The prognostic value of lymphatic metastatic size in head and neck squamous cell carcinoma.

BACKGROUND: Lymphatic metastatic size was proved to predict prognosis in different types of carcinomas, except in head and neck squamous cell carcinoma (HNSCC) located in hypopharynx, oropharynx and supraglottic region et al. The aim of this study is to evaluate the prognostic value of lymphatic metastatic size in HNSCC, which may guide clinical decision-making in practice. METHODS: From 2008 to 2022, 171 patients, who were diagnosed as HNSCC in our center, were included. The demographic data, clinicopathological characteristics and lymphatic metastatic size were recorded and analyzed using the Kaplan-Meier method and Cox regression analysis. RESULTS: Among 171 patients, 107 cases were hypopharyngeal cancer, 38 cases supraglottic cancer and 26 cases oropharyngeal cancer. The median of lymphatic metastatic size was 8 mm (range 0-46). According to lymphatic metastatic size, the patients were assigned to three subgroups: Group I (0 mm), Group II ( ≤ 10 mm) and Group III (> 10 mm). Kaplan-Meier analysis with log rank test revealed that Group I and Group II had similar locoregional control rate, distant metastasis free probability, disease-free survival and overall survival (all p > 0.05), whereas Group III had significant worse prognosis. Adjusted for demographic and other clinicopathological characteristics, lymphatic metastatic size was an independent predictor of disease-free survival and overall survival in HNSCC. CONCLUSIONS: Lymphatic metastatic size was an independently prognostic factor in HNSCC, which may assist in postoperative adjuvant treatment decisions.

Comparison of 980-nm/1470-nm Dual-Wavelength Fiber Laser Versus Ultrasonic Scalpel Device in Open Thyroidectomy.

Background: To investigate the application value of 980-nm/1470-nm dual-wavelength fiber laser in thyroidectomy. Methods: The clinical data of 130 patients undergoing thyroid surgery from March 2017 to December 2018 were retrospectively analyzed. According to the use types of energy devices, the patients were divided into laser group and ultrasonic scalpel group, with 65 patients in each group. The baseline data, operation-related indicators, operation complications, postoperative pathological conditions, and follow-up results of the two groups were compared. Results: The operations were successfully completed in both groups. The median operative time of total thyroidectomy (TT), lobectomy+central lymph node dissection (CLND), TT+CLND in the laser group were longer than that in the harmonic scalpel group, and the difference was statistically significant (p < 0.05). The incidence of parathyroid gland congestion in the laser group (10.3%) was lower than that in the harmonic scalpel group (19.2%), and the difference was statistically significant (p < 0.05). No significant differences were found in operative type, intraoperative blood loss, postoperative drainage volume, operative complications, postoperative hospital stay, and lymph node metastasis rate between the two groups (p > 0.05). No incidence was noted of recurrence, metastasis, or death in both groups. Conclusions: The 980-nm/1470-nm dual-wavelength fiber laser had an efficacy in open thyroidectomy similar to that of the harmonic scalpel, was safe and feasible, and less damage to the parathyroid gland blood supply than a scalpel. It can be used as a new option for thyroid surgery.

Benzo[de]isoquinoline-1,3-dione condensed asymmetric azaacenes as strong acceptors.

We have designed and synthesized three novel benzo[de]isoquinoline-1,3-dione (BQD) condensed asymmetric azaacenes, BQD-TZ, BQD-AP and BQD-PA, with different end groups of 1,2,5-thiadiazole, acenaphthylene and phenanthrene. The triisopropylsilylethynyl groups were grafted to increase the solubility and crystallinity of the three molecules. These molecules have high electron affinity values of 3.87, 3.69 and 3.74 eV for BQD-TZ, BQD-AP and BQD-PA, respectively as confirmed by cyclic voltammetry measurements. Single-crystal X-ray diffraction revealed that these molecules have strong π-π stacking with distances of 3.31-3.41 Å and different stacking arrangements.

Fabrication of ultralight nitrogen-doped reduced graphene oxide/nickel ferrite composite foams with three-dimensional porous network structure as ultrathin and high-performance microwave absorbers.

The development of lightweight and high-performance microwave absorbers is still a challenge in the field of electromagnetic absorption. Graphene foam with three-dimensional (3D) network structure and low bulk density has been considered as an ideal candidate for microwave absorption. In this work, nitrogen-doped reduced graphene oxide/nickel ferrite composite foams were prepared by the solvothermal and hydrothermal two-step method. The as-prepared composite foams had very low bulk density (7.8 âˆ¼ 10.0 mg·cm-3) and a unique 3D porous network structure. Furthermore, results revealed that the microwave absorption performance of attained composite foams could be improved by adjusting the calcination temperature. Significantly, the obtained composite foam exhibited the best microwave absorption performance when calcined at 650.0 °C for 2.0 h. The minimum reflection loss was as large as -60.6 dB at an ultrathin matching thickness of only 1.55 mm, and the effective absorption bandwidth could reach 5.5 GHz with a thin thickness of 1.62 mm. In addition, the possible microwave attenuation mechanisms of attained composite foams were proposed. It was believed that our results could be helpful for developing graphene-based 3D magnetic composites as lightweight and high-performance microwave absorbers.

Fabrication of three-dimensional nitrogen-doped reduced graphene oxide/tin oxide composite aerogels as high-performance electromagnetic wave absorbers.

Developing light-weight and high-efficiency electromagnetic wave (EMW) absorbers has been considered as an effective strategy to resolve the electromagnetic radiation pollution problem. Herein, nitrogen-doped reduced graphene oxide/tin oxide (NRGO/SnO2) composite aerogels were facilely prepared through the hydrothermal process and subsequent lyophilization treatment. Morphological characterization results manifested that the attained NRGO/SnO2 composite aerogels possessed unique three-dimensional (3D) porous network structure constituted by the tiny SnO2 nanoparticles decorated wrinkled surfaces of flake-like NRGO. Moreover, excellent EMW absorption performance could be achieved through facilely regulating the additive volumes of ethylenediamine and filler contents. Impressively, the composite aerogel with a doped nitrogen concentration of 6.5 wt% displayed the optimal minimum reflection loss of -62.3 dB at a matching thickness of 3.5 mm and the broadest effective absorption bandwidth of 5.1 GHz under an ultrathin thickness of merely 1.6 mm. Furthermore, the as-synthesized composite aerogels showed a light-weight characteristic with the low bulk density of 19.9-25.7 mg·cm-3. Additionally, the potential EMW absorption mechanisms of obtained composite aerogels were revealed, which were mainly ascribed to the unique 3D porous network structure, synergistic effects between conduction loss and polarization loss, as well as the balanced attenuation loss and impedance matching. This work could be valuable for the structural design and fabrication of 3D graphene-based dielectric composites as light-weight and high-efficiency EMW absorbers.

[Etiological Study of Late Onset Hemorrhagic Cystitis after Allogeneic Hematopoietic Stem Cell Transplantation in Children].

OBJECTIVE: To prospectively study the correlation BKV with the occurrence and development of late onset hemorrhagic cystitis (LOHC) after allogeneic hematopoietic stem cell transplantation(allo-HSCT). METHODS: The clinical data of a total of 276 patients with allo-HSCT in our department between January 1998 and March 2016 were analyzed ratrospectvely. Quantitative Real-time PCR assay was used to prospectively monitor the BKV DNA load of the urine and plasma for 23 patients accepting allo-HSCT from August 2015 to March 2016. RESULTS: LOHC(24.28%) occurred in 67 of 276 cases with allo-HSCT. Univariate analysis showed that age older than 6 years, different diseases, unrelated donor, pretreatment with BU, Ⅲ-Ⅳ aGVHD significantly correlated with LOHC. Multivariate analysis demonstrated that age older than 6 years (P<0.01), pretreatment with BU(P<0.05), and aGVHD of grade Ⅲ-Ⅳ （P= 0.011） were the independent risk factors for LOHC. Among 23 patients after allo-HSTC, 10 of which were positive of urine BKV, and LOHC occurred in 6 cases. The positive rate of urine BKV (85.7%)in group LOHC+ was significantly higher than that in the group LOHC-(25.0%）(χ2=5.043, P<0.01). The incidence of LOHC positively correlated with the positive rate of BKV (r=0.564, P<0.01), and the severity of LOHC positively correlated with urinary BKV load (r = 0.502, P<0.01). And 5 of 6 petriatic patients with LOHC had aGVHD. All of them were subject to the strengthened antiviral treatment, and 4 of them accepted intensive immunosuppression therapy. CONCLUSION: Age ≥6 years old, precenditioning regieme with BU and aGVHD of grade Ⅲ-Ⅳ are independent risk factors for LOHC after allo-HSCT, the positive rate of urine BKV load positively correlates with the severity of LOHC after allo-HSCT.

[Combination antifungal therapy for invasive fungal disease in children with hematologic disease].

OBJECTIVE: To evaluate antifungal combination strategy in children with hematologic diseases and invasive fungal disease( IFD). METHODS: A retrospective clinical study was performed based on 67 childhood patients with hematologic diseases and IFD who firstly accepted combination antifungal therapy for ≥ 7 days during January 2012 and December 2014. Of them, 11 cases received combination of echinocandin with azole, 10 cases received combination of echinocandin with amphotericin B, and 46 cases received combination of azole with amphotericin B. RESULTS: Overall response rate was 79.1%. Univariate analysis revealed that granulocyte recovery (P=0.031), status of underling disease (P=0.023) and the duration of the therapy (P=0.046) were significantly associated with efficacy. Multivariate analysis showed that the independent prognostic factor was the duration of combination antifungal therapy (OR=0.229, 95% CI 0.061- 0.863, P=0.029). The response rates of echinocandin combined with azole, echinocandin combined with amphotericin B and azole combined with amphotericin B were 81.8%, 60.0% and 82.6%, respectively (P>0.05), and 12-week survival rates were 81.8%, 80.0% and 86.5%, respectively (P>0.05). The drug- related adverse reactions occurred 59 times in 34 patients. BUN increasing, hypokalemia and abnormal liver functions were considered the main side effects. CONCLUSION: For IFD in children with hematologic disease, to extend the duration of treatment (≥ 14 days) could significantly improve the curative effect. Combinations of echinocandin with azole, echinocandin with amphotericin B and azole with amphotericin B can be used as a combination treatment options. Combination of Azole with amphotericin B is efficacious, safe and economic treatment option considering efficacy, survival rate, cost and dosage form.

Nurse-led cognitive screening model for older adults in primary care.

AIM: The present study aimed to establish a nurse-led cognitive screening model for community-dwelling older adults with subjective memory complaints from seven communities in Chongqing, China, and report the findings of this model. METHODS: Screenings took place from July 2012 to June 2013. Cognitive screening was incorporated into the annual health assessment for older adults with subjective memory complaints in a primary care setting. Two community nurses were trained to implement the screening using the Mini-Mental State Examination and Montreal Cognitive Assessment. RESULTS: Of 733 older adults, 495 (67.5%) reported having subjective memory complaints. Of the 249 individuals who participated in the cognitive screening, 102 (41%) had mild cognitive impairment, whereas 32 (12.9%) had cognitive impairment. A total of 80 participants (78.4%) with mild cognitive impairment agreed to participate in a memory support program. Participants with cognitive impairment were referred to specialists for further examination and diagnosis; only one reported that he had seen a specialist and had been diagnosed with dementia. CONCLUSIONS: Incorporating cognitive screening into the annual health assessment for older adults with subjective memory complaints was feasible, though referral rates from primary care providers remained unchanged. The present study highlights the urgent need for simple screenings as well as community-based support services in primary care for older adults with cognitive or mild cognitive impairments.

General practitioners' knowledge of ageing and attitudes towards older people in China.

AIM: To explore general practitioners (GPs)knowledge of ageing, attitudes towards older people and factors affecting their knowledge and attitudes in a Chinese context. METHODS: Four hundred GPs were surveyed using the Chinese version of the Aging Semantic Differential (CASD) and the Chinese version of the Facts on Aging Quiz (CFAQ1) scale. RESULTS: The CASD scores indicated that GPs had a neutral attitude towards older people. The CFAQ1 scores indicated a low level of knowledge about ageing. GPs' awareness of the mental and social facts of ageing was poorer compared to that of physical facts. Male GPs had a significantly higher negative bias score than female GPs. No other variables had a statistically significant influence on knowledge and attitudes. CONCLUSIONS: The findings suggest the need for education interventions for GPs regarding knowledge of ageing and also provide evidence to guide future development of continuing medical programs for this group of medical doctors.

[Effectiveness of mini incision and absorbable screw fixation for treatment of anterior cruciate ligament tibial eminence avulsion fracture].

OBJECTIVE: To investigate the effectiveness of open reduction by mini incision and absorbable screw internal fixation for the treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture. METHODS: Between January 2006 and July 2012, 90 patients (90 knees) with ACL tibial eminence avulsion fracture were treated. There were 58 males and 32 females, aged from 10 to 58 years with an average of 33.7 years. The causes of injury were traffic accident injury in 60 cases, sports injury in 22 cases, and fallinginjury in 8 cases. The disease duration was 1-365 days with a median of 106 days. Combined injuries included 14 cases of meniscus injury, 5 cases of medial collateral ligament injury, and 3 cases of avulsion fracture of the anterior horn of the lateral meniscus. All patients underwent open reduction by mini incision and internal fixation with absorbable screw. Postoperative rehabilitation exercise was performed. RESULTS: Two patients had delayed healing of incision, and others obtained primary healing. All the patients were followed up 6-72 months (mean, 40.1 months). X-ray examination showed that bone union was achieved in all patients at 3-12 months after operation; nail tail came off in 7 cases at 4-13 months after operation, and the nail tail was taken out under arthroscopy. At 6-12 months after operation, the range of motion (ROM), Tegner score, Lysholm score, and International Knee Documentation Committee (IKDC) score were significantly increased when compared with preoperative ones (P < 0.05). CONCLUSION: A combination of open reduction by mini incision and absorbable screw internal fixation for the treatment of ACL tibial eminence avulsion fracture has the advantages of easy operation, firm fixation, and satisfactory functional rehabilitation, so it is a safe and effective method for the treatment of ACL tibial eminence avulsion fracture.