60. The 1696 MR examinations included 1128 on 1.5T MR and 568 on 0.5T MR. Of all the anal fistulas was 29.0%(492) high position and 71.0%(1204) was low position. Among the 1696 patients, 1057 were intersphincteric fistulas(62.3%), 407 were transphincteric fistulas(24.0%), 68 were suprasphincteric fistulas(4.0%), 54 were extrasphincteric fistulas (3.2%), 67 were superficial fistulas(4.0%), and 43(2.5%) were difficult to classify. A total of 1996 internal openings were found and most of them were located around the dentate line of 5-7 o'clock in lithotomy position(47.7%, 952/1996).@*CONCLUSIONS@#Anal fistula mainly occur in young men, and the most common type is intersphincteric fistula. MRI can accurately classify anal fistulas and clearly demonstrate internal openings, and provide reliable evidence for clinical treatment and surgery.