[Value of Head and Neck CT Angiography in the Clinical Evaluation of Intraoperative Bleeding Volume of Carotid Body Tumours].

Objective To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Methods Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. Results The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(P=0.019),the maximum diameter of tumours on axial images(P=0.003),the maximum upper and lower diameters(P=0.004),Shamblin classification(P=0.012),and number of blood supply arteries(P<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Conclusions Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.

Dosimetric Comparisons of Volumetric Modulated Arc Therapy and Tomotherapy for Early T-Stage Nasopharyngeal Carcinoma.

PURPOSE: To compare the dosimetric differences between volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) in treating early T-stage nasopharyngeal carcinoma (NPC). METHOD: Ten patients with early T-stage NPC who received tomotherapy using simultaneously integrated boost (SIB) strategies were replanned with VMAT (RapidArc of Varian, dual-arc). Dosimetric comparisons between the RapidArc plan and the HT plan included the following: (1) D98, homogeneity, and conformity of PTVs; (2) sparing of organs at risk (OARs); (3) delivery time and monitor units (MUs). RESULTS: (1) Compared with RapidArc, HT achieved better dose conformity (CI of PGTVnx + nd: 0.861 versus 0.818, P = 0.004). (2) In terms of OAR protection, RapidArc exhibited significant superiority in sparing ipsilateral optic nerve (Dmax: 27.5Gy versus 49.1Gy, P < 0.001; D2: 23.5Gy versus 48.2Gy, P < 0.001), contralateral optic nerve (Dmax: 30.4Gy versus 49.2Gy, P < 0.001; D2: 26.2Gy versus 48.1Gy, P < 0.001), and optic chiasm (Dmax: 32.8Gy versus 48.3Gy, P < 0.001; D2: 30Gy versus 47.6Gy, P < 0.001). HT demonstrated a superior ability to protect the brain stem (D1cc: 43.0Gy versus 45.2Gy, P = 0.012), ipsilateral temporal lobe (Dmax 64.5Gy versus 66.4 Gy, P = 0.015), contralateral temporal lobe (Dmax: 62.8Gy versus 65.1Gy, P = 0.001), ipsilateral lens (Dmax: 4.27Gy versus 5.24Gy, P = 0.009; D2: 4.00Gy versus 5.05Gy, P = 0.002; Dmean: 2.99Gy versus 4.31Gy, P < 0.001), contralateral lens (Dmax: 4.25Gy versus 5.09Gy, P = 0.047; D2: 3.91Gy versus 4.92Gy, P = 0.005; Dmean: 2.91Gy versus 4.18Gy, P < 0.001), ipsilateral parotid (Dmean: 36.4Gy versus 41.1Gy, P = 0.002; V30Gy: 54.8% versus 70.4%, P = 0.009), and contralateral parotid (Dmean: 33.4Gy versus 39.1Gy, P < 0.001; V30Gy: 48.2% versus 67.3%, P = 0.005). There were no statistically significant differences in spinal cord or pituitary protection between the RapidArc plan and the HT plan. (3) RapidArc achieved a much shorter delivery time (3.8 min versus 7.5 min, P < 0.001) and a lower MU (618MUs versus 5646MUs, P < 0.001). CONCLUSION: Our results show that RapidArc and HT are comparable in D98, dose homogeneity, and protection of the spinal cord and pituitary gland. RapidArc performs better in shortening delivery time, lowering MUs, and sparing the optic nerve and optic chiasm. HT is superior in dose conformity and protection of the brain stem, temporal lobe, lens, and parotid.

Development and Testing of a Reliable and Valid Patient-Needs Questionnaire for Breast Cancer Inpatients in China.

INTRODUCTION: Breast cancer patients are demanding more active roles in their care, especially in the initial diagnosis and treatment stages. At present, there is no suitable patient questionnaire that appropriately incorporates Chinese language, habits, and cultural differences. AIM: To develop and validate a patient-needs questionnaire for female breast cancer inpatients in China. MATERIALS AND METHODS: The questionnaire structure was based on Maslow's model and a modern medical model. In the first step, a focus group was used to design 125 questions, of which 64 constituted the initial questionnaire for item screening with a group of 115 hospitalized patients with breast cancer. Items were included or excluded based on the evaluation of eight statistical analysis. Ultimately, 38 items were selected and validated. The reliability and validity of the 38-item questionnaire were determined in a cohort of 323 patients. RESULTS: The scale was set up with the 38 selected items. The four primary areas were disease knowledge, medical environment, psychosocial parameters and sexual attitudes. Cronbach's coefficient was 0.959. The split-half reliability value was 0.935. Principal component factor analysis extracted four common factors. CONCLUSION: Our new questionnaire, designed to assess the care needs of Chinese inpatients with breast cancer is reliable, sensitive, effective, independent and representative. It can be used in medical practice as a tool for a more complete assessment of patients' needs.

Clinical utility of microRNA-378 as early diagnostic biomarker of human cancers: a meta-analysis of diagnostic test.

A meta-analysis was performed to evaluate the diagnostic value of miR-378 for detecting human cancers. Systematic electronic searches were conducted in PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang from the inception to January 15, 2016. We used the bivariate mixed effects models to estimate the combined sensitivity, specificity, PLRs (positive likelihood ratios), NLR (negative likelihood ratios), DORs (diagnostic odds ratios) and their 95% CI (confidence intervals) for assessing the diagnostic performance of miR-378 for cancers. Twelve studies were included in the meta-analysis, with a total number of 1172 cancer patients and 809 health controls. The overall estimated sensitivity and specificity were 0.75 and 0.74. The pooled PLR was 2.91, NLR was 0.34, DOR was 8.50, and AUC (Area Under the Curve) was 0.81. The subgroup analyses suggested that AUC for plasma-based is higher than serum-based. The overall diagnostic values of miR-378 in the present meta-analyses are moderate accurate for human cancers; The source of specimen has an effect on the diagnostic accuracy. The diagnostic value of serum-based was higher than that of plasma-based.

Prevalence of Depression Among College-Goers in Mainland China: A Methodical Evaluation and Meta-Analysis.

There are no proper statistics available to assess how much of a burden it is to them. This study was conducted to gauge the pooled prevalence and offer evidence in support of few prevention and regulation strategies. A methodical literature search was conducted with the help of the Web of Knowledge, PubMed, Chinese Web of Knowledge, Wanfang, and Chongqing VIP databases. Furthermore, articles published from 2000 to 2014, reporting about the estimated prevalence of depression among college students in mainland China, were covered as well. In this study, a meta-analysis was deployed to approximate the overall prevalence of depression among college-goers in mainland China. A total of 45 studies were conducted on 50,826 participants. The average pooled prevalence of depression was 30.39% (26.38-34.55%). Subgroup analyses showed that 29.45% (22.88-36.48%) were men and 28.65% (23.44-34.16%) were women. Furthermore, 28.10% (22.83-33.70%) were from the northern part and 32.44% (26.67-38.48%) were from the southern. The prevalence of depression was 30.45% (23.96-37.36%) for sample sizes of <500 subjects, 30.99% (25.08-37.23%) for samples with 500 to 1000 people, and 29.54% (33.32-37.33%) in case of samples with >1000 people. Publications between 2000 and 2006 showed a depression prevalence of 8.45% (22.34-35.00%), whereas 30.52% (21.30-40.61%) and 31.79% (27.31-36.45%) were the corresponding values according to publications during 2007 to 2011 and 2012 to 2014. The prevalence of depression among college students in mainland China had reached the world's epidemic level.

Re: ''laparoscopic vs open approach to resection of hepatocellular carcinoma in patients with known cirrhosis: systematic review and meta-analysis''.

Twaij and colleagues have carried out a meta-analysis of cohort studies to review the currently available literature comparing laparoscopic to open resection of hepatocellular carcinoma in patients with known liver cirrhosis. We congratulate and applaud their important work, but several important issues should be noted.

MicroRNA-433 inhibits cell proliferation in hepatocellular carcinoma by targeting p21 activated kinase (PAK4).

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. P21-activated kinase 4 (PAK4) has been identified as an oncogenic protein in a variety of cancers. However, the contribution and regulation of PAK4 in HCC remain poorly understood. In the present study, we found that inhibition of PAK4 expression by specific shRNA significantly attenuated HCC cell proliferation. Moreover, we show that microRNA-433 (miRNA-433) could directly target PAK4 through the miRNA-433 binding sequence at the 3'-UTR of PAK4 mRNA, and inhibit PAK4 protein expression. We further show that miRNA-433 expression was downregulated in HCC tissues and cell culture as well, which inversely correlated with PAK4 expression levels. Overexpression of miRNA-433 significantly suppressed the proliferation of HepG2 cells, while this effect was partially rescued by forced expression of PAK4 through restoring PI3K/AKT signaling in HepG2 cells. These findings will shed light on the roles and mechanisms of miRNA-433 in regulating HCC proliferation, and may benefit future development of therapeutics targeting miRNA-433 and PAK4 in HCC.

Relationship between red cell distribution width and serum uric acid in patients with untreated essential hypertension.

We assessed whether red cell distribution width (RDW) is associated with serum uric acid (UA) level in a group of 512 patients with newly diagnosed hypertension, recruited in Beijing. Patients were divided into high uric acid group and low uric acid group according to the median (334.9 µmol/L) of serum uric acid. Compared with the low uric acid group, the patients with high uric acid had higher red blood cell count (P < 0.001) and RDW (P = 0.032). The multiple linear regression analysis showed that RDW (P = 0.001) was positively correlated with uric acid level after the adjustment of related factors. Stepwise multiple logistic regression model confirmed that RDW (odds ratio: OR = 1.75) was independent determinants of high serum uric acid as well as sex (OR = 6.03), triglycerides (OR = 1.84), and Blood Urea Nitrogen (BUN, OR = 1.30). RDW may be independently associated with serum UA level in patients with newly diagnosed hypertension. To firmly establish the causal role of RDW in the incidence of high uric acid level among hypertensive patients, large cohort studies are needed.

[Effects and mechanisms of punicosides on acute alcoholic liver damage in mice].

OBJECTIVE: To evaluate the protective effects of punicosides on alcohol induced acute liver injury in mice and its possible mechanisms as well. METHOD: The 60 mice were randomly divided into normal control, model group, three dose groups of punicosides with low, medium and high, then there is silibinin group. Three dose groups of punicosides and silibinin were given in advance by gavage for 4 weeks, then the mouse model of alcoholic acute liver injury was established. The serum levels of ALT, AST and TG were determined, and the mice were killed to calculate somatic index of liver, thymus as well as spleen. MDA, SOD, GSH-Px and GSH-ST were detected in the liver homogenate. Histopathological changes of the liver were observed by HE staining. The expression of MCP-1 and NF-kappaB in the liver tissues were detected by immunohistochemistry. RESULT: Mid and high dose of punicosides reduced the liver index in mice significantly, improved liver steatosis, decreased the level of ALT, AST and TG in serum and the content of MDA in liver homogenate, furthermore the two dose groups increased the activity of SOD, GSH-Px and GSH-ST, inhibited the expression of MCP-1 and NF-kappaB in liver tissue. CONCLUSION: Punicosides can protect the acute liver damage induced by alcohol.

Prevalence of suicidal ideation in Chinese college students: a meta-analysis.

BACKGROUND: About 1 million people worldwide commit suicide each year, and college students with suicidal ideation are at high risk of suicide. The prevalence of suicidal ideation in college students has been estimated extensively, but quantitative syntheses of overall prevalence are scarce, especially in China. Accurate estimates of prevalence are important for making public policy. In this paper, we aimed to determine the prevalence of suicidal ideation in Chinese college students. OBJECTIVE AND METHODS: Databases including PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang (Chinese database) and Weipu (Chinese database) were systematically reviewed to identify articles published between 2004 to July 2013, in either English or Chinese, reporting prevalence estimates of suicidal ideation among Chinese college students. The strategy also included a secondary search of reference lists of records retrieved from databases. Then the prevalence estimates were summarized using a random effects model. The effects of moderator variables on the prevalence estimates were assessed using a meta-regression model. RESULTS: A total of 41 studies involving 160339 college students were identified, and the prevalence ranged from 1.24% to 26.00%. The overall pooled prevalence of suicidal ideation among Chinese college students was 10.72% (95%CI: 8.41% to 13.28%). We noted substantial heterogeneity in prevalence estimates. Subgroup analyses showed that prevalence of suicidal ideation in females is higher than in males. CONCLUSIONS: The prevalence of suicidal ideation in Chinese college students is relatively high, although the suicide rate is lower compared with the entire society, suggesting the need for local surveys to inform the development of health services for college students.

Relationship between red blood cell distribution width and early-stage renal function damage in patients with essential hypertension.

BACKGROUND: Red cell distribution (RDW) has been suggested to be associated with cardiovascular mortality and mortality. However, few studies have yet investigated the possible association between RDW and early-stage renal function damage in patients with primary hypertension without receiving drug treatment. Accordingly, the aim of the present study was to evaluate early-stage renal function status in patients with RDW levels. RESULTS: The study included 513 primary hypertension patients (319 men and 194 women) without receiving drug treatment. Significant positive correlation was observed between albumin-to-creatinine ratio (ACR) and RDW in hypertensive patients (r = 0.531, P < 0.001). In multivariate line regression analysis, night-time SBP (B = 0.042, P < 0.001), ACR (B = 0.005, P < 0.001), and uric acid (B = 0.001, P = 0.022) were positive predictors of RDW independent of age, sex, hemoglobin, and other indexes, whereas daytime SBP (B = -0.019, P < 0.001) was inversely associated with RDW. The receiver operating characteristics curves (ROC) explored the relationship between renal function status and RDW, estimated glomerular filtration rate (eGFR), serum creatinine, and high-sensitivity C-reactive protein. The area under the curve was 0.81 (95% CI: 0.77-0.85; P < 0.001), 0.45 (95% CI: 0.39-0.50; P = 0.049), 0.49 (95% CI: 0.43-0.54; P = 0.583), and 0.49 (95% CI: 0.44-0.55; P = 0.811), respectively. Using a cutoff point of 12.8, the RDW predicted renal function status (ACR) with a sensitivity of 76% and a specificity of 70%. CONCLUSION: RDW, as an easy and quick measurable index, can predict early-stage renal function damage in essential hypertensive patients without receiving drug treatment.

[Primary risk factors of hepatitis E virus infection:a meta-analysis].

OBJECTIVE: To analyze the main risk factors of hepatitis E virus infection. METHODS: Literatures published in China and abroad about the risk factors on the transmission of HEV were searched. HEV, risk factors, epidemiology and case-control were used as keywords to retrieve papers in Chinese literature databases including CNKI, Wanfang and SinoMed databases. The same strategy was used to retrieve English papers in English literature database including EBSCO and PubMed databases, supplemented by literature tracing method. Time range was from January 1994 to December 2012. A total of 258 papers were collected. Stata 11.0 software was used to calculate combined odds ratio (OR) and 95% confidence internals (CI). RESULTS: A total of 21 studies was included in this Meta-analysis, which contained 3566 cases and 14 724 controls. The results of univariate analysis including OR (95%CI) : Dining out: 2.13 (1.62-2.81), consumption of aquatic products: 2.21 (1.76-3.31), unboiled water: 2.04 (1.13-3.71), not washing hands before meals:1.72 (1.07-2.77), common health facilities: 2.53(1.73-3.70), touching animals:2.00 (1.58-2.52), consumption of contaminated food:1.56 (1.18-2.05), contacting with patients: 2.33 (1.92-2.83), drinking alcohol: 2.56 (1.42-4.63) and gender (male):1.64 (1.15-2.33). The results of multivariate analysis including OR (95%CI) : Dining out: 2.04 (1.68-2.48), consumption of aquatic products: 2.31(1.70-3.15), unboiled water: 1.43 (1.10-1.85), not washing hands before meals: 2.01 (1.46-2.77), common health facilities: 2.28 (1.48-3.51), consumption of contaminated food: 2.16 (2.06-2.26), touching animals: 2.17 (1.55-3.04), contacting with patients: 2.32 (1.68-3.21), drinking alcohol: 1.66 (1.31-2.10) and gender (male): 1.67 (1.46-1.92). CONCLUSION: The independent risk factors of HEV infection were dining out, consumption of aquatic products, unboiled water, not washing hands before meals, common health facilities, touching animals, consumption of contaminated food, contacting with patients, drinking alcohol and gender (male).