Etiological analysis of surveillance cases of diarrhea syndrome in Gansu Province from 2009 to 2018 / 中华疾病控制杂志

@#Objective To understand pathogenic distribution and epidemiological characteristics of diarrhea syndrome in Gansu Province． Methods Fecal specimens from diarrhea syndrome surveillance cases at sentinel hospitals in Gansu Province from 2009 to 2018 were collected，and virus nucleic acids were detected by real－time fluorescent chain reaction，and bacteria were detected by isolation culture． Ｒesults 1 547 positive cases were detected from 4 406 stool specimens with the positive rate of 35. 11%． Among the positive samples，1 281 cases were positive for virus with the positive rate of 47. 20%; 287 ca- ses were positive for bacteria with the positive rate of 8. 57%． Top five of pathogenic spectrum were rota- virus ( 46. 04%) ，astrovirus ( 13. 37%) ，norovirus ( 13. 15%) ，Shigella ( 9. 90%) and adenovirus ( 7. 81%) ． In different age groups，statistically significant differences were found in the positive rates of rotavirus，norovirus，astrovirus，Shigella and non typhoid Salmonella ( all P＜0. 05) ． The positive rate of virus was higher from November to March of next year，and the positive rate of bacteria was higher from June to August． The epidemic seasons of pathogens were different，of which rotavirus was dominating in four seasons． Conclusions The pathogenic spectrum of diarrhea is wide relatively in Gansu Province， and viral diarrhea is more common，with obvious seasonal peak． Continuous monitoring should be strengthened to grasp characteristics and epidemic trends of pathogens，and it is helpful to take targeted and seasonal preventive measures in population at high risk．

Influence factors and predictive ability of a risk prediction model for carotid atherosclerosis in a follow-up population / 中华疾病控制杂志

Objective To explore factors influencing the incidence of carotid atherosclerosis in different genders so as to provide reference for the specific prevention of the disease. Methods A nested case-control study was conducted to analyze factors influencing the incidence of carotid atherosclerosis in Jinchang cohort population who were randomly selected through stratified sampling by age and followed up. A risk prediction model was established and the goodness of fit was evaluated by the area under the receiver operator characteristic curve (ROC). Results The standardized incidence of carotid atherosclerosis in this follow-up population was 12.32%, and the incidence rate of males (13.65%) was greater than that of females (11.29%). The difference was statistically significant ( 2=4.267, P<0.001). Age, education, elevated systolic blood pressure, and elevated low-density lipoprotein cholesterol were common risk factors for carotid atherosclerosis in both men and women. Elevated fasting plasma glucose (OR=2.556, 95% CI: 1.618-4.038) and elevated triglyceride (OR=1.535, 95% CI: 1.058-2.227) were only associated with men. Abdominal obesity (OR=1.414, 95% CI: 1.013-1.974) was only associated with women. The area under ROC of male and female prediction models was 0.835 (95% CI: 0.815-0.856) and 0.809 (95% CI: 0.788-0.831), respectively. The sensitivity was 78.0% and 78.9%, the specificity was 78.8% and 73.1%, and the diagnostic coincidence rate was 91.3% and 82.4%, respectively. Conclusions There are different risk factors for carotid atherosclerosis in males and females, and targeted prevention and control measures should be taken according to gender. The risk prediction model established by Logistic regression had certain guiding value.

Current status and prospectives of proton and heavier-ion beam therapy for tumor in the digestive system / 中华胃肠外科杂志

Particle radiotherapy using proton and heavier-ion beam was first proposed for clinical application by Robert Wilson in 1946. Compared to conventional photon radiation, proton and heavier-ion beam has significant physical advantage, and heavier-ion has unique biological characteristics. With the development of accelerator and radiation technique, it is being investigated for tumor treatment in many clinical centers. This article reviews the current status of clinical application of particle therapy using proton and heavier-ion beam in digestive system tumor.

Prognostic value of CYFRA 21-1 and CEA in patients with undifferentiated nasopharyngeal carcinoma before and after radiotherapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The purpose of this study was to evaluate the potential of CYFRA 21-1 (CYFRA) and CEA as a prognostic marker in patients with undifferentiated nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>From March 2004 to February 2008, 62 patients with newly diagnosed, undifferentiated NPC were treated in our department. Their clinocopathological data were analyzed retrospectively. All patients received intensity-modulated radiotherapy using 6 MV X-rays, and serum CYFRA and CEA before and after radiotherapy were assayed. The association among the long-term follow-up results and age, sex, smoke, TNM stage, chemotherapy, CEA, CYFRA and the changes in any direction of serum CYFRA and CEA were determined.</p><p><b>RESULTS</b>Patients with low pre-RT level (≤ 2.49 µg/L) of CYFRA had a significantly better overall survival (OS) than patients with high level (> 2.49 µg/L,OR = 8.555, P = 0.029). N classification and T classification were positively associated with the prediction of progression free survival (OR = 4.054, P = 0.001;OR = 3.873, P = 0.001). But there was no significant association between the rest predictors (age, sex, CEA, post-RT CYFRA, chemotherapy and a radiation-induced decrease in serum markers) and the survival or recurrence rate by multivariate analysis.</p><p><b>CONCLUSIONS</b>The results of the present study show that pre-RT serum CYFRA level is a valuable factor for predicting long-term survival in patients with undifferentiated nasopharyngeal carcinoma. More aggressive treatment may be given to those patients with a high serum CYFRA level.</p>

The prognostic value of metabolic tumor volume in FDG PET/CT evaluation of post-operative survival in patients with esophageal squamous cell cancer / 中华核医学杂志

ObjectiveTo evaluate the prognostic value of MTV on 18F-FDG PET/CT in patients with esophageal cancer.MethodsForty-nine patients with esophageal cancer underwent 18 F-FDG PET/CT scan before surgery.The median follow-up time for the patients was 29 months (range,8- 57 months).The prognostic significance of MTV,age,sex,histologic grade,SUVmax of the primary tumor,tumor size measured on PET/CT,T stage,N stage,M stage,American Joint Committee on Cancer (AJCC) stage,number and location of lymph nodes metastases were assessed by Kaplan-Meier analysis and multivariate Cox model.ResultsIn the univariate analysis,AJCC stage (x2 =16.206,hazard ratio (HR) =1.177,P ＜0.001),N stage (x2 =9.536,HR =10.833,P =0.002),T stage (x2 =5.810,HR=2.397,P=0.016),number of lymph nodes metastases (x2 =11.423,HR =1.567,P =0.001 ),and MTV (x2 =3.872,HR =2.433,P =0.049 ) were significant predictors of survival.Multivariate analysis showed that MTV and AJCC stage were independent predictors of survival (x2 =4.525,HR1.170,P =0.033 ;X2=4.875,HR =3.071,P =0.027).Kaplan-Meier survival curves revealed longer survival time of low-MTV group as compared to high-MTV group ( Log-rank,x2 =4.186,P =0.041 ).ConclusionMTV on 18 F-FDG PET/CT may be an independent prognostic factor in patients with esophageal cancer.