Expression of PD-L1 in Primary Colorectal Cancer and Its Predictive Value for Recurrence After Microwave Ablation of Liver Metastases / 肿瘤防治研究

Objective To investigate the expression of programmed death ligand 1(PD-L1) in primary tumor cells(TCs) and tumor-infiltrating immune cells(TICs) in patients with liver metastases from colorectal cancer(CRC) and determine its predictive value for recurrence after microwave ablation(MWA) of liver metastases. Methods The paraffin-embedded specimens of 28 patients with CRC liver metastasis were collected retrospectively. The expression of PD-L1 in the primary lesions was detected by immunohistochemistry, and the relationship between PD-L1 and clinical features was analyzed. Recurrence-free survival(RFS) was analyzed by Kaplan-Meier method and Log rank test. Cox proportional hazards regression model was used to analyze the factors influencing recurrence. Results The positive rates of PD-L1 in TCs and TICs in primary CRC were 14.3%(4/28) and 46.4%(13/28), respectively. PD-L1 expression in primary TICs of CRC patients with liver metastases was significantly correlated with the largest hepatic tumor diameter (P < 0.05). PD-L1 expression in primary TICs of CRC patients with liver metastasis was correlated with poor RFS after MWA (P < 0.05). PD-L1 expression in primary TICs and the largest hepatic tumor diameter > 3 cm in CRC patients with liver metastases were the risk factors for recurrence after MWA (P < 0.05). Conclusion PD-L1 expression in primary TICs of CRC patients with liver metastasis may increase the risk of recurrence after MWA for liver metastasis.

Disease burden of gestational complications associated with ozone pollution in the Yangtze River Delta region / 环境与职业医学

Background In recent years, ozone (O3) has gradually become a key air pollutant affecting public health. Studies have been conducted to evaluate O3 pollution-associated disease burden for general population, but there is a lack of research on O3 pollution-associated disease burden of gestational complications. Objective To assess the disease burden of O3 pollution on pregnancy complications in the Yangtze River Delta region and the changes in the disease burden resulting from the improvement of O3 pollution levels. Methods Through Chinese databases such as China National Knowledge Infrastructure (CNKI) and Wanfang, as well as English databases including PubMed and Web of Science, a systematic search was conducted to retrieve epidemiological studies investigating the association between O3 exposure and pregnancy complications from January 1, 2010 to February 28, 2023. Using predetermined inclusion and exclusion criteria, retrieved studies were screened and assessed for heterogeneity using the Higgins I2 statistic. The exposure increment was standardized to 10 µg·m−3, and a meta-analysis was conducted to evaluate the exposure-response relationship. Spatial analysis and environmental health risk assessment were then employed, using O3 monitoring data at national air monitoring stations, population data, and related disease burden parameters in the Yangtze River Delta region, to evaluate changes in the disease burden of pregnancy complications associated with improvements in O3 pollution levels. Results The meta-analysis revealed a significant association between maternal O3 exposure and increased risks of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), particularly in early pregnancy, and the related odds ratios (OR) and 95% confidence intervals (CI) were 1.028 (1.002, 1.055) and 1.031 (1.023, 1.040), respectively. The cities with higher attribution fractions (AF) of GDM and HDP related to O3 exposure in 2017 and 2020 in the Yangtze River Delta region were Xuzhou, Huaibei, Suzhou (Anhui Province), Changzhou, and Wuxi, with most cities showing a significant decrease in AF in 2020. Except for Hefei, the cases of GDM and HDP attributable to O3 exposure in the remaining cities of the Yangtze River Delta region decreased by 16.31% to 57.41% in 2020 compared to 2017. In addition, except for Hefei, Suqian, Anqing, and Wuxi, the direct medical costs attributed to O3 exposure in the remaining cities decreased by 1.12% to 45.36% in 2020 compared to 2017. Conclusion Exposure to O3 during pregnancy is associated with increased risks of GDM and HDP. There are differences in the disease burden of GDM and HDP related to O3 pollution among cities in the Yangtze River Delta region in 2017 and 2020. In 2020, compared to 2017, the disease burden in most cities is decreased.

Correlation between mental health problems with bullying behaviors among primary and middle school students / 中国学校卫生

Objective@#To analyze epidemiological characteristics of campus bullying among primary and middle school students in central China to explore its relation with mental health problems, and to provide a reference for the campus bullying prevention.@*Methods@#Stratified cluster sampling method was used to select primary and middle school 10 581 students from Anyang, Nanyang and Xinxiang cities of Henan Province, Middle School Students Mental Health Scale and the Self designed Scale of Adolescent Bullying Behavior were used to analyze the relationship between mental health problems with campus bullying behavior.@*Results@#The total report rate of bullying penetrator was 12.5% among students in the three cities. Among primary and middle school students with mental health problems such as hostility, interpersonal stress, academic pressure and emotional imbalance, the detection rate of bullying behavior was 24.2%, 20.3%, 19.4% and 20.1%, respectively. The results of multivariate analysis showed that hostility symptoms ( OR =3.78, 95% CI =1.71-8.32), interpersonal stress ( OR =3.50, 95% CI = 1.62 -7.57), academic pressure ( OR = 1.62 , 95% CI =1.21-2.16) and emotional imbalance ( OR =2.80, 95% CI =1.41-5.56) showed a significant impact on campus bullying ( P <0.05).@*Conclusion@#Mental health problems of primary and middle school students are closely related to the occurrence of bullying behavior. It is necessary to pay attention to the mental health education of bullies and intervene bullying behaviors from the source.

Health literacy and cancer prevention / 中华预防医学杂志

This article reviews the literature on health literacy and cancer prevention, screening, treatment and prognosis. A large number of studies have shown that health literacy is positively correlated with public cancer risk awareness, cancer knowledge awareness rate, and cancer screening behavior, and positively correlated with the health service resource utilization ability of cancer patients, treatment compliance, and quality of life, and negatively correlated with the unhealthy lifestyle such as smoking and drinking. Some studies have problems such as small sample size, limited population, and inappropriate design. Some studies do not support the conclusions above. Therefore, multi-center, large-scale clinical studies and cohort studies should be conducted to provide more robust evidence for the relationship between the health literacy and cancer prevention, screening, and treatment.

Prediction model for distant metastasis of breast cancer based on magnetic resonance imaging / 中国肿瘤临床

Objective: To establish a prediction model for the distant metastasis of breast cancer based on qualitative magnetic reso-nance imaging (MRI) parameters. Methods: A retrospective analysis of 3,032 patients with breast MRI from January 2011 to Decem-ber 2016 in Tianjin Medical University Cancer Institute and Hospital was conducted. After the confirmation of invasive breast cancer, the subjects were divided in 2 groups: metastasis and metastasis-free. A total of 93 patients were included in the metastasis group, and 186 patients without the presence of distant metastasis in the metastasis-free group. We analyzed the correlation between breast cancer molecular subtypes and distant metastasis in the metastasis group. Univariate and Logistic regression analyses of qualitative MRI features were performed for the groups. Subsequently, we used the results to establish prediction models. Results: The results showed that hormone receptor-positive tumors (Luminal type) had a greater tendency to develop bone metastasis in the metastasis group. Triple-negative tumors showed a greater tendency to develop lung metastasis. Human epidermal growth factor receptor 2 gene overexpression cases were more likely to develop liver metastasis. The results of the univariate analysis showed that the type of le-sion, multifocality or multicentricity of the cancer, T1-weighted signal uniformity, T2-weighted signal uniformity, and tumor size were statistically different between the groups (P<0.05). The results of the logistic regression analysis showed that the type of lesion, multi-focality or multicentricity of the cancer, T2-weighted signal uniformity, and tumor size were independent predictors of distant metasta-sis. Based on select independent predictors, we established a prediction model for the distant visceral metastasis of breast cancer. The accuracy, area under the curve, sensitivity, and specificity of the model were 82.8%, 0.801, 85.7%, and 75.0%, respectively. Conclu-sions: The prediction model based on the clinical pathology and MRI features established in this study can predict the distant metasta-sis of breast cancer.

Association between bullying and family factors among middle school students in a city of central China / 中国学校卫生

Objective@#To explore the relationship between bullying among middle school students and family factors in a city of central China, so as to provide support for the prevention and reduction of school bullying among middle school students.@*Methods@#The stratified cluster random sampling method was used to investigate the bullying involvement and family factors of 2 996 middle school students from first grade in junior high school to third grade in high school in a city in central China. Chi-square test and Logistic-regression analysis were used to analyze the relationship between family factors and bullying participation of middle school students.@*Results@#Among 2 996 students, 390 students(13.0%) were found of having bullying behavior, and 1 127 students(37.6%) were found of being bullied. Univariate analysis showed that there were statistically significant differences in family factors such as whether she or he is the only child, father-child relationship, mother-child relationship, marital status of parents, whether the mother work away from hometown, education level of father and mother(χ2=8.88, 56.49, 30.85, 30.91, 3.89, 10.36, 11.72；25.00, 69.33, 46.76, 57.09, 3.93, 23.19, 45.49, P<0.05). Logistic regression analysis showed that the only child and mother’s education degree was junior college and below were the risk factors for middle school students’ bullying involvement (OR=1.37，1.39). Parents’ harmonious marital status and father’s not working outside are the protective factors of middle school students’ bullying(OR=0.53, 0.83).The only child is the risk factor of bullying in middle school students (OR=1.42), and good father relationship is the protective factor of bullying in middle school students (OR=0.38).@*Conclusion@#Family factors have a certain impact on the involvement of middle school students in bullying in a city of central China, and corresponding preventive measures should be formulated from the perspective of family to focus on the intervention of high-risk groups.

Triple-negative and non-triple-negative breast cancer prediction by mammographic radiomics features / 中华放射学杂志

Objective To develop and validate a radiomics predictive model based on mammogram for preoperative predicting triple-negative breast cancer (TNBC) or non-triple-negative breast cancer (NTNBC). Methods We retrospectively analyzed 459 Chinese women who were diagnosed with invasive breast cancer (confirmed by pathology) during August 2015 to November 2015. Our cohort included 34 TNBC and random selected 102 NTNBC cases. Regions of interest (ROIs) were manually selected from craniocaudal and mediolateral oblique mammograms by radiologists through manual lesion segmentation, and 43 radiomics features were evaluated. Craniocaudal (CC) single-view, mediolateral oblique (MLO) single-view and CC and MLO double-view classification model were constructed respectively. Classification performance was evaluated by the area under receiver operating characteristic curve (AUC), accuracy, sensitivity and specificity. Kruskal-Walls U test and t test were used to compare the radiomics features between TNBC and UTNBC. Results The model that used the combination of both the CC and MLO view images achieved the overall best performance than using either of the two views alone, yielding an AUC of 0.791, accuracy of 0.798, sensitivity of 0.776 and specificity of 0.806 for TNBC comparing with NTNBC. Three features were selected by the model (gray scale span and inverse different moment for CC, roundness for MLO) showed a statistical significance (P<0.05) and AUC>0.6 in the subtype classification. Conclusion This research constructed model based on mammograms classification model can effectively distinguish between TNBC and NTNBC. This model has potential value for breast cancer molecular subtype classification and clinical treatment.

Vitamin D status and its associated risk factors among healthy adults in Gansu province / 中华临床营养杂志

Objective To investigate the prevalence of vitamin D deficiency and its associated metabolic risk factors in the healthy adults in Gansu Province, a western province of China.Methods Through stratified, multistage probability population sampling, 11 300 adults (4 740 men and 6 417 women aged 18-79 years) who had been living in their current residence for at least 5 years were arbitrarily chosen from seven representative geographical cities in Gansu Province from June 2014 to December 2015.The data obtained from a questionnaire-based survey, anthropometric and biochemical assessments, and areal bone mineral density measurement were collected and analyzed.Results The overall mean serum 25(OH)D was (16.07±9.40) μg/L.The prevalence of severe deficiency (0.05).Conclusions Vitamin D deficiency is highly prevalent among adult populations in Gansu, northwestern of China, and is largely attributed to younger age and female sex.The cumulative effects of factors including sun exposure, physical activity, and calcium supplementation play an influential role in maintaining vitamin D levels.

The current situation of maternal self-efficacy of breast feeding and its influencing factors / 中国实用护理杂志

Objective To investigate the current situation of maternal self- efficacy of breastfeeding and explore its influencing factors in Zhengzhou. Methods Using the general condition questionnaires, breast feeding self-efficacy scale, perceived social support scale and Edinburgh postnatal depression scale to assess the situation of 180 puerperas by the convenience sampling in one obstetric hospital of Zhengzhou. Results The total score of maternal breast feeding self-efficacy was(114.04 ± 21.57)points.The frequency of delivery, the way of delivery and feeding ways, the average income of family were effected with breastfeeding self-efficacy. The total score of social support was(68.87 ± 10.43) points, the total score of puerperas depression was(7.61 ± 4.25) points.The social support score had positive correlation with breastfeeding self-efficacy(r=0.423, P<0.01). Puerperas depression had negative correlation with breastfeeding self- efficacy(r=- 0.342, P<0.01). Conclusions The maternal breastfeeding level in Zhengzhou was at a lower level. The level of maternal breastfeeding self-efficacy scale was impacted by maternal social support degree, the degree of depression. Measures should be taken to enhance maternal social support degree, reduce the degree of depression, in order to improve the level of maternal breastfeeding self-efficacy.

Prevalence and related risk factors of hypothyroidism in adults of Gansu province / 中华健康管理学杂志

Objective To investigate the prevalence and epidemiological characteristics of hypothyroidism, possible related lifestyle and metabolic risk factors of hypothyroidism in adults of Gansu province, and to provide scientific evidence for the prevention of hypothyroidism. Methods Stratified multi-stage cluster sampling with probability proportionate to size method was used to collect data from 10071 residents aged 18 to 79 years and who had lived in the local area for more than 5 years. All participants were asked to fill in the questionnaire, and to take physical examination including anthropometric measurements and venous blood samples. Risk factors of hypothyroidism were analyzed by Chi-square test and multivariate logistic regression analysis. Result The prevalence of hypothyroidism was 10.1％ (overt hypothyroidism: 1.5％, subclinical hypothyroidism: 8.7％). Female (12.1％) had a higher percentage when compared to male (7.5％). In addition to the increased odds with older age and female gender, current or previous smoking history (OR: 0.467, 95％CI: 0.289-0.754, P=0.002), salty taste preference (OR:0.355, 95％CI:0.162-0.776, P=0.022) and a frequent seafood intake (OR:0.148, 95％CI:0.057-0.385, P<0.001) were tended to be associated with reduced risk of hypothyroidism. Logistic regression analysis showed that positive thyroid peroxidase antibodies (OR:1.976, 95％CI:1.037-3.768, P=0.039), positive thyroglobulin antibodies (OR:2.419, 95％CI:1.160-5.043, P=0.018) and triglycerides (OR:1.241, 95％CI:1.044-1.474, P=0.014) were associated with increased risk of hypothyroidism. Conclusion The prevalence of hypothyroidism in Gansu province was high, affecting approximately one in ten adults, and majority of which were SCH. Both lifestyle factors and metabolic factor were associated with hypothyroidism. Developing a healthy lifestyle at work and home, and paying attention to the control of blood lipids are conducive to the prevention of hypothyroidism.

Research in CaNa2EDTA in the treatment of chronic moderate lead poisoning in children / 临床儿科杂志

Objectives To explore the efficacy of CaNa2EDTA in the treatment of chronic moderate lead poisoning, so as to optimize the chelation therapy for lead poisoning in children. Methods The clinical data of 14 patients with chronic moderate lead poisoning treated with CaNa2EDTA for 3 consecutive courses of lead removal during September 2014 to December 2016 were analyzed retrospectively. Twenty-four hour urinary lead levels during hospitalization were analyzed. The changes of blood lead levels before treatment, 3 days, and 5 days after treatment were also analyzed. Results In the 14 children (4 males and 10 females) average age was 2.35±1.47 years. After treatment with CaNa2EDTA for 3 consecutive courses, the blood lead levels were decreased significantly in all the patients, and the blood lead levels at 3 days after treatment were 0.76, 0.77, 0.72 times those at 5 days after treatment respectively. The decrease of blood lead levels per unit of drug in the first 3 days of treatment were significantly higher than those in 5 days of treatment (P<0.05). The decrease of blood lead levels at 3 days after treatment was 0.65, 0.71, 0.70 times , those in 5 days' treatment respectively. The decrease of urine lead levels per unit of drug in the first 3 days of treatment were significantly higher than those in 5 days of treatment (P<0.05). Conclusions CaNa2EDTA has an obvious effect on removal of lead.The efficiency of lead removal in 3 days of treatment was higher than in 5 days of treatment. Thus, a course of treatment for 3 days may be an altenative for a course of 5 days.

Short-term effects of anterior cruciate ligament reconsruction with femoral tunnel suspension fixation on bone tunnel and graft change / 中国组织工程研究

BACKGROUND:Femoral tunnel suspensory fixation device for anterior cruciate ligament reconstruction has a certain clinical comparison. However, there are a few fixture researches on the expansion of bone tunnel and graft changes. OBJECTIVE:To observe the short-period effect of femoral tunnel side fixtures Endobutton and Tightrope used in autologous hamstring anterior cruciate ligament reconstruction on bone tunnel and implant change. METHODS:Twenty-three patients with anterior cruciate ligament injuries received one-stage hamstring reconstruction, including 13 cases of femoral tunnel fixation with Endobutton and 10 cases with Tightrope. Tibial tunnel used extrusion screws. We observed operation time, recent effects after operation (Lysholm knee score, IKDC score) and the postoperative change of femoral tunnel diameter and graft length. RESULTS AND CONCLUSION:(1) Twenty-three cases were fol owed up for 9-12 months, averagely 10 months. (2) Joint motion was not limited in both groups. No significant difference in IKDC and Lysholm scores was determined between the two groups (P>0.05). (3) Graft length and femoral tunnel diameter were significantly higher in the Endobutton group during final fol ow-up compared with that at 1 week postoperatively (P<0.05). (4) These results suggested that the recent effects were similar between Tightrope and Endobutton fixation, but Tightrope fixation device reduces the length of graft and the extent of bone tunnel enlargement.

Analysis of clinical characteristics between patients with idiopathic pulmonary fibrosis combined with emphysema and without emphysema / 中国医师进修杂志

Objective To investigate the differences of clinical features,pulmonary function tests,chest imaging and prognosis between patients with idiopathic pulmonary fibrosis (IPF) combined with emphysema and without emphysema.Methods A total of 43 patients with IPF and with pulmonary fibrosis and emphysema (CPFE) were selected as observation group,and 40 patients with IPF and without emphysema were selected as control group.The clinical data of two groups of patients,including pulmonary function,partial pressure of oxygen,cellular components of bronchoalveolar lavage fluid (BALF),survival time were retrospectively analyzed and compared between two groups.Results The smoking index was (29 ± 17) pack years in observation group,much higher than that in control group (17 ± 15) pack years,the difference was statistically significant (P ＜ 0.05).The percentage of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was (70 ± 6)％ in observation group,significantly lower than that in control group (84 ± 9)％,the difference was statistically significant (P ＜ 0.05).The percentage of diffusion capacity of carbon monoxide (DLCO) in observation group was (43 ± 11)％,significantly lower than that in control group (55 ± 17)％,the difference was statistically significant (P ＜ 0.05).The percentage of lung volume in observation group was (78 ± 12)％,significantly higher than that in control group (63 ± 11)％,the difference was statistically significant (P ＜0.05).The vital capacity was expected to account for partial pressure had no significant difference in percentage and resting arterial oxygen value between two groups (P ＞ 0.05).The total number of BALF cells,macrophages,neutrophils,lymphoeytes and eosinophils ratio had no significant difference between two groups (P ＞ 0.05).Conclusion Smoking is an important risk factor of IPF with emphysema,emphysema does not affect the prognosis of patients with IPF.

Comparison of effectiveness of intensity-modulated radiotherapy with conventional two-dimensional radiotherapy for patients with locally recurrent nasopharyngeal carcinoma / 中华放射肿瘤学杂志

ObjectiveTo compare the efficacy and side-effects in locally recurrent nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT) and two-dimensional conventional radiotherapy (2DCRT).MethodsAmong the 292 newly diagnosed,nonmetastatic recurrent NPC,211were treated with IMRT and 81 with 2DCRT.All patients were staged according to the seventh edition of the UICC 2009 staging system.Kaplan-Meier and Logrank methods were used for survival analysis.A Cox proportional hazard model was used to examine prognostic factors.ResultsThe follow-up rate was 91.8％,there are 38 patients in 2DCRT and 106 patients in IMRT group was followed more than 3 years.There were significant differences in the 3-year actuarial overall survival (OS) rate ( 36.9％ and 51.3％,x2 =8.44,P =0.004) and local progression-free survival (LRFS) rate (63.3％ and 86.0％,x2 =13.83,P =0.000),and no significant differences in actuarial distant metastasis free survival rates (79.0％ and 83.5％,x2 =0.25,P=0.618 ) between the 2DCRT group and the IMRT group.Multivariate analysis showed that T category and IMRT ( yes vs.no) were the independently prognostic factors for OS and LRFS ( x2 =9.51,5.20,P =0.002,0.023 and x2 =4.84,9.24,P =0.027,0.002 ).The incidence of grade 3and4 trismus and radiation-induced encephalopathy were 19.9％,8.1％ for the IMRT group and 43.2％,24.7％ for the 2DCRT group ( x2 =16.37,P =0.000 and x2 =14.64,P =0.000).Whereas,severe mucosa necrosis and/or massive hemorrhage in the nasopharynx was observed in IMRT group which was not common in 2DCRT (33.2％∶7.4％,x2 =20.19,P=0.000).ConclusionsHigher local tumor control and overall survival were achieved by IMRT than 2DCRT,the incidence of severe trismus and radiation-induced encephalopathy was also reduced by IMRT,in cost of a higher incidence of mucosa necrosis and/or massive hemorrhage in the nasopharynx.

Effect of intrathecal administration of a mixture of butorphanol and ketamine on cAMP-PKA-CREB signal transduction pathway in spinal dorsal horn of rats with inflammatory pain / 中华麻醉学杂志

Objective To investigate the effect of intrathecal administration of a mixture of butorphanol and ketamine on cAMP-PKA-CREB signal transductian pathway in the spinal dorsal ham of the rats with inflammatory pain. Methods Twenty-four male SD rats, weighing 240-280 g,in which intrathecal catheters were successfully placed, were divided into 4 groups randomly (n = 6 each): inflammatory pain group (group IP), butorphanol group (group B), ketamine group (group K), and butorphanol + ketamine group (group BK). The inflammatory pain was induced by injection of 5% formalin 50 μl into the plantar surface of left hind paw. Normal saline 10 μl, butorphannl 12.5 μg, ketamine 50 μg, and a mixture of butorphanol 12.5 μg and ketamine 50 μg was injected intrathecally 30 min before subcutaneous injection of formalin in group IP, B, K and BK respectively.Pain intensity score (PIS) was used to assess pain behavior every 5 min within an hour after subcutaneous injection of formalin. The animals were killed at 2 h after subcutaneous injection of formalin, and the L5 segment of the spinal cord was removed for determination of protein kinase A (PKA) and phosphorylated cAMP response element binding protein (p-CREB) expression using immunohistochemistry. Results Fonnahn administration induced pain behaviour expressed as two phases. PIS scores, PKA and p-CBEB expression, and staining scores were significantly lower during the fast and second phases in group BK than in group IP (P < 0.05 or 0.01), while no significant differences were found in the indices mentioned above between group B and IP and between group K and IP (P>0.05). Conclusion lntrathecal injection of a mixture of butorphanol and ketamine can reduce inflammatory pain in rats, and the mechanism may be related to the cAMP-PKA-CREB signal transduction pathway.