Safety and efficacy of adjuvant chemotherapy with oxaliplatin and S-1 for patients with locally advanced gastric cancer after D2 lymph nodes dissection / 中华胃肠外科杂志

Objective: To investigate the safety and efficacy of oxaliplatin combined with S-1 (SOX) as adjuvant chemotherapy after D2 radical gastrectomy for locally advanced gastric cancer. Methods: A descriptive case series study was applied. Case inclusion criteria: (1) locally advanced gastric cancer confirmed by endoscopic biopsy or surgical specimen pathology as gastric adenocarcinoma; (2) receiving D2 radical gastric resection followed by SOX regimen adjuvant chemotherapy. Case exclusion criteria: (1) postoperative pathological TNM stage I or IV; (2) acute complications and emergency surgeries; (3) receiving neoadjuvant therapy; (4) concurrent malignancies and complications compromising patients' treatment or survival; (5) without receiving adjuvant SOX chemotherapy. A total of 94 patients with stage II-III gastric cancer who underwent D2 radical gastrectomy and postoperative adjuvant SOX chemotherapy at department of Gastrointestinal Surgery, Peking University People's Hospital from January 2014 to December 2019 were retrospectively enrolled. Chemotherapy-related adverse events, overall survival (OS) and progression-free survival (PFS) were analyzed. Kaplan-Meier survival analysis was performed and log rank test was used to analyze the difference between groups. P<0.2 or clinically significant indicators in univariate analysis were included in Cox regression model for multivariate survival analysis. Results: Among these 94 patients, there were 65 males and 29 females with an average age of (58.2±12.1) years; 33 patients with hypertension, diabetes mellitus, or cardiovascular and cerebrovascular diseases, 11 patients with family history of gastrointestinal tumors; 59 patients with tumors locating in the antrum or pylorus, 16 patients in the gastric body, 19 patients in the gastric fundus or cardia; 29 patients underwent total gastrectomy, 5 patients underwent proximal subtotal gastrectomy, and 60 patients underwent distal subtotal gastrectomy. In this study, 73 patients (77.7%) completed at least 5 cycles of adjuvant SOX regimen chemotherapy. Grade 3-4 adverse reactions included thrombocytopenia (23.4%, 22/94), nausea and vomiting (18.1%, 17/94) and peripheral neurotoxicity (6.4%, 6/94). Eighty-nine patients (94.7%) completed follow-up with a median follow-up time of 32 months. The 3-year and 5-year OS rates were 89.8% and 83.7%, respectively, and the 3-year and 5-year PFS rates were 81.4% and 78.1%, respectively. Taking 5 chemotherapy cycles as the cut-off point, the 3-year OS rate and 3-year PFS rate were 72.2% and 53.9% in the adjuvant chemotherapy < 5 cycles group, and 93.7% and 87.1% in the adjuvant chemotherapy ≥5 cycles group, respectively; the differences were statistically significant (P=0.029, P=0.006). Univariate analysis showed that the adjuvant chemotherapy < 5 cycles group was associated with worse 3-year OS (P=0.029). Multivariate analysis showed that insufficient chemotherapy cycle (HR=9.419, 95% CI: 2.330-38.007, P=0.002) was an independent risk factor for 3-year OS. Meanwhile, univariate analysis showed that the adjuvant chemotherapy <5 cycles (P=0.006), preoperative CEA > 4.70 μg/L (P=0.035) and adjacent organ resection (P=0.024) were associated with worse 3-year PFS. Multivariate analysis showed that adjuvant chemotherapy <5 cycles (HR=10.493, 95% CI: 2.466-44.655, P=0.001) and adjacent organ resection (HR=127.518, 95% CI: 8.885-1 830.136, P<0.001) were independent risk factors for 3-year PFS. Conclusions: Oxaliplatin combined with S-1 as an adjuvant chemotherapy regimen for locally advanced gastric cancer has high efficacy and low incidence of adverse reactions. At least 5 cycles of SOX regimen adjuvant chemotherapy can significantly improve prognosis of patients with stage II-III gastric cancer.

Expression of long non-coding RNA MALAT1, NEAT1 and NEAT2 in peripheral blood of tuberculosis patients / 中华疾病控制杂志

Objective To analyze the differences in the expression levels of the lncRNA MALAT1, NEAT, NEAT2 in peripheral blood mononuclear cell (PBMC) from tuberculosis patients and healthy controls. Methods We detected the lncRNA expression levels in PBMC from 79 tuberculosis patients and 82 healthy controls by quantitative reverse transcription polymerase chain reaction, and analyzed the correlation between lncRNA expression levels and some clinical features and laboratory indicators in tuberculosis patients. Results The expression levels of MALAT1, NEAT1 in PBMC of tuberculosis patients were significantly higher than healthy controls (Z=-4.386, P<0.001; Z=-10.175, P<0.001). There was no significant difference in the expression of NEAT2 between tuberculosis patients and healthy controls (Z=-0.203，P=0.839). The correlation results of lncRNA levels and some clinical features, laboratory indicators in tuberculosis patients suggested that the NEAT2 level in PBMC of newly treated tuberculosis patients was higher than recurrent tuberculosis patients, while the NEAT2 level in PBMC of sputum smear positive tuberculosis patients was lower than that of sputum smear negative tuberculosis patients (all P<0.05). There was a negative correlation between MALAT1 level and erythrocyte sedimentation rate (rs=-0.256, P=0.034). Conclusion MALAT1 and NEAT1 are abnormally expressed in PBMC of tuberculosis patients, and may be involved in the pathogenesis of pulmonary tuberculosis.

A qualitative research on the behaviors caused by fear of hypoglycemia in type 2 diabetic patients / 中国实用护理杂志

Objective To explore the behaviors caused by fear of hypoglycemia in type 2 diabetic patients, and deeply analyze the causes of these behaviors, providing help for medical staff to fully understand the inner demands of diabetic patients with hypoglycemia, so as to manage the blood glucose effectively, laying the foundation of Hypoglycemia Fear Survey-behavior scale suitable for domestic type 2 diabetic patients. Methods The interpretative phenomenological analysis method was used guided by the knowledge-attitude-belief-practice and social cognitive theory, 33 patients with hypoglycemia from 5 hospitals with different levels were interviewed by semi-structured interview. Results Four themes were extracted, including excess sensitivity, caution, avoidance and compromise. The theme excess sensitivity contained three kinds of behaviors, that were meal with sensitive alertness, drug sensitivity and excessive response to the hypoglycemia, while the theme caution contained two kinds of behaviors, that were strive to blood sugar stable and must prepare food. Conclusions The results show that the fear of hypoglycemia is serious in type 2 diabetic patients, and they make many behavior change to avoid it, affecting their quality of life and glycemic management. Medical staff should attach importance to the inner feelings and behaviors of diabetic patients with hypoglycemia, and provide guidance and support after comprehensive assessment, working together with the patient to realize the effective management of blood glucose.

Study on fatigue and related factors in patients with type 2 diabetes mellitus / 中国实用护理杂志

Objective To investigate the fatigue in patients with type 2 diabetes mellitus (T2DM),and analyze its related factors.Methods A total of 211 patients with type 2 diabetes were investigated with Chinese version of Multidimensional Fatigue Inventory-20 (MFI-20),Medical Outcomes Study Health Status Short Form-Vitality (SF-36-VT) and demographic survey questionnaire.T test,one-way AVOVA and multiple linear regression analysis were used to analyze the data.Results The fatigue incidence of 211cases of patients with type 2 diabetes was 63.5％ (134/211),the mean score of MFI-20 was 54.10±15.63,and women's score (57.89±15.32) was significantly higher than that of men (51.54±15.37)(t=2.949,P ＜ 0.01).Physical fatigue got the highest score of the three dimensions in MFI-20,which was 2.99±1.03,the mental fatigue scored 2.67±0.82.Multiple linear regression analysis showed that fatigue was related to the sports,2hPBG,rest situation,cerebrovascular complications and the number of complications,which could totally explain 30.7％ of the variance.Conclusions More attention should be paid to fatigue of T2DM patients.Effective interventions should be carried out to relieve the fatigue status of T2DM patients and improve their self-management ability and quality of life.

Comparison of Two Molecular Assays For Detecting Smear Negative Pulmonary Tuberculosis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To compare the performance of MTBDRplus V2 and Xpert MTB/RIF for detecting smear negative pulmonary tuberculosis (PTB).</p><p><b>METHODS</b>Clinical PTB suspects were enrolled consecutively in Anhui Chest Hospital and Xi'an Chest Hospital from January to December in 2014. The sputum samples of smear negative PTB suspects were collected and decontaminated. The sediment was used to conduct MTBDRplus V2, Xpert MTB/RIF and drug susceptibility test (DST). All the samples with discrepant drug susceptibility result between molecular methods and phenotypic method were confirmed by DNA sequencing.</p><p><b>RESULTS</b>A total of 1973 cases were enrolled in this study. The detection rates of Mycobacterium tuberculosis complex (MTBC) by MTBDRplus V2 and Xpert MTB/RIF were 27.67% and 27.98%, respectively. When setting MGIT culture result as a gold standard, the sensitivity and specificity of MTBDRplus V2 were 86.74% and 93.84%, and the sensitivity and specificity of Xpert MTB/RIF were 86.55% and 93.43%, respectively. For the detection of the resistance to rifampin, the sensitivity and specificity of MTBDRplus V2 were 94.34% and 96.62%, and the sensitivity and specificity of Xpert MTB/RIF were 88.68% and 95.96%, respectively. For the detection of the resistance to isoniazid, the sensitivity and specificity of MTBDRplus V2 were 77.38% and 98.02%, respectively.</p><p><b>CONCLUSION</b>MTBDRplus V2 and Xpert MTB/RIF can be used to detect MTBC in smear negative samples with satisfactory performance.</p>

The reliability and validity of Chinese Version of Hypoglycemia Fear Survey Ⅱ-Worry Scale (CHFSⅡ-WS) in type 2 diabetes mellitus / 中国实用护理杂志

Objective The purpose of the study was to evaluate the reliability and validity of the Chinese Version of Hypoglycemia Fear Survey Ⅱ-Worry Scale (CHFSⅡ-WS) and provide a psychological assessment tool for patients with type 2 diabetes mellitus.Methods The CHFSⅡ-WS was tested in 300 patients with type 2 diabetes mellitus for measuring the scale's reliability and validity.Results The itemlevel content validity index (Ⅰ-CVI) of the CHFSⅡ-WS was 0.78～1.00,the scale-level content validity index (S-CVI) was 0.928.Through the exploratory factor analysis two factors were extracted which accounted for 52.959％ of the total variance.The test-retested reliability of the CHFSⅡ-WS was 0.911,Cronbach'α coefficient was 0.904.Conclusions The CHFSⅡ-WS has excellent reliability and validity,which can be used as a valid tool for type 2 diabetes mellitus patients in China.

Effects of postnatal lambda-cyhalothrin exposure on synaptic proteins in ICR mouse brain / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To evaluate the influence on the synaptic protein expression in different brain regions of ICR mice after lambda-cyhalothrin (LCT) exposure during postnatal period.</p><p><b>METHODS</b>Two male and 4 female healthy ICR mice were put in one cage. It was set as pregnancy if vaginal plug was founded. Offspring were divided into 5 groups randomly, and exposed to LCT (0.01% DMSO solution) at the doses of 0.1, 1.0 and 10.0 mg/kg by intragastric rout every other day from postnatal days (PND) 5 to PND13, control animals were treated with normal saline or DMSO by the same route. The brains were removed from pups on PND 14, the synaptic protein expression levels in cortex, hippocampus and striatum were measured by western blot.</p><p><b>RESULTS</b>GFAP levels of cortex and hippocampus in the LCT exposure group increased with doses, as compared with control group (P < 0.05), while Tuj protein expression did not change significantly in the various brain regions of ICR mice. GAP-43 protein expression levels in the LCT exposed mouse hippocampus and in female ICR mouse cortex increased with doses, as compared with control group (P < 0.05). Presynaptic protein (Synapsin I) expression levels did not change obviously in various brain regions. However, postsynaptic density protein 95 (PSD95) expression levels of the hippocampus and striatum in male offspring of 10.0 mg/kg LCT group, of cortex of female LCT groups, and of female offspring in all exposure groups, of striatum, in 1.0 or 10.0 mg/kg LCT exposure groups significantly decreased (P < 0.05).</p><p><b>CONCLUSIONS</b>Early postnatal exposure to LCT affects synaptic protein expression. These effects may ultimately affect the construction of synaptic connections.</p>