Hepatic resection prolongs overall survival in the selected patients with nasopharyngeal carcinoma liver metastases.

BACKGROUND: The role of surgery in nasopharyngeal carcinoma liver metastases (NCLM) remains elusive, and the current application is limited. We aim to investigate whether hepatic resection (HR) of NCLM improves survival compared with non-hepatic resection (NHR) treatment. METHODS: One hundred and thirty-three patients with NCLM from 2007 to 2017 were divided into two groups. Propensity score matching (PSM) analysis was used to compare the clinical outcomes. RESULTS: After PSM the median overall survival (OS) and the 1, 3 and 5-year OS rates in HR group were 32.60 months, 86.2%, 37.3% and 37.3%, respectively; while for NHR group these values were 19.57 months, 61.5%, 12.9% and 2.9%, respectively (P = 0.008). Multivariate analysis indicated hepatitis B virus infection (P = 0.029) and hepatic resection (P = 0.018) were independent prognostic factors. CONCLUSION: Our study revealed that hepatectomy yields a survival benefit safely compared with systemic treatments, especially for patients with the size of largest metastasis < 5 cm, unilobar distribution of liver tumor and received unanatomical hepatectomy.

[Quantitatively evaluate the effects of precipitation and vegetation variation to flood under the condition of single rainstorm: A case study of Pengchongjian small watershed, Jiangxi, China]. / 场次暴雨条件下降雨和植被变化对洪水影响的定量评估­­ä»¥å½­å†²æ¶§å°æµåŸŸä¸ºä¾‹.

Precipitation and vegetation are two key factors affecting floods in the watershed. Quantitative evaluating their contribution to flood is of great scientific significance to vegetation construction and water resources management. Based on the geographic information data and hydrometeorological data from 1983 to 2014, we analyzed the characteristics of rainstorm and flood in Pengchongjian small watershed in red soil region of South China by Mann-Kendall test method, cumulative anomaly method and HEC-HMS model, and quantitatively evaluated the contribution rate of precipitation and vegetation variation to flood. The results showed that the rainstorm volume and total flood volume in Pengchongjian small watershed from 1983 to 2014 showed a non-significant upward/downward trend, respectively. HEC-HMS model had good simulation effect on single rainstorm flood, with the evaluation results being within the error range. The contribution rates of precipitation and vegetation variation of different rainstorm floods were different with respect to the total flood volume or to the peak flow. The average contribution rate of precipitation and vegetation variation to the total flood volume was 66.5% and 33.5%, while to the peak flow was 58.9% and 41.1%, respectively. Our results could provide scientific basis for flood evaluation, vegetation construction and comprehensive control of soil erosion in small watershed.

Rising challenge of multidrug-resistant tuberculosis in China: a predictive study using Markov modeling.

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is on the rise in China. This study used a dynamic Markov model to predict the longitudinal trends of MDR-TB in China by 2050 and to assess the effects of alternative control measures. METHODS: Eight states of tuberculosis transmission were set up in the Markov model using a hypothetical cohort of 100 000 people. The prevalence of MDR-TB and bacteriologically confirmed drug-susceptible tuberculosis (DS-TB+) were simulated and MDR-TB was stratified into whether the disease was treated with the recommended regimen or not. RESULTS: Without any intervention changes to current conditions, the prevalence of DS-TB+ was projected to decline 67.7% by 2050, decreasing to 20 per 100 000 people, whereas that of MDR-TB was expected to triple to 58/100 000. Furthermore, 86.2% of the MDR-TB cases would be left untreated by the year of 2050. In the case where MDR-TB detection rate reaches 50% or 70% at 5% per year, the decline in prevalence of MDR-TB would be 25.9 and 36.2% respectively. In the case where treatment coverage was improved to 70% or 100% at 5% per year, MDR-TB prevalence in 2050 would decrease by 13.8 and 24.1%, respectively. If both detection rate and treatment coverage reach 70%, the prevalence of MDR-TB by 2050 would be reduced to 28/100 000 by a 51.7% reduction. CONCLUSIONS: MDR-TB, especially untreated MDR-TB, would rise rapidly under China's current MDR-TB control strategies. Interventions designed to promote effective detection and treatment of MDR-TB are imperative in the fights against MDR-TB epidemics.

Comparison of hepatic resection and systemic treatment of breast cancer liver metastases: A propensity score matching study.

BACKGROUND: The role of surgery in breast cancer liver metastases (BCLM) remains elusive, and current application is limited. Our aim is to investigate whether hepatic resection (HR) of BCLM improves survival compared with non-hepatic resection (NHR) treatment. METHODS: Three hundred and eighty-four patients with BCLM from 2008 to 2018 were divided into two groups. Propensity score matching (PSM) analysis was used to compare the clinical outcomes. RESULTS: After PSM the mean overall survival (OS) and the 1, 3, and 5-year OS rates in HR group were 61.8 months, 92.6%, 54.7% and 54.7%, respectively; while for NHR group these values were 38.6 months, 79.2%, 45.6% and 21.9%, respectively (p < 0.007). Multivariate analysis indicated hormonal receptor status (p = 0.039) and hepatic resection (p = 0.032) were independent prognostic factors. CONCLUSION: Our study revealed that hepatectomy yields a survival benefit safely compared with medical treatments, especially for patients with positive hormonal receptors.

Acceptance of Chemo-prophylaxis for Latent Tuberculosis Infection among High School/College Student Contacts of Tuberculosis Patients in Shanghai, China.

Student contacts of tuberculosis (TB) cases are susceptible to latent tuberculosis infection (LTBI), and chemo-prophylaxis can reduce the risk of active TB among them. This study aimed to assess the acceptance of chemo-prophylaxis for LTBI among students, and their concerns regarding TB and its preventive treatment. A total of 560 students contacts were included in the investigation. The extent of contact was categorized from high to low (4 levels) with 12.9% of the students being close contacts. About 87.0% of the students were willing to receive chemo-prophylaxis if diagnosed with, LTBI, whereas 73 students declined. Students with a higher level of knowledge about TB (aOR = 1.11) or close contact with TB patients (aOR = 4.30) were more likely to accept treatment. To conclude, education regarding TB transmission is necessary. Moreover, LTBI detection should be integrated into the current school-based TB contact investigation.

Post-2015, why delay to seek healthcare? Perceptions and field experiences from TB healthcare providers in northern Malawi: a qualitative study.

BACKGROUND: Malawi is a low-income country with high Tuberculosis (TB) burden. TB diagnosis delay and untimely initiation of treatment is still a major problem in Malawi which could increase the risk of tuberculosis transmission in the communities. This study investigated factors related to the diagnostic delay of tuberculosis from TB healthcare providers in the northern region of Malawi. METHODS: Nine focus group discussions were conducted with 57 participants in total. The participants were healthcare cadres including district TB officers, clinical officers, TB nurses, laboratory technicians and Health Surveillance Assistants (HSAs). NVivo (11.0) software was used for data analysis. RESULTS: The factors related to diagnostic delay were categorized into three themes: client factors, institutional factors and healthcare provider related factors. Client's stigma and fear for HIV test, resource shortage within healthcare institutions and the healthcare workers' poor attitude against potential patients were among the most influential factors behind the TB diagnostic delay. CONCLUSIONS: The TB control strategies should aim to reduce HIV stigma, improve resource supply and improve TB healthcare workers' morale in order to achieve timely TB diagnosis.

[Compensation effects of regulated deficit irrigation and tillering interference to winter wheat].

Pot experiments were carried out to explore the approach of optimizing crop group performance through restriction of individual growth redundancy and increasing crop yield potential. Two winter wheat varieties of 'Xiaoyan-22' (with moderate tillering ability) and 'Zhengmai-7698' (with strong tillering ability) were chosen to investigate the effects of two irrigation schedules (full irrigation and regulated deficit irrigation) and three kinds of tillering interference (only retaining the main stem and the biggest tiller at jointing stage; removing all nonbearing tillers at heading stage; and without any interference as the control treatment). Thus, we simulated the compensation effects of different water supplies and unpredictable disturbances on the physiology, growth, yield, and water use efficiency of winter wheat. The results showed that there existed growth redundancy for both varieties. Compared with 'Xiaoyan-22', 'Zhengmai-7698' had relatively higher tillering number but weak panicle traits. Regulated deficit irrigation and removing all nonbearing tillers at heading stage could reduce growth redundancy, weaken competitive ability, change source-sink relations, and optimize resources allocation. However, excessive elimination of redundancy (e.g. only retaining the main stem and the biggest tiller at jointing stage) could destroy the inherent root-shoot balance and functional structure of plant and lead to inadequate compensation. In contrast to the control treatment (full irrigation and without any disturbance), the combination of regulated deficit irrigation and removing all nonbearing tillers at heading stage could help crops sufficiently exploit and utilize their own regulation potentials at spatial and temporal scales and finally realize compensation growth. The combination above could increase the water use efficiency by 20.4% - 25.4% without remarkable impact on grain yield, and hence, could be suitable for wheat growth redundancy reduction.

[Determination of the content of eight metal elements in enteral nutritional powder (VIVONEX) by microwave digestion-AAS].

Enteral nutritional powder (VIVONEX) is mainly used to provide nourishment for critical patients and those patients who have just undergone surgical operation. Microelements included in it exert significant influence on the patients' physical functioning. In the present paper, Enteral nutritional powder was digested with HNO3 by microwave digestion. After that, the content of eight metal elements in it, K, Na, Ca, Mg, Fe, Mn, Cu and Zn, was determined by FAAS. With the good linear correlations of standard curves (r = 0.999 2-0.999 8), the recovery (n = 6) ranging from 97% to 103%, and the RSD (n = 6) from 0.46% to 1.12%, the method can be applied to simultaneous determination of several metal elements in enteral nutritional powder, and offers advantages of low detection limit, high sensitivity, speediness and accuracy. The determination of metal elements in samples by this method gives satisfactory results. Hence, the method helps to guarantee quality control of this kind of medicine, and supplies statistical evidence for the safety of clinical drug use.