Relationships between serum lipids, CA153 level and breast cancer incidence and clinicopathological features of patients / 国际肿瘤学杂志

Objective:To explore the relationships between serum lipids, CA153 level and breast cancer incidence and clinicopathological features of patients.Methods:A total of 198 patients with breast cancer diagnosed and treated at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were enrolled as the case group, and 198 healthy women were selected with 1∶1 age pairing as controls. Five milliliters of fasting venous blood was collected to measure serum lipids levels in all subjects and CA153 levels in breast cancer patients. The difference of serum lipids levels between the two groups was compared. Logistic regression model was used to analyze the risk factors of breast cancer. For 165 breast cancer patients who did not receive neoadjuvant chemotherapy, independent sample t-test was used to compare serum lipids and CA153 levels in breast cancer patients with different pathological features, and Pearson correlation analysis was used to calculate the correlation between variables and CA153. Results:The triglyceride (TG) levels in the case group and the control group were (1.22±0.73) mmol/L and (1.06±0.52) mmol/L respectively, and the difference was statistically significant ( t=2.559, P=0.011); the total cholesterol (TC) levels were (4.47±0.86) mmol/L and (4.99±0.80) mmol/L respectively, and the difference was statistically significant ( t=-6.228, P<0.001); the high-density lipoprotein cholesterol (HDL-C) levels were (1.32±0.34) mmol/L and (1.53±0.38) mmol/L respectively, and the difference was statistically significant ( t=-5.913, P<0.001). Higher TC and HDL-C levels were independent protective factors for breast cancer ( OR=0.350, P<0.001; OR=0.531, P=0.013). The TC levels in lymph node positive and lymph node negative patients were (4.36±0.73) mmol/L and (4.67±0.83) mmol/L respectively, and the difference was statistically significant ( t=-2.518, P=0.013); low-density lipoprotein cholesterol (LDL-C) levels were (2.53±0.58) mmol/L and (2.77±0.70) mmol/L respectively, and the difference was statistically significant ( t=-2.312, P=0.022). The TC levels in patients with stage Ⅰ and stage Ⅱ/Ⅲ were (4.90±0.89) mmol/L and (4.46±0.76) mmol/L respectively, and the difference was statistically significant ( t=2.855, P=0.005); LDL-C levels were (2.95±0.71) mmol/L and (2.60±0.63) mmol/L respectively, and the difference was statistically significant ( t=2.705, P=0.008). The level of CA153 in triple-negative breast cancer patients [(14.94±7.45) U/ml] was significantly higher than that in non-triple-negative breast cancer patients [(11.96±5.96) U/ml], and the difference was statistically significant ( t=2.359, P=0.020). The level of CA153 was positively correlated with the level of TG ( r=0.167, P=0.032). Conclusion:Dyslipidemia is associated with an increased risk of breast cancer. The levels of serum lipids vary among patients with different lymph node status and tumor stages. CA153 level is positively correlated with TG level to some extent.

Advances in the relevance of laryngopharyngeal reflux and tinnitus / 中华耳鼻咽喉头颈外科杂志

Tinnitus is the most common symptom in otorhinolaryngology. In the past, tinnitus was often localized in the auditory system lesions, causing a great amount of idiopathic tinnitus patients inadequately treated. At present, it is believed that the pathogenesis of tinnitus not only originates from auditory system itself, but also participates in systemic disorders. In recent years, investigating in the effects of laryngopharyngeal reflux on tinnitus is undergoing rapid progress. This review highlights the current state of relationship between laryngopharyngeal reflux and tinnitus, which may provide a new systemic insight into diagnosis and treatment on tinnitus as well as laryngopharyngeal reflux.

Establishment and research of a New Zealand rabbit model of laryngopharyngeal reflux / 中华耳鼻咽喉头颈外科杂志

Objective@#To establish a New Zealand rabbit animal model of laryngopharyngeal reflux disease (LPRD) using esophageal balloon together with metal internal stent dilation and to investigate the changes of mucosa.@*Methods@#20 New Zealand rabbits were randomly divided into experimental group and control group, with 10 in each group. Balloon dilatation and metal internal stent dilation were carried out in experimental group to reproduce the animal model of LPRD.The middle of balloon was placed at the lower esophageal sphincter (LES) while the stent was placed at the upper esophageal sphincter (UES). The guide wire was placed in the control group, but the balloon was not expanded and the stent was not placed. The general condition, pH value of hypopharynx, laryngeal histopathology and changes of pepsin content of New Zealand rabbits were observed regularly. The difference between experimental group and control group was compared.@*Results@#The 24-hour Dx-pH monitoring results showed that the number of reflux episodes(20.0[9.5, 35.0], 13.0[6.5, 22.0]), and the percent time below pH 5.5 (1.36%[0.60%, 4.57%], 1.36%[0.43%, 2.77%]) in the experimental group at the 2nd and 4th week were significantly different from those in the control group (0[0,3.0], 1.0[0.5, 3.8]; 0[0, 0.01%], 0[0, 0], respectively, all P<0.01), suggesting that the experimental group New Zealand rabbits developed LPRD. Compared with the control group under microscope, lymphocytes infiltration and submucosal gland hyperplasia increased in the mucosa of the throat of the experimental group. The results of pepsin immunohistochemical staining between the two groups were statistically significant (P=0.014).@*Conclusion@#The use of balloon dilatation of the LES combined with metal stent dilatation of the UES can successfully establish a laryngopharyngeal reflux model, and lesions in the throat tissue can be observed.

Analyses of pathogenic factors and clinicopathological characteristics of vocal leukoplakia / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the pathogenic factors of vocal leukoplakia and its clinical and pathological features.@*Methods@#Eighty-one patients with vocal cord leukoplakia who underwent surgery between February 2010 and December 2016 and 160 volunteers without pharyngeal symptoms designed as controls were included in this case control study. The clinicopathological characteristics of 81 patients were summarized and analyzed synthetically.@*Results@#There was statistical significance in reflux symptom index(RSI), reflux finding score(RFS), smoking index, and drinking index between case group and control group(Z=-5.35, -4.82, -4.76, -2.44, P<0.05). The voice-using duration per day in case group was significantly longer than that of control group.There was no statistical significance in hospital anxiety and depression scale for anxiety(HADA) scores、hospital anxiety and depression scale for depression(HADD) scores between case group and control group(P>0.05). In 42 patients who received 24-hour dual probe pH monitoring the prevalence of pathologic LPR was 42.8%. In 81 patients, 39(48%)patients were pathologically diagnosed as squamous cell hyperplasia, 18(22%)patients as mild dysplasia, 12(15%)sides as moderate dysplasia , 10(12%)patients as severe dysplasia and 2(2%)patients as carcinoma in-situ. The average age of high-risk pathological vocal leukoplakia was significantly higher than that of low-risk leukoplakia(t=-2.73, P<0.01). The propotion of speckled leukoplakia in high-risk leukoplakia was significantly higher than that of low-risk leukoplakia(χ2=23.81, P<0.01). There was no statistical significance between high-risk leukoplakia and low-risk leukoplakia in the prevalence of pathologic LPR(P>0.05). The bilateral lesions, speckled leukoplakia were more likely to relapse(χ2=4.27, 12.17, P<0.05). The more serious the pathology, the more likely it was to relapse (Z=-2.168, P=0.03). There was no statistical significance between recurrence group and non-recurrence group in the prevalence of pathologic LPR(P>0.05).@*Conclusions@#LPR, smoke constitute the risk factors of vocal cord leukoplakia. Drinking, voice abuse are related to vocal cord leukoplakia. Senile, speckled leukoplakia are more likely to be malignancy. A speckled leukoplakia, bilateral leukoplakia, severe pathological degree are important factors to predict recurrence.

Surgical treatment and prognostic analysis for 57 patients with gastrointestinal lymphoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore clinicopathologic characteristics, surgical features and prognostic factors in patients with primary gastrointestinal lymphoma(PGIL) in order to provide evidence for optimizing surgical treatment.</p><p><b>METHODS</b>Clinicopathological data of 57 PGIL patients undergoing abdominal surgery in Sun Yat-sen University Cancer Center between October 1990 and January 2015 were retrospectively collected. The survival rates were compared among patients with different clinicopathologic characteristics by Kaplan-Meier method, while Cox regression model was employed to analyze the prognostic factors.</p><p><b>RESULTS</b>Among 57 patients, 43 were male and 14 were female, with a median age of 48 (range 16 to 80) years. Seventeen (29.8%) cases were classified as Musshoff I( stage, 19 (33.3%) cases as II( stage, 9 (15.8%) cases as III( stage, and 12(21.1%) cases as IIII( stage. Forty-four (77.2%) cases underwent selective operation, 13(22.8%) cases underwent emergent operation due to acute abdomen. Thirty-two(56.1%) cases had radical resection, 18 (31.6%) cases had partial resection and the rest 7(12.3%) cases failed to perform resection. Four (7.0%) cases received simple surgical operation, and 53 (93.0%) cases received comprehensive treatment, including 5(8.8%) cases with preoperative chemotherapy and surgery, 40 (70.2%) cases with surgery and postoperative chemotherapy, and 8 (14.0%) cases with surgery and perioperative chemotherapy. Stage III( and IIII( accounted for 76.9%(10/13) in patients undergoing emergent operation and accounted for 25.0%(11/44) in patients undergoing selective operation, whose difference was statistically significant (χ=9.503, P=0.002). Univariate prognostic analysis showed that T lymphocyte source pathological cell phenotype (P=0.000), clinical Musshoff stage III( and IIII((P=0.001), emergent operation (P=0.000) and incomplete tumor resection(P=0.007) had worse 5-year overall survival. Multivariate Cox regression analysis indicated that tumor pathological cell phenotype (HR=13.75, 95%CI:3.546-53.308, P=0.000) and surgical timing (HR=7.497, 95%CI:1.163-48.313, P=0.034) were independent prognostic risk factors of patients with stage I( and II(.</p><p><b>CONCLUSIONS</b>Surgical operation is an important part of comprehensive treatment for PGIL. T lymphocyte source and ulcerative lymphoma indicates poorer prognosis.</p>

Relation between autogenous arteriovenous fistula diameter and hemodynamic parameter / 中华肾脏病杂志

Objective To analyze the relationship between the least diameter of autogenous arteriovenous fistula and other parameters like flow rate and artery diameter. To identify an appropriate way in defining fistula stenosis. Methods Physical examination and Doppler ultrasound were used to examine the autogenous arteriovenous fistula of maintenance hemodialysis patients. Well?used wrist arteriovenous fistula was included. The least diameter of the fistula vein was found and marked by ultrasound, and the diameter and the distance between the point and the anastomotic stoma were measured. Diameters of different places along the cephalic vein of the fistula, including the forearm place, the place close to elbow and the upper arm place were measured by ultrasound. Meanwhile, diameter as well as flow velocity and flow rate of brachial artery, radial artery and ulnar artery were also measured. Result Sixty?eight patients were enrolled in the study. The average age of those patients was 52.56 ± 2.00 years old. Thirty?one patients were female. Forty?nine fistula were located on the left arm. The average diameter and flow rate of brachial artery were 5.72(5.34, 6.33) mm and 821.50 (540.50, 1075.00) ml/min, respectively. The average diameters of radial artery and ulnar artery were 3.95 ± 0.10mm and 3.17(2.73,3.75) mm, respectively. The least diameter of cephalic vein was 3.34 ± 0.11mm in average. The distance between the least place to the anastomotic stoma was 3.76±0.14cm in average. The diameter of forearm cephalic vein was averaged 5.36(4.52, 6.45) mm. Diameter of place close to elbow and the upper arm place in the cephalic vein were (5.57±0.12) mm and (5.80±0.14) mm, respectively. The least diameter of cephalic vein was positively and statistically associated with the diameter and flow rate of brachial artery as well as radial artery. The least diameter was also positively and statistically associated with the diameter of each place in the cephalic vein. Statistical inter?group difference was found when the division was based on the value of the least diameter. Conclusion sThe least diameter of the wrist autogenous arteriovenous fistula vein will indeed affect the whole diameter and flow rate of the fistula. The value of the least diameter is more closely associated with the fistula function rather than narrow rate.

Clinical study of the influence of laryngopharyngeal reflux on quality of life in patients with dysphonia / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the morbidity of laryngopharyngeal reflux in patients with dysphonic diseases and to investigate the influence of LPR on the patients.</p><p><b>METHODS</b>One hundred and twenty-seven patients with dysphonic diseases were encountered in Peking University of the People Hospital. Under the agreement, the patients were asked to fill in the scales of RSI, RFS, VHI and SF-36.24-hour ambulatory double pH monitoring was applied to diagnose LPR definitely. 2643 volunteers were recruited to fill in the RSI scale through physical examination, outpatient, the ward and web survey.</p><p><b>RESULTS</b>46.46% (59/127) patients were diagnosed with LPR definitely. 1241 of 2643 volunteer, who filled in the RSI, score more than zero in the first entry of hoarseness or dysphonia, 65.0% (807/1241) of them, scoring 13 points or higher, were diagnosed with clinically suspected LPR. Based on the 24-hour ambulatory double pH monitoring, VHI total scores and subscores in the emotional domains were higher in positive group than in negative group. There was no statistical difference (P>0.05) in functional and physical domains. The SF-36 scale was used to evaluate the quality of life of the patients. The difference of 6 dimensionality, scores had statistical significance (P<0.05), including role-physical, general health, validity, social function, role-emotional and mental health. There was no statistical difference in dimensionalities of role-physical and bodily pain.</p><p><b>CONCLUSIONS</b>The volunteers who were diagnosed with hoarseness or dysphonia had the higher morbidity rate of LPR. At the time of treatment, more attention should be paid to the quality of life.</p>

Research on the association of the laryngeal carcinoma and laryngopharyngeal reflux / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The objective of this study is to investigate the association between laryngeal carcinoma and laryngopharyngeal reflux.</p><p><b>METHODS</b>This was a case-control study with 31 laryngeal cancer patients who had undergone 24-hour ambulatory double pH monitoring and 76 in the control group which were divided into negative group (36 patients) and positive group (40 patients) by the score of RSI (reflux symptom index) and RFI (reflux findings index) scale. The results of reflux and parameters of 24-hour ambulatory double pH monitoring among the three groups were statistically analysed.</p><p><b>RESULTS</b>The smoking rate of 80.6% (25/31) in laryngeal carcinoma group was significantly higher than that of (36.1%, P < 0.0167) in the negative group while it did not vary in laryngeal carcinoma group and the positive group (65.0%, P > 0.0167). The drinking rate of 71.0% (22/31) in laryngeal carcinoma group was higher than that of (36.1%, P < 0.0167) in the negative group whereas there was no significant difference between laryngeal carcinoma group and positive group (50.0%, P > 0.0167). The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group, the positive group, the negative group were 74.2% (23/31), 16.7% (6/36) and 52.5% (21/40) respectively, which was significantly different (P < 0.05). The positive rate of gastroesophageal reflux in the three groups above were 71.0% (22/31), 52.8% (19/36) and 75.0% (30/40), which had no significant difference (P > 0.05). The positive rate of laryngopharyngeal reflux differed in laryngeal carcinoma group and the negative group (P < 0.0167) while did not differ in laryngeal carcinoma group and the positive group (P > 0.0167). In the results of 24-hour ambulatory double pH monitoring, there was significant difference in the total and upright reflux number, the total reflux time, the percent times for the pH falling below 4, total reflux number which lasted more than 5 minutes and DeMeester Scores.</p><p><b>CONCLUSIONS</b>The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group was very high while the drinking and smoking rate were also high. Therefore whether the laryngopharyngeal reflux is a risk factor of the laryngeal carcinoma, it needs further research.</p>

The relationships among organization climate, psychological empowerment and job embeddedness / 中国实用护理杂志

Objective To explore the relationships among organization climate,psychological empowerment and job embeddedness by using path analysis.Methods A total of 514 clinical nurses from 26 departments in 3 hospitals were recruited by convenience cluster sampling method and investigated with demography questionnaire,Nurses Organizational Climate Scale,Psychological Empowerment Scale and Job Embeddedness Scale.Results The mean scores of organization climate,psychological empowerment and job embeddedness was (3.01±0.46),(3.27±0.44),(3.08±0.39).The predictors of job embeddedness of nurses were resources support,work experience,human resources management,marital status,job title,management support,quality management,and self-egicacy,explained 48.9％ of its variance; organization climate,psychological empowerment had direct positive influence on nurses' job embeddedness,explained 33.3％ of its variance.Conclusions Improvement and maintenance of sound organizational climate,increase the sense of psychological empowerment of nurses,are effective ways and means to increase the degree of job embedding of nurses.