Behavioural and emotional problems in Malaysian children and adolescents with type 1 diabetes mellitus: A cross-sectional study in a single centre / Journal of the ASEAN Federation of Endocrine Societies

Introduction@#Type 1 diabetes mellitus (T1DM) is an autoimmune disorder that requires a lifelong treatment regimen which may affect psychosocial development.@*Objective@#To identify behavioural and emotional problems in children and adolescents with T1DM.@*Methodology@#A cross-sectional study using the Child Behaviour Check List (CBCL) was conducted among all T1DM patients receiving treatment at the Paediatric Endocrine Unit, Hospital Tunku Azizah Kuala Lumpur, Malaysia.@*Results@#Forty T1DM patients were included. The mean age of the participants was 12.4 years (SD=2.69), with 52.5% males, and 75% Malay. The average duration of illness was 4.8 years, 9 were pre-pubertal, while mean HbA1c was 9.4%. Thirty-five percent of the respondents had parent-reported internalizing problems and 17.5% had parent-reported externalizing problems. Those >12 years old had more internalizing problems (p=0.004) compared to those ≤12 years old. The differences were in the anxious/depressed syndrome subscale (p=0.001) and withdrawn/depressed syndrome subscale (p=0.015). There were no statistically significant differences in the 3 main global scores by gender, glycaemic control, duration of illness and pubertal status by univariate analysis.@*Conclusion@#T1DM patients >12 years old were at higher risk of developing psychosocial difficulties. This highlighted the benefit of screening of behavioural and emotional issues in children and adolescents with T1DM.

Current status and research progress of occupational health monitoring in welding fume operations / 中华劳动卫生职业病杂志

Welding operations are widely present in the manufacturing production process, involving a large number of occupational groups, and are the key occupations where work injuries and occupational diseases occur in China. For different welding processes and welding materials, the content and focus of occupational health monitoring are different. At present, the item of occupational health examination in welding operation is in poor consistency with the on-site exposure of occupational hazard factors, and it is mainly concentrated in the stage of disease development, which can not reflect the early health damage caused by welding dust exposure in time. The emergence of biomarkers of welding dust can make up for this defect. Therefore, it is of great significance to describe the current situation of occupational health monitoring of welding dust and summarize the research progress of related biomarkers for the early prevention of diseases caused by welding dust and the practice of occupational health monitoring.

Iodine nutrition status thyroid nodule detection and influencing factors in 450 health check-up residents in Chengdu / 公共卫生与预防医学

Objective To study the iodine nutrition status and analyze the detection of thyroid nodules and its related influencing factors in 450 health check-up residents in Chengdu area and to provide evidence for the prevention of thyroid nodules. Methods A total of 450 residents who underwent health check-up in the Western Theater General Hospital from January 2019 to January 2022 were selected as the research subjects. The gender, age, weight and other basic conditions of the subjects were investigated, and their urinary iodine levels and occurrence of thyroid nodules were examined. Univariate and multivariate methods were used to analyze the influencing factors of occurrence of thyroid nodules. Results The overall urinary iodine level of the 450 health check-up people in Chengdu area was (96.89 -212.38) μg/L, with an average of (164.86±42.58) μg/L. The urinary iodine level of males was significantly higher than that of females (P60 years old (P60 years old , people in rural areas and people with history of diabetes mellitus in the thyroid nodule group were higher than that in the non-thyroid nodule group, and thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) were higher than those in the non-thyroid nodule group (P60 years old, history of diabetes mellitus and high levels of TGAb and TPOAb were risk factors for the occurrence of thyroid nodules (P<0.05). Conclusion The overall iodine nutrition level of 450 health check-up people in Chengdu is in the appropriate range, and the detection rate of thyroid nodules is high. It is necessary to strengthen the examination of thyroid nodules in key populations (women , history of diabetes mellitus, the elderly, etc.), and provide early detection and active intervention to prevent the occurrence and progression of thyroid nodules.

Evaluation of Four Predictive Models for Identifying Malignancy of Solitary Pulmonary Nodules in Health Check-up Population / 肿瘤防治研究

Objective To compare and validate the efficiency of four models predicting the malignancy of solitary pulmonary nodules (SPN). Methods Patients diagnosed with SPN during health check-up were selected as the research subjects. Risk assessment was conducted using four predictive models. Outcomes were obtained through prospective follow-up. Statistical description and univariate analysis were performed for all risk factors of the four models. ROC curve was applied to compare the efficiency of the four predictive models. Results A total of 479 cases were included in this study. Among these patients, 82 were diagnosed with lung tumor, and the malignant rate was 17.12%. Age, nodule diameter, smoking, family history of tumor, history of extrapulmonary tumor ≥5 years, upper lobe site, unclear boundary, and spiculation rates were higher in the malignancy group than those in the benign group (P < 0.05). The efficiency of Brock model was the best. Its AUC was 0.833, sensitivity was 80.49%, and specificity was 74.31%. Its Youden index, positive likelihood ratio, positive predictive value, and negative predictive value were the highest, and its negative likelihood ratio was the lowest. The AUC, sensitivity, and specificity of Mayo model were 0.815, 81.71%, and 67.51%, respectively; those of PKUPH model were 0.754, 69.51%, and 73.55%, respectively; and those of VA model were 0.738, 68.29%, and 67.55%, respectively. Conclusion The Brock model might be the most appropriate predictive model for the risk assessment of SPN among the health check-up population, and the VA model is the worst. The combination of Brock, Mayo, and PKUPH models requires further study.

Validation of MyDiagnostick tool to identify atrial fibrillation in a multi-ethnic Asian population

INTRODUCTION@#MyDiagnostick is an atrial fibrillation (AF) screening tool that has been validated in the Caucasian population in the primary care setting.@*METHODS@#In our study, we compared MyDiagnostick with manual pulse check for AF screening in the community setting.@*RESULTS@#In our cohort of 671 candidates from a multi-ethnic Asian population, AF prevalence was found to be 1.78%. Of 12 candidates, 6 (50.0%) had a previous history of AF and another 6 (50.0%) were newly diagnosed with AF. Candidates found to have AF during the screening were older (72.0 ± 11.7 years vs. 56.0 ± 13.0 years, P < 0.0001) and had a higher CHADSVASC risk score (2.9 ± 1.5 vs. 1.5 ± 1.1, P = 0.0001). MyDiagnostick had a sensitivity of 100.0% and a specificity of 96.2%. In comparison, manual pulse check had a sensitivity of 83.3% and a specificity of 98.9%.@*CONCLUSION@#MyDiagnostick is a simple AF screening device that can be reliably used by non-specialist professionals in the community setting. Its sensitivity and specificity are comparable and validated across various studies performed in different population cohorts.

Factors associated with failure to undergo health check-ups in Nagasaki Prefecture, Japan / Journal of Rural Medicine

Objective: Municipal National Health Insurance (NHI) in Nagasaki Prefecture in Japan struggles with poor attendance of health check-ups, which was only 39.6% in 2018. This study aimed to evaluate factors that encourage healthy behaviors, including opting for health check-ups, and the characteristics of middle-aged and older individuals who did not undergo health check-ups.Materials and Methods: This cross-sectional study, using a self-administered questionnaire, was conducted in August 2020 in three municipalities of Nagasaki Prefecture. In addition to questions regarding sociodemographic information, such as sex, age, educational status, self-rated economic status, and family structure, the questionnaire included questions on daily lifestyle habits such as alcohol intake and exercise, current medical treatment, self-rated health, and information related to health check-ups. Of the 18,710 questionnaires distributed in the three municipalities, 8,756 (46.8%) were collected by the end of December 2020, of which 7,840 were valid for analysis. The compliance rate for health check-ups was obtained from the Public Health and Welfare Bureau of Nagasaki Prefecture. Statistical analyses were performed according to two age groups: 40−59 and 60−74 years.Results: Among the respondents who did not undergo health check-ups in the year prior to this study, “lack of time” and being “too bothersome” were the most popular reasons for not attending health check-ups. “Living alone” and “low self-rated economic status” were negative factors for receiving health check-ups regardless of age group.Conclusions: Vulnerable middle-aged and older persons, such as those living alone and with low economic status, were less likely to undergo health check-ups. Emphasis on home visits by public health nurses may also be needed to increase awareness of individual health conditions, especially for people living alone and those who are socioeconomically disadvantaged.

Iodine check results in edible salt in Suzhou in 2017-2021 / 公共卫生与预防医学

Objective To understand the quality status of salt iodine monitoring results at the county level and checking results at the city level from 2017 to 2021 in Suzhou，and to provide a scientific basis for the development of iodine deficiency disease（IDD）prevention and control strategies and measures.  Methods During the past five years, Suzhou CDC randomly selected 15 samples of 300 monitored salt samples from each county/district CDC each year for spot checks. The data were processed by comparative analysis of relative error and grouped data t test.  Results In the conformity of iodized salt and non-iodized salt, the sample monitoring results of some counties/districts were non-iodized salt, while the city-level test results were iodized salt. In the conformity of iodized salt and seaweed iodized salt (or enhanced salt), the sample monitoring results of county/district level were iodized salt, while the test results at the city level were seaweed iodized salt (or enhanced salt). The non-conformity was relatively concentrated in some county/district laboratories, and the total amount of non-conformity tended to increase year by year. The total number of samples with relative error of >20% between the county/district and city-level results was the least in 2021, with 6, and the most in 2018, with 25. The number of samples with relative error of >30% between the county/district and city-level results was the least in 2017 being 0, while there were 12 samples in 2018, fluctuating within a small range in the past three years. The t-test results of grouped data showed that the average value of the checking results at the city level was generally higher than the monitoring results at the county level. There were 21 pairs of data with no statistical significance (P>0.05) and 29 pairs of data with statistical significance (P<0.05) between the results at the county/district level and at the city level. Among them, there were 7 counties/districts whose sample monitoring results were not significantly different from the city-level test results in 2020, while there were 9 counties/districts whose monitoring results were statistically different from the city-level test results in 2021.  Conclusion  The data analysis results show that the monitoring data of iodized salt in Suzhou is basically reliable and accurate, but there still exist some problems. Therefore, in the future work it is necessary to strengthen the monitoring system of IDD, increase training efforts, continuously monitor and check the quality of iodized salt to provide a scientific basis for effective prevention and control of IDD.

Analysis of factors influencing the frequency of health check-up and health check-up behavior in healthy population / 中华行为医学与脑科学杂志

Objective:To analyze the relevant factors affecting the frequency and behavior of health check-up among the population of medical examinees.Methods:From January to June 2022, 491 health examinees who had health check-ups at the Second Affiliated Hospital of Shandong First Medical University were included.Basic information of the check-up population and their needs for check-up services (form of check-up, content of check-up, cost of check-up, form of feedback on check-up results, and needs for check-up providers) were obtained based on a questionnaire survey.According to the frequency of previous medical check-up, the examinees were divided into never-check-up group (frequency of check-up was 0, n=45), the irregular check-up group (the interval between two physical examinations >1 year, n=49) and the regular check-up group (frequency of check-up=1 year, n=347). The frequency of previous medical check-up was used as the dependent variable, and the age, gender, education level, income, form of medical check-up and cost of medical check-up were used as independent variables to analyse the relevant factors affecting the frequency of their medical check-ups.The above count data were analyzed by one-way analysis using chi-square test, and the count data with statistically significant differences in one-way analysis were analyzed by binary logistic regression.The statistical software was SPSS 21.0. Results:The study included 491 medical examinees, of which 9.16%(45/491) were in the never-check-up group, 20.16%(99/491) in the irregular check-up group and 70.68%(347/491) in the regular check-up group. The impact of demography characteristics of physical examinees on the frequency of health check-up, and there were statistically significant differences in the frequency of health check-up in terms of gender, job, education, and income ( χ2=21.826, 157.113, 104.764, 45.486, all P<0.05). The understanding of health check-up and the attention paid to one's own health were influencing factors that affected the frequency of health check-up. There were statistically significant differences in the frequency of health check-up in necessity of health check-up, attention to one's own health, health check-up forms, health check-up institutions, health check-up price and health check-up contents ( χ2=9.277, 25.863188.239, 59.115, 39.250, 28.314, all P<0.05). Logistic regression analysis showed gender, job type, monthly income, necessity of health check-up, concerns for items of check-up, forms and institutions of check-up were influencing factor of health check-up frequency(all P<0.05). Conclusion:The health check-up behavior of the population and the frequency of regular medical check-ups are influenced by the factors such as gender, education, occupation, income, form of medical check-up, price of medical check-up, choice of medical check-up institution and the degree of concern for one’s own health. The popularisation of health check-ups for special groups such as men, low-income people, low literacy and insufficient awareness of the importance of one’s own health will help improve the overall health awareness of the population.

Prevalence of musculoskeletal disorders and its risk factors among Class 4 workers of rural tertiary health-care hospitals in Western India: A cross-sectional study

Background: The least attention is given to the real heroes of the hospital is the Class 4 workers are associated with a lot of duties of lifting and transferring patients and are at risk of work-related musculoskeletal disorders (WMSDs). Aim and Objectives: The aim of the study was to find the prevalence of WMSDs in 9 body regions among Class 4 workers of tertiary care hospitals and ergonomics assessment of their exposure to risk factors for the development of WMSDs. Materials and Methods: This cross-sectional study was conducted among 148 Class 4 workers (male: 99; female: 49 Age: >23 years) from tertiary care hospitals. A structured questionnaire comprises demographic questions, Nordic Musculoskeletal Questionnaire-Extended for WMSDs assessment in nine body parts and quick exposure check (QEC) method for ergonomic assessment, and new job stress scale for assessing job-related stress. The prevalence of WMSDs for each body region was determined. Results: Respondents’ mean age was 31.3 years (SD = 9). Point prevalence for WMSDs was high in regions like the lower back (43.8%), followed by the knee (40.8%), and shoulder (34.4%). Among 49 female respondents, 25 reported lower back pain (51%), and 20 reported neck pain (41.6%). Among 99 male respondents, 25 reported lower back pain (25.5%) while 22 reported knee pain (22.2%). QEC assessment showed that level of exposure to WMSDs risk was high among 50% of the study population. Conclusion: The lower back and knee were the most affected areas among Class 4 workers. Moreover, QEC findings warned the level of exposure to WMSDs risks is high.

Routine medical check-up and self-treatment practices among population living in mountainous area of a tribal district of Odisha

Background: Self-treatment is recognized as one of the global public health issues. Geographical distance, constrained financial resources, and lack of awareness are the main barriers for people in remote areas to access health care. Self-treatment may also have risky consequences such as side effects and antibiotic resistance. It is assumed that the rate of self-treatment is high in the unreachable hilly tribal areas because of the geographical factor. Aim and Objective: The primary objective of the present study is to find out the prevalence and reason of self-medication, and the sources of drug information. The secondary objective is to assess the awareness of routine medical check-up among the tribal population of the hilly areas of the Koraput district of Odisha. Materials and Methods: A retrospective study was conducted after receiving clearance from the Institutional Ethical Committee, SLN MCH, Koraput. The study was conducted from February 2022 in some hilly villages near Koraput, which is a typical mountainous commune with the terrain divided by many mountains. Simple random sampling was done using computer software for selecting participants (sample size: 200). The participants were contacted and our interviewer visited door-to-door for face-to-face interviews. The research team developed a structured questionnaire to use in the face-to-face interviews. The questionnaire included questions about demographic characteristics, access to medical facilities, frequency of routine medical check-ups in the past 12 months, health information sources, and distance to the nearest health facility. A series of questions regarding self-treatment practices were also asked: Whether they had purchased any medication without prescription in the past 3 months, what the symptoms were, and what kind of medicines they bought, and the reasons they bought the medicines on their own. Results: The study found that prevalence of self-medication was 92 (46%, C.I. 95%). The majority of residents had self-medication when they suffered from common cold and cough (16% of participants), fever (8%), diarrhea (6%), body pain or myalgia (8%), and allergy (2%). The most prevalent groups of drugs used were antipyretics such as paracetamol (36%), antibiotics (30%), antihistamines (14%), and analgesics such as diclofenac and nimesulide (26%). The most common reason for choosing a local practitioner or private pharmacist and health worker was the subjects’ proximity to them. Of the self-medicated population in our study, 62% procured medicines from local practitioners, chemists, or health workers residing in their villages or nearby villages. Conclusion: Rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time and at the lowest cost to them and their community. Self-medication unfortunately does not follow the standard, scientific, and rational criteria. Due to self-medication quality of medicine, scientific, and rational procurement, rational prescription is always questionable.

Combined association of oral and skeletal muscle health with type 2 diabetes mellitus among community-dwelling older adults in Japan: a cross-sectional study / Journal of Rural Medicine

Objective: Although oral health and skeletal muscle status are known to be risk factors for type 2 diabetes mellitus (T2DM), there is limited information on their combined effects among community-dwelling older adults. The purpose of this study was to investigate the association between oral health and skeletal muscle status among older adults with T2DM in Japan.Participants and Methods: This cross-sectional study included data from individuals aged ≥60 years. T2DM was defined as a glycosylated hemoglobin A1c level ≥48 mmol/mol (≥6.5%) or the use of hypoglycemic agents. For oral health status, dental hygienists assessed the number of teeth (NT) and masticatory function (MF). Skeletal muscle status was assessed using skeletal muscle mass index (SMI) and handgrip strength (HGS). Logistic regression analysis examined T2DM in nine-category combinations of oral health status (each of the three categories in NT and MF) and skeletal status (each of the three categories in SMI and HGS).Results: T2DM was prevalent in 83 participants (16.4%) and was significantly associated with low NT and SMI (odds ratio [OR] = 5.93, 95% confidence interval [CI]: 1.37–25.73) and low MF and SMI (OR = 4.48, 95% CI: 1.23–16.35) compared to high NT and SMI and high MF and SMI, respectively.Conclusion: Our findings indicate that low muscle mass with tooth loss or masticatory dysfunction is associated with T2DM among community-dwelling older adults. This suggests that maintaining oral health and muscle mass may be an effective strategy for the prevention of T2DM.

Abstaining from annual health check-ups is a predictor of advanced cancer diagnosis: a retrospective cohort study

BACKGROUND@#Cancer prevention is a crucial challenge in preventive medicine. Several studies have suggested that voluntary health check-ups and recommendations from health professionals are associated with increased participation in cancer screening. In Japan, it is recommended that individuals aged 40-74 years should undergo annual health check-ups; however, the compliance to this recommendation is approximately <50%. According to the national survey, individuals who do not undergo annual health check-ups are at a higher risk for cancer. However, to the best of our knowledge, no previous study has investigated the association between the use of health check-ups and the incidence rate of cancer. We hypothesised that not undergoing periodic health check-ups and/or less use of outpatient medical services are predictors for advanced cancer.@*METHODS@#To explore the relationship between health check-up or outpatient service utilisation and cancer incidence, this retrospective cohort study used data at two time points-baseline in 2014 and endpoint in 2017-from the National Health Insurance (NHI) claims and cancer registry. A multivariable logistic regression analysis was performed to investigate whether cancer diagnosis was associated with health check-up or outpatient service utilisation.@*RESULTS@#A total of 72,171 participants were included in the analysis. The results of the multivariable logistic regression showed that individuals who skipped health check-ups had a higher risk of cancer diagnosis (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04-1.40). Moreover, not undergoing health check-ups increased the risk of advanced-stage cancer (OR, 1.78; 95% CI, 1.29-2.44). Furthermore, increased rate of outpatient service utilisation was negatively associated with advanced cancer diagnosis.@*CONCLUSIONS@#This is the first study reporting that not undergoing health check-ups is a predictor of cancer diagnosis and advanced cancer stage. Primary prevention strategies for NHI members who do not undergo health check-ups must be reassessed. Moreover, future research should examine secondary prevention strategies, such as health education and recommendations from health professionals to facilitate adequate utilisation of preventive health services.

Research Advances of Immunotherapy for Follicular Lymphoma --Review / 中国实验血液学杂志

Follicular lymphoma is an indolent malignant tumor originating from lymph nodes and lymphoid tissues, which may affect the patients' quality of survival due to the recurrence and progression. In recent years, with the deepening understand of the molecular biology and signaling pathways, many new targeted drugs for follicular lymphoma have been discovered, such as monoclonal antibodies, checkpoint inhibitors, epigenetic regulation related targeted therapies and signaling pathway inhibitors. In this review, the new progress of immunotherapy for follicular lymphoma is summarized briefly.

Immune checkpoint inhibitors induced pituitary immune-related adverse events: diagnosis and management / 中华肿瘤杂志

Immune checkpoint inhibitors (ICIs) have been used in treating a wide variety of cancers, but they challenge clinicians with a series of special immune related adverse events (irAEs) resulting from activated immune system. Since June 2018, when the first programmed cell death 1 (PD-1) inhibitor, nivolumab, was approved by the National Medical Products Administration (NMPA), abundant experience has been accumulated in coping with irAEs from PD-1 and PD-1 ligand 1 (PD-L1) blockade therapies. In October 2021, the first CTLA-4 inhibitor, ipilimumab, which has a different spectrum of irAEs was also approved by NMPA. The discrepancy in clinical features of pituitary irAEs is obvious between these two types of ICIs. Pituitary irAEs include hypophysitis and hypopituitarism. In this review of latest literature, we have summarized the incidence, possible mechanisms, time of onset, clinical presentations, hormone test, pituitary imaging, treatment strategies and recovery patterns of pituitary irAEs. By referring to domestic and foreign clinical guidelines, we have proposed practical suggestions for screening, diagnosing and treating pituitary irAEs.

Establishment and evaluation of an autoverification scheme for hematology analysis in cancer patients / 中华检验医学杂志

Objective:According to the characteristics and common problems of hematology analysis in cancer patients, an autoverification scheme for cancer patients was formed, and the effectiveness and efficiency of the autoverification scheme were verified.Methods:The hematology review of international consensus and ourselves were respectively combined with Chinese multicenter autoverification rules to form two autoverification schemes. 10 063 blood samples (460 cases reviewed by microscope) were selected as the establishment group. Retrospective judgment was made in the instrument middleware, and various indexes such as autoverification pass rate and missed detection rate of different schemes were compared. By analyzing the data of missed cases one by one, the autoverification rules are adjusted according to the characteristics of diagnosis and treatment of cancer patients. By analyzing the platelet count variation range within 7 days in 19 300 cases, the Delta rules of platelet count were established. The platelet count Delta rules and the adjusted autoverification rules were combined to form the autoverification rules of our hospital and then combined with our hematology review rules to form the autoverification scheme of our hospital. The establishment group and verification group (10 876 cases, including 1 740 cases of microscopic examination) of the autoverification schemes were judged. The recognition function of Ethylenediaminetetraacetic acid-dependent pseudo thrombocytopenia (EDTA-PTCP) and PLT Delta check were programmed in the laboratory information system (LIS), and other rule judgment functions are performed in middleware. After four months of clinical trial application of 61 602 specimens, the effectiveness of our autoverification scheme was comprehensively evaluated.Results:The autoverification pass rates of international hematology review rules, our review rules, and Chinese multicenter autoverification rules are 46.36%, 52.26%, and the missed detection rates are 2.02%, 1.06%, respectively. The autoverification pass rates of our hospital autoverification scheme in the establishment group and the verification group are 51.19% and 52.78%, the missed detection rates are 0% and 0.03%, and the true positive rate are 100% and 99.95%, respectively. 56.06% of cases were passed automatically during the clinical trial application, and there were no missing cases, the true positive rate is 100%. The performance of our autoverification scheme is superior to the current autoverification schemes combined with mainstream hematology review rules and autoverification rules. The median time of TAT by autoverification was shortened by 15 minutes, and the 90th percentile time was shortened by 58 minutes, which was significantly lower than that of the same period last year. The marker function of "EDTA-PTCP" identified 31 special patients and 68 samples had been analyzed in total. After correction, the median increase of PLT was 76.5×10 9/L ( Z=-7.17, P<0.001). Conclusions:This study has established an autoverification scheme that combined by rules of hematology review and autoverification rules. It is suitable for cancer patients with high pass rate and very low rate of missed detection. This autoverification scheme can ensure the accuracy of the hematology analysis of cancer patients in our hospital and improve work efficiency.

Convenience of “Loco-check” Combination in Quick Screening of Latent Preliminary Group of Locomotive Syndrome by Measurement of Handgrip Strength: Secondary Analysis of the Previous Report / 社会薬学

As a screening tool for detecting latent pre-locomotive syndrome (latent pre-LS) in women over the age of 40, measuring handgrip strength with a cut-off value of 26 kg was proposed in a previous report. However, this screening method missed 22% of latent pre-LS. It would be beneficial to screen almost persons with latent pre-LS in community pharmacies. In this study, it was investigated whether screening using the combination of measuring handgrip strength and the questionnaire, “Loco-check,” which was proposed by the Japanese Orthopaedic Association, improved the detection of latent pre-LS in the same group mentioned above. Combining only one of the “Loco-check” questions, “I cannot put on a pair of socks while standing on one leg,” with the measurement of handgrip strength with the cut-off value of 26 kg, the detection of latent pre-LS was increased to 90.2%. The odds ratio was 9.72 in logistic regression analysis. Using the combination of the measurement of handgrip strength and the response to one question is both rapid and convenient. Therefore, in this study, this screening combination is proposed to be a useful tool in community pharmacies for detecting early latent pre-LS.

Research progress of metformin in tumor immunotherapy / 国际肿瘤学杂志

In recent decades, immune checkpoint inhibitors (ICIs) have ushered in a new era in oncology treatment. Despite the remarkable efficacy of ICIs, there are still many patients who do not benefit from immunotherapy alone. Combination therapy is currently the main research direction in China and abroad. Metformin can enhance the number and function of T cells, affect macrophage polarization, promote natural killer cell activation and regulate immune checkpoint expression. A large number of preclinical and clinical studies are exploring the efficacy and safety of ICIs in combination with metformin in different tumors.

Analysis of poor vision among people aged 60 and over in a town in the suburbs of Shanghai / 上海预防医学

ObjectiveTo understand the state of low vision and blindness and vision parameters of the elderly in a town in the suburbs of Shanghai， and analyze the factors that affect the weakened vision of the elderly. MethodsA total of 5 243 community residents who participated in a community physical examination in Sijing Town of Songjiang District of Shanghai were selected as the subjects. Their eyesight was examined for low vision and blindness using the international standard visual acuity chart. At the same time， medical vision examinations were carried out on the subjects， including eye acuity， spherical degree， axial position， horizontal corneal curvature， vertical corneal curvature and cylinder degree. ResultsThe increase in age has an impact on the incidence of low vision and blindness in the elderly community in Sijing Town， with an increased proportion of monocular low vision （χ2=112.545， P<0.05）， binocular low vision （χ2=21.006， P<0.05） and monocular blindness （χ2=9.418， P<0.05）. P<0.05）， a significant downward trend of cylindrical power （F=20.358， P<0.05） and a significant upward trend of spherical power （F=50.274， P<0.05）， axial position （F=7.934， P<0.05） and corneal curvature vertical data （F=7.351， P<0.05）. ConclusionThe incidence of low vision and blindness among elderly community residents in Sijing Town is related to the increase of age. Systematic visual inspection is helpful for early detection and treatment of low vision and blindness among elderly residents in the community.

Verification Phantom-based clinical quality control and detection of the MLC of CyberKnife M6 / 中华放射医学与防护杂志

Objective:To provide a new morning check method for the output dose stability of the multileaf collimator (MLC) of the CyberKnife M6 (CK-M6) system.Methods:The CT images of a verification phantom with a size of 20 cm × 20 cm × 10 cm were transmitted into the Precision Treatment Plan ning System (ver. 1.1.1.1). The high-precision alignment between the accelerator output front and the fixed position of the phantom surface was achieved using the fiducial tracking method. A 10 cm × 10 cm radiation field was formed by the MLC and a DailyCheck plan with an output of 200 MU was designed. The repeatability, sensitivity, and accuracy of the DailyCheck plan were measured, and the CK-M6 system was continuously tested for one month using the artificial fixed method and the DailyCheck plan designed in this study. Results:The average and the standard deviation of 10 repeated measurements by the DailyCheck plan were 492.28 pC and 0.09, respectively, indicating good stability. There was a linear correlation between the measured values and the output dose, with a correlation coefficient of R2 > 0.999. Moreover, there was a position deviation of 2 mm between the phantom and the accelerator output front, and the result ant effect on the measured values was equivalent to a dose deviation caused by an output of 1.24 MU. The result from the continuous measurement of both the artificial fixed method and the DailyCheck plan fell within permissible limits, showing high consistency. Conclusions:The DailyCheck plan established through the fiducial tracking of a verification phantom can achieve the convenient, quick, and accurate daily detection of the output dose stability of the MLC of CK-M6. Therefore, this method can be widely applied in the clinical quality control of the CK-M6 system.

Clinical and CT imaging features of immune checkpoint inhibitor-associated pneumonia / 中华放射学杂志

Objective:To explore the clinical and CT imaging features of immune checkpoint inhibitor-associated pneumonia (CIP) and to improve the early diagnostic ability of CIP.Methods:From June 1, 2020 to October 31, 2021, the clinical data and chest CT images of 2 067 patients with advanced malignant tumor treated with immune checkpoint inhibitor (ICI) in the First Medical Center, Chinese PLA General Hospital were retrospectively analyzed. Patients with CIP were enrolled according to the guidelines for CIP diagnosis, and the incidence, time from the start of medication to the onset of CIP, medication cycle, imaging features, imaging patterns, CT grade and outcomes were analyzed. χ 2 test was used to compare the incidence of CIP in patients with or without basic lung disease. Results:Among 2 067 patients with malignant tumors treated with ICI, 67 patients developed CIP, the incidence of CIP was 3.2%. The incidence of CIP was significantly different between 386 patients with basic lung disease (7.00%, 27/386) and 1 681 patients without basic lung disease (2.4%, 40/1 681) (χ 2=21.32, P<0.001). The time from the start of medication to the onset of CIP was 7-367 d (median 52 days), and the duration of medication was 1-12 cycles (median 2 cycles). The imaging features of CIP presented as ground glass opacities in 54 cases (80.6%), solid nodules in 26 cases (38.8%), consolidations in 25 cases (37.3%) and irregular reticular opacities in 24 cases (35.8%). The main radiologic pattern was organizing pneumonia (OP, 34 cases, 50.7%), and followed by diffuse alveolar damage (DAD) pattern (14 cases, 20.9%). According to CT grading, there were 26 cases in low risk grade, 17 cases in moderate risk grade and 24 cases in high risk grade. Of 43 low-and medium-risk grade cases, 25 were OP pattern, accounting for 58.1%, and among 24 high-risk grade patients, 13 were DAD pattern, accounting for 54.2%. Forty-three of the 52 patients were initially untreated, of which 23 patients progressed, 17 had lesion shrinkage, and 3 had resolution, and relapsed in 8 cases after resolution or drug withdrawal. Conclusions:The imaging manifestations of CIP are mainly ground glass opacities, nodules, consolidations, and irregular reticular opacities. The radiologic patterns are mainly OP and DAD. OP is the most common pattern in low-moderate risk grade CIP and DAD is the most common pattern in high risk grade CIP. Patients with basic lung disease are more likely to get CIP.