Effect evaluation of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: Using propensity score matching method(PSM) to investigate the clinical effect of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma. Methods: A retrospective analysis was conducted on the clinical data of 324 patients diagnosed with advanced tonsillar squamous cell carcinoma and treated in Peking Union Medical College Hospital from 2000 to 2018, confirmed by pathology and without distant metastasis. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching(PSM). Results: Of the 324 patients, 102 were treated with non-surgery chemoradiotherapy treatment strategies and 222 with surgical plus radio(chemo)therapy treatment. Cox multivariate analysis showed that the non-surgery treatment group had a favorable prognosis than the surgical treatment group, however, these outcomes were not significantly different [overall survival(OS): adjusted Hazard Ratios(aHR): 0.92, 95% confidence interval(CI): 0.60-1.42; disease-specific survival(DSS): aHR: 0.71, 95%CI: 0.43-1.20; disease-free survival(DFS): aHR: 0.82, 95%CI: 0.53-1.28]. The new patient cohort consisted of 102 subpairs after PSM. There were no significant differences between two groups(OS: aHR: 0.85, 95%CI: 0.51-1.40; DSS: aHR: 0.62, 95%CI: 0.35-1.11; DFS: aHR: 0.80, 95%CI: 0.49-1.33). Conclusion: Our findings indicate that patients with non-surgical treatment do not have significantly better survival outcomes compared to surgical treatment group, while non-surgical treatment has advantages in improving the quality of life of patients, so comprehensive treatment based on radiotherapy and chemotherapy may be recommended for advanced tonsillar squamous cell carcinoma.

Clinicopathological Analysis of Children's Systemic EBV-Positive T-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To explore the clinical and pathologic features as well as prognosis of systemic EBV-positive T-cell lymphoma in children.@*METHODS@#The clinical data including clinical manifestation, pathologic changes and treatment in 16 patients with children's systemic EBV-positive T-cell lymphoma were analyzed retrospectively, and follow-up of patients were carried out.@*RESULTS@#The 16 cases included 12 males and 4  females with median age of 3.3 years old. It was demonstrated that the clinical and pathological features of the children's systemic EBV-positive T-cell lymphoma were as followed fever, hepatosplenomegaly, cytopenia, lymphadenopathy, and hemophagocytosis in bone marrow or organ. Histologically, the structures of lymph node was normal, partially or completely destoryed. The paracortical zone was expanded with prominent infiltration of small to medium-sized atypical lymphocytes. The major immunophenotypic characteristics were as follows: (1) Almost all biopsies exhibited prominent T cell proliferation. (2) CD3 was expressed in 16 patients (100%, 16/16), CD4 in 5 patients (31.3%, 5/16)，CD5 in 13 patients (81.3%, 13/16)，CD7 was expressed in 11 patients (68.8%, 11/16)，CD8 in 15 patients (93.8%, 15/16)，CD4 and CD8 were expressed in 5 patients (31.3%, 5/16)，CD4 and CD8 double-negative in patients (6.3%, 1/16)，16 patients were CD56 negative (100%, 16/16). (3) TCR gene cloning rearrangement in 16 patients (93.8%, 15/16). (4) EBV-EBER was expressed in 16 patients (100%, 16/16). 11 out of 16 cases died, 1 cese failed to be followed up, 1 case relapsed，and 3 cases survived, reseptively. The media survival time was 4 months.@*CONCLUSION@#Systemic EBV-positive T-cell lymphoma predominantly occurred in childhood and early teen-age, and lacks specific clinic features, usually combined with hemophagocytic syndrome. The confirmed diagnosis requires comprehensive analysis of clinical manifestation, pathomorphology, immunohistochemical detection, EBV-EBER insite hybridization, and TCR gene test. The overall prognosis of the disease is poor and the fatality rate is high.

Health literacy level and its influencing factors among residents in Ningbo City / 预防医学

Objective To analysis the health literacy status, trends and distribution characteristics of Ningbo residents during 2015-2016, and to provide basis for developing health policies and intervention strategies. Methods During 2015-2016, 9810 residents of 15-69 years old in Ningbo were investigated by face-to-face interviews using the unified national questionnaire and multistage PPS sampling method. Results Totally 9750 residents correctly filled out the questionnaire. The adjusted health literacy (AHL) of residents in 2016 was 21.73％, increased by 6.29 percentage points than 2015 (15.44％) .The monitoring results of two years both showed that there was no significant differences of AHL between men and women (P >0.05) . However, the AHL of residents with different age-groups, occupations and education levels all assumed significant differences (P<0.05) . The AHL was significantly higher in urban residents than rural residents (P<0.05) .Among the 6 health issues, the AHL of safety and first aid was the highest (2015: 56.98％, 2016: 61.32％), and the chronic disease prevention (2015:11.23％, 2016: 12.10％) and basic medical care (2015: 11.97％, 2016: 13.81％) were the lowest, also who had the smallest lifting range. Logistic regression analysis displayed that residents with higher level of education had higher AHL (OR=1.72, 95％CI: 1.61-1.83) . Comparison with civil servants, institutions, teachers and medical professionals, farmers (OR=0.74, 95％CI: 0.58-0.94), workers (OR=0.70, 95％CI: 0.57-0.86) and other occupational groups (OR=0.78, 95％CI: 0.64-0.96) had lower AHL. Conclusion The health literacy of Ningbo residents is on the rise, Knowledge of chronic disease prevention and basic medical care will be the main contents of health literacy enhancement program in the future, especially for people with less education.

Application of unilateral olfactory testing and clinical analysis of unilateral hyposmia / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate whether patients presenting with self-reported olfactory disorders demonstrates significant side difference in odour recognition by measuring separately for each nostril.</p><p><b>METHODS</b>One hundred and four patients with chief complaint of hyposmia were evaluated by medical history, physical examination, T&T olfactory testing and medical imaging. Smell was tested using T&T olfactometry in each nostril separately.</p><p><b>RESULTS</b>Based on the history and results from the clinical examination, unilateral sinonasal diseases and abnormal nasal structure were excluded. In almost one eighth of all presenting patients (13.46%), a side difference was detected. Especially, six of the patients were identified with lateralized hyposmia.</p><p><b>CONCLUSIONS</b>Olfactory testing could be performed in each nostril separately. The above findings suggested that testing each nostril separately was necessary so as not to miss unilateral hyposmia as a special clinical manifestation of olfactory disorder.</p>

MRI features of olfactory bulb volume in healthy middle and old-aged persons / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the differences of olfactory bulb (OB) volumes between younger and older, male and female, left-side and right-side in healthy middle and old-aged persons by MRI.</p><p><b>METHODS</b>Ninety five healthy middle and old-aged volunteers (male:female = 45:50) were divided into 2 groups, group one included persons aged from 50 to 69, group two included persons elder than 70. The left-side, right-side and both-side volumes of OB, the volumes of brain and the ratio of OB/brain were measured by MRI.</p><p><b>RESULTS</b>(1) The left-side and both-side volumes of OB (x(-) +/- s), the volumes of brain [(39.89 +/- 8.7) mm(3), (81.70 +/- 16.8) mm(3) and (1281.86 +/- 140.2) cm(3)] in 50 - 69 years old group were respectively larger than those in >/= 70 years old group [(34.45 +/- 10.4) mm(3), (72.10 +/- 19.3) mm(3) and (1165.77 +/- 165.3) cm(3)], and the differences reached statistical significance (t were respectively 2.649, 2.449, 3.516, all P < 0.05). There were no significant differences of right-side OB volumes and the ratio of OB/brain between 50 - 69 years old group and >/= 70 years old group (t were respectively 1.904, 0.616, each P > 0.05). (2) The male's OB volumes of left-side, right-side and both-side, the brain volumes and the ratio of OB/brain were respectively larger than females', and the differences reached statistical significance (t were respectively 4.461, 3.630, 4.399, 3.800, 2.400, all P < 0.05). (3) The right-side OB volumes were larger than left-side's and significant differences were found in female group, 50 - 60 years old group and >/= 70 years old group (t were respectively 2.732, 2.117, 3.516, all P < 0.05). There were no significant differences of OB volumes between left-side and right-side in female (t = 2.649, P = 0.110). The ratio of right-side OB/brain were larger than the ratio of left-side's and the differences reached statistical significance (t = 3.183, P = 0.002).</p><p><b>CONCLUSIONS</b>MRI could be used to measure the volume of OB. The older the people, the smaller the OB volumes. There was no influence of age on the ratio OB/brain. The OB volumes of right-side were larger than those of left-side. The OB volumes of male were larger than those of female.</p>