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Objective:To study the clinical significance of alveolar-arterial oxygen gradients (P A-aO 2) for late preterm and full-term infants with acute respiratory distress syndrome (ARDS). Methods:From January 2020 to June 2022, infants (gestational age ≥34 weeks) diagnosed with ARDS were admitted to the Neonatology Department of our hospital. The infants were assigned into the invasive group and the non-invasive group according to the ventilation mode. The infants with the same gestational age and diagnosed with neonatal wet lung were assigned into the control group. P A-aO 2 levels within 1 h after birth were compared among the three groups. The correlation of P A-aO 2 with ARDS, ventilation mode and duration were studied. Receiver operating characteristic (ROC) curve was used to determine the predictive value of P A-aO 2 within 1 h after birth for ARDS and the need of invasive ventilation. Results:A total of 36 cases were enrolled in the invasive group, 19 cases in the non-invasive group and 50 cases in the control group. Within 1 h after birth, P A-aO 2 in the invasive group was significantly higher than the non-invasive group and the control group ( P<0.05), and the non-invasive group higher than the control group ( P<0.05). Correlation analysis showed that P A-aO 2 within 1 h after birth in the invasive group was positively correlated with the duration of invasive ventilation and total mechanical ventilation ( r=0.601, P<0.001; r=0.504, P=0.002); P A-aO 2 before successful withdrawal of invasive ventilation was not correlated with subsequent non-invasive ventilation duration; and no correlation existed between P A-aO 2 within 1 h after birth and the duration of non-invasive ventilation in the non-invasive group. The area under the ROC curve for P A-aO 2 within 1 h after birth to predict ARDS was 0.875, with a sensitivity of 87.3% and a specificity of 72.0% at a cutoff value of 50.0 mmHg. The area under the ROC curve for predicting the need for invasive ventilation in infants with ARDS was 0.851, with a sensitivity of 80.0% at a cutoff value of 73.3 mmHg and a specificity of 75.0%. Conclusions:Late preterm and full-term infants have a higher risk of ARDS at P A-aO 2>50.0 mmHg within 1 h after birth. Infants with ARDS are more likely to require invasive ventilation if P A-aO 2>73.3 mmHg. The higher the level of P A-aO 2, the longer the duration of invasive ventilation and total duration of mechanical ventilation.
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ObjectiveTo analyze the characteristics and trends of notifiable infectious diseases in Yangpu District of Shanghai, from 1950 to 2020, and to provide scientific basis for the formulation of control measures. MethodsDescriptive epidemiological method was used to collect and analyze the epidemiological data of notifiable infectious diseases. ResultsA total of 1 186 675 cases from 38 types of infectious diseases were reported. The annual morbidity of Class A and Class B infectious diseases fluctuated between 138.22/105 and 7 861.45/105, showing a decreasing trend. Among the 3 785 cases of death, the top five were measles, viral hepatitis, dysentery, tuberculosis and epidemic cerebrospinal meningitis. The high incidence diseases were intestinal infectious diseases, and the respiratory infectious diseases fluctuated in a wide range. Furthermore, blood-borne infectious diseases and sexual -transmitted diseases had continued to increase in recent years. As the result of normative vaccination, the incidence of associated infectious disease showed a downward trend. ConclusionThe incidence of infectious diseases in Yangpu District was on the drop from 1950 to 2020. Prevention and control work should focus on respiratory infectious diseases, blood-borne infectious diseases and sexual -transmitted diseases in the future. Furthermore, it is important to guarantee normative vaccination, especially, for prevention and control of infectious diseases.
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@#[摘 要] 目的:探讨lncRNA FLJ26245在前列腺癌组织和细胞中的表达及其对PC-3细胞增殖与迁移能力的影响及其分子机制。方法:选用2017年3月至2019年5月在洛阳中心医院手术切除的52例前列腺癌及相应的癌旁组织标本,以及前列腺细胞系LNCaP、C4-2B、PC-3、DU-145和正常前列腺上皮细胞RWPE-1,用qPCR法检测前列腺癌组织和细胞中FLJ26245的表达水平。分别将FLJ26245 mimic和阴性对照质粒(lncR-NC)转染到PC-3细胞中,用MTT法、细胞划痕愈合实验分别检测细胞的增殖和迁移能力。生物信息学技术预测和双荧光素酶基因报告实验验证FLJ26245与miR-200a-3p、酪氨酸磷酸酶受体G(PTPRG)三者之间的靶向关系。用qPCR和WB法分别检测FLJ26245下游基因及增殖与迁移相关蛋白的表达。结果:FLJ26245在前列腺癌组织和细胞中的表达水平分别显著低于癌旁组织(P<0.01)和RWPE-1细胞(P<0.01或P<0.05),以PC-3细胞中的表达水平为最低(P<0.01)。FLJ26245过表达可明显抑制PC-3细胞的增殖和迁移能力(P<0.05或P<0.01)。FLJ26245可与miR-200a-3p靶向结合,miR-200a-3p可与PTPRG靶向结合(均P<0.01)。FLJ26245过表达的PC-3细胞中miR-200a-3p表达水平显著降低(P<0.01)、PTPRG mRNA和蛋白表达水平均明显升高(均P<0.01),细胞中增殖和迁移相关蛋白cyclin A、CDK2和Twist、N-cadherin均显著降低(均P<0.01)。结论:FLJ26245在前列腺癌组织及细胞中均低表达,其可能通过miR-200a-3p/PTPRG轴调控前列腺癌PC-3细胞的增殖与迁移能力。
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OBJECTIVE@#To observe the effect of tapping at acupoints along meridian combined with thunder-fire moxibustion on upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke.@*METHODS@#A total of 140 patients with upper-limb hemiplegia after stroke were randomly divided into a combination group (35 cases, 2 cases dropped off), an acupoint-tapping group (35 cases), a moxibustion group (35 cases, 2 cases dropped off) and a routine group (35 cases). The patients in the routine group were only treated with routine treatment and nursing. On the basis of the treatment in the routine group, the patients in the acupoint-tapping group were treated with tapping along the large intestine meridian of hand @*RESULTS@#Compared before treatment, body mass indexs of shoulder abduction, elbow extension, wrist flexion as well as BI scores in the four groups were significantly increased after treatment (@*CONCLUSION@#Tapping at acupoints along meridian combined with thunder-fire moxibustion could effectively improve the upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke, and its effect is superior to simple tapping at acupoints along meridian or thunder-fire moxibustion.
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Humans , Activities of Daily Living , Acupuncture Points , Acupuncture Therapy , Hemiplegia/therapy , Meridians , Moxibustion , Stroke/therapy , Treatment Outcome , WristABSTRACT
OBJECTIVE@#To establish a new mechanical model of distal humerus in children with epiphysial cartilage, stimulate supracondylar humerus fracture and perform three dimensional finite elements, and study effect of pins numbers, pin tract, outlet height and pin configurations on stability of fixation.@*METHODS@#Three dimensional computed tomography (CT) data of 6-year-old boy with distal humerus was downloaded from picture archiving and communications systems software (PACS), the data of picture was imported into Simpleware and SolidWorks 2016 software to establish distal humerus fracture in children contained ossific nucleus of the capitellum (ONC) and distal cartilage. Normal extense supracondylar humerus fracture model was established to stimulate configurations of crossed and lateral pinning fixation, 30 N was added on the direction of flexion extension and varus valgus, while 50 N was added on the direction of internal and external turning. Stability was analyzed by displacement degree of distal fracture.@*RESULTS@#Among 2-pin configurations, 2-crossed pins were more stable against rotation forces which could resist rotation stress over 2 585 Nmm/ °, while low position through ONC of 2-divergent lateral pins were more stable, which could resist stress of 45 N /mm and 190 N /mm during the test of resistant strains and varus-valgus stress. The third pins was added into the more stable lateral 2-pins, the stability in all directions were increased obviously, and 3 crossed pins is the most stable, stress of flexion-extension, varus-valgus and internal-external turning were 198 N /mm, 395 N /mm and 6 251 Nmm/ °.@*CONCLUSION@#Two-divergent lateral pins could provide enough stability for supracondylar humerus fracture in children. In two-crossed pins, the upper border of MDJ could provide the best stability. Three-crossed pins could offer the best stability against both translation and rotation forces.
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Child , Humans , Male , Biomechanical Phenomena , Bone Wires , Finite Element Analysis , Fracture Fixation, Internal , HumerusABSTRACT
AIM: To analyze the effect of calcium dobesilate combined with hypoglycemics for patients with diabetic retinopathy (DR) and cataract, and the influence on microcirculation of eye fundus, hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) level. METHODS: Totally 98 DR patients with cataract (126 eyes) from January 2013 to December 2015 in our hospital were selected as the research objects, and were divided into two groups randomly(treatment group:64 eyes in 49 patients, control group: 62 eyes in 49 patients). The control group was treated with acarbose tablet and metformin, while treatment group was treated with calcium dobesilate additionally. The clinical effect, the glycemic control effect, serum HIF-1α and VEGF level, eye function and fundus microcirculation of two groups after 12mo were compared. RESULTS: After 12mo, the total effective rates of two groups were 87.5%,61.3% respectively, which indicated significantly difference (P<0.05); the vision of treatment group was significantly higher than that of control group (P<0.05). Two groups' blood glucose level decreased significantly, and no significant difference between two groups(P>0.05). After 1-month treatment, the plasma viscosity, erythrocyte aggregation index, erythrocyte deformability index, erythrocyte sedimentation rate and hematocrit in the treatment group were significantly lower than those in the control group (P<0.05). The PSV and EDV of the posterior ciliary artery and central artery in the treatment group were significantly higher than those in the control group (P<0. 05), and RI was significantly lower than that in the control group (P<0.05). After 12-month treatment, the HIF-1α level of two groups were 35 90士11.36mmol/L, 46.75士12.08mmol/L respectively;the VEGF of two groups level were 89.72士13.61mmol/L, 110.30士16.74mmol/L, respectively, the treatment group's HIF- 1α level and VEGF were significantly lower than control group (P<0.05), and both decreased significantly after treatment (P<0.05). CONCLUSION: Calcium dobesilate combined with hypoglycemics can effectively increase the clinical effect in the treatment of retinopathy diabetic cataract, effectively control blood glucose, improve microcirculation of eye fundus, decrease HIF - 1α, VEGF level, inhibit angiogenesis.
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AIM To establish the HPLC fingerprints of Yupingfeng Powder aqueous decoction and to determine the contents of nine constituents.METHODS The analysis of aqueous decoction was developed on a 30 ℃ thermostatic Hypersil ODS column (250 mm × 4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-water flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 220 nm.RESULTS There were fifteen common peaks in the fingerprints of ten batches of samples,with the similarities of more than 0.95.Nine of them were identified as prim-O-glucosylcimifugin,calycosin-7-O-β-D-glucoside,cimifugin,4'-O-β-glucopyranosyl-5-O-methylvisamminol,psoralen,calycosin,sec-O-glucosylhamaudol,formononetin and atractylon,which showed good linear relationships within their own ranges (r ≥ 0.999 7),the average recoveries were 97.91%-99.81% with the RSDs of 0.58%-1.27%.CONCLUSION This stable and reliable method can beused for the quality control of Yupingfeng Powder aqueous decoction.
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Objective To describe the prevalence of smoking and smoking cessation in adults of Jiangxi province in 2013.Methods Multi-stage stratified cluster random sampling method was used to select 6 000 individuals aged ≥18 years from 10 chronic and non-communicable disease and risk factor surveillance points of Jiangxi province in 2013.A face-to-face questionnaire survey was carried out to collect information about the risk factors for chronic and non-communicable diseases and 5 997 records were used in final analysis of smoking and smoking cessation.Sample was weighted to represent the adult population of Jiangxi province.The prevalence of different groups were analyzed.Results The prevalence of current smoking of the sample was 21.53% (1 291/5 997).After complex weighting,the prevalence of smoking was 26.07% in adults in Jiangxi (95% CI:23.48%-28.66%),and it was much higher in men (50.62%,95%CI:46.31%-54.94%) than in women (1.46%,95%CI:0.57%-2.35%),the difference was statistically significant (P<0.05).The differences in smoking prevalence were significant among different age groups (P=0.029),and the smoking prevalence increased with educational level,but decreased with the worse of self-reported health condition.Most current smokers smoked every day (87.16%,95%CI:83.29%-91.03%) and averagely 19.27 (95% CI:17.69-20.85) cigarettes were smoked daily.The proportion of smokers with average daily consumption ≥20 cigarettes was 64.74% (95%CI:55.79%-73.70%).The smokers' average age of starting daily smoking was 20.28 (95%CI:19.74-20.82) years old,which was lower in men [20.11 (95% CI:19.61-20.61) years old] than in women [26.88(95% CI:24.73-29.03) years old],the difference was statistically significant (P<0.05).Among the male smokers,27.04% (95% CI:18.91%-35.16%) of male smokers was less than 18 years old when they started daily smoking,and the proportion was 17.46% (95% CI:0%-37.71%) in female smokers.The smoking cessation rate was 14.80% (95%CI:10.88%-18.72%) and increased with age,the increase of income level and the worse of self-reported health condition.The successful smoking cessation rate was 10.89% (95% CI:8.36%-13.42%).Only 32.10%(95%CI:21.95%-42.25%) of current smokers attempted to quit smoking.The prevalence of passive smoking was 54.71% (95% CI:44.20%-65.21%).Conclusion The prevalence of smoking was high in adults in Jiangxi and the proportion of heavy smokers was large.Less smokers quitted smoking and the proportion of current smokers attempting to quit smoking was small.Males and adolescent smokers are targeted populations for tobacco control and special strategy should be taken according to the characteristics of smoking population in Jiangxi.
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Objective To describe the prevalence of smoking and smoking cessation in adults of Jiangxi province in 2013.Methods Multi-stage stratified cluster random sampling method was used to select 6 000 individuals aged ≥18 years from 10 chronic and non-communicable disease and risk factor surveillance points of Jiangxi province in 2013.A face-to-face questionnaire survey was carried out to collect information about the risk factors for chronic and non-communicable diseases and 5 997 records were used in final analysis of smoking and smoking cessation.Sample was weighted to represent the adult population of Jiangxi province.The prevalence of different groups were analyzed.Results The prevalence of current smoking of the sample was 21.53% (1 291/5 997).After complex weighting,the prevalence of smoking was 26.07% in adults in Jiangxi (95% CI:23.48%-28.66%),and it was much higher in men (50.62%,95%CI:46.31%-54.94%) than in women (1.46%,95%CI:0.57%-2.35%),the difference was statistically significant (P<0.05).The differences in smoking prevalence were significant among different age groups (P=0.029),and the smoking prevalence increased with educational level,but decreased with the worse of self-reported health condition.Most current smokers smoked every day (87.16%,95%CI:83.29%-91.03%) and averagely 19.27 (95% CI:17.69-20.85) cigarettes were smoked daily.The proportion of smokers with average daily consumption ≥20 cigarettes was 64.74% (95%CI:55.79%-73.70%).The smokers' average age of starting daily smoking was 20.28 (95%CI:19.74-20.82) years old,which was lower in men [20.11 (95% CI:19.61-20.61) years old] than in women [26.88(95% CI:24.73-29.03) years old],the difference was statistically significant (P<0.05).Among the male smokers,27.04% (95% CI:18.91%-35.16%) of male smokers was less than 18 years old when they started daily smoking,and the proportion was 17.46% (95% CI:0%-37.71%) in female smokers.The smoking cessation rate was 14.80% (95%CI:10.88%-18.72%) and increased with age,the increase of income level and the worse of self-reported health condition.The successful smoking cessation rate was 10.89% (95% CI:8.36%-13.42%).Only 32.10%(95%CI:21.95%-42.25%) of current smokers attempted to quit smoking.The prevalence of passive smoking was 54.71% (95% CI:44.20%-65.21%).Conclusion The prevalence of smoking was high in adults in Jiangxi and the proportion of heavy smokers was large.Less smokers quitted smoking and the proportion of current smokers attempting to quit smoking was small.Males and adolescent smokers are targeted populations for tobacco control and special strategy should be taken according to the characteristics of smoking population in Jiangxi.
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One hundred and fifty patients with impacted upper-ureteral calculi were treated with ureteroscopic lithotripsy (URSL group,n =58),percutaneous nephrolithotomy (PCNL group,n =42) or retroperitoneal laparoscopic ureterolithotomy (RPLU group,n =50) from April 2011 to August 2015.The operative time,length of postoperative hospital stay,stone-free rate and the incidence of postoperative complications were observed and compared among three groups.The stone-free rate of URSL group one month after surgery was 77%,which was significantly lower than PCNL (95%) and RPLU groups (100%) (P < 0.05).But the operative time and length of postoperative hospital stay of URSL group [(37.2 ± 5.6)min,(3.9-±0.8)d] were significantly shorter than PCNL group[(75.2 ±6.7) min,(7.9 ±0.9))d] and RPLU group [(65.3 ± 6.1) min,(8.7 ± 0.9) d] (all P < 0.05).The postoperative complication rates of three groups were 8%,10% and 10%,respectively.
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Objective To discuss the influence of different doses budesonide aerosol inhalation on serum cytokines levels in children with severe asthma.Methods 96 children with severe asthma aged 4 to 14 years old in our hospital were chosen,and they were randomly divided into the observation group and the control group,48 cases in each group.All patients were given conventional treatment, and the control group was given 1mg/time budesonide treatment on the basis of conventional treatment (3 times a day),while the observation group was given 2mg/time budesonide treatment (3 times a day).Before and 1 week after treatment,the clinical symptoms of two groups were observed and compared,as well as the changes of IL-4,IFN-gamma,IL-10 and TNF-α.Results In the obser-vation group,wheezes,coughing,wheezy sound and rales disappearance time were (2.10 ±0.77)d,(5.45 ±1.20)d, (3.46 ±1.03)d,(5.55 ±1.35),which were significantly shorter than (2.98 ±1.02)d,(7.48 ±1.19)d,(5.43 ± 1.06)d,(7.56 ±1.67)d in the control group (t=4.77,8.32,9.23 and 8.32,all P0.771).Conclusion High doses of budesonide aerosol inhalation in the treatment of children with severe asthma has obvious clinical curative effects,which could significantly improve the patients'clinical symptoms,and also has low incidence of adverse reactions,which is worthy of clinical promotion.
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The current situation of medical staff's awareness about high alert medication was investigated in order to promote safe medication and standardized management of the high alert medication in China. Twenty questions were designed concerning elementary knowledge of high alert medications, storage management, medication issues and risks. In order to understand the knowledge level and education status of high alert medication, a convenient survey was conducted among 300 medical staffs in Tianjin. Medical staff's average score of high alert medication knowledge was 12.43±0.27, and the average scores of elementary knowledge of high alert medication, storage management, medication issues and risks were 3.38±0.11, 2.46±0.14, 3.17±0.11 and 3.41±0.12 respectively. Occupation (F=4.86, P=0.003), education background (F=5.57, P=0.019) and professional titles (F=13.44, P≤0.001) contributed to the high alert medications knowledge scores. Currently, the most important channel to obtain high alert medication knowledge was hospital files or administrative rules, and clinical pharmacist seminars were the most popular education form. It was suggested that the high alert medication knowledge level of the medical staff needs to increase, and it might benefit from targeted, systematic and diverse training to the medical staff working in the different circulation nodes of the medications. Further research to develop and validate the instrument is needed.
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Humans , China , Drug Prescriptions , Knowledge , Medical Staff , PsychologyABSTRACT
The current situation of medical staff's awareness about high alert medication was investigated in order to promote safe medication and standardized management of the high alert medication in China. Twenty questions were designed concerning elementary knowledge of high alert medications, storage management, medication issues and risks. In order to understand the knowledge level and education status of high alert medication, a convenient survey was conducted among 300 medical staffs in Tianjin. Medical staff's average score of high alert medication knowledge was 12.43±0.27, and the average scores of elementary knowledge of high alert medication, storage management, medication issues and risks were 3.38±0.11, 2.46±0.14, 3.17±0.11 and 3.41±0.12 respectively. Occupation (F=4.86, P=0.003), education background (F=5.57, P=0.019) and professional titles (F=13.44, P≤0.001) contributed to the high alert medications knowledge scores. Currently, the most important channel to obtain high alert medication knowledge was hospital files or administrative rules, and clinical pharmacist seminars were the most popular education form. It was suggested that the high alert medication knowledge level of the medical staff needs to increase, and it might benefit from targeted, systematic and diverse training to the medical staff working in the different circulation nodes of the medications. Further research to develop and validate the instrument is needed.
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Objective To further study the pathogenesis for congenital heart disease (CHD) and connective tissue growth factor(CTGF) for the early diagnosis of CHD and pulmonary hypertension (PH).Methods Sixty-six cases of children with CHD were selected from the thoracic surgery who were performed in the Children's Hospital of Shanxi Province during the period between Sep.2012 and Jan.2013.Based on the cardiac color Doppler estimation of the pulmonary artery systolic pressure,they were classified into several groups:unincorporated PH group with 16 cases,mild PH group with 18 cases,moderate PH group with 17 cases,and severe PH group with 15 cases.Based on types,the 66 cases could be classified as ventricular septal defect (VSD) group with 23 cases,atrial septal defect (ASD) group with 17 cases,patent ductus arteriosus(PDA) group with 14 cases,and composite(including 2 or more of the congenital cardiovascular anomalies) group with 12 cases.Twenty healthy children who had medical examination over the same period in the Children's Hospital of Shanxi Province were randomly chosen as the healthy control group.The serum concentration of CTGF in the research objects were determined with the aid of double antibody sandwich enzyme-linked immunosorbent assay method.According to the different pulmonary artery systolic pressure and different types of CHD,the serum concentration of CTGF were compared among groups.The correlation of between the CTGF concentration in the serum and pulmonary artery systolic pressure were also analyzed among the groups of children with CHD.Results Quantitative measurement revealed that the serum CTGF concentration measured in the groups of children with CHD were significantly higher than that in the healthy control group(P < 0.05) ; the serum CTGF concentration of the children with CHD and PH was higher than that in the group of children with CHD alone(P < 0.05).With the increase in pulmonary artery pressure,CHD patients serum levels of CTGF also increased(P < 0.05).By the correlation analysis,the results showed that the serum level of CTGF in the CHD groups were positively correlated with the pulmonary artery pressure (r =0.670,P =0.005 ; r =0.514.P =0.029 ; r =0.517,P =0.034 ; r =0.707,P =0.003).The difference in terms of serum CTGF concentration in different types of CHD patients was not significant (F =0.270,P =0.847).Conclusions There exists certain damage in CHD early myocardial fibrosis(unincorporated PH),when combined with PH,myocardial fibrosis increases with the gradual increase of pulmonary artery pressure.However,the degree of myocardial fibrosis shows no correlation with the type of CHD.
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Objective: To investigate the significance of doctor -patient communication courses to medical staff.Methods:Using self-made questionnaire and self -evaluation of anxiety scale (SAS), selection in our u-niversity study of 200 cases of medical personnel , in accordance with the doctor -patient communication before and after the course is divided into classes before and after teaching group , respectively on two groups before and after learning the medical staff on the SAS scores and questionnaire survey .Results:Compared with group before teach-ing, teaching group after medical staff thought through the study of doctor -patient communication course , is con-ducive to cultivating communication consciousness , improve doctor -patient communication skills as well as pre-venting the doctor-patient contradiction (P<0.05).After teaching group SAS score (34.50 ±6.88), signifi-cantly lower than the teaching group SAS score (45.51 ±6.97), difference was statistically significant (t =15 .622 ,P<0 .01 ) .Conclusion:Doctor-patient communication courses are effective way to improve the ability to communicate , to alleviate the anxiety of the medical staff at the same time also has a certain value .
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Objective To explore the behaviors of smokers as well as the tobacco consumption in Jiangxi province.Impact regarding the increases of tobacco retail price on the smoking behaviors among cigarette consumers was also studied.Data was provided for further development on measurements including legislation,taxing and increasing the retail price on tobacco.Methods 805 residents above 15 year-olds were chosen through random clustered sampling,and face to face interviewed,in Shangrao and Yichun of Jiangxi province.A chart was drawn to show the relationship between the change of smoking behavior and the increase of sales price of tobacco.Results The average rate of smoking was 27.08% (46.62% for males and 3.05% for females).16.06% (35/218) of the smokers had ever tried to quit smoking but failed.The years of smoking ranged from 1 year to 50 years,with 96.33% of the smokers purchased cigarettes on their own.Price of the cigarette ranged from 15 to 30 RMB per package,and smokers usually spent on average 192 RMB which accounted 13% of their monthly income,per month.According to the chart,if the cigarette price had a 50% increase,it would lead to 45% of the smokers reduce the number of cigarette consumption with another 5% of the smokers attempt to quit smoking.If cigarette price had an increase by 2 times,50% of the smokers would attempt to quit smoking.So the chart could be used to estimate the percentage of smokers' behavior change according to the increase of tobacco's sales price.Conclusion The cconomy burden of tobacco consumption among cigarette smokers was huge,suggesting that the Chinese smokers did need to change their smoking behavior.Chinese government should develop tobacco-related legislations and laws and set proper cigarette tax,hopefully this could reduce the number of smokers in a long run.
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PURPOSE: The objective of this study was to investigate the diagnostic accuracy of multi-detector computerized tomography urography (MDCTU) for the detection of bladder tumors. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 143 patients who were scanned by use of 64-channel MDCTU and who underwent cystoscopy due to painless hematuria or a clinical suspicion of bladder tumor. We examined the accuracy of MDCTU for the detection of bladder tumors by comparing the results obtained by MDCTU with those obtained by cystoscopy. The associations between tumor characteristics, frequency of transurethral resection (TUR), and bladder volume and detectability of bladder tumors on MDCTU were also analyzed. RESULTS: Of 143 patients, 50 patients had a history of urothelial carcinomas. In these patients, the sensitivity and specificity of MDCTU were 60.0% and 80.0%, respectively. In 93 patients without previous urothelial carcinomas, the sensitivity and specificity of MDCTU were 86.7% and 96.8%, respectively. Falsely diagnosed cases had a smaller distended bladder volume (p=0.014) and a smaller tumor size (p=0.022) than did true diagnosed cases. The false-negative rate increased when the bladder tumor was located at the bladder neck. In the univariate analysis, the tumor location, size, frequency of TUR, bladder volume, and initial hematuria were associated with detectability by MDCTU (p<0.05). CONCLUSIONS: To improve the accuracy of MDCTU for diagnosing bladder tumors, bladder filling is recommended. Thus, cystoscopy should be considered as a standard diagnostic tool for bladder tumors even in patients with normal MDCTU results, especially in the evaluation of recurrent, bladder neck-located, small, or sessile bladder tumors.
Subject(s)
Humans , Cystoscopy , Hematuria , Medical Records , Neck , Retrospective Studies , Sensitivity and Specificity , Tomography, Spiral Computed , Urinary Bladder , Urinary Bladder Neoplasms , UrographyABSTRACT
Objective To evaluate the safety and efficacy of 125I radioactive seeds implantation combined with postoperative chemotherapy as a treatment option for thoracic advanced esophageal squamous cell carcinoma(ESCC). Methods A prospective cohort study was carried out between 2000and 2005. According to preoperative CT staging criteria,298 patients in phase Ⅱ-Ⅲ of ESCC, who had were admitted to Oncology Center Surgery of Nanjing First Hospital Affiliated to Nanjing Medical University and Thoracic Surgery of YanCheng Oncology Hospital, were randomly divided into three groups: intraoperative 125I seeds implantation combined with postoperative chemotherapy (group A, 98cases), postoperative chemoradiotherapy (group B, 100 cases) and surgery alone (group C, 100cases). All patients received radical resection of esophageal cancer. According to pTNM staging criteria after operation, 233 patients in phase Ⅱb-Ⅲ of ESCC were finally enrolled in the study (78 in group A, 75 in group B, and 80 in group C). With 0. 5 m Ci of single seed, total activity of 5-11 mCi and matched peripheral dose in 60-70 Gy, 10-22 125I seeds were implanted into the target of patients in group A under direct vision in accordance with treatment planning system. The validation and quality assessment of radioactive seeds were demonstrated according to CT scan or X-ray imaging. The postoperative complications were observed. The local recurrence of the cancer was demonstrated using CT scan. The survival rate of patients was followed up for 1-,3-,5- and 10 years. Results The satisfied quality assessment of 125I seeds was observed. There was no displacement or loss of seed. The local recurrence in group A, B and C was 11. 5%, 13. 3% and 38. 8%, respectively, with statistical significance (P < 0. 05). There was no significant difference among three groups with respect to complications and 1-year survival (P>0. 05). However, the overall survival rate 3-, 5- and 10-years was 64.8%,37. 7% and 25. 1% in group A respectively; 63.3%, 36.9% and 24.9% in group Brespectively; 43. 6i%, 25.0%, and 12.6% in group C, respectively (all P<0. 05). The 3-,5- and 10-year progression free survival rates were 63.5 %, 37.4 % and 15.1% in group A respectively; 62.5 %,36.6% and 14. 4% in group B respectively; 42.5%, 25.6% and 6.2% in group C respectively (all P<0. 05). Conclusions It is a safe, effective and simple method for intraoperative 125I seeds implantation combined with postoperative chemotherapy in treatment of advanced ESCC, which may reduce the local recurrence and improve survival rates in patients with ESCC.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of the united intraoperative (125)I seed implantation as a treatment option for thoracic advanced esophageal squamous cell carcinoma (ESCC).</p><p><b>METHODS</b>From January 2000 to August 2004, according to preoperative CT staging criteria, 298 patients in phase II to III of ESCC had been enrolled in this prospective study. With informed consent, they were randomized into two groups: intraoperative (125)I seed implantation (group A) and surgery alone (group B). With 0.5 mCi of single seed, total activity in 10 to 30 mCi, matched peripheral dose in 60 to 70 Gy, 20 to 40 (125)I seeds were implanted into the target under direct vision in accordance with treatment planning system. The post-operative complications were observed. The validation and quality assessment of radioactive seeds were demonstrated according to CT scan or X imaging. The short-term efficacy was evaluated according to WHO criteria. The 1-, 3-, 5-, and 7-year survival rate were followed up.</p><p><b>RESULTS</b>On the close date of August 31st 2008, the satisfied quality assessment of (125)I seeds was observed. There was no displacement or loss of seed. The local recurrence rates in the group A and group B were 14.9% and 38.7%, respectively, which were statistically significant (P < 0.05). The complete response and partial response rate in the group A was 78.8%. It was significantly higher than 30.3% in the group B (P < 0.05). There was no statistical difference among groups when comparing the complications (P > 0.05). The 1-year survival rates were no statistical difference among the two groups. However, the 3-, 5-, and 7-year survival rates in group A (64.0%, 42.7%, and 25.1%) were statistically different from that in the B group (52.0%, 34.5%, and 12.6%) (P < 0.05).</p><p><b>CONCLUSIONS</b>It is safe, effective and simple application about the intraoperative (125)I seed implantation for advanced ESCC. It may reduce the local recurrence rate and improve survival.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Brachytherapy , Carcinoma, Squamous Cell , Radiotherapy , General Surgery , Esophageal Neoplasms , Radiotherapy , General Surgery , Follow-Up Studies , Intraoperative Care , Iodine Radioisotopes , Therapeutic Uses , Prospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the role of postoperative chemoradiotherapy (CRT) as a multimodality treatment option for locally advanced thoracic esophageal squamous cell carcinoma (ESCC) by a prospective comparison between surgery alone and postoperative CRT.</p><p><b>METHODS</b>Using preoperative computed tomography (CT)-based staging criteria, 158 patients with ESCC (stage II-III) were enrolled in this prospective study. With informed consent, the patients were randomized into two groups: postoperative CRT (78 cases) and surgery alone (S, 80 cases). After a few minor adjustments to the enrolled patients, the actual patients of postoperative CRT group and S group were 74 cases and 77 cases, respectively. Comparison of the complications, local recurrence rate, distant metastasis rate, survival rate and progression-free survival in the two groups was carried out.</p><p><b>RESULTS</b>With a median follow-up of 37.5 months, the 1-, 3-, 5-, 10-year overall survival (OS) rates were 91.0%, 62.8%, 42.3%, 24.4% and 87.5%, 51.3%, 33.8%, 12.5% for the postoperative CRT and S arm, respectively. A significant difference in OS was detected between the two arms (P = 0.0276). There was a significant difference of progression-free survival (PFS) between the two arms (P = 0.0136). The local recurrence rates in the postoperative CRT group and S group were 14.9% and 36.4%, respectively (P < 0.05). No significant difference was detected between the complications of the two groups (P > 0.05). Toxicities of chemoradiotherapy in the postoperative CRT arm were moderate, which can be relieved rapidly by adequate therapy.</p><p><b>CONCLUSION</b>Rational application of postoperative chemoradiotherapy can provide a benefit in progression-free survival and overall survival in patients with locally advanced esophageal squamous cell carcinoma.</p>