The value of serum related cytokines in predicting intestinal mucosal injury in severe acute pancreatitis patients / 中国医师杂志

Objective:To analyze the value of serum related cytokines in predicting intestinal mucosal injury in patients with severe acute pancreatitis (SAP) and its correlation with intestinal mucosal injury.Methods:A total of 92 patients with SAP admitted to the First Hospital of Qinhuangdao from January 2020 to December 2021 were included in the study. According to the presence or absence of intestinal mucosal barrier dysfunction, the patients were divided into intestinal mucosal barrier dysfunction group (33 cases) and non-intestinal mucosal barrier dysfunction group (59 cases). Another 100 healthy subjects were selected as the control group. Clinical data of the subjects were collected. Serum levels of procalcitonin (PCT), D-lactic acid (D-L), endotoxin, diamine oxidase (DAO), citrulline and intestinal fatty acid binding protein (I-FABP) of the three groups were compared, and the correlation between the above indexes was analyzed by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was used to analyze the value of each indicator in predicting intestinal mucosal barrier dysfunction in SAP patients.Results:The levels of serum PCT, D-L, endotoxin, DAO and I-FABP in intestinal mucosal barrier dysfunction group, non-intestinal mucosal barrier dysfunction group and control group showed a downward trend, while the level of serum citrulline showed an upward trend, with statistically significant difference (all P<0.05). Pearson correlation analysis showed that serum citrulline was negatively correlated with serum PCT, D-L, and endotoxin levels ( r=-0.740, -0.629, -0.310, all P<0.05); There was a positive correlation between serum DAO and serum PCT, D-L and endotoxin levels ( r=0.482, 0.779, 0.338, all P<0.05); There was a positive correlation between serum I-FABP and serum PCT, D-L and endotoxin levels ( r=0.613, 0.421, 0.341, all P<0.05). The ROC curve results showed that the area under the curve (AUC) of serum PCT, D-L, endotoxin, DAO, citrulline, and I-FABP predicting intestinal mucosal injury in SAP patients were 0.816, 0.789, 0.732, 0.801, 0.812, and 0.857, respectively. The AUC of the combination of the above indicators predicting intestinal mucosal barrier dysfunction in SAP patients was 0.909, significantly higher than that predicted by each index alone (all P<0.05). Conclusions:The occurrence of intestinal mucosal barrier dysfunction in SAP patients may be related to the increase of serum PCT, D-L, endotoxin, DAO, I-FABP levels and the decrease of citrulline levels. It may be considered to predict the risk of intestinal mucosal injury by detecting the levels of various indicators in patients′ serum.

Erratum: Author correction to 'Ablation of Akt2 and AMPKα2 rescues high fat diet-induced obesity and hepatic steatosis through Parkin-mediated mitophagy' Acta Pharmaceutica Sinica B 11 (2021) 3508-3526

[This corrects the article DOI: 10.1016/j.apsb.2021.07.006.].

Ablation of Akt2 and AMPKα2 rescues high fat diet-induced obesity and hepatic steatosis through Parkin-mediated mitophagy

@#Given the opposing effects of Akt and AMP-activated protein kinase (AMPK) on metabolic homeostasis, this study examined the effects of deletion of Akt2 and AMPKα2 on fat diet-induced hepatic steatosis. Akt2–Ampkα2 double knockout (DKO) mice were placed on high fat diet for 5 months. Glucose metabolism, energy homeostasis, cardiac function, lipid accumulation, and hepatic steatosis were examined. DKO mice were lean without anthropometric defects. High fat intake led to adiposity and decreased respiratory exchange ratio (RER) in wild-type (WT) mice, which were ablated in DKO but not Akt2−/− and Ampkα2−/− mice. High fat intake increased blood and hepatic triglycerides and cholesterol, promoted hepatic steatosis and injury in WT mice. These effects were eliminated in DKO but not Akt2−/− and Ampkα2−/− mice. Fat diet promoted fat accumulation, and enlarged adipocyte size, the effect was negated in DKO mice. Fat intake elevated fatty acid synthase (FAS), carbohydrate-responsive element-binding protein (CHREBP), sterol regulatory element-binding protein 1 (SREBP1), peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), peroxisome proliferator-activated receptor-α (PPARα), PPARγ, stearoyl-CoA desaturase 1 (SCD-1), phosphoenolpyruvate carboxykinase (PEPCK), glucose 6-phosphatase (G6Pase), and diglyceride O-acyltransferase 1 (DGAT1), the effect was absent in DKO but not Akt2−/− and Ampkα2−/− mice. Fat diet dampened mitophagy, promoted inflammation and phosphorylation of forkhead box protein O1 (FoxO1) and AMPKα1 (Ser485), the effects were eradicated by DKO. Deletion of Parkin effectively nullified DKO-induced metabolic benefits against high fat intake. Liver samples from obese humans displayed lowered microtubule-associated proteins 1A/1B light chain 3B (LC3B), Pink1, Parkin, as well as enhanced phosphorylation of Akt, AMPK (Ser485), and FoxO1, which were consolidated by RNA sequencing (RNAseq) and mass spectrometry analyses from rodent and human livers. These data suggest that concurrent deletion of Akt2 and AMPKα2 offers resilience to fat diet-induced obesity and hepatic steatosis, possibly through preservation of Parkin-mediated mitophagy and lipid metabolism.

SMARCB1 (INI1)-deficient sinonasal carcinoma: a clinicopathological analysis of six cases / 中华病理学杂志

Objective@#To study the clinicopathological features, diagnostic features and differential diagnoses of SMARCB1 (INI1)-deficient sinonasal carcinoma (SDSC).@*Methods@#Six cases of SDSC diagnosed at Eye, Ear, Nose and Throat Hospital, Fudan University from 2016 to 2018 were retrieved; the clinical features, histomorphology, immunophenotype, radiology and outcome were analyzed with review of literature.@*Results@#There were five men and one woman with age range of 37 years to 75 years (mean 56 years). One case was in stage T2, and 5 cases were in stage T4. Computer tomography and magnetic resonance imaging showed a mass occupying the sinonasal cavity with bone destruction in all six patients. Microscopically, the tumors had infiltrative margins. Four tumors were composed mostly of basaloid cells, which possessed high nuclear/cytoplasmic ratio,scant cytoplasm,and minimalnuclear pleomorphism; and the cells were arranged in sheets or nests in a desmoplastic stroma. Two tumors were composed of rhabdoid cells, which possessed abundant, eosinophilic cytoplasm and eccentric nuclei, often growing in a nests or sheets pattern. Immunohistochemical staining showed that 6/6 cases had complete loss of INI1, diffusely and strongly positive for CKpan, and were negative for S-100 and EBER ISH; 4/6 cases were focally positive for p63; 1/5 was focally positive for Syn and p16. The Ki-67 index was 30% to 70%. The follow-up period ranged 1-26 months, with one patient died of extensive metastases, one had local recurrence, and two had lymph node metastases; one was alive without disease, and one was lost to follow-up.@*Conclusions@#SMARCB1 (INI1)-deficient sinonasal carcinoma is mostly aggressive, with rapid progression and poor prognosis. Histomorphological spectrum predominantly consists of basaloid type and rhabdoid type. The complete loss of nuclear expression of INI1 can help to distinguish this tumor from its many mimickers.

Status of general practice residency training and career choice of trainees in Henan Province / 中华全科医师杂志

Objective:To survey the status general practice residency training and career choice of trainees in Henan Province.Methods:From December 2017 to February 2018, 332 trainees from the first general practice residency training program (2014-2017) were enrolled in the study. The self- administered questionnaire included the demographic information and the current career status. The logistic regression model was used to analyze the influencing factors of the career choice when their completed the training.Results:Of 332 participants, there were 167 participants designated by the institutions and the others were directly enrolled by the program. The designated participants were from the 56 medical institutions in Henan. The percentage of participants from the tertiary hospitals was 75.5% (126/167), which was much higher than that from the secondary hospitals (24.5%,41/167). There were 24 participants who did not have a work six months after graduation. Of the 308 employed participants, there were only 111 (36.0%, 111/308) working in the department of general practice, and 197 (64.0%, 197/308) working in other departments. The participants designated by the institutions and with the post-graduate degrees preferred to choose other specialties, instead of the general practice. The reasons were that there was no department of general practice in their institutions or the participants had been designated to the other departments (57.9%, 114/197).Conclusion:The survey suggests that the general practice residency training program should enroll trainees mainly from the medical graduates in order to improve the effectiveness of general practitioner residency training and the allocation of health resources in Henan Province.

Different region genotyping of 15 Yersinia pestis in Inner Mongolia / 中华地方病学杂志

Objective:To study the different region (DFR) genotyping of 15 strains of Yersinia pestis from Inner Mongolia. Methods:Fifteen strains of Yersinia pestis isolated from Otog Banner and Darhan Muminggan Joint Banner in Meriones unguiculatus plague foci in Inner Mongolia Plateau, Zhengxiangbai Banner in Spermophilus dauricus plague foci in the Songliao Plain in 2019 were amplified by PCR, and identified DFR genotyping. Results:Two strains of Yersinia pestis in Otog Banner jointly deleted DFR loci 1, 6, 7, 13, 15, 16, 17, 18, 23, and 13 strains of Yersinia pestis in Darhan Muminggan Joint Banner and Zhengxiangbai Banner jointly deleted DFR loci 1, 6, 7, 12, 13, 15, 16, 17, 18 and 23. G17 and G20 were classified as genotyping by comparison with DFR locus distribution and genotyping results. Conclusion:The genotyping of Yersinia pestis in the natural foci of Meriones unguiculatus plague foci in Inner Mongolia Plateau and Spermophilus dauricus plague foci in the Songliao Plain is the same as that of the historical strain.

Analysis of thyroid function under different iodine nutritional status / 中华地方病学杂志

Objective To understand the iodine nutritional status of medical examination people and the thyroid dysfuction rates under different urinary iodine.Methods A total of 2 650 medical examination people from Inner Mongolia National Examination Medical Center from March to December of 2018 were selected.The average age was (46.2 ± 12.5) years old,including 697 males and 1 953 females.Blood samples were collected for determination of thyroid function [thyroid stimulating hormone (TSH),thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),free thyroxine (FT4),and free triiodothyronine (FT3)],and according to the results of the examination,people were divided into normal thyroid function,subclinical hypothyroidism,subclinical hyperthyroidism,hypothyroidism,hyperthyroidism,autoimmune antibody abnormalities,and other abnormal groups.Urine samples were collected to detect urinary iodine levels,to analyze the thyroid dysfuction rates of each group people and different urinary iodine.The thyroid function was detected by automatic electrochemiluminescence immunoassay analyzer,the urinary iodine was determined by arsenic cerium catalytic spectrophotometry.Results Among the 2 650 medical examination people,there were 1 270 patients with abnormal thyroid function,and the total abnormal rate was 47.92％.The abnormal rates of males and females were 28.84％ (201/697) and 54.74％ (1 069/1 953),respectively,and the abnormal rate of females was higher than that of males (x2 =376.19,P ＜ 0.05).The urinary iodine medians of each group were 145.38,152.60,103.21,176.31,134.17,138.92,and 127.00 μg/L,all in the appropriate range of iodine (100-199 μg/L).Thyroid abnormal rates [55.56％ (125/225),50.86％ (445/875)] of urinary iodine ≥ 300 μg/L (iodine excess) group and ＜ 100 μg/L (iodine deficiency) group were higher than that of 100-199 μg/L group [44.70％ (460/1 029),x2 =12.65,12.61,P ＜ 0.05].Among thyroid abnormal people,autoimmune antibody abnormalities people was the most,accounting for 69.61％ (884/1 270).Urinary iodine was positively correlated with FT4 and FT3 (r =0.04,0.05,P ＜ 0.05);FT4 was negatively correlated with TSH and TgAb (r =-0.20,-0.73,P ＜ 0.05),and it was positively correlated with FT3 (r =0.52,P ＜ 0.05);TPOAb was positively correlated with TgAb (r =0.64,P ＜ 0.05).Conclusions Urinary iodine of medical examination people is in the appropriate range of iodine,indicating that the overall iodine nutritional status is good.However,some people still have iodine excess and iodine deficiency,both of which lead to an increase in thyroid abnormal rate.

Expression of CD117, MITF and NAT10 and their prognostic values in sinonasal mucosal melanoma / 中华病理学杂志

Objective@#To investigate the correlation between the expression of CD117, MITF, NAT10 and clinical parameters in sinonasal mucosal melanoma (SNMM).@*Methods@#Formalin-fixed paraffin-embedded tumor specimens of 80 cases of SNMM at the Eye, Ear, Nose and Throat Hospital, Fudan University, from December 1999 to November 2013 were analyzed for CD117, MITF and NAT10 expression by immunohistochemistry.@*Results@#There were 40 men and 40 women. The median age was 61 years, age 26 to 85 years. There was no correlation of the expression of CD117, MITF and NAT10 with the patients′ age, gender, tumor site, stage, therapy method and brain metastases (P>0.05). The expression of MITF and NAT10 was associated with lymph node metastasis and the tumors were more likely to metastasize when MITF and NAT10 were positive. However, expression of CD117 had no correlation with lymph node metastasis. Log-rank test revealed that the expression of CD117 was correlated with both three-year and five survival rate (P=0.012, P=0.023; respectively) and patients with tumor having low expression of CD117 had the worse outcome. COX test revealed that low CD117 expression, advanced age and lymph node metastasis were independent risk factors (P<0.05). No significant association was found between the expression of CD117, MITF and NAT10 with disease free survival (P>0.05).@*Conclusions@#Patients with SNMM expressing low level of CD117 have decreased survival rate. Tumors with high level of MITF and NAT10 expression are more likely to metastasize. The expression level of CD117 can be used as an important indicator for the patient survival, and the expression of MITF and NAT10 can be used as a predictor of tumor metastasis.

Clinical analysis of malignant salivary gland tumors of the larynx / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the clinical features, treatments and prognoses of malignant salivary gland tumors of the larynx.@*Methods@#A total of 14 patients with malignant salivary gland tumors of the larynx diagnosed and treated in our hospital between 2003 and 2014 were analyzed retrospectively, and were compared with 62 patients from the Surveillance, Epidemiology, and End@*Results@#(SEER) database of American for survival rates. Results Among 14 patients from our hospital, 9 males and 5 females, with a median of 66.5 years old; 8 patients with adenoid cystic carcinoma, 4 with mucoepidermoid carcinoma and 2 with adenocarcinoma; supraglottic, glottic and 4 subglottic malignancies respectively accounting for 5, 5 and 4 cases; 8 cases treated with surgery, 5 with surgery and postoperative radiotherapy and/or chemotherapy, and 1 with radiotherapy alone. The 14 patients showed a three-year overall survival rate of 50.0% and a five-year overall survival rate of 42.9%, respectively in contrast with the rates of 67.1% and 59.8% in SEER database.@*Conclusions@#The malignant salivary gland tumor of the larynx is rare and it is difficult to be diagnosed early. It is more likely to occour local recurrence and distant metastasis. Extensive surgical resection with postoperative radiotherapy is advocated.

Comparative study on evaluation algorithms for neck muscle fatigue based on surface electromyography signal / 生物医学工程学杂志

The purpose of this study is to compare the differences among neck muscle fatigue evaluation algorithms and to find a more effective algorithm which can provide a human factor quantitative evaluation method for neck muscle fatigue during bending over the desk. We collected surface electromyography signal of sternocleidomastoid muscle of 15 subjects using wireless physiotherapy Bio-Radio when they bent over the desk using memory pillows for 12 minutes. Five algorithms including mean power frequency, spectral moments ratio, discrete wavelet transform, fuzzy approximation entropy and the complexity algorithms were used to calculate the corresponding muscle fatigue index. The least squares method was used to calculate the corresponding coefficient of determination and slope of the linear regression of the muscle fatigue metric. The coefficient of determination evaluates anti-interference ability of algorithms. The maximum vertical distance which is obtained by the Kolmogorov-Smirnov test for the slopes evaluates the ability to distinguish fatigue of algorithms. The results indicate that in the aspect of anti-interference ability, the fuzzy approximation entropy has the largest when using memory pillows with different heights. When the fuzzy approximate entropy is compared with average power frequency or the discrete wavelet transform, the differences are significant ( < 0.05). In terms of distinguishing the degree of fatigue, the approximate entropy is still the largest, with a maximum of 0.496 7. Fuzzy approximation entropy is superior to other algorithms in ability of anti-interference and distinguishing fatigue. Therefore, fuzzy approximation entropy can be used as a better evaluation algorithm in the evaluation of cervical muscle fatigue.

Gene detection and multilocus sequence typing of carbapenem resistant Klebsiella pneumonia / 实用医学杂志

Objective To investigate the cause of high isolation rate of carbapenem resistant Klebsiella pneumoniae(CRKP)in the first half of 2016 and the mechanism of its resistance and homology,in order to pro-vide basis for the control of nosocomial infection.Methods We collected CRKP from January to June 2016 to con-firm carbapenemase phenotype by modified Hodge test. Carbapenemase genes were amplified by using PCR meth-od,and the PCR product was sequencing to determine the genotypes by multilocus sequence analysis(MLST)to analyze the homology.Results From January 2016 to June,89 non redundant KPN89 strains were isolated, with 41 strains of CRKP and the isolation rate was 46.07%.CRKP was mainly isolated from Department of Critical Care Medicine,Department of Neurosurgery,Department of Respiration and so on. The specimens were sputum, blood,urine,cerebrospinal fluid specimens. Forty-one strains of CRKP were 100% sensitive to polymyxin, 95.12% sensitive to complement and 4.88% sensitive to minocycline,and were resistant to the other 23 antimicrobi-al agents. Hodge test of 41 strains of CRKP was positive and sequencing confirmed that all carried KPC-2 type of carbapenems.MLST classification results belonged to type ST11. Conclusions CRKP outbroken in our hospital is MLST typing of type sT11. With serious drug resistance,it may be the same strain spread among different pa-tients in different wards and the main drug resistance mechanism is producing type KPC-2 carbapenems. All rele-vant departments should carry out epidemiological investigations timely for the prevention and control.

Expression and prognostic values of PD-1, PD-L1 and IDO-1 in sinonasal malignant mucosal melanoma / 中华病理学杂志

Objective@#To investigate the correlation between the expression of programmed death-1(PD-1), PD ligand-1(PD-L1), indoleamine 2, 3-dioxygenase 1(IDO-1) and clinical parameters in sinonasal malignant mucosal melanoma (SNM).@*Methods@#Samples from 86 SNM patients who did not receive immune-targeted therapy and radio-chemotherapy were analyzed for PD-1, PD-L1, and IDO-1 expression by immunohistochemistry.@*Results@#High clinical/pathologic staging, brain metastases and advanced age were independent risk factors of poor prognosis. The overall survival rate of SNM without pigment was lower than that with pigment. PD-1, PD-L1 and IDO-1 expression was not correlated with tumor pigmentation, but correlated with different primary site.PD-1, PD-L1 and IDO-1 were expressed in 47.6% (41/86), 53.5% (46/86) and 58.1% (50/86)of SNM samples respectively. PD-1 was associated with brain metastasis. Negative expression of PD-1(P=0.031) and IDO-1(P=0.017 9) correlated with worse disease-free survival. No significant association was found between PD-L1 and prognosis. For stages Ⅲ, ⅣA and ⅣB patients, PD-1 expression was associated with better outcome (P=0.025), but PD-L1 negative and IDO-1 positive patients hadworse outcome (P>0.05). PD-1 positive and IDO-1 negative stage ⅣC patients had poorer overall survival.@*Conclusions@#In SNM patients, clinical/pathologic staging, brain metastases, age and pigmentation were prognostic indicator. IDO-1 and PD-1 can also be used as reference to evaluate prognosis. Anti-IDO-1 targeted therapy may be suitable for middle to late stage patients, while advanced stage patients might benefit from anti-PD-1 targeted therapy. PD-1/PD-L1 and IDO-1 may be considered as joint targeted therapy.The predictive value of PD-L1 requires further study.

The validation of EORTC QLQ-STO22 scale in patients with gastric cancer in China / 肿瘤研究与临床

Objective To test the effectiveness, reliability and acceptability of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-STO22 scale in gastric cancer patients in China. Methods One hundred and twenty-eight cases were collected in the Affiliated Cancer Hospital of Xiangya School of Medicine of Central South University from September 2014 to April 2015. All the patients completed the EORTC QLQ-STO22 and EORTC QLQ-C30 scales and given the Zubrod-ECOG-WHO (ZPS) score. Karen Bach coefficient and Pearson correlation test were used for statistical analysis while using ZPS score to detect EORTC QLQ-STO22 in validity. After score was standardized, P<0.05 represented the difference had statistical significance. Results The Karen Bach coefficient was 0.607-0.830, confirming that the EORTC QLQ-STO22 scale had good reliability. A number of enhanced analysis showed that the scale had good convergent validity and divergent validity. In the same or similar dimension, EORTC QLQ-C30 and EORTC QLQ-STO22 scales had good correlation and the correlation scores were higher than 0.400. The patients were divided into four groups according to ZPS score, with ZPS score increase, the overall quality of life scores were decreasing and entries associated with symptoms were increasing, showing difference between different groups(P<0.05). Conclusion The EORTC QLQ-STO22 scale shows high reliability and validity that can be used for assessing the quality of life of patients with advanced gastric cancer in China.

Research and development of an auto-switched intravenous infusion system / 中国医学装备

Objective: To enhance the safety of intravenous infusion and reduce the working strength of the nursing staff, a novel auto-switched intravenous infusion system was developed. Methods: The system was controlled by a low power consumption microchip. A signal was detected when the infusion was finished in one channel and then a cam mechanism was used to switch the infusion channel automatically under the supervision of the microchip. Results:A novel auto-switched intravenous infusion system was proposed and analyzed. The proposed concept is innovative, feasible and of functionality. Conclusion: The proposed auto-switched intravenous infusion system is cost effective and practical. It has potential applications and can benefit for improving current intravenous infusion situation.

Expression and prognostic value of MTDH, Bcl-2 and E-cadherin in sinonasal malignant mucosal melanoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the expression and predictive value of MTDH, Bcl-2 and E-cadherin in sinonasal malignant mucosal melanoma (SNM).</p><p><b>METHODS</b>Seventy-four formalin-fixed paraffin-embedded SNM specimens were subjected to immunohistochemical staining of MTDH, Bcl-2 and E-cadherin. Correlation between staining results and disease outcome was analyzed.SPSS 19.0 software was used to analyze the data.</p><p><b>RESULTS</b>Positive staining of MTDH, Bcl-2 and E-cadherin was observed in 56/74 (75.7%), 18/74 (24.3%) and 21/74 (28.4%) cases, respectively. MTDH positive patients had higher metastatic rate than MTDH negative patients (67.9% vs. 33.3%, P=0.009, OR=2.037, 95% CI: 1.034-4.016). Negative Bcl-2 was correlated with worse overall survival time (HR=2.023, P=0.025). Expression of E-cadherin was adversely associated with expression of MTDH (r=-0.315, P=0.006).</p><p><b>CONCLUSION</b>High MTDH expression and low Bcl-2 expression suggest poor prognosis of SNM, while the predictive value of E-cadherin needs further study.</p>

Aberrant expression of circulating microRNAs in pancreatic cancer patients and in patients with gemcitabine resistance / 国际外科学杂志

Objective To investigate the differentially expressed circulating microRNAs of pancreatic cancer,and of the pancreatic cancer with gemcitabine resistance,to find potential biomarkers for noninvasive diagnosis of pancreatic cancer and the prediction of prognosis of gemcitabine.Methods To screen the highly deregulated microRNAs in the plasma samples of pancreatic cancer,and in the plasma samples ofpancreatic cancer patients with gemcitabine resistance using reverse transcription and quantitative PCR.Results Twenty-eight microRNAs expressing differentially with fold-exchange ＞ 2 was screened out comparing pancreatic cancer and healthy controls,and 28 microRNAs was screened out comparing gemcitabine resistant patients and gemcitabine positive patients.Conclusions There is a specific circulating mIcroRNA profile in pancreatic cancer as well as in pancreatic cancer with gemcitabine resistance.These profiles may have potential in noninvasive diagnosis of pancreatic cancer and the prediction of prognosis of gemcitabine.

Relationship between fasting plasma glucose in early pregnancy and diagnosis of gestational diabetes mellitus / 中华围产医学杂志

Objective To investigate the relationship between fasting plasma glucose (FPG) in early pregnancy and diagnosis of gestational diabetes mellitus (GDM) and to confirm the rationality of the new standard for GDM diagnosis in early pregnancy set by the International Association of Diabetes and Pregnancy Study Groups (IADPSG).Methods Clinical materials of 2761 pregnant women without diabetes mellitus,who accepted prenatal cares in Peking University First Hospital from April 1,2011 to December 31,2011,were collected and analyzed.The difference between FPG levels of GDM and non-GDM women was compared.According to the early pregnancy FPG level,the subjects were divided into group A (FPG＜5.1 mmol/L,n=2431) and B (FPG≥5.1 mmol/L,n=330).The incidence of GDM and pregnant outcomes of the two groups were compared with t or Chi-square test.Relationship between FPG and GDM was analyzed by Logistic regression and receiver operating characteristic curve.Results (1) Among the 2761 subjects,515 were diagnosed as GDM (18.7％) and the early pregnancy FPG level in GDM group was significantly higher than that in non-GDM group [(4.84±0.46) mmol/L vs (4.57 ± 0.35) mmol/L,t =11.924,P =0.000].In early pregnancy,the risk of GDM increased by 7.984-fold (OR=8.984,95％CI:6.605-12.220) with every 1 mmol/L increase of the FPG level.(2) The diagnostic rate of GDM during mid-and last-trimester in group A (15.2％,370/2431) was lower than that of group B (43.9％,145/330),x2 =123.976,P =0.000.(3) Receiver operating characteristic curve analysis of FPG in early pregnancy and diagnosis of GDM:The largest area under the curve was 0.718 (95％ CI:0.690-0.747).The sensitivity and specificity were 0.600 and 0.612,or 0.735 and 0.726 respectively,when 4.795 mmol/L or 4.785 mmol/L were set as the cut-off value.(4) Among the 1208 cases delivered,GDM was diagnosed in 227 cases.The cesarean section rate (54.2％,123/227) of GDM women was higher than that (39.2％,385/981) of non-GDM women (x2 =16.884,P=0.000).There were no differences in the incidences of macrosomia,neonatal hyperbilirubinemia,low birthweight infant,premature delivery,fetal growth restriction and preeclampsia between GDM and non-GDM group (all P＞0.05).The incidence of premature birth in GDM women with FPG＜ 5.1 mmol/L was lower (5.8％,10/173) than that (14.8％,8/54) of women with FPG≥5.1 mmol/L (x2=4.601,P＜0.05).The incidence of cesarean section,insulin administration,macrosomia and preeclampsia increased from low FPG group to high FPG group,however there was no statistical significances.Conclusions Diagnosing GDM with FPG≥5.1 mmol/L in early pregnancy is not recommended as over diagnosis might happen.But this cut-off value might indicate that the patient are at risk of GDM,and this population should not be ignored.

Synthetic treatment of malignant tumor of nasal cavity and sinus based-on modern technique radiotherapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the therapeutic effect of malignant tumor of nasal cavity and sinus that based on modern radiotherapy.@*METHOD@#Two hundred cases of malignant tumor of nasal cavity and sinus were retrospectively analyzed from 2004 to 2007. All the cases were location by CT simulator system and were treated with three dimensional conformal radiotherapy.@*RESULT@#Among malignant tumor of nasal cavity and sinus, the incidence for locations was nasal cavity > maxillary sinus > ethmoid sinus > sphenoid sinus; the incidence for the type of pathology was squamous cell carcinoma > adenocarcinoma > olfactory neuroblastoma and olfactory esthesioneuroepithelioma > malignant melanoma > rhabdomyosarcoma; the incidence for general metastasis was rhabdomyosarcoma > malignant melanoma > adenocarcinoma, inverted papilloma and malignant changes > squamous cell carcinoma, olfactory neuroblastoma and olfactory esthesioneuroepithelioma. No severe radiation-related complication were found.@*CONCLUSION@#Clinical stage, pathological type were the important factors effecting the prognosis of patients with malignant tumor of nasal cavity and sinus. Three dimensional conformal radiotherapy based on CT simulator system could improve therapeutic effect and protect the normal tissue very well.

Giant cell granuloma outside the jaw three cases and literature review / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinicopathological features, diagnosis and treatment of giant cell granuloma outside the jaw.@*METHOD@#The clinical and pathological datas of 3 cases in nasopharynx, temporal bone and maxillary sinus were analyzed retrospectively. The relevant literatures were also reviewed.@*RESULT@#The patients presented with local painless mass, part of which were aggressive. Histopathological feature was, replacement of the normal bone structure with proliferating fibrous tissue containing numerous giant cells was shown.@*CONCLUSION@#Giant cell granuloma outside the jaw was a non-neoplastic lesion, and extremely rare. It was somewhat difficult to make a correct diagnosis. Combining the clinical data and pathological feature were more helpful to the diagnosis. Total surgical resection was an effective therapeutic method.

Prognostic value of synchronized detection of microvascular and lymph vessel density in nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the distribution patterns of microvascular density(MVD) and lymph vessel density (LVD) in nasopharyngeal carcinoma, and to discuss their relationships with tumor recurrence-metastasis and prognosis.@*METHOD@#One hundred and six patients with pathologically proved nasopharyngeal carcinoma were included in this study. Immunostainings for the vascular endothelial marker CD34 and the lymph vessel marker D2-40 were performed. The microvascular and lymph vessels within the tumor and the peritumoral area were respectively quantified with computer assisted morphometric analysis.@*RESULT@#Both microvascular and lymph vessels were positive in the specimen of 106 nasopharyngeal carcinoma patients, with MVD and LVD higher in the peritumoral area than in the tumor. Univariate analysis showed that intra-tumor MVD,intra-tumor and peritumor LVD were correlated with nasopharyngeal carcinoma recurrence-metastasis (P 0.05). Multivariate analysis demonstrated that intra-tumor MVD and peri-tumor LVD were two independent risk factors of nasopharyngeal carcinoma recurrence-metastasis. Higher intra-tumor MVD was associated with adverse prognosis of nasopharyngeal carcinoma (P < 0.05).@*CONCLUSION@#High MVD and LVD may be of significance in predicting poor prognosis in patients with nasopharyngeal carcinoma. Intra-tumor and peri-tumor microvessels may play different roles in the tumor recurrence and metastasis. Intra-tumor MVD and peri-tumor LVD should be the therapeutic targets in the nasopharyngeal carcinoma.