ObjectiveTo investigate the status of undernutrition, nutritional risk as well as nutritional support in patients with gastrointestinal tumor. MethodsIn this prospective cohort study, patients with gastrointestinal tumor were recruited from Septemper 2009 to June 2011. Patients were screened by using Nutritional Risk Screening 2002 (NRS2002) at admission. Data of the nutritional risk, application of nutritional support, complications, and tumor staging were collected. ResultsNine hundred and sixty-one patients with gastrointestinal tumor were recruited, the overall prevalence of nutritional risk was 38.9% (374/961) at admission, 49.2% （176/358） in gastric tumor and 32.8% （198/603） in colorectal tumor, respectively. The highest prevalence was found in stage Ⅳ gastric tumor 〔87.3% (48/55)〕 and colorectal tumor 〔58.8% (50/85)〕 while the lowest prevalence was found in stage ⅡA gastric tumor 〔16.1% (5/31)〕 and stageⅠcolorectal tumor 〔9.8% (6/61)〕. 62.3% (152/244) of gastric tumor patients with nutritional risk while 48.6% (144/296) without nutritional risk received nutritional support. 37.7% (92/244) of colorectal tumor patients with nutritional risk while 51.4% (152/296) without nutritional risk received nutritional support. The ratio of parental nutrition and enteral nutrition was 1.251. The rate of complications in the gastrointestinal tumor patients with nutritional risk was higher than that in the patients without nutritional risk 〔32.4% (121/374) versus 20.4% (120/587), P=0.000 0〕. For the gastrointestinal tumor patients with nutritional risk, the complication rate of the patients with nutritional support was significantly lower than that of the patients without nutritional support 〔27.5% (67/244) versus 40.8% (53/130), P=0.008 6〕. For the gas trointestinal tumor patients without nutritional risk, the complication rate of gastric tumor patients with nutritional support was significantly lower than that of the patients without nutritional support (P=0.039 6), while the complication rate was not significantly different in the colorectal tumor patients with nutritional support or not (P=0.464 7). ConclusionsPatient with gastrointestinal tumor has a high nutritional risk which is related to tumor staging. Patients with nutritional risk have more complications, and nutritional support is beneficial to the patients with nutritional risk by a lower complication rate.
Objective To investigate the incidence and risk factors associated with the development of retinopathy of prematurity (ROP) in Hubei province. MethodsFrom July 2009 to May 2011, 313 premature infants (626 eyes) with gestational age less than 37 weeks were examined by indirect ophthalmoscopy and RetCamⅡ as part of ROP screening.Two hundred infants were male and 113 were female. Their birth weight was from 890 to 3500 grams, with a mean of (1977.37±497.03) grams. Their gestational age was from 26 to 37 weeks, with a mean of (33.13±2.44) week. The infants were divided into ROP group and non-ROP group according to the results of screening. All infants were followed up until retinopathy was stable or received laser therapy as the requirements of prevention and control guidelines of ROP. The sex, gestational age, birth weight, delivery mode, IVF baby, multiple pregnancy, oxygen therapy, intrauterine hypoxia, eclampsia, threatened abortion, oxygen history of infants, respiratory distress syndrome, hypoxicischemic encephalopathy, jaundice, and blueray radiation therapy in two groups were statistically analyzed. ResultsIn 313 infants (626 eyes), ROP developed in 52 infants (16.61%) and 87 eyes (13.90%), which including 2 eyes suffering from AP-ROP, 38 eyes from stage 1, 36 eyes from stage 2, 11 eyes from stage 3. There were 261 infants (83.39%) and 539 eyes (8610%) in nonROP group. Eleven infants (20 eyes) received laser therapy. The results of statistical analysis showed that gestation age(t=-4.348), birth weight (t=-3.966), oxygen therapy (χ2=9.05;OR=3.403, 95%CI=1.475 - 7.854) were significantly related to ROP (P＜0.05).ConclusionThe incidence of ROP in Hubei province is 16.61%. The gestation age, birth weight and oxygen therapy are closely related to the occurrence of ROP.
ObjectiveTo provide reference for further treatment by analyzing the relationship between mutant genes of breast cancer and histological classification and molecular typing of breast cancer.MethodsRetrospectively collectted the pathological specimens of 46 breast cancer patients who treated by the Dongguan Maternal and Child Health Hospital and the Dongguan Houjie Hospital between February 2016 and August 2017 without chemotherapy. Among the selected 46 breast cancer patients, we detected tumor tissue estrogen receptor (ER)/ pregnancy hormone receptor (PR)/human epidermal growth factor receptor-2 (HER-2) status by immunohistochemistry and classified the pathological tissue section. By using multiple PCR techniques, we detected 207 hot mutation regions of the 50 extended tumor-related genes on the semiconductor sequencing platform.ResultsThere were 8 cases of grade Ⅰ, 18 cases of grade Ⅱ, 20 cases of grade Ⅲ in 46 breast cancer patients according to histological grade. Of the 46 cases, there were 23 cases of Luminal B, 9 cases of Luminal A, 9 cases of HER-2 (+), 5 cases of type besal-like according to ER/PR/HER-2 expression status. Moreover, we found that there were 33 gene locus mutations of 8 genes, including AKT1, APC, BRAF, CDKN2A, KRAS, PTEN, PIK3CA, and TP53. Among of them, the mutation of PIK3CA gene took the most of 24 cases, followed by TP53 (18 cases), 2 cases of CDKN2A gene mutation, and 1 case in the remaining four types of genes respectively. we found that the gene mutations of breast cancer were not related to the histological classification and molecular type (P>0.05), the PIK3CA gene mutation was related to the histological classification of breast cancer, the lower the histological classification level, the higher PIK3CA gene mutation rate (P<0.05). TP53 gene mutation was not related to histological grading and molecular type (P>0.05).Conclusions The PIK3CA gene mutation rate in patients with histological grading Ⅰ level increased significantly. The combination of PIK3CA gene mutation and histological grading of breast cancer may become a molecular biological indicator to judge the degree of malignancy and prognosis of breast cancer.
Objective To compare the economic effectiveness of universal screening, high-risk population screening, and no screening strategies for thyroid disease prevention and control among pregnant women in China through cost-effectiveness analysis, providing evidence-based support for optimizing health policy decisions on prenatal thyroid disease screening. Methods Based on the characteristics of thyroid disorders during pregnancy, a combined decision tree and Markov model was developed to conduct a lifetime cost-effectiveness analysis across three strategies: no screening, high-risk population screening, and universal screening. Sensitivity analyses were performed on key parameters. Results Base-case analysis demonstrated that universal screening was the most cost-effective strategy when the World Health Organization (WHO)-recommended payment threshold of 1×gross domestic product (GDP) per capita was used, with an incremental cost-effectiveness ratio (ICER) of 20636.18 yuan per quality-adjusted life year (QALY) compared to no screening, followed by high-risk population screening (ICER=21071.71 yuan/QALY). The results of the sensitivity analysis showed a strong stability of the model. Conclusions Of the 3 screening programs for thyroid disease in pregnancy, universal screening is the most cost-effective when the WHO-recommended payment threshold of 1×GDP per capita is used.
Objective To summarize the nutritional assessment methods for liver cancer patients and their development, and to provide reference for rationally nutritional assessment and nutritional support. Method Domestic and foreign literatures were searched to summarize the nutritional assessment methods for liver cancer patients and their development, in order to determine a practical and feasible assessment method. Results The evaluation validity of traditionally nutritional assessment methods which contained many individual indicators was low. But subjective global assessment (SGA), mini nutritional assessment (MNA), and nutritional risk screening 2002 (NRS-2002) had similar evaluation validity, this 3 kinds of nutritional assessment methods were more suitable for liver cancer patients compared with the traditionally nutritional assessment methods. Conclusion The clinician should simultaneously apply SGA, MNA, NRS-2002, and other comprehensively nutritional assessment methods, as well as related anthropometric and laboratory indexes, to get a more accurate assessment of the nutritional status for patients with liver cancer.
Objective To study the prevalence of combined pulmonary fibrosis and emphysema (CPFE) in a community-based lung cancer screening program in Shanghai. Methods From June 2018 to July 2019, eligible participants who were assessed through a high-risk lung cancer questionnaire in Xuhui, Shanghai underwent low-dose computed tomography of the lungs. The suspected CPFE patients were invited to provide medical history and blood for analysis, and received high-resolution CT (HRCT) scanning for confirmation. Results Of the 15 cases of suspected CPFE from a total of 4478 participants in which 1704 males and 2774 females, 4 declined further examination and 11 received further examine. Eight subjects were confirmed as CPFE, and all were male, of whom two were ex-smokers and six were active smokers. These CPFE patients had cough, chest tightness and dyspnea. There were 3 cases of centrilobular emphysema, 2 cases of paraseptal emphysema, 1 case of panlobular emphysema and 2 cases of mixed emphysema. There were 2 cases of usual interstitial pneumonia, 3 cases of non-specific interstitial pneumonia, 2 cases of airspace enlargement with fibrosis and 1 case of unclassifiable smoking-related interstitial fibrosis. The KBILD scores were 61.7±7.5 and mMRC scores were 1.5±0.8. Serum Krebs von den Lungen-6 concentration was (380.75±212.05)U/mL. Lung function test showed normal or mild restrictive ventilatory function, and mild-moderate impairment in diffusion capacity. Conclusions The prevalence of CPFE is 1.79‰ in a community-based lung cancer screening population, and is 4.69‰ in male lung cancer screening population.
In order to solve the current problems in medical equipment maintenance, this study proposed an intelligent fault diagnosis method for medical equipment based on long short term memory network(LSTM). Firstly, in the case of no circuit drawings and unknown circuit board signal direction, the symptom phenomenon and port electrical signal of 7 different fault categories were collected, and the feature coding, normalization, fusion and screening were preprocessed. Then, the intelligent fault diagnosis model was built based on LSTM, and the fused and screened multi-modal features were used to carry out the fault diagnosis classification and identification experiment. The results were compared with those using port electrical signal, symptom phenomenon and the fusion of the two types. In addition, the fault diagnosis algorithm was compared with BP neural network (BPNN), recurrent neural network (RNN) and convolution neural network (CNN). The results show that based on the fused and screened multi-modal features, the average classification accuracy of LSTM algorithm model reaches 0.970 9, which is higher than that of using port electrical signal alone, symptom phenomenon alone or the fusion of the two types. It also has higher accuracy than BPNN, RNN and CNN, which provides a relatively feasible new idea for intelligent fault diagnosis of similar equipment.
ObjectiveTo summarize the research progress of patient-derived organoid (PDO) and patient-derived xenograft (PDX) models in preclinical drug screening for gastric cancer, aiming to provide a new perspective for precise drug screening and promote the application of personalized medicine and precision medicine for gastric cancer. MethodA literature review was conducted on the use of PDO and PDX models in the basic research and preclinical drug screening for gastric cancer. ResultsThe PDO and PDX models of gastric cancer exhibited a higher tumor biological simulation capability and a relatively accurate preclinical drug response prediction. However, they each have some certain limitations. The advent of organoid models based on xenografting, which combines the advantages of both, is expected to compensate for their respective shortcomings. These models can better reflect the heterogeneity of patients’ tumors and have unique advantages in the evaluation of new targeted drugs for specific molecular targets in gastric cancer, such as epidermal growth factor receptor. They show a certain correlation with the actual clinical response of patients, paving a new way for the development of new drugs, the study of drug action and resistance mechanisms, and personalized therapy. ConclusionPDO and PDX models, as a highly promising research platform, show a great potential in the screening of anti-tumor drugs and the development of personalized medical strategies.
ObjectiveTo summarize the current status and progress of nutritional support therapy for pancreatic cancer in order to improve the understanding of the impact of nutritional support treatment on pancreatic cancer and guide clinical work.MethodThe literatures about nutritional support and chemotherapy for pancreatic cancer at home and abroad were read and reviewed.ResultsFor most patients with malignant pancreatic tumors, nutritional risk or malnutrition might accompany them for a lifetime. Regular nutritional risk screening, timely nutritional assessment and necessary nutritional treatment played an extremely important role in the process of comprehensive anti-tumor treatment.ConclusionAlthough there are still some core problems to be solved in nutritional support therapy and chemotherapy for pancreatic cancer, its efficacy is gradually recognized and widely used by clinical workers, which might be helpful to improve the prognosis of patients with pancreatic cancer.
Objective To overview the characteristic in development and progress of retinopathy of prematurity (ROP). Method Six hundred and thirty eight premature birth infants with birth weight less than 2000 grams born or hospitalized in three hospitals in Guangdong province were examined by indirect ophthalmoscopy as part of ROP screening. 1172 eyes in 586 infants are included. Follow-up has not been completed in 52 infants. The first time of screening was 4 to 6 weeks after birth or 32 weeks corrected for gestational age. Threshold and pre-threshold (type I) disease was treated by laser photo-coagulation within 48 hours. All infants were followed until complete vascularization, natural regress or for more than 1 month after effective therapy. Data regarding incidence of ROP, corrected gestational age and days after birth of ROP onset, corrected gestational age and days after birth of getting treatment, progress pace and prognosis were collected and analyzed by Spearman statistical analyses. ResultsIn 1172 eyes, ROP developed in 118 eyes (10.07%). In 1054 eyes (89.93%) were completed vascularized. Sixty eyes received laser treatment. In ROP infants, the median gestational age was 29.3 weeks and the median corrected gestational age and days after birth when ROP develops were 36.4 weeks and 59.5 days respectively. There was a negative correlation between gestational age and ROP development and treatment timing （R=-0.65,-0.80；P=0.000）.The median interval days from stage 1 to stage 2, from stage 2 to stage 3, and stage 3 to getting treatment were 14.0, 10.5 and 3.0 days respectively. The interval showed a nonnormal distribution and there is statistical difference （H=30.69，P=0.000）.During the follow-up after treatment, the ocular fixation and following reactions were normal. The structure of optic disc, the macula lutea and retina were normal. ConclusionsTiming of ROP development is about 36.4 weeks corrected for gestational age and 37.5 weeks when treated. The interval is shorter when ROP progresses.The prognosis is good for the treatment of aular.
