The Role of Education and Demographic Factors in Condom Use among Male Drug Users in Malaysia

@#Introduction: The rising prevalence of human immunodeficiency virus (HIV) among people who inject drugs is a major public health issue. This study intends to explore education and demographic correlates of use of condoms among male drug users in Malaysia. Methods: Data were extracted from the Integrated Biological and Behavioral Surveillance Survey 2017. Pearson’s chi-square tests and a logistic regression were used to examine the associations between condom use and education, and demographic factors. Results: Only a small proportion of drug users used condoms (25.7%). Educational backgrounds, age, ethnicity and marital status were associated with condom use. The likelihood of using condoms was lower among less educated drug users (aOR: 0.308–0.339). There was an interaction effect of education and age on condom use (aOR: 0.116–0.308). Chinese (aOR: 3.117) and those of other ethnicities (aOR: 2.934) were more likely to use condoms when compared with Malays. Being married (aOR: 0.291) or divorced/widowed (aOR: 0.346) was associated with reduced odds of using condoms. Conclusion: Education and demographic factors play an important role in influencing the decisions of Malaysian drug users to use condoms. Therefore, HIV-preventive measures targeting drug users could benefit by paying special attention to these factors.

Effects of self-made Ningxin Huoxue Qutan Decoction combined with Aspirin on serum cyclophilin A level after percutaneous coronary intervention in acute coronary syndrome / 国际中医中药杂志

Objective:To explore the effects of self-made Ningxin Huoxue Qutan Decoction combined with Aspirin on the level of serum cyclophilin A (CyPA) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).Methods:Randomized controlled trial. A total of 142 patients in the hospital from February 2017 to January 2022 were selected as the participants by randomized controlled trial design, and they were divided into the two groups by the random number table method, with 71 in each group. The control group was given oral administration of Aspirin while the observation group was treated with self-made Ningxin Huoxue Qutan Decoction on the basis of the control group. Both groups were treated for 8 weeks. The left ventricular ejection fraction (LVEF), left ventricular end-systolic volume index (LVESVI) and wall motion score index (WMSI) were measured by color ultrasonic diagnostic instrument before and after treatment. The levels of serum angiopoietin-like protein 2 (Angptl2), hypersensitive C-reactive protein (hs-CRP), MMP-9, CyPA and myeloperoxidase (MPO) were detected by ELISA. Serum endothelin-1 (ET-1), MDA and SOD levels were detected by radioimmunoassay. Nitrate reductase was used to detect NO level, and the clinical efficacy was evaluated.Results:The total effective rate in observation group was 92.96% (66/71) and that in control group was 80.28% (57/71) ( χ2=4.92, P=0.027). After treatment, the LVEF in observation group was significantly higher than that of the control group ( t=2.19, P<0.05) while the LVESVI was significantly lower than that of the control group ( t=3.13, P<0.01). The levels of serum hs-CRP, MMP-9, CyPA, MDA and Angptl2 were significantly lower than those in the control group ( t=2.44, 2.20, 2.08, 2.10, 2.35, P<0.05), and the SOD activity was significantly higher than that of the control group ( t=2.66, P<0.05), and the level of NO was significantly higher than that of the control group ( t=2.66, P<0.05). Conclusion:Self-made Ningxin Huoxue Qutan Decoction combined with Aspirin for patients with ACS after PCI can reduce the level of serum CyPA, improve the cardiac function and vascular endothelial function, inhibit the body' s inflammatory stress response and enhance the clinical efficacy.

Study on molecular mechanism of Jichuanjian improving Yang deficiency constipation based on Ca / 中国药理学通报

Aim To investigate the effect of JiChuanjian(JCJ)on the Yang deficiency constipation based on Ca

Manufacturing classification system for oral solid dosage forms of traditional Chinese medicines(Ⅲ): classification of granule dissolving behaviors / 中国中药杂志

Solubility is an important sensory quality attribute of traditional Chinese medicine(TCM) granules. In this paper, 90 batches of granules(30 batches of TCM formula granules, 30 batches of Chinese patent medicine granules and 30 batches of Japanese Kampo granules) were used as the research objects. The turbidity sensor was used to characterize the turbidity curve of the granule dissolution process. The classification system of granule dissolution behaviors was constructed from three dimensions: dissolution degree, equilibrium time, and dissolution mechanism. According to the equilibrium time, the granule dissolution rates were divided into three categories : faster(<100 s), general(101-300 s) and slow(>301 s). According to the turbidity curve profile, the granule dissolution mechanisms were classified into dissolution-controlled type(α-type), dispersion-controlled type(β-type), and dispersion-controlled type followed by dissolution-controlled type(γ-type). The proportion of TCM formula granules, Chinese patent medicine granules and Japanese Kampo granules with complete dissolution or slight turbidity at the end of dissolution was 46.7%, 96.7%, and 10.0%. The proportion of TCM formula granules, Chinese patent medicine granules, and Japanese Kampo granules with faster dissolution rates(<100 s) was 23.3%, 26.7%, and 40.0%. The average dissolution rate of Japanese Kampo granules was faster than that of TCM formula granules, and it was slightly faster than the average dissolution rate of Chinese patent medicine granules. The dissolution mechanism of Chinese patent medicine granules was mainly α-type, while that of Japanese Kampo granules was mainly β-type, and the three types of dissolution mechanisms of TCM formula granules accounted for a relatively average. The purpose of improving the solubility and dispersion of granules can be achieved by combining the comprehensive application of various functional excipients with the small dosage of Japanese Kampo granules and the wide addition scope of excipients. In the process of transforming TCM compound prescriptions into formulas, there is still much room for innovation in formula excipients and process optimization.

Study on the diagnostic value of different posterior cruciate ligament index measurement methods for anterior cruciate ligament injury / 中国骨伤

OBJECTIVE@#To compare the posterior cruciate ligament(PCL) index with six different measurement methods, and analyze and verify its clinical diagnostic value in anterior cruciate ligament (ACL) injury.@*METHODS@#The Magnetic resonance imaging (MRI) data of 225 knee joints in our hospital from May 2018 to March 2022 were retrospectively analyzed, aged from 18 to 60 years old, with a median of 32 years old. On the sagittal MRI images of 114 patients with ACL injury and 111 patients with intact ACL, Measure the straight-line distance (A) between the femoral attachment point and the tibial attachment point of the PCL on the MRI sagittal image and the maximum vertical distance (B) between the straight line and the arcuate mark point of the PCL on the sagittal image, calculate the PCL index and evaluate the diagnostic value of the PCL index for ACL injury.@*RESULTS@#The PCL index of the ACL normal group and the ACL injury group were statistically described. There was no significant difference in PCL index 1, 2, 3 and 6 between the two groups(P>0.05). The difference of PCL index 4 and 5 between the two groups was statistically significant (P<0.001). This study only found that the PCL index 2, 6 in the ACL normal group had a negative correlation with the patient's age (correlation coefficient=-0.213, -0.819;P<0.05), and the PCL index 5 in the ACL injury group was significantly correlated with the patient's body mass index(BMI)had a negative correlation (correlation coefficient=-0.277, P<0.05).@*CONCLUSION@#The change of PCL index is helpful for the diagnosis of ACL injury, PCL index 4 and 5 can be used as effective reference indexes for diagnosing ACL injury in clinic.

Acupuncture-Neuroimaging Research Trends over Past Two Decades: A Bibliometric Analysis / 中国结合医学杂志

OBJECTIVE@#To identify topics attracting growing research attention as well as frontier trends of acupuncture-neuroimaging research over the past two decades.@*METHODS@#This paper reviewed data in the published literature on acupuncture neuroimaging from 2000 to 2020, which was retrieved from the Web of Science database. CiteSpace was used to analyze the publication years, countries, institutions, authors, keywords, co-citation of authors, journals, and references.@*RESULTS@#A total of 981 publications were included in the final review. The number of publications has increased in the recent 20 years accompanied by some fluctuations. Notably, the most productive country was China, while Harvard University ranked first among institutions in this field. The most productive author was Tian J with the highest number of articles (50), whereas the most co-cited author was Hui KKS (325). Evidence-Based Complementary and Alternative Medicine (92) was the most prolific journal, while Neuroimage was the most co-cited journal (538). An article written by Hui KKS (2005) exhibited the highest co-citation number (112). The keywords "acupuncture" (475) and "electroacupuncture" (0.10) had the highest frequency and centrality, respectively. Functional magnetic resonance imaging (fMRI) ranked first with the highest citation burst (6.76).@*CONCLUSION@#The most active research topics in the field of acupuncture-neuroimaging over the past two decades included research type, acupoint specificity, neuroimaging methods, brain regions, acupuncture modality, acupoint specificity, diseases and symptoms treated, and research type. Whilst research frontier topics were "nerve regeneration", "functional connectivity", "neural regeneration", "brain network", "fMRI" and "manual acupuncture".

Perception about E-Cigarettes in Malaysia: Sociodemographic Correlates

Introduction@#The prevalence of e-cigarette smoking is increasing. Many people still have a poor understanding of the risks of e-cigarettes. The purpose of this study is to examine sociodemographic factors associated with knowledge about e-cigarettes with a focus on the perception that e-cigarettes are less dangerous than regular cigarettes. @*Methods@#Multivariable logistic regressions are utilised to estimate the effects of sociodemographic factors on the likelihood of having the perception that e-cigarettes are less dangerous than regular cigarettes. These regressions are stratified by ethnic groups. A Malaysian nationwide survey that consists of a large sample size (n = 4176) is used for secondary analysis. @*Results@#Age, gender and educational level are associated with the perception about e-cigarettes. Older individuals are less likely to think that e-cigarettes are less dangerous than regular cigarettes compared with younger individuals. Males are more likely to have the perception that e-cigarettes are less dangerous than regular cigarettes relative to females. Having primary or secondary educational level rather than tertiary educational level is associated with a reduced likelihood of having the perception that e-cigarettes are less dangerous than regular cigarettes. @*Conclusions@#Sociodemographic factors play an important role in determining the perception about e-cigarettes. Nationwide policies directed toward improving knowledge about e-cigarettes among individuals who think that e-cigarettes are less dangerous than regular cigarettes may be effective in lowering the risk of suffering from the currently unknown long-term negative effect of e-cigarettes.

基于网络 ? ? 学探讨 ? 脾补肾活血方治疗 缺血性 ? 中的作用机 / 中国药理学通报

Aim To explore the mechanism of Danshen decoction in the treatment of colon cancer using network pharmacology and molecular docking.Methods The active components and corresponding target proteins of Salvia miltiorrhiza, Santalum album and Amo-mum villosum in Danshen decoction were screened based on Traditional Chinese Medicine Systems Pharmacology database and analysis platform.The targets of colon cancer were searched by using Genecards database, and the common targets were selected.The network diagram of traditional Chinese medicine-active components-target-disease was constructed by using Cytoscape 3.7.0.The protein protein interaction network of common targets was constructed by using STRING database.The gene ontology(GO)and Kyoto Encyclopedia of Genes and Gnomes(KEGG)enrichment analysis were carried out based on R4.0.2.The important targets in the key pathways and the important active components in the network diagram of traditional Chinese medicine-active ingredients-target-disease network were selected for Surflex Dock.Results A total of 78 active components, 142 targets, 3 239 colon cancer targets, 105 overlapping targets and 69 corresponding active components were screened out.KEGG analysis showed that the key signaling pathway was PI3K/AKT.Luteolin and Tanshinone IIA with high correlation were selected to dock with protein kinase B(AKT1).Both active components had hydrogen bonding with AKT1.Conclusions Danshen decoction plays a positive role in colon cancer treatment.The mechanism may be related to the regulation of PI3K/AKT signaling pathway.

Effect of miR-30c/YWHAZ axis on drug resistance of pancreatic cancer cells / 中华内分泌外科杂志

Objective:To investigate whether microRNA-30c (miR-30c) mediates the resistance of pancreatic cancer cells to gemcitabine (Gb) by targeting tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activating protein zeta polypeptide (YWHAZ) .Methods:SW1990 cell line with the lowest expression of miR-30c in human pancreatic cancer cell lines was screened by RT-qPCR. Gb-resistant cell line SW1990/Gb was established and divided into SW1990/Gb group (untransfected) , miR-30c over expression (Ad-miR-30c) group, Ad-miR-30c negative control (Ad-eGFP) group, and SW1990 group. The level of miR-30c was measured by RT-qPCR; the half inhibitory concentration (IC50) and drug resistance index (IR) were measured by CCK-8 method; the expression of drug resistance-related protein P-gp, apoptosis-related protein Caspase-1, migration and transfer-related proteins MMP-9, YWHAZ and downstream pathway-kinase mitogen-activated protein kinase (p38MAPK) /extracellular regulatory protein kinase 1 (ERK1) protein was measured by Western blot. After co-transfection of Ad-miR-30c and YWHAZ overexpressing adenovirus (Ad-YWHAZ) , the expression of P-gp and YWHAZ pathway related proteins was measured by Western blot method.Results:The IC50 (59.16±5.14, nmol/L) , IR (11.15±0.19) , expressions of YWHAZ protein (1.59±0.15) and P-gp (2.43±0.26) in SW1990/Gb-resistant cells were high, the expression of miR-30c (0.25 ±0.02) was low ( P<0.05) , and the p38MAPK/ERK pathway was activated. After up-regulating the expression of miR-30c (1.59±0.15) in SW1990/Gb cells, the IC50 (25.14±2.15, nmol/L) and IR (5.48±0.12) , YWHAZ (1.49±0.13) , P-gp (1.46± 0.10) decreased ( P<0.05) , and the p38MAPK/ERK pathway was activated. Up-regulating the expression of YWHAZ could reverse the above-mentioned effects of Ad-miR-30c ( P<0.05) . Conclusions:The expression of miR-30c is low in pancreatic cancer Gb-resistant cell lines. Up-regulating the expression of miR-30c can target and inhibit the YWHAZ/p38MAPK/ERK pathway, inhibit the expression of drug-resistant protein P-gp, and reduce the resistance of pancreatic cancer cells to Gb.

Sociodemographic factors associated with consumption of high-sodium foods: Evidence from Malaysia

@#Introduction: The objective of the present study was to investigate the influences of sociodemographic factors on consumption of high-sodium foods among adults in Malaysia. Methods: Data were extracted from the Malaysian Community Salt Survey (MyCoSS) (n=1046). A seemingly unrelated regression (SUR) was utilised to assess factors associated with the number of servings of high-sodium foods (nasi lemak, roti canai, fried rice, fried noodles, and fried vermicelli) consumed per week. The independent variables were sociodemographic factors. Results: Younger individuals consumed more high-sodium foods than their older counterparts. Adults with secondary level education consumed more high-sodium foods compared with those with tertiary level education. Consumption of high-sodium foods was higher among males and Malays compared to females and non-Malays. Conclusion: Consumption of high-sodium foods was common in the population. Sociodemographic factors, such as age, education level, gender, and ethnicity, play an important role in influencing the decisions of people to consume high-sodium foods.

Risk for metabolic syndrome in the population with visceral fat area measured by bioelectrical impedance analysis

Background/Aims@#To investigate whether visceral fat area (VFA) measured by bioelectric impedance analysis (BIA) was associated with metabolic syndrome in subjects with and without obesity. @*Methods@#A total 23,202 participants who underwent medical check-ups were assessed. Participants were stratified by body mass index (BMI) and VFA. We evaluated six different groups for metabolic syndrome: Group 1 (normal weight and low VFA), Group 2 (normal weight and high VFA), Group 3 (overweight and low VFA), Group 4 (overweight and high VFA), Group 5 (obesity and low VFA), and Group 6 (obesity and high VFA). @*Results@#Metabolic syndrome traits and metabolic syndrome were significantly more prevalent in the high-VFA (≥ 100 cm2 ) subgroup in each BMI group. Adjusted logistic regression analyses revealed that the odds ratio for metabolic syndrome compared with Group 1 was the highest in Group 6 (24.53; 95% confidence interval [CI], 21.77 to 27.64). Notably, the odds ratio of Group 2 was higher than that of Group 3 (2.92; 95% CI, 2.30 to 3.69 vs. 2.57; 95% CI, 2.23 to 2.97). @*Conclusions@#Our study demonstrates that the combination of BMI assessment and VFA determination by BIA may be a useful method for predicting the risk of metabolic syndrome. The VFA by BIA may be a useful target for interventions to improve metabolic syndrome.

Epidemiological investigation of tinnitus in Sichuan and Chongqing / 中华耳鼻咽喉头颈外科杂志

Objectives: To investigate the prevalence and associated risk factors of tinnitus in Sichuan and Chongqing. Methods: We designed a tinnitus epidemiological questionnaire. The multi-stage stratified cluster random sampling methods was applied to obtain study subjects in six areas (Nanchong, Jiangjin, Fengdu, Yunyang, Suining and Ya'an), which were selected for epidemiological investigation. Home visit completion of epidemiological questionnaires was conducted. The trained investigators guided the respondents to fill in the tinnitus epidemiological questionnaires, and the epidemiological status of six areas on prevalence and risk factor was investigated. SPSS 22.0 software was used for statistical analysis. Results: Sampling population were 10 289, in which 9 273 were valid questionnaires. There were 4 281 males and 4 992 females, with an average age of 47.3 years, among which 34.83% (3 230/9 273) had tinnitus. 3.99% (370/9 273) were diagnosed with bothersome tinnitus. In a multivariable logistic regression mod, the following factors were associated with onsetting of tinnitus: sleep disorder [Odds Ratio(OR)=3.74] and noise exposure(OR=1.99). The risk of disease was lowest in the age of 30-40 years old, while the risk of disease was higher for people under 30 and over 40. In another multivariable logistic regression mode, the following factors were associated with having bothersome tinnitus: older people were more likely to suffer from tinnitus, sleep disorders (OR=4.68) and noise exposure (OR=1.56). Conclusions: The prevalence of tinnitus in Sichuan and Chongqing is about 34.83%, but most of the tinnitus is short-lived and has low loudness, which will not affect the patients. Only a small number of patients with tinnitus (3.99%) persist and affect their health and need treatment. The occurrence and exacerbation of tinnitus may be related to sleep, age, and noise exposure.

Five-year Change in Corneal Endothelial Cell Density after Foldable Iris-fixed Lens Insertion

Purpose@#To investigate changes in corneal endothelial cell density over 5 years after implantation of Artiflex lenses (Ophtec BV, Groningen, The Netherlands) and to explore the influence of anterior chamber depth and volume on changes in endothelial cell density. @*Methods@#This study included 146 eyes of 88 patients implanted with foldable phakic iris-fixation intraocular (Artiflex) lenses for myopia correction from March 2009 to March 2014. To simulate chronological changes in endothelial cell density with age, we collected normal endothelial cell density data from 100 healthy subjects aged 20, 25, or 30 years, and compared the changes among these groups at 5 years after surgery. Changes in corneal endothelial cell density were compared among four groups to which subjects were assigned based on the distance from the intraocular lens to the corneal endothelium, and the volume and depth of the preoperative anterior chamber. @*Results@#The mean endothelial cell density, pre-operatively and at 1, 3, and 5 years post-operatively, was 3,038.8 ± 223.2, 2,985.3 ± 235.5, 2,905.1 ± 231.3, and 2,814.9 ± 250.5 cells/mm2, respectively (1.73%, 4.36%, and 7.31% reduction, respectively, vs. pre-operatively, p < 0.001). These differences were greater than those observed among different age groups (2.2% difference between 20- and 25-year-olds, and 1.2% difference between 25- and 30-year-olds, p < 0.001). A shorter distance from the lens to the endothelium and smaller anterior chamber volume were associated with greater decreases in endothelial cell density following surgery. @*Conclusions@#Corneal endothelial cell density significantly decreased during a 5-year follow-up after Artiflex lens implantation. The distance from the intraocular lens to the corneal endothelium, and the anterior chamber volume, were negatively correlated with the rate at which endothelial cell density decreased over time.

Five-year Change in Corneal Endothelial Cell Density after Foldable Iris-fixed Lens Insertion

Purpose@#To investigate changes in corneal endothelial cell density over 5 years after implantation of Artiflex lenses (Ophtec BV, Groningen, The Netherlands) and to explore the influence of anterior chamber depth and volume on changes in endothelial cell density. @*Methods@#This study included 146 eyes of 88 patients implanted with foldable phakic iris-fixation intraocular (Artiflex) lenses for myopia correction from March 2009 to March 2014. To simulate chronological changes in endothelial cell density with age, we collected normal endothelial cell density data from 100 healthy subjects aged 20, 25, or 30 years, and compared the changes among these groups at 5 years after surgery. Changes in corneal endothelial cell density were compared among four groups to which subjects were assigned based on the distance from the intraocular lens to the corneal endothelium, and the volume and depth of the preoperative anterior chamber. @*Results@#The mean endothelial cell density, pre-operatively and at 1, 3, and 5 years post-operatively, was 3,038.8 ± 223.2, 2,985.3 ± 235.5, 2,905.1 ± 231.3, and 2,814.9 ± 250.5 cells/mm2, respectively (1.73%, 4.36%, and 7.31% reduction, respectively, vs. pre-operatively, p < 0.001). These differences were greater than those observed among different age groups (2.2% difference between 20- and 25-year-olds, and 1.2% difference between 25- and 30-year-olds, p < 0.001). A shorter distance from the lens to the endothelium and smaller anterior chamber volume were associated with greater decreases in endothelial cell density following surgery. @*Conclusions@#Corneal endothelial cell density significantly decreased during a 5-year follow-up after Artiflex lens implantation. The distance from the intraocular lens to the corneal endothelium, and the anterior chamber volume, were negatively correlated with the rate at which endothelial cell density decreased over time.

The Influence of Non-Linear Frequency Compression on the Perception of Speech and Music in Patients with High Frequency Hearing Loss

Background and Objectives@#Non-linear frequency compression (NLFC) technology compresses and shifts higher frequencies into a lower frequency area that has better residual hearing. Because consonants are uttered in the high-frequency area, NLFC could provide better speech understanding. The aim of this study was to investigate the clinical effectiveness of NLFC technology on the perception of speech and music in patients with high-frequency hearing loss. @*Subjects and Methods@#Twelve participants with high-frequency hearing loss were tested in a counter-balanced order, and had two weeks of daily experience with NLFC set on/off prior to testing. Performance was repeatedly evaluated with consonant tests in quiet and noise environments, speech perception in noise, music perception and acceptableness of sound quality rating tasks. Additionally, two questionnaires (the Abbreviated Profile of Hearing Aid Benefit and the Korean version of the International Outcome Inventory-Hearing Aids) were administered. @*Results@#Consonant and speech perception improved with hearing aids (NLFC on/off conditions), but there was no significant difference between NLFC on and off states. Music perception performances revealed no notable difference among unaided and NLFC on and off states. The benefits and satisfaction ratings between NLFC on and off conditions were also not significantly different, based on questionnaires, however great individual variability preferences were noted. @*Conclusions@#Speech perception as well as music perception both in quiet and noise environments was similar between NLFC on and off states, indicating that real world benefits from NLFC technology may be limited in Korean adult hearing aid users.

Postoperative Clinical Outcomes of Colonic Stent Placement as Bridge-to-surgery vs. Emergency Surgery in Left-sided Malignant Colonic Obstruction / 대한소화기암학회지

Background/Aims@#Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes. @*Methods@#The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence. @*Results@#Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-tosurgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridgeto-surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-tosurgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024). @*Conclusions@#SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

Comparison of Usefulness of Ultrasound-Guided Fine Needle Aspiration and Core Needle Biopsy in Diagnosis of Cervical Lymphadenopathy / 대한이비인후과학회지

Background and Objectives@#The purpose of this study is to compare diagnostic outcome and safety of fine needle aspiration (FNA) and core needle biopsy (CNB) in patients with cervical lymphadenopathy. Subjects and Method This retrospective studies were conducted on 164 cases with cervical lymphadenopathy that had undergone FNA, and 44 cases that had undergone CNB. The cytopathological results from FNA and CNB were compared with the histopathological results confirmed by excisional biopsy in the nodes according to different sizes and radiological levels, respectively. Diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were evaluated according to disease entities. @*Results@#FNA is more accurate than CNB in most of the sizes and at all cervical levels. However, there is no statistically significant difference between the results of the two tests. Sensitivity and NPV for diagnosis of malignant lymphoma are higher with FNA than with CNB. However, specificity and PPV for malignant lymphoma are higher with CNB than with FNA. Also CNB showed superior sensitivity, PPV and NPV for metastatic lymphadenopathy. @*Conclusion@#Although CNB is beneficial in reducing the false negative rate, it still has several limitations. Since CNB has no statistically significant advantage over FNA, FNA can be a good alternative method with less complication and high diagnostic value for lesions where CNB is difficult to perform.

Does pulmonary metastasectomy of colorectal metastases translate to better survival? A systematic review

INTRODUCTION@#Surgical resection of the primary and metastatic tumour is increasingly recommended in suitable patients with metastatic colorectal cancer (CRC). While the role of metastasectomy is well studied and established in colorectal liver metastasis, evidence remains limited in pulmonary metastases. This systematic review was conducted to examine the current evidence on the role of lung metastasectomy (LUM) in CRC.@*METHODS@#Three databases were systematically searched, to identify studies that compared survival outcomes of LUM, and factors that affected decision for LUM.@*RESULTS@#From a total of 5,477 records, 6 studies were eventually identified. Two papers reported findings from one randomised controlled trial and 4 were retrospective reviews. There was no clear survival benefit in patients who underwent LUM compared to those who did not. When compared against patients who underwent liver metastasectomy, there was also no clear survival benefit. Patients who underwent LUM were also more likely to have a single pulmonary tumour, and metachronous disease.@*CONCLUSION@#The evidence suggests a role for LUM, but is limited by inherent selection bias in retrospective reviews, and the single randomised clinical trial performed was not completed. More prospective studies are required to understand the true effect of LUM on outcomes in metastatic CRC.

Efficacy of medicinal penetration on acupoint as adjunctive therapy on histiocytic necrotizing lymphadenitis of heat-toxin syndrome: a randomized controlled trial / 中国针灸

OBJECTIVE@#To evaluate the clinical efficacy of medicinal penetration on acupoint combined with medication for histiocytic necrotizing lymphadenitis (HNL) of heat-toxin syndrome, and to explore the methods of improving the clinical effect.@*METHODS@#A total of 72 cases with HNL with heat-toxin syndrome were randomly divided into an observation group and a control group, 36 cases in each group. The patients in the control group were treated with oral administration of prednisone tablets for 40 days (first 5 days: 10 mg, three times a day; since then, reduced by 5 mg every 7 days). In the observation group, on the basis of the medication in the control group, the patients were treated with acupoint application and ultrasonic drug penetration therapy, once a day for 14 days. The acupoints of Waiguan (TE 5), Fengchi (GB 20) of affected side and points were selected. The changes of target lymph node swelling, visual analogue score (VAS), axillary temperature and total score of symptoms and signs were evaluated before treatment and 7, 14, 28 and 40 d into treatment; the changes of white blood cell (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and lactic dehydrogenase (LDH) were evaluated on 14 d and 40 d into treatment; the patients were followed-up for half a year.@*RESULTS@#① Fourteen days into treatment, the clinical cured rate in the observation group was 38.9% (14/36), which was superior to 16.7% (6/36) in the control group (0.05). ④ The recurrence rate in the observation group was 5.6% (2/36), which was similar to 16.7% (6/36) in the control group (>0.05).@*CONCLUSION@#The medicinal penetration on acupoint as adjunctive treatment could effectively relieve the discomfort symptoms of HNL patients with syndrome of heat and toxin, improve the clinical cured rate, and provide the research direction for shortening the course of medication.

A Case of a Bleeding Duodenal Lipoma Successfully Controlled by Endoscopic Resection

This is a case report of successful endoscopic resection (ER) of a bleeding duodenal lipoma. An 85-year-old woman who was diagnosed with asymptomatic subepithelial tumor of the duodenum 3 years ago visited the emergency room with hematemesis and was admitted to our hospital. Emergent esophagogastroduodenoscopy revealed bleeding from an ulcer on the superior aspect of a subepithelial tumor measuring about 20 mm in diameter, at the superior duodenal angle. The ulcer was in the active stage (A1), with a visible vessel. The bleeding was controlled by ER of the tumor using a snare. The final pathological diagnosis was duodenal lipoma with mucosal ulceration. The patient showed no signs of bleeding for 10 days after the procedure; subsequently, she was discharged and followed up for regular checkups.