Prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer. Methods:A retrospective analysis was conducted on the clinical data of 91 patients with T3 glottic laryngeal cancer. Results:Among the 91 patients, 58 cases （63.7%） had anterior invasion and 33 cases （36.3%） had posterior invasion. The posterior invasion was significantly correlated with invasions of the dorsal plate of cricoid cartilage （P<0.001）, arytenoid cartilage （P= 0.001）, and subglottic region（P = 0.001）. There was no statistical difference in survival outcomes between the total laryngectomy group and the partial laryngectomy group. But in the partial laryngectomy group, the 5-year disease-free survival（DFS） of patients with anterior invasive tumors was better than that of patients with posterior invasion tumors （HR: 4.681, 95%CI 1.337-16.393, P=0.016）, and subglottic invasion was associated with worse loco-regional recurrence-free survival（LRRFS）（HR: 3.931, 95%CI 1.054-14.658, P=0.041）. At the same time, we found that involvement of the dorsal plate of cricoid cartilage was an independent risk factor for postoperative laryngeal stenosis in partial laryngectomy patients （HR:11.67, 95%CI 1.89-71.98,P=0.008）. Conclusion:Compared with total laryngectomy, selected partial laryngectomy can also achieve favorable oncological outcomes. Posterior invasion and subglottic extension are independent prognostic factors for recurrence of partial laryngectomy in T3 glottic laryngeal cancer, and the involvement of the dorsal plate of cricoid cartilage is associated with postoperative laryngeal stenosis. The tumor invasion pattern of laryngeal cancer should be further subdivided in order to select a more individualized treatment plan.

The value of ankylosing spondylitis disease activity score in Chinese ankylosing spondylitis patients / 中华风湿病学杂志

Objective To validate the discriminatory capacity of the new ankylosing spondylitis disease activity scores (ASDAS) in Chinese ankylosing spondylitis (AS) patients, and assess its clinical value. Method One hundred and twenty-nine patients with AS was included in the study, in which 87 were par-ticipat clinical trials with Etanercept (n=87) and 42 were participants of clinical trails with. The disease activity and treatment effecticacy were assessed by ASDAS, BASDAI and patient global assessment. Discriminatory ability of all the measures was analyzed as standardized mean difference (SMD) and (-score. Pearson's correlation, two indepen -dent samples t test and simple linear regression model were used for statistical analysis. Result The four ASDAS scores correlated well with patient global assessment (r=0.56～0.74), ESR (r=0.50～0.80) and CRP (r=0.50～0.69) both at baseline and the changes form baseline to 6 weeks after treatment. The four ASDAS outperformed BASDAI, patient global assessment, ESR and CRP in differentiating patients with different levels of disease activity and patients with different levels of change. There was little difference in performance between the four ASDAS versions. Conclusion The four ASDAS are highly discriminatory in evaluating the disease activity and the efficacy of drugs in Chinese AS patients, showing a significant value in clinical practice.

An exploratory study on occupational stress and work-related unintentional injury in off-shore oil production / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the association between occupational stress and other socio-psychological factors and work-related unintentional injury in off-shore oil production.</p><p><b>METHODS</b>A cross-sectional survey was conducted among 561 Chinese off-shore oil workers. They were inquired with a self-administered questionnaire involving in socio-demographic characteristics, occupational stress, type A behavior personnel, social support and coping style, and work-related unintentional injury in the past year.</p><p><b>RESULTS</b>Seventy-six (13.5%) workers experienced work-related unintentional injury for once time or more in the past year. A total 141 number of person-times were counted including 18 person-times being serious injury, 26 person-times moderate, and 97 person-times light. After adjustment for age, educational level, marital status, duration of off-shore work and job title, logistic regression indicated that perceived stress from "management problem and relationship with others" were significantly associated with work-related unintentional injuries in the past year (OR = 1.33, 95% CI: 1.05-1.68; P < 0.05). Workers lack of emotional support from friends seemed to less reporting on work-related unintentional injuries (OR = 0.37, 95% CI: 0.22-0.63).</p><p><b>CONCLUSION</b>The results implied emphasizing on that the training and guidance as well as better cooperation among the workers might reduce work-related unintentional injuries in off-shore oil industry.</p>