[Quality assessment of global lung cancer screening guidelines and consensus].

Objective: To understand the research progress and quality of lung cancer screening guidelines and consensus in China and abroad, and to provide reference for the formulation of high-quality lung cancer screening guidelines in China. Methods: Databases including PubMed, Medline, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, SinoMed, VIP and Wanfang Data were searched, websites and important references were also searched by hand retrieval. The Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) were used to assess the quality of newly published or updated guidelines and consensus. Results: A total of 9 guidelines and consensus published between 2015 and 2020 were included in this study, with countries including the United States, China, Canada, Saudi Arabia and South Africa. The field of scope and purpose and clarity of presentation scored relatively high but the rigor of development and applicability scored low. Five guidelines were judged to be A-level, all of which were published abroad, and the remaining four were B-level, including three guidelines and consensus issued by China and 1 guideline issued by South Africa. The report rate of RIGHT were higher in basic information and background, lower in review and quality assurance, funding and declaration and management of interests. There were 5 guidelines with a good level and 4 guidelines and consensus with a moderate level. The best overall quality guidelines were those published by the American College of Chest Physicians in 2018 and by the Canadian Task Force on Preventive Health Care in 2016. Conclusions: The number of countries and institutions that issue lung cancer screening guidelines and consensus had been increasing gradually, but the quality in China remained low. It is necessary to develop high-quality lung cancer screening guidelines suitable for China's national conditions in combination with evidence-based methods to guide practice.

A simple program for fast tilting electron-beam sensitive crystals to zone axes.

Tilting crystals to proper zone axes is a necessary but tedious work in taking selected area electron diffraction patterns (SAED) and high-resolution images using transmission electron microscope (TEM). This process not only costs a lot of time but also limits the application of TEM in electron-beam sensitive materials. Therefore, it is desirable to develop a simple method for tilting crystals from random orientations to a specific zone axis quickly. Herein, we describe a novel program, Zones, which can index the electron diffraction pattern and calculate the tilting angles of a double-tilt sample holder from the current orientation to a desired zone axis. It can also bring crystals that are slightly deviated from a zone axis to the exact zone with the help of Laue ring in the diffraction pattern. This program has been successfully applied to studies of zeolites and metal-organic frameworks (MOFs), known as being electron-beam sensitive. The program shows its power not only in saving the operator's time but also in preventing the crystals from quick beam damages.

The household economic burden of non-communicable diseases in 18 countries

BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of death globally. In 2014, the United Nations committed to reducing premature mortality from NCDs, including by reducing the burden of healthcare costs. Since 2014, the Prospective Urban and Rural Epidemiology (PURE) Study has been collecting health expenditure data from households with NCDs in 18 countries. METHODS: Using data from the PURE Study, we estimated risk of catastrophic health spending and impoverishment among households with at least one person with NCDs (cardiovascular disease, diabetes, kidney disease, cancer and respiratory diseases; n=17 435), with hypertension only (a leading risk factor for NCDs; n=11 831) or with neither (n=22 654) by country income group: high-income countries (Canada and Sweden), upper middle income countries (UMICs: Brazil, Chile, Malaysia, Poland, South Africa and Turkey), lower middle income countries (LMICs: the Philippines, Colombia, India, Iran and the Occupied Palestinian Territory) and low-income countries (LICs: Bangladesh, Pakistan, Zimbabwe and Tanzania) and China. RESULTS: The prevalence of catastrophic spending and impoverishment is highest among households with NCDs in LMICs and China. After adjusting for covariates that might drive health expenditure, the absolute risk of catastrophic spending is higher in households with NCDs compared with no NCDs in LMICs (risk difference=1.71%; 95% CI 0.75 to 2.67), UMICs (0.82%; 95% CI 0.37 to 1.27) and China (7.52%; 95% CI 5.88 to 9.16). A similar pattern is observed in UMICs and China for impoverishment. A high proportion of those with NCDs in LICs, especially women (38.7% compared with 12.6% in men), reported not taking medication due to costs. CONCLUSIONS: Our findings show that financial protection from healthcare costs for people with NCDs is inadequate, particularly in LMICs and China. While the burden of NCD care may appear greatest in LMICs and China, the burden in LICs may be masked by care foregone due to costs. The high proportion of women reporting foregone care due to cost may in part explain gender inequality in treatment of NCDs. (AU)

[Studies on bone density in healthy girls during their period of growth spurt].

Bone mass in 69 healthy girls in their period of growth spurt was measured twice, with an interval of one year, by dual energy X-ray bone densitometer to study the relationship between changes in bone density and the speed of height growth, development of secondary sex characteristics and nutritional status. Results showed that bone density in the different sites in the period of growth spurt increased significantly with their age, but with difference in the magnitude of its increase and in the time. Their nutritional status (overweight or underweight) correlated closely with sex development and increase in bone density. It suggests that it is necessary to strengthen nutrient intake during their puberty for preventing from osteoporosis. In addition, early puberty is an important period for the increase in female bone density, as a result of comparison of bone mass between prepuberty girls and young women. The results in this study can provide reference for further studies on bone mass in girls during their puberty.

[The relationship between severe burn injury and systemic inflammatory response syndrome].

OBJECTIVE: To study course of systemic inflammatory response syndrome (SIRS). METHODS: The relationship was observed between SIRS and the effect of burn injury on cellular and humoral immunity between survivors. Nonsurvivors were also compared. The gastric mucosal pHi was measured. RESULTS: The SIRS initiated 22 hours after burn injury and peaked 3 days to 7 days postburn. Compared to the survivors significan increase of content of TNF and decrease of content of G-CSF were detected in the nonsurvivors serum. Obvious immunosuppression could be found. In patients with SIRS accompanied with infection or organ failure, marked increase of mortality was seen. The value of pHi was very low. CONCLUSION: Severe burn injury can lead to the release of massive inflammatory mediators. The second insult such as infection can further amplify the process leading to a vicious cycle of inflammation which cause tissue damage and immunosuppression. To prevent MODS, early diagnosis and treatment including organ supply, use of antibacterial agents, oxygen supply and immunity therapy were necesary.

[Management of deep facial burn with early postburn debridement and delayed skin grafting].

OBJECTIVE: To explore optimal methods of the management of deep facial burn, so as to prevent the development of facial scar hypertrophy and deformity. METHODS: Partial tangential excision, delayed skin grafting, early relief of the eyelid eschar and immediate skin grafting were carried out in burn patients with deep facial burn during the early postburn stage. RESULTS: The wounds in 12 cases had healed completely within 3 postburn weeks(PBW). Scar hypertrophy and facial deformity were not observed during the follow-up. All the patients could express natural facial expressions. CONCLUSION: Facial deep burn wound could be managed as soon as possible with early partial tangential excision and delayed skin grafting. As a result, facial scar hypertrophy and deformity could be avoided.

[Early enteral feeding and supplement of glutamine prevent occurrence of stress ulcer following severe thermal injury].

UNLABELLED: Gastroscopic and gastric juice analysis studies were carried out on 12 patients with total body surface area over 30 percent who received early enteral feeding, supplemented with glutamine. The results indicated that early feeding was safe in major burn patients. All patients were found to have ASML on postburn days 1 to 2. Stress ulcer was not found in patients after several excision operations, and about 86 percent of ASML disappeared within about 2 weeks. CONCLUSION: early feeding and supplement of glutamine can prevent the complication of stress ulcer following severe thermal injury.

Firm elevation of the auricle in reconstruction of microtia with a retroauricular fascial flap wrapping an autogenous cartilage wedge.

During conventional reconstruction of the auricle in patients with microtia, simply separating the auricle from the mastoid region with a full-thickness skin graft usually fails to create firm elevation and sufficient projection. To achieve frontal symmetry is difficult, and sometimes the normal auricle needs to be set back. We reconstructed the auricle in patients with microtia in two major stages using a modified Nagata's method. Using a wide W-incision skin flap, the first stage includes implantation of a cartilage framework and transposition of the ear lobule. Our modification lies in the second stage. Instead of using the superficial temporoparietal fascial flap, we elevated a retroauricular fascial flap from the mastoid region, turning it over to wrap an autogenous costal-cartilage wedge, and covered it with a full-thickness skin graft. Between June 1996 and May 1999, eight patients underwent this operation. All the fascial flaps and overlying full-thickness skin grafts survived well. The advantages of our technique include firm elevation, good frontal projection and a natural appearance of the posterior aspect of the ear. Additionally, by using this fast and practical procedure, we avoid creating additional scars on the scalp and preserve the superficial temporoparietal fascia and superficial temporal vessels.