Development and validation of a prognostic prediction model for patients with stage Ⅰ to Ⅲ colon cancer incorporating high-risk pathological features / 中华外科杂志

Objective: To examine a predictive model that incorporating high risk pathological factors for the prognosis of stage Ⅰ to Ⅲ colon cancer. Methods: This study retrospectively collected clinicopathological information and survival outcomes of stage Ⅰ~Ⅲ colon cancer patients who underwent curative surgery in 7 tertiary hospitals in China from January 1, 2016 to December 31, 2017. A total of 1 650 patients were enrolled, aged (M(IQR)) 62 (18)years (range: 14 to 100). There were 963 males and 687 females. The median follow-up period was 51 months. The Cox proportional hazardous regression model was utilized to select high-risk pathological factors, establish the nomogram and scoring system. The Bootstrap resampling method was utilized for internal validation of the model, the concordance index (C-index) was used to assess discrimination and calibration curves were presented to assess model calibration. The Kaplan-Meier method was used to plot survival curves after risk grouping, and Cox regression was used to compare disease-free survival between subgroups. Results: Age (HR=1.020, 95%CI: 1.008 to 1.033,P=0.001), T stage (T3:HR=1.995,95%CI:1.062 to 3.750,P=0.032;T4:HR=4.196, 95%CI: 2.188 to 8.045, P<0.01), N stage (N1: HR=1.834, 95%CI: 1.307 to 2.574, P<0.01; N2: HR=3.970, 95%CI: 2.724 to 5.787, P<0.01) and number of lymph nodes examined (≥36: HR=0.438, 95%CI: 0.242 to 0.790, P=0.006) were independently associated with disease-free survival. The C-index of the scoring model (model 1) based on age, T stage, N stage, and dichotomous variables of the lymph nodes examined (<12 and ≥12) was 0.723, and the C-index of the scoring model (model 2) based on age, T stage, N stage, and multi-categorical variables of the lymph nodes examined (<12, 12 to <24, 24 to <36, and ≥36) was 0.726. A scoring system was established based on age, T stage, N stage, and multi-categorical variables of lymph nodes examined, the 3-year DFS of the low-risk (≤1), middle-risk (2 to 4) and high-risk (≥5) group were 96.3%(n=711), 89.0%(n=626) and 71.4%(n=313), respectively. Statistically significant difference was observed among groups (P<0.01). Conclusions: The number of lymph nodes examined was an independent prognostic factor for disease-free survival after curative surgery in patients with stage Ⅰ to Ⅲ colon cancer. Incorporating the number of lymph nodes examined as a multi-categorical variable into the T and N staging system could improve prognostic predictive validity.

Distribution signature analysis between intussusception and rotavirus diarrhea in young children / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the annual incidence rate of intussusception over a 5-year period in Suzhou and to determine whether there was a potential link between intussusception rotavirus diarrhea.</p><p><b>METHODS</b>Outpatient and inpatient data from 1999 through 2003 retrospectively were reviewed for young children (< 2 year old) whose diagnosis was confirmed by ultrasonography or radiography and patients were reduced by air enema or surgery. From September 2001, to August 2003, inpatients with diarrhea (< 2 year old) were detected rotavirus antigen in the stool by ELISA technology.</p><p><b>RESULTS</b>From 1999 through 2003, 1101 cases were reported in children below 2 years old. The incidence rate of intussusception under 1 year age each year was 275.3, 338.2, 547.0, 515.3, and 425.4 per 100,000 child years respectively (the average annual incidence was 418.1 per 100,000 child years), and the incidence of intussusception increased over time from 1999 to 2003. A peak age distribution of intussusception was infants 4 to 10 months old (692/1101, 62.85%) and mean age was 9.62 +/- 5.65 months, which were greatly different from those of patients with rotavirus diarrhea, whose peak age distribution was 5 to 16 months old (252/331, 76.13%), and mean age was 11.42 +/- 5.14 months (Z = 6.90, P < 0.01). The peak month distribution of intussusception was from April to August (595/1101, 54.04%), which was distinct from that of patient with rotavirus diarrhea, whose peak month distribution was between October and January (232/331, 70.09%). Test: chi2 = 226.06, P < 0.001.</p><p><b>CONCLUSION</b>The annual incidence rate of intussusception for < 1 year of age was 418.1 per 100,000 child years in Suzhou. We found no epidemiologic evidence for an association between intussusception and rotavirus diarrhea.</p>

Epidemiological study on rotavirus-borne diarrhea in infants and children in different areas / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze and compare the epidemiological features of rotavirus diarrhea among infants in the different areas so as to provide data for rotavirus vaccine research.</p><p><b>METHODS</b>From Sep. 2001 through Sep. 2003, sentinel sites were set up in Suzhou Children's Hospital and Maanshan Hospital. Fecal samples from children (< 5 years) with acute diarrheal were collected and enzyme linked immunosorbent assay was used to detect rotavirus antigen. Reverse transcription-polymerase chain reaction was used to determine the G serotypes and P genotypes of rotavirus strains. The features of strains in the two places and other areas of China were analyzed and compared.</p><p><b>RESULTS</b>(1) Rotavirus infection appeared in autumn and winter, but the peaks varied. In Suzhou the peaks were from December to next February in 2001, and November to next January in 2002. But in Maanshan, it was November to next January for both two years. (2) Rate of rotavirus infection in Suzhou was much higher than that in Maanshan, infective rates of Inpatient Department and Outpatient Department are 47.28%, 28.39% and 30.38%, 14.77% respectively in the two hospitals. (3) Rates of infection in two hospitals showed age difference but the highest group was in 6 - 35 month-olds. No gender difference was found. (4) Secular distribution of G-typing and P-typing of rotavirus strain was different in Suzhou and Maanshan. G3 was mainly found in Suzhou and G1 in Maanshan. From 2002-2003 on, G3 became dominant in Maanshan.</p><p><b>CONCLUSION</b>Rotavirus caused diarrhea among infant and children were different in terms of areas, period and types, suggesting that the introduction of rotavirus vaccine should be adjusted according to different strains with specific types and optimal timeline.</p>

Lactulose Breath Hydrogen Test in Diagnosis of Small Intestinal Bacterial Overgrowth in Children / 实用儿科临床杂志

Objective To evaluate lactulose breath hydrogen test in diagnosis of small intestinal bacterial overgrowth in children.Me-thods Thirty-five children,aged 3 to 13 years old with mean (7.72?3.06) years old presented with chronic diarrhea,abdominal pain and flatulence.Among them,18 cases were male and 17 cases were female.Breath hydrogen test was carried out after the administration of a 0.5 g?kg-1 or 10 g lactulose,which was 100 g?L-1 solution.After the ingestion of lactulose,the breath hydrogen was collected in every 20 minutes and up to 3 hours.Small intestinal bacterial overgrowth was diagnosed as positive when the hydrogen concentration increased more than 20 mg?m-3 in a sample.Results Eighteen cases in 35 (51.43%) children were positive and 17 cases were negative.Among these positive cases,8 cases in 18 (22.86%) patients were typically double peaks in breath hydrogen concentrations.Among the causes of small intestinal bacterial overgrowth in children,4 cases with chronic superficial gastritis,4 cases with chronic bacterial enteritis,2 cases with malnutrition and anorexia,1 case with volvulus of stomach,1 case with massive resection of small intestine,1 case with steatorrhea and 5 cases with unknown causes.Four cases of chronic bacterial enteritis were gained remission by antimicrobial agents.The other cases were treated by lac-to-and bifidbacteria probiotics.Seven patients of the clinical systems were controlled,3 cases were improved remarkably and 4 cases were failed.Conclusions The lactulose breath hydrogen test is validated as screening test in the diagnosis of small intestinal bacterial overgrowth in children.Antimicrobial agents and bifidbacteria probiotics is effective in treatment of small intestinal bacterial overgrowth.

Observation and Analysis of Intestinal Flora Microecology in Infant Rats Model with Irritable Bowel Syndrome / 实用儿科临床杂志

Objective To explore the changed status of the intestinal flora microecology in the model infant rats with irritable bowel syndrome(IBS) by integrative method.Methods To establish 20 infant rats model with IBS.The IBS rats were randomly divided into the treatment group A with bifico and positive control group B,and another 10 infant rats which grew up regularly were taken as negative control group C.The feces smear staining and intestinal flora detection was performed in the 3 groups respectively,meanwhile the dry and wet weight of each group rats feces and the content of water in the feces were compared.Results The intestinal flora imbalance rate of infant rats IBS group(A+B) was 70%,and there was 30% in the control group C,the difference between model group and group C was very significantly(?~2=4.34 P