[Value of perineural invasion in prostatectomy specimen in the assessment on tumor progression and prognosis].

OBJECTIVE: To assess perineural invasion in prostatectomy specimen(PNIp)on tumor progression and prognosis after radical prostatectomy. METHODS: Retrospective analysis including 502 prostate cancer patients admitted in Renji Hospital, School of Medicine, Shanghai Jiaotong University from December 2002 to May 2014 was studied.Differences of serum prostate specific antigen(PSA), Gleason score of prostate biopsy, Gleason score of prostatectomy specimen, tumor stage, capsular invasion, positive surgical margin, seminal invasion, pelvic lymph node metastasis, nadir PSA were analyzed in patients with PNIp and without PNIp. Logistic regression analysis, Log-rank test and Cox regression analysis was used to analyzed the data, respectively. RESULTS: There were 91 patients with PNIp(18.1%) and 411 patients without PNIp(81.9%). Differences of serum PSA, Gleason score of prostate biopsy, Gleason score of prostatectomy specimen, tumor stage, capsular invasion, seminal invasion, nadir PSA between the two groups were found(all P<0.05). In the multivariable logistic regression analysis, PNIp was independent predictor of Gleason score of prostate biopsy, Gleason score of prostatectomy specimen, tumor stage, capsular invasion(OR=1.515, 1.955, 2.069, 1.859, all P<0.05). One hundred and twenty-one patients with biochemical serum recurrence(26.7%). Serum PSA, Gleason score of prostate biopsy, Gleason score of prostatectomy specimen, tumor stage, PNIp, seminal invasion were related to biochemical serum recurrence(P<0.05). In the multivariable cox regression analysis, serum PSA, Gleason score of prostate biopsy, PNIp, seminal invasion were independent predictors of biochemical serum recurrence(HR=1.021, 1.441, 1.663, 3.257, all P<0.05). CONCLUSION: PNIp is the important predictor of the tumor progression and prognosis of prostate cancer.

Occurrence of fumonisins and aflatoxins in cereals from markets of Hebei Province of China.

Fumonisins B1, B2 and B3 (FB1, FB2 and FB3) and aflatoxins B1 (AFB1), B2 (AFB2), G1 (AFG1) and G2 (AFG2) are both major mycotoxins of food concern, because of their wide range of concentration and possible co-occurrence. Therefore, a contamination survey in corn and wheat flour by liquid chromatography-tandem mass spectrometry was carried out. Quantification of fumonisins and aflatoxins was based on internal calibration (by the use of ¹³C34-fumonisin) and external calibration, respectively. Fumonisins were detected in 95% of corn samples and in 7% of wheat flour samples, with the mean level (FB1 + FB2 + FB3) of 441 µg kg⁻¹ and 0.09 µg kg⁻¹, respectively. Low levels of aflatoxins were detected in 37% of the samples with a mean level (B1 + B2 + G1 + G2) of 0.12 µg kg⁻¹. Fumonisins and aflatoxins were not detected in 29% of the samples analysed. Simultaneous occurrence of fumonisins and aflatoxins was observed in 12% of samples.

Ethyl carbamate levels in wine and spirits from markets in Hebei Province, China.

Ethyl carbamate (EC) in wine, grain spirits and wine sauce (145 samples) was analysed using solid-phase extraction and stable isotope dilution GC/MS. Samples were obtained from markets in eight areas (Shijiazhuang, Baoding, Handan, Qinhuangdao, Langfang, Zhangjiakou, Xingtai and Cangzhou) of Hebei Province, China. The method had a limit of detection of 2 µg kg⁻¹, with recoveries varying from 95.7 to 102% and RSD ranging 2.3-5.6%. The average concentrations of ethyl carbamate in wines, grain spirits and wine sauce were 14.7 (<2.0-44.5) µg kg⁻¹, 33.8 (2.9-129) µg kg⁻¹ and 8.7 (<2.0-63.3) µg kg⁻¹, respectively. The results led to the development of limit standards that can be used to predict the concentration of ethyl carbamate in Chinese fermented wines.

Analysis of care-seeking pathways of tuberculosis patients in Guangxi, China, with and without decentralised tuberculosis services.

SETTING: Tuberculosis (TB) care has been decentralised to township hospitals in a rural, poor area of Guangxi, China, since 1 April 2005. Routine county-based TB care was provided in a comparable control area. OBJECTIVE: To compare patients' care-seeking behaviours between the intervention and control groups. METHODS: In February 2007, all 230 new pulmonary TB smear-positive patients registered in the intervention and control groups between 1 April 2005 and 31 July 2006 were approached; of these, 171 were surveyed using a structured questionnaire. Their patient records were reviewed to minimise recall bias. RESULTS: Patients in the intervention group spent less for treating TB symptoms prior to TB diagnosis compared with the control group (P < 0.01). Travel costs were lower in the intervention than control group, but the difference was not statistically significant (P > 0.05). Diagnostic delays for patients in the intervention and control groups were respectively 26 and 38 days (t = -0.835, P> 0.05). Logistic regression suggested that visiting county general hospitals tended to prolong patient diagnostic delay and cost more before TB diagnosis. CONCLUSION: Decentralising TB services to township hospitals brought TB care closer to rural patients, shortened TB patient care-seeking pathways and reduced costs before TB diagnosis.

[Functional assessment of infiltrating immunocytes in patients with primary hepatocellular carcinoma after percutaneous microwave coagulation therapy].

OBJECTIVE: To assess the function local immune cells in patients with primary hepatocellular carcinoma (HCC) after percutaneous microwave coagulation therapy (PMCT). METHODS: Thirty-eight patients with histologically proved primary HCC underwent ultrasound guided PMCT. Specimens were taken from the lesion site before and 17 days after PMCT respectively using 18-guage core needle through US-guide biopsy, embedded in paraffin, and stained by immunohistochemistry. The panel of monoclonal antibodies of CD3, CD56, CD68 and Fas-L were used to detect the CD3+, CD56+, CD68+ cells and T lymphocyte Fas-ligand. The positive cells were detected under light microscopy. Their diameter and area and the Fas-L expression rate of T lymphocytes and changes of secondary lysosomes in macrophages were measured by computer. RESULTS: Before PMCT, only a few infiltrating immunocytes were seen in the tumor specimens; the diameter of most CD3+ and CD56+ cells was less than 10 microns and the diameter of CD68+ cells was less than 18 microns. The amount and volume of CD3+, CD56+, and CD68+ cells significantly increased after PMCT (t = 3.48, P = 0.025 for CD3+ cells, t = -4.76, P = 0.000 for CD56+ cells, and t = -2.46, P = 0.028 for CD68+ cells). The percentage of CD3+ and CD56+ cells with the largest diameter > 10 microns increased from 10.4% and 20.1% respectively before PMCT to 24.9% and 30.2% respectively after PMCT. The percentage of CD68+ cells with the largest diameter > 18 microns increased from 10.2% before PMCT to 33.4% after PMCT. The Fas-l expression rate of T lymphocytes increased from 7.2% to 20.1% (t = -19.12, P = 0.000). The secondary lysosomes and cellular debris within microphages and the cellular organs in T lymphocytes significantly increased. CONCLUSION: The function of intratumaral infiltrating immunocytes is significantly enhanced after PMCT.

[Social economical status, behaviors and environment as the risk factors of tuberculosis in Chengdu China].

OBJECTIVE: To study the risk factors of pulmonary tuberculosis in Chengdu, Southwest China. METHODS: A population-based case-control study was used which included 174 cases selected from 12 communities in Chengdu and 174 controls selected from registered population with normal chest radiograph. Cases were active TB patients which were matched for age, sex with controls, then interviewed by trained interviewers using a standardized questionnaire. RESULTS: Social economic status measured by education, occupation and income did not show obvions influence to TB; It found that the active smoking, passive smoking, type of cigarettes and alcohol consumption had no significanct effects on TB during logistic regression analysis. The study showed that a person who was smoking and also alcohol intake had a higher risk to get TB (OR = 6.12, 95% CI = 1.15 - 32.49). Significant association was showed in the Dose-Response Analysis (OR = 1.37, 95% CI = 1.30 - 2.30). Crowded living space (OR = 1.14, 95% CI = 1.05 - 1.25), degree of darkness (OR = 2.18, 95% CI = 1.11 - 4.27) and moisture (OR = 4.06, 95% CI = 2.25 - 7.33), poor sanitary (OR = 3.03, 95% CI = 1.22 - 4.44), airpollution of working environment, which were filled with dusts (OR = 2.35, 95% CI = 1.18 - 4.70) and chemical fumes (OR = 5.15, 95% CI = 1.44 - 18.40) were strongly associated with pulmonary tuberculosis. BMI also had strong relationship with TB (OR = 4.72, 95% CI = 2.68 - 8.33). CONCLUSION: Poor environment and exposure to dust and chemical fume under working condition, low BMI, smoking combining alcohol consumption were the risk factors of adult pulmonary tuberculosis in Chengdu, China.

Bioequivalence of generic and brand-name levothyroxine products in the treatment of hypothyroidism.

OBJECTIVE: To compare relative bioavailability of Synthroid, Levoxine (Levoxine has been renamed Levoxyl), and 2 generic levothyroxine sodium preparations. DESIGN: Single-blind (primary investigators blinded), randomized, 4-way crossover trial. SETTING: Ambulatory care. PATIENTS: Twenty-two women with hypothyroidism who were clinically and chemically euthyroid and were receiving levothyroxine sodium, 0.1 or 0.15 mg. INTERVENTIONS: All patients received each of the 4 levothyroxine products for 6-week periods in the same dosage as their prestudy regimen with no washout period. The order of the drug sequences was randomly determined before study initiation. MAIN OUTCOME MEASURES: Area under the curve, time to peak serum concentrations, and peak serum concentrations of thyroxine, triiodothyronine, and free thyroxine index for all 4 products. RESULTS: All data analyses were completed prior to unblinding of the product codes. No significant differences between the 4 products were found in area under the curve or peak serum concentrations of total thyroxine, total triiodothyronine, or free thyroxine index. Although Synthroid produced a more rapid rise in total serum triiodothyronine concentration and a higher total peak serum triiodothyronine concentration than the other products, these differences were not statistically significant (P=.08). The Food and Drug Administration criterion for relative bioequivalence within 90% confidence intervals (0.8-1.25) was demonstrated (P<.05) for all pairs of products. Relative bioequivalence of 0.95 to 1.07 was demonstrated, tighter than the current bioequivalence criterion for oral formulations. CONCLUSIONS: The 4 generic and brand-name levothyroxine preparations studied are different but are bioequivalent by current Food and Drug Administration criteria and are interchangeable in the majority of patients receiving thyroxine replacement therapy. Further investigation is required to determine whether our results are equally applicable to all existing levothyroxine preparations.