Research progress of miR-139-5p / 中国胸心血管外科临床杂志

@#MicroRNAs (miRNAs) are a class of short, highly conserved, non-coding RNA molecules that regulate gene expression by specific binding to the messenger RNAs (mRNAs). At present, the researches on miRNAs have caused immense global concern, and expression of miR-139-5p plays a significant role in tumorigenesis, metastasis and recurrence, through regulating proliferation, migration, and invasion of cancer cells in lung cancer, esophageal cancer, breast cancer, tongue squamous cell carcinoma, hepatocellular carcinoma, etc. MiR-139-5p has a positive impact on the prognosis of cancer, and it can combine with some chemotherapeutic drugs to reverse resistance and enhance the sensitivity of radiotherapy. It also works in the cells and tissues of other diseases, including nerve cells, and inflammation. This article reviewed the progress of miR-139-5p.

The predictive value of CT signs of mixed ground-glass nodules in pathological subtypes and differentiation of lung adenocarcinoma / 中国胸心血管外科临床杂志

@#Objective    To explore the predictive value of CT signs of mixed ground-glass nodules in the pathological subtype and differentiation of lung adenocarcinoma. Methods    The clinical data of 66 patients with mixed ground-glass nodules pathologically diagnosed as invasive adenocarcinoma (IAC) in the Second Department of Thoracic Surgery, the First Affiliated Hospital of Xiamen University from May to December 2021 were retrospectively analyzed, including 20 males and 46 females, aged 35-75 years. The CT findings were analyzed before operation, and the lesion profile was cut after operation to distinguish the ground-glass and solid components, and the pathological results of different positions were obtained. According to the postoperative pathological results, the patients were divided into a low-risk group (containing adherent type and no components of micropapillary subtype and solid subtype, n=16), a medium-risk group (containing niple or acinar type and no components of micropapillary subtype and solid subtype, n=38), and a high-risk group (containing micropapillary or solid subtype, n=12). The relationships between CT features and the pathological subtype and degree of differentiation were analyzed and compared. Results    In 66 patients with IAC, the infiltration degree of solid components was greater than that of ground-glass components. When the solid component ratio (CTR) was≥25% (sensitivity 90.2%, specificity 64.0%, P=0.005), and the average CT value was>−283.95 HU (sensitivity 82.9%, specificity 64.0%, P=0.000), the histological grade was more inclined to medium and low differentiation. The CTR, Ki-67, average CT value and histological grade of IAC in the medium- and high-risk groups were higher than those of nodules in the low-risk group. Conclusion    The infiltration degree of solid components is higher than that of ground-glass components in IAC mixed ground-glass nodules. The pathological subtype, Ki-67 expression and histological grade of lung adenocarcinoma can be predicted according to its CT characteristics, which has important clinical significance for determining the timing of surgery.

Oral administration of artemisinin nanospheres alleviates inflammation in mice with spontaneous ulcerative colitis / 细胞与分子免疫学杂志

Objective To investigate the anti-inflammatory effect of artemisinin (ART) encapsulated by β-lactoglobulin (BLG) nanoparticles on Winnie spontaneous ulcerative colitis mouse model. Methods BLG-ART nanoparticles were prepared and their effects on the solubility and stability of ART were evaluated. A mouse model of colitis induced by dextran sulfate sodium (DSS) was used to compare the therapeutic effects of artemisinin (ART) administered by direct gavage and artemisinin encapsulated by β-lactoglobulin nanoparticles (BLG-ART) administered by gavage. Winnie mice were randomly divided into blank group, ART group and BLG-ART group. Mice in the ART group were given 50 mg/kg ART by gavage; mice in the BLG-ART group were given the same dose of BLG-ART nanoparticle PBS dispersion by gavage; mice in the blank group were given the same amount of PBS by gavage, for 16 days. The body mass and disease activity index (DAI) of each group of mice were measured. HE staining was used to observe the pathological changes of mouse intestinal tissue, and real-time quantitative PCR was used to detect the mRNA expression levels of TNF-α, interleukin 1β (IL-1β), IL-10 and IL-17 in mouse colon tissue. Results Compared with the ART group and the blank group, the body mass of the BLG-ART group increased and the DAI decreased after 16-day treatment; the crypt structure of the proximal and distal colon regions of the mice recovered; goblet cell loss decreased; neutrophil infiltration decreased and the mRNA expression levels of pro-inflammatory and anti-inflammatory cytokines were significantly down-regulated. Conclusion ART-BLG can alleviate intestinal inflammation in spontaneous ulcerative colitis mice.

Thoracic drainage with traditional chest tube versus central venous catheter after video-assisted thoracoscopic lobectomy: A randomized controlled study / 中国胸心血管外科临床杂志

@#Objective    To evaluate the effectiveness and safety of a central venous catheter for thoracic drainage after video-assisted thoracoscopic lobectomy compared with a conventional chest tube. Methods    This study collected 200 patients with lung cancer who underwent thoracoscopic lobectomy and systematic hilar and mediastinal lymph node dissection between January 2018 and September 2019 in our hospital. The patients were randomly divided into two groups, including a group A (left with 28F chest tubes postoperatively) and a group B (left with 12G central venous catheters postoperatively). Patients in both groups were left with 2 chest tubes after upper lobectomy and 1 chest tube after middle or lower lobectomy. Duration and total volume of drainage, length of hospital stay, maximum visual analogue scale score and so forth were compared between the two groups. Results    Finally, 151 patients were included for analysis. There were 73 patients in the group A, including 26 males and 47 females, with an average age of 55.38±9.95 years, and 78 patients in the group B, including 37 males and 41 females, with an average age of 59.86±10.18 years. No statistical  difference was found between the two groups in drainage volume on postoperative day 2, and proportion of prolonged air leaks, hemothorax, chylothorax or drain reinsertion (all P>0.05). There was a statistical difference in drainage volume on postoperative day 1 [200.0 (120.0, 280.0) mL vs. 57.5 (10.0, 157.5) mL, P=0.000], postoperative day 3 [155.0 (100.0, 210.0) mL vs. 150.0 (80.0, 215.0) mL, P=0.023], total volume of drainage [890.0 (597.5, 1 530.0) mL vs. 512.5 (302.5, 786.3) mL, P=0.000], maximum pain score (2.29±0.72 points vs. 2.09±0.51 points, P=0.013) and length of hospital stay [7 (7, 9) d vs. 5 (4, 7) d, P=0.000]. Conclusion    Compared with conventional chest tubes, central venous catheters for chest drainage in patients with lung cancer after thoracoscopic lobectomy shortens the length of hospital stay and reduces postoperative pain.

Artificial intelligence in thoracic surgery / 中国胸心血管外科临床杂志

@#As an emerging technology, artificial intelligence (AI) uses human theory and technology for robots to study, develop, learn and identify human technologies. Thoracic surgeons should be aware of new opportunities that may affect their daily practice by the direct use of AI technology, or indirect use in the relevant medical fields (radiology, pathology, and respiratory medicine). The purpose of this paper is to review the application status and future development of AI associated with thoracic surgery, diagnosis of AI-related lung cancer, prognosis-assisted decision-making programs and robotic surgery. While AI technology has made rapid progress in many areas, the medical industry only accounts for a small part of AI use, and AI technology is gradually becoming widespread in the diagnosis, treatment, rehabilitation, and care of diseases. The future of AI is bright and full of innovative perspectives. The field of thoracic surgery has conducted valuable exploration and practice on AI, and will receive more and more influence and promotion from AI.

Effect of glucocorticoid use before radical resection of esophageal cancer on postoperative inflammation indexes and lung inflammation / 中国胸心血管外科临床杂志

@#Objective    To explore the effect of preoperative glucocorticoid on systemic inflammatory indexes and pulmonary inflammation after radical esophagectomy. Methods    A total of 44 patients with esophageal cancer treated in the First Affiliated Hospital of Xiamen University from July 2019 to September 2020 were selected and randomly divided into an intervention group and an observation group by random number table. There were 22 patients in the intervention group, including 20 males and 2 females with an average age of 62.86±5.22 years and 22 patients in the observation group, including 19 males and 3 females with an average age of 63.00±6.19 years. Two groups were given thoracoscope-assisted incision via right chest, upper abdomen and left neck. The intervention group was given an intravenous infusion of methylprednisolone 500 mg before induction of anesthesia, and the observation group was given the same dose of normal saline. The second generation cephalosporins were routinely used to prevent infection in the two groups. The levels of interleukin-6 (IL-6) and C-reactive protein (CRP), lymphocyte and neutrophil count before operation and 1 day, 3 days and 5 days after operation were recorded and compared between the two groups. Utrecht Pneumonia Scoring System (UPSS) score 1 day after operation, the healing of the surgical incision and the anastomotic leakage within 2 weeks after the operation were evaluated. Results    The level of IL-6 in the intervention group was significantly lower than that in the  observation group at 1 hour and 1 day after operation (both P<0.05). CRP showed significant difference between the two groups 2 days after operation (P=0.044). The white blood cell count in the intervention group was significantly less than that in the observation group 1 day and 3 days after operation (both P<0.05). There was no significant difference in lymphocyte or neutrophil count between the two groups 1 day after operation. There was no significant difference in the rate of non-grade A wound healing or the incidence of anastomotic leakage between the two groups within 2 weeks after operation. The pneumonia score of UPSS in the intervention group was lower than that in the observation group 1 day after operation (P=0.027). Conclusion    The use of glucocorticoid before radical esophagectomy can reduce the systemic inflammatory reaction and improve the short-term postoperative pulmonary inflammation. At the same time, no adverse effect on the healing of surgical incision and anastomotic stoma is found, which has certain safety.

Artificial intelligence-assisted diagnosis and treatment system in prediction of benign or malignant lung nodules and infiltration degree / 中国胸心血管外科临床杂志

@#Objective    To evaluate the effectiveness of the artificial intelligence-assisted diagnosis and treatment system in distinguishing benign and malignant lung nodules and the infiltration degree. Methods    Clinical data of 87 patients with pulmonary nodules admitted to the First Affiliated Hospital of Xiamen University from January 2019 to August 2020 were retrospectively analyzed, including 33 males aged 55.1±10.4 years, and 54 females aged 54.5±14.1 years. A total of 90 nodules were included, which were divided into a malignant tumor group (n=80) and a benign lesion group (n=10), and the malignant tumor group was subdivided into an invasive adenocarcinoma group (n=60) and a non-invasive adenocarcinoma group (n=20). The malignant probability and doubling time of each group were compared and its ability to predict the benign and malignant nodules and the invasion degree was analyzed. Results    Between the malignant tumor group and the benign lesion group, the malignant probability was significantly different, and the malignant probability could better distinguish malignant nodules and benign lesions (87.2%±9.1% vs. 28.8%±29.0%, P=0.000). The area under the curve (AUC) was 0.949. The maximum diameter of nodules in the benign lesion group was significantly longer than that in the malignant tumor group (1.270±0.481 cm vs. 0.990±0.361 cm, P=0.026); the doubling time of benign lesions was significantly longer than that of malignant nodules (1 083.600±258.180 d vs. 527.025±173.176 d, P=0.000), and the AUC was 0.975. The maximum diameter of the nodule in the invasive adenocarcinoma group was longer than that of the non-invasive adenocarcinoma group (1.350±0.355 cm vs. 0.863±0.271 cm, P=0.000), and there was no statistical difference in the probability of malignancy between the invasive adenocarcinoma group and the non-invasive adenocarcinoma group (89.7%±5.7% vs. 86.4%±9.9%, P=0.082). The AUC was 0.630. The doubling time of the invasive adenocarcinoma group was significantly shorter than that of the non-invasive adenocarcinoma group (392.200±138.050 d vs. 571.967±160.633 d, P=0.000), and the AUC was 0.829. Conclusion    The malignant probability and doubling time of lung nodules calculated by the artificial intelligence-assisted diagnosis and treatment system can be used in the assessment of the preoperative benign and malignant lung nodules and the infiltration degree.

Comparison of HRCT imaging features of ground glass opacity of COVID-19 and early-stage lung carcinoma / 中华胸心血管外科杂志

Objective:To investigate the difference of HRCT imaging features between COVID-19 and the ground-glass opacity(GGO) lesion of early-stage lung carcinoma, standardize the diagnosis and treatment process of ground-glass opacity(GGO) degeneration during the epidemic.Methods:A total of 34 patients with diagnosed COVID-19 who confirmed by positive results of the new coronavirus nucleic acid test were collected as observation group 40 patients with pathologically diagnosed early-stage lung carcinoma whose preoperative HRCT examination showed pure ground glass lesions and received surgical intervention were recruited from the Department of Thoracic Surgery (The First Affiliated Hospital of Xiamen University) from January 2018 to December 2019 as the control group. The HRCT imaging features of these two groups of patients were compared and statistically analyzed.Results:The HRCT imaging features of the new type of COVID-19 showed significant difference by characteristics of multiple lesions, lesion rapid variation within 3 days, reticular pattern, vacuolar sign and clear boundary compared to the GGO lesion of early-stage lung carcinoma( P<0.05). The chinical and imaging characteristic the sex, age, with pleural effusion or not and the lesion location showed no significant difference between these 2 groups ( P>0.05). Conclusion:Contrast with inert early lung carcinoma lesions, COVID-19 disease developed rapidly. Imaging dynamic examination can provide evidences to distinguish Novel Coronavirus Pneumonia and early-stage lung carcinoma.

Omega3-polyunsaturated fatty acid ameliorates metabolic disorders in adulthood rats caused by postnatal early overfeeding / 中华内分泌代谢杂志

Objective:To explore the effect and mechanism of omega 3-polyunsaturated fatty acid(ω3-PUFA) dietary intervention on mitochondrial function of white adipose tissue in adult rats with postnatal early overfeeding.Methods:An overfed animal model by adjusting litter size was developed for the study of neonatal overfeeding. The litter size was adjusted to 3 male rats per litter(small litter, SL group) and 10 pups per litter(normal litter, NL group). After weaning(week 3), the pups were fed standard chow or ω3-PUFA diet(SL-FO) until postnatal weeks 13. Food intake, body weight, and rectal temperature of rats were measured regularly, and energy metabolism of animals was monitored in week 13. During week 3 and 13, subcutaneous adipose tissue was collected. Inguinal preadipocytes of mice were isolated and induced to differentiate, and 50 μmol/L eicosapentaenoicacid(EPA) was administered for 48 h at the late stage of differentiation. The mRNA and protein expression levels of mitochondrial related genes, mitochondrial copy number, and oxygen consumption rate of adipocytes were detected in adipose tissue and adipocytes.Results:By the 3rd week, the body weight, food intake, and fat cell area in SL group were higher than those in NL group while the body temperature was lower until to 13 weeks. By the 13th week, the O 2 consumption, CO 2 output, and heat production of rats in SL group were lower than those in NL group. Meanwhile, the expressions of mitochondrial function related genes such as uncoupling protein 1(UCP1), carnitine palmitoyltransferase 1(CPT1), SIRT1, and mitochondrial biosynthesis regulatory gene peroxisome proliferator-activated receptor coativator-1 (PGC1α) in adipose tissue by the 3rd and 13th week were significantly reduced( P<0.05). After weaning, ω3-PUFA diet significantly reduced weight gain in SL rats, increased UCP1 protein expression, restored energy metabolism level and mitochondrial function related gene expression. In vitro intervention of EPA increased the mitochondrial copy number, the mRNA and protein expression levels of mitochondrial biosynthesis and functional genes, as well as the mitochondrial basic oxygen consumption rate( P<0.05). Conclusion:ω3-PUFA improves postnatal overfeeding-induced impairment of the mitochondrial function and biosynthesis of subcutaneous white adipose tissue in rats, which may be an important mechanism for fish oil diet to inhibit the early over-nutrition program and restore the thermogenic metabolism.

Accuracy and technical feasibility of mutual corroboration in the diagnosis of pulmonary nodule: A report of 1 368 cases / 中国胸心血管外科临床杂志

@#Objective    By applying the mutual corroboration in the diagnosis, we aimed to improve the accuracy of preoperative imaging diagnosis, select the appropriate timing of operation and guide the follow-up time for patients with pulmonary nodules. Methods    Clinical data of 1 368 patients with pulmonary nodules undergoing surgical treatment in our department from July 2016 to October 2019 were summarized. There were 531 males and 837 females at age of 44 (21-67) years. The intraoperative findings, images and pathology were classified and analyzed. The imaging pathology and pathological changes of pulmonary nodules were shown as a dynamic process through mutual collaboration and interaction. Results    Of 1 368 patients with pulmonary nodules, 376 (27.5%) were pure ground-glass nodules, 729 (53.3%) were mixed ground-glass nodules and 263 (19.2%) were solid nodules. Among the pure ground-glass nodules, adenocarcinoma in situ (AIS) accounted for the highest proportion (156 patients), followed by microinvasive adenocarcinoma (MIA, 90 patients), atypical adenomatous hyperplasia (AAH, 85 patients), and benign tumors (20 patients). Among mixed ground-glass nodules, 495 patients were invasive adenocarcinoma (IA) and 207 patients of MIA. no patient was featured by AAH, AIS or MIA. Conclusion    The mutual collaboration and interaction can improve the accuracy of preoperative diagnosis of pulmonary nodules, and it supports the choice of operation timing and the judgment of follow-up time.

Omega3-polyunsaturated fatty acid ameliorates metabolic disorders in adulthood rats caused by postnatal early overfeeding / 中华内分泌代谢杂志

Objective@#To explore the effect and mechanism of omega 3-polyunsaturated fatty acid(ω3-PUFA) dietary intervention on mitochondrial function of white adipose tissue in adult rats with postnatal early overfeeding.@*Methods@#An overfed animal model by adjusting litter size was developed for the study of neonatal overfeeding. The litter size was adjusted to 3 male rats per litter(small litter, SL group) and 10 pups per litter(normal litter, NL group). After weaning(week 3), the pups were fed standard chow or ω3-PUFA diet(SL-FO) until postnatal weeks 13. Food intake, body weight, and rectal temperature of rats were measured regularly, and energy metabolism of animals was monitored in week 13. During week 3 and 13, subcutaneous adipose tissue was collected. Inguinal preadipocytes of mice were isolated and induced to differentiate, and 50 μmol/L eicosapentaenoicacid(EPA) was administered for 48 h at the late stage of differentiation. The mRNA and protein expression levels of mitochondrial related genes, mitochondrial copy number, and oxygen consumption rate of adipocytes were detected in adipose tissue and adipocytes.@*Results@#By the 3rd week, the body weight, food intake, and fat cell area in SL group were higher than those in NL group while the body temperature was lower until to 13 weeks. By the 13th week, the O2 consumption, CO2 output, and heat production of rats in SL group were lower than those in NL group. Meanwhile, the expressions of mitochondrial function related genes such as uncoupling protein 1(UCP1), carnitine palmitoyltransferase 1(CPT1), SIRT1, and mitochondrial biosynthesis regulatory gene peroxisome proliferator-activated receptor coativator-1 (PGC1α) in adipose tissue by the 3rd and 13th week were significantly reduced(P<0.05). After weaning, ω3-PUFA diet significantly reduced weight gain in SL rats, increased UCP1 protein expression, restored energy metabolism level and mitochondrial function related gene expression. In vitro intervention of EPA increased the mitochondrial copy number, the mRNA and protein expression levels of mitochondrial biosynthesis and functional genes, as well as the mitochondrial basic oxygen consumption rate(P<0.05).@*Conclusion@#ω3-PUFA improves postnatal overfeeding-induced impairment of the mitochondrial function and biosynthesis of subcutaneous white adipose tissue in rats, which may be an important mechanism for fish oil diet to inhibit the early over-nutrition program and restore the thermogenic metabolism.

Assessment on the capacity for prevention and control programs for chronic non-communicable diseases in China, in 2014 / 中华流行病学杂志

Objective To assess the capacity of prevention and control on chronic non-communicable diseases (NCDs) in China.Methods On-line questionnaire survey was adopted by 3 395 CDCs at provincial,municipal and county (district) levels and 3 000 primary health care units,and assess on capacity of policy,infrastructure,capacity of training and guidance,cooperation,surveillance,intervention and management,assessment and scientific research from September 2014 to March 2015.Results (1) Capacity of policy:23 (71.9％) provincial,139 (40.6％) municipal and 919 (31.2％) county (district) governments or health administrative departments had existing plans for prevention and control of NCDs.(2) Capacity of infrastructure:25 (78.1％) provincial,136 (39.8％)municipal and 529 (18.0％) county (district) CDCs had set up departments dedicated to the prevention and control of NCDs,with 9 787 staff members,accounting for 5.0％ of the total CDC personnel,working on NCDs prevention and control programs.68.1％ of the CDCs had special funding set for NCDs prevention and control.(3) Capacity of training and guidance:2 485 CDCs (74.9％) held all kinds of training on prevention and control ofNCDs.2 571 (87.3％) CDCs at the county (district) level provided technical guidance for primary health care units.(4) Capacity of cooperation:42.0％ of the CDCs had experiences collaborating with the mass media.(5) Capacity of surveillance:73.8％ of the CDCs had set up programs for death registration while less than 50.0％ of the CDCs had implemented surveillance programs on major NCDs and related risk factors.In terms of primary health care units,32.4％ of them had set up reporting system for newly developed stroke case and 29.9％ of them having programs on myocardial infarction case reporting.(6) Capacity of intervention and management:69.1％ and 68.2％ of the CDCs conducted individualized intervention programs on hypertension and diabetes,while less than 40.0％ CDCs conducting intervention programs on other NCDs and risk factors.More than 90.0％ of the primary health care units carried out follow-up surveys on hypertension and diabetes.However,only 17.4％ and 13.7％ of the CDCs working on hypertension and diabetes patient management programs while 83.7％ and 80.4％,of them following the standardized guidelines for management,with successful rates of control as 59.2％ and 55.2％,respectively.(7) Capacity of assessment:32.4％ of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs.(8) Capacity of scientific research:the capacity on scientific research among provincial CDCs was apparently higher than that at the municipal or county (district) CDCs.Conclusions Compared with the results of previous two surveys,the capacity on policies set for the prevention and control programs improved continuously,at all level NCDs,but remained relatively weak,especially at both county (district) and primary health care units.

Assessment on the capacity for prevention and control programs for chronic non-communicable diseases in China, in 2014 / 中华流行病学杂志

Objective To assess the capacity of prevention and control on chronic non-communicable diseases (NCDs) in China.Methods On-line questionnaire survey was adopted by 3 395 CDCs at provincial,municipal and county (district) levels and 3 000 primary health care units,and assess on capacity of policy,infrastructure,capacity of training and guidance,cooperation,surveillance,intervention and management,assessment and scientific research from September 2014 to March 2015.Results (1) Capacity of policy:23 (71.9％) provincial,139 (40.6％) municipal and 919 (31.2％) county (district) governments or health administrative departments had existing plans for prevention and control of NCDs.(2) Capacity of infrastructure:25 (78.1％) provincial,136 (39.8％)municipal and 529 (18.0％) county (district) CDCs had set up departments dedicated to the prevention and control of NCDs,with 9 787 staff members,accounting for 5.0％ of the total CDC personnel,working on NCDs prevention and control programs.68.1％ of the CDCs had special funding set for NCDs prevention and control.(3) Capacity of training and guidance:2 485 CDCs (74.9％) held all kinds of training on prevention and control ofNCDs.2 571 (87.3％) CDCs at the county (district) level provided technical guidance for primary health care units.(4) Capacity of cooperation:42.0％ of the CDCs had experiences collaborating with the mass media.(5) Capacity of surveillance:73.8％ of the CDCs had set up programs for death registration while less than 50.0％ of the CDCs had implemented surveillance programs on major NCDs and related risk factors.In terms of primary health care units,32.4％ of them had set up reporting system for newly developed stroke case and 29.9％ of them having programs on myocardial infarction case reporting.(6) Capacity of intervention and management:69.1％ and 68.2％ of the CDCs conducted individualized intervention programs on hypertension and diabetes,while less than 40.0％ CDCs conducting intervention programs on other NCDs and risk factors.More than 90.0％ of the primary health care units carried out follow-up surveys on hypertension and diabetes.However,only 17.4％ and 13.7％ of the CDCs working on hypertension and diabetes patient management programs while 83.7％ and 80.4％,of them following the standardized guidelines for management,with successful rates of control as 59.2％ and 55.2％,respectively.(7) Capacity of assessment:32.4％ of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs.(8) Capacity of scientific research:the capacity on scientific research among provincial CDCs was apparently higher than that at the municipal or county (district) CDCs.Conclusions Compared with the results of previous two surveys,the capacity on policies set for the prevention and control programs improved continuously,at all level NCDs,but remained relatively weak,especially at both county (district) and primary health care units.

Enlightenment of the United Nations high-level summit on non-communicable disease prevention and control on the development of public health system in China / 中华预防医学杂志

The Third UN High-level Meeting on Non-Communicable Diseases was held on September 2018. The conference carried out a series of activities on the theme of "Time To Deliver", and adopted the 2018 Political Declaration on Non-Communicable Diseases. The new "5×5" strategy for non-communicable diseases prevention and control was clearly put forward, slow progress of non-communicable diseases prevention and control was criticized and the seven major challenges hindering the progress of non-communicable diseases prevention and control was analyzed, the main role and responsibility of governments at all levels in coping with the challenges of non-communicable diseases was reiterated, and put forward clear requirements. The declaration also reiterates the importance of strengthening public health measures. The meeting and declaration aroused strong repercussions and were regarded as a milestone to promote the global prevention and control of non-communicable diseases, and also brought a series of important inspirations for the development of public health in China in the new era. In order to cope with the heavy burden of non-communicable diseases in China, we must give full play to our institutional advantages, mobilization advantages and organizational advantages, adhere to prevention-oriented, emphasize the role of professional public health institutions, and consolidate and strengthen the disease control system and capacity building.

The changing trend of capacity on policy implementation related to the prevention and control of chronic non-communicable disease at the provincial level, from 2011 to 2017 / 中华流行病学杂志

Objective@#To assess the follow-up situstion and changes of policies related to the prevention and control on chronic non-communicable diseases (NCDs), in various provinces from 2011 to 2017.@*Methods@#Three national assessment programs on the prevention and control capacity of NCDs were carried out from September 2012 to March 2013, September 2014 to March 2015, and July to November 2018 respectively. Data related to the capacity on policy implementation among the 31 provinces, autonomous regions, municipality directly under the central government and Xinjiang Production and Construction Corps, were collected through online surveys.@*Results@#The rate of data collection in all the provinces reached 100%, for all three surveys. In 2011, 2013, and 2017, the capacity for policy development special funding was distributed for prevention and control NCDs under the provincial fiscal revenue by 27 provinces (84.4%), 26 provinces (81.3%) and 25 provinces (78.1%), and the numbers of provincial governments leaders attended the local activities related to prevention and control NCDs was 15 (46.9%), 13 (40.6%) and 19(59.4%), respectively. From 2009 to 2011, 14 (43.8%) proposals related to the topics on prevention and control of NCDs, were raised at the provincial People’s Congress and Political Consultative Conference, while from 2011 to 2013 and2014 to 2017, 13 (40.6%) and 12 (37.5%) were respectively raised. In terms of capacity for policy development, numbers of provincial comprehensive plan which targeting prevention and control of NCDs reached 6 (18.8%), 20 (62.5%) and 27 (84.4%) in 2011, 2013, and 2017 respectively. In 2011, 2013 and 2017, numbers of provincial special plans that targeting on NCDs or the risk factors of NCDs prevention and control were 0, 1, and 3, respectively.@*Conclusions@#Under the continuous introduction of international and national policies related to prevention and control on NCDs, capacity for policy formulation in various provinces has been greatly improved. However, a slight progress has been made in the capacity for policy making. The increase of capacity building on policy making regarding prevention and control of NCDs, at the provincial government level, has become a key issue.

Impact of the number of lymph node examined on the prognosis of esophageal squamous cell carcinoma / 中华消化外科杂志

Objective To investigate the effect of the number of lymph nodes examined (NLNE) on the prognosis of esophageal squamous cell carcinoma (ESCC).Methods The retrospective case-control study was conducted.The clinicopathological date of 628 ESCC patients who underwent radical resection in the Tianjin Medical University Cancer Institute and Hospital from January 2005 to March 2013 was collected.Patients underwent radical resection of ESCC through right thorax.Observation indicators:(1) surgical and postoperative pathological examinations;(2) follow-up and survival situations;(3) effect of NLNE on the prognosis of ESCC;(4) factors analysis affecting prognosis of ESCC patients;(5) subgroup analysis.Follow-up using outpatient examination,telephone interview and mail was performed to detect postoperative survival up to February 2018.Measurement data with skewed distribution were described as M (range).Receiver operating characteristic (ROC) curve analysis was used to determine the appropriate cut-off of the NLNE.The survival curve and survival rate were respectively drawn and calculated by the Kaplan-Meier method,and the survival analysis was done by the log-rank test.Multivariate analysis was done by the Cox proportional hazard model.Results (1) Surgical and postoperative pathological examinations:472 and 156 patients underwent respectively Ivor-Lewis and Mckeown operations.There were 284 patients with tumor diameter ≤ 3.5 cm and 344 patients with tumor diameter ＞ 3.5 cm.The total NLNE was 11 139 for all of the 628 patients,with an average NLNE of 18 per case(range,2-78 per case) and a median NLNE of 16 per case.Of 628 patients,high-,moderate-and low-differentiated tumors were respectively detected in 48,469 and 111 patients;staging T0-1,T2,T3 and T4a of depth of tumor invasion in 30,119,260 and 219 patients;N0,N1,N2 and N3 of degree of lymph node metastasis in 349,173,69 and 37 patients;rN0,rN1,rN2 and rN3 of rate of lymph node metastasis in 349,184,54 and 41 patients.(2) Follow-up and survival situations:all the 628 patients were followed up for 3-144 months,with a median time of 36 months.The 1-,3-and 5-year survival rates were 82.4％,53.7％ and 41.3％,respectively.(3)Effect of NLNE on the prognosis of ESCC:ROC curve showed that the appropriate cut-off value of the NLNE was 16.Using NLNE =16 as a cut-off value,5-year survival rate was respectively 36.7％ in patients with NLNE ＜ 16 and 45.1％ in patients with NLNE ≥ 16,with a statistically significant difference in survival (x2 =9.527,P＜0.05).According to a median NLNE of 23,the patients with NLNE ≥ 16 were further divided into patients with 16 ≤ NLNE ≤ 23 and NLNE ＞ 23.Results showed that 5-year survival rate in patients with NLNE ＜ 16,16 ≤ NLNE ≤ 23 and NLNE ＞ 23 was respectively 36.7％,41.2％ and 50.3％,with a statistically significant difference in survival among them (x2 =10.588,P＜0.05),between patients with NLNE ＜ 16 and 16 ≤ NLNE ≤ 23 (x2 =4.419,P＜0.05).There was no statistically significant difference between patients with 16 ≤ NLNE ≤ 23 and NLNE ＞ 23 (x2 =1.413,P＞0.05).Five-year survival rate in patients with NLNE ≤ 23 and NLNE ＞23 was respectively 38.6％ and 50.3％,with a statisctically significant difference (x2 =5.885,P＜0.05).(4)Factors analysis affecting prognosis of ESCC patients:results of univariate analysis showed that age,smoking history,BMI,tumor diameter,NLNE,depth of tumor invasion,degree and rate of lymph node metastasis were related factors affecting the prognosis of ESCC patients (x2 =5.454,4.875,7.669,10.691,10.588,30.612,59.780,76.565,P＜0.05).Results of muhivariate analysis showed that age,tumor diameter,NLNE,depth of tumor invasion and rate of lymph node metastasis were independent factors affecting the prognosis of ESCC patients [HR=1.268,1.300,0.762,1.354,1.357,95％ confidence interval (CI):1.034-1.556,1.038-1.629,0.662-0.878,1.183-1.549,1.089-1.692,P＜0.05].(5) Subgroup analysis:among 279 patients with lymph node metastasis,5-year survival rate in patients with NLNE ＜ 16,16 ≤ NLNE ≤ 23 and NLNE ＞ 23 was respectively 23.7％,19.4％ and 39.5％,with a statistically significant difference among them (x2 =8.397,P＜0.05),between patients with 16≤ NLNE ≤ 23 and NLNE ＞ 23 (x2=5.425,P＜0.05).There was no statistically significant difference between patients with NLNE ＜ 16 and 16 ≤ NLNE ≤ 23 (x2 =0.389,P＞ 0.05).Five-year survival rate in patients with NLNE ≤ 23 and NLNE ＞ 23 was respectively 21.9％ and 39.5％,with a statisctically significant difference (x2=7.942,P＜ 0.05).Among 349 patients without lymph node metastasis,5-year survival rate in patients with NLNE ＜ 16,16 ≤ NLNE ≤ 23 and NLNE ＞ 23 was respectively 45.6％,60.3％ and 59.2％,with a statistically significant difference among them (x2 =9.755,P＜0.05) and between patients with NLNE ＜ 16 and 16 ≤ NLNE ≤ 23 (x2 =8.208,P＜0.05).There was no statistically significant difference between patients with 16 ≤ NLNE ≤ 23 and NLNE ＞ 23 (x2 =0.284,P＞0.05).Five-year survival rate in patients with NLNE ≤ 23 and NLNE ＞ 23 was respectively 51.1％ and 59.2％,with no statisctically significant difference (x2 =1.147,P＞ 0.05).Conclusions The NLNE is an independent factor affecting the prognosis of ESCC patients,and at least 16 to 23 lymph nodes should be dissected.For patients with lymph node metastasis,and more than 23 lymph nodes should be dissected.For patients without lymph node metastasis,more than 23 lymph nodes dissection cannot obviously improve the prognosis of patients.

Dosimetry analysis of radioactive seed implantation supported by coplanar template for lung cancer patients with mediastinal lymph node metastases 4R / 中华放射医学与防护杂志

Objective To compare the planned radiation dose and the actual dose received after 125I radioactive seeds implantation supported by coplanar template (CPT) in lung cancer patients with mediastinal node metastases 4R,and to evaluate the clinical efficacy.Methods Totally 32 patients with lung cancer with mediastinal lymph node metastases 4R who had been diagnosed via cellular pathology studies were selected from January 2008 to December 2014.The mediastinal lymph node metastases were treated by CPT-assisted 125I radioactive seed implantation.Digital imaging and communications in medicine (DICOM) data were acquired by chest CT scan before implantation,brachytherapy radiation treatment planning system (BTPS) was introduced to carry out the plan,and the prescribed dose(PD) was 120 Gy.CPT was used to control the precision of needle penetration and implantation of radioactive seeds.Computer tomography (CT) was used to ensure the correct position of needles and radioactive seeds.Dose evaluation was performed immediately after implantation and was compared with planned dose using paired t-test.The 6-months postoperative chest CT was conducted to evaluate treatment efficacy according to response evaluation criteria in solid tumors(RECIST Version 1.1).Results All patients went through implantation procedure successfully.Dose evaluation after implantation was as followed.The average dose received (231.9 ±29.6)Gy,the dose received by 90％ of the target(D90) (150.8 ± 16.6) Gy,the dose received by 100％ of the target(D100) (100.4 ± 12.6)Gy,the volume of 100％PD covering the target(V100)(94.1 ± 2.6) ％,the volume of 200％ PD covering the target(V200) (33.0 ± 5.7) ％,the conformal index (CI) 0.75 ±0.06,the external index(EI) (22.7 ± 5.8)％,the average dose received by the superior vena cava (19.3 ± 7.2)Gy,and the average dose received by aorta (12.1 ± 5.1)Gy.Efficacy was followed for 6 months after implantation and the effective rate was 84.37％.There was no serious complications (such as radioactive lung injury,major vascular injury,bleeding,and et al.) occurred in follow-up period.Conclusions CPT assisted CT guided 125I radioactive seed imnplantation in treating mediastinal node metastases 4R can achieve preoperative BTPS,minimize major vascular or organ injury.It is an accurate,effective and safe treatment approach and may be of great value to standardize the procedure of radioactive seed implantation in mediastinal metastases.

The value of high-resolution magnetic resonance imaging of arterial walls in the diagnosis of cerebral artery dissection / 国际脑血管病杂志

Objective To investigate the value of high-resolution magnetic resonance imaging (HR-MRI) of arterial walls in the diagnosis of cerebral artery dissection (CAD).Methods The patients diagnosed as CAD and completed computed tomography angiography (CTA),magnetic resonance angiography (MRA),digital subtraction angiography (DSA),and HR-MRI were enrolled retrospectively.The detection rate and diagnostic value of the 4 imaging techniques were compared and analyzed.Results A total of 15 patients were enrolled,5 had internal carotid artery dissection,7 had vertebral artery dissection,2 had middle cerebral artery dissection,and 1 had basilar artery dissection.HR-MRI revealed 11 intramural hematoma,9 intimal flap,3 double lumen sign,and 2 pseudoaneurysm.A total of 18 CADs were detected in 15 patients,17 (94.44％),14 (77.78％),5 (27.78％) and 6 (33.33％) were detected with HR-MRI,DSA,CTA and MRA,respectively.There were significant difference in CAD detection rates of HR-MRI,DSA,CTA and MRA (x2 =24.939,P ＜ 0.001).The CAD detection rate of HR-MRI and DSA were significantly higher than those of CTA and MRA (all P ＜ 0.01 for HR-MRI,all P ＜ 0.05 for DSA),but there was no significant difference in CAD detection rate between HR-MRI and DSA.Conclusion HR-MRI is a diagnostic method for CAD with higher sensitivity.

Bibliometric analysis of medical papers of Shandong Province covered in SCI / 中华医学科研管理杂志

A statistical analysis was conducted to evaluate the publication status in medical research of Shandong province in 2013, based on papers covered in SCI-Expanded database, aimed to provide an objective assessment of the level of medical research in Shandong Province.Factors involved in the analysis including medical papers authored by researchers in Shandong province, numbers and types of publication, distribution of author's location, institution, type of periodical, and impact factor.

Comparative analysis of domestic and foreign medical MOOC / 中华医学图书情报杂志

Objective To provide the effective and convenient medical MOOC and remote medical education by comparatively analyzing domestic and foreign medical MOOC.Methods The following items were comparatively an-alyzed, including the number of medical MOOC, the universities offering medical MOOC, the languages used in teaching medical MOOC, the identification of MOOC, and the development of domestic and foreign medical MOOC on platforms of Coursera, edX, China university MOOC and people's health MOOC.Results The domestic medical MOOC still had a longer way to go than foreign medical MOOC in their number, scale and identification.Conclu-sion Domestic medical workers should grasp the opportunity to provide more effective and convenient medical MOOC platform.