CT findings and clinical characteristics in distinguishing renal urothelial carcinoma mimicking renal cell carcinoma from clear cell renal cell carcinoma.

BACKGROUND: We aimed to characterize the clinical and multiphase computed tomography (CT) features, which can distinguish renal urothelial carcinoma (RUC) mimicking renal cell carcinoma (RCC) from clear cell renal cell carcinoma (ccRCC) with collecting system invasion (CSI). METHODS: Data from 56 patients with RUC (46 men and 10 women) and 366 patients with ccRCC (262 men and 104 women) were collected and assessed retrospectively. The median age was 65.50 (IQR: 56.25-69.75) and 53.50 (IQR: 42.25-62.5) years, respectively. Univariate and multivariate logistic regression analyses were performed on clinical and CT characteristics to determine independent factors for distinguishing RUC and ccRCC, and an integrated predictive model was constructed. Differential diagnostic performance was assessed using the area under the receiver operating characteristic curve (AUC). RESULTS: The independent predictors for differentiating RUC from ccRCC were infiltrative growth pattern, hydronephrosis, heterogeneous enhancement, preserving reniform contour, and hematuria. The differential diagnostic performance of the integrated predictive model-1 (AUC: 0.947, sensitivity: 89.07%, specificity: 89.29%) and model-2 (AUC: 0.960, sensitivity: 92.1%, specificity: 89.3%) were both better than that of the infiltrative growth pattern (AUC: 0.830, sensitivity: 71.9%, specificity: 92.9%), heterogeneous enhancement (AUC: 0.771, sensitivity: 86.3%, specificity: 67.9%), preserving reniform contour (AUC = 0.758, sensitivity: 85.5%, specificity: 66.1%), hydronephrosis (AUC: 0.733, sensitivity: 87.7%, specificity: 58.9%), or hematuria (AUC: 0.706, sensitivity: 79.5%, specificity: 51.8%). CONCLUSION: The CT and clinical characteristics showed extraordinary discriminative abilities in the differential diagnosis of RUC and ccRCC, which might provide helpful information for clinical decision-making.

Prevalence and Determinants of Secondhand Smoke Exposure Among Adolescent Girls - China, 2019.

What is already known about this topic?: The rate of secondhand smoke (SHS) exposure among female junior high students in 2013-2014 in China was 69.9%. What is added by this report?: The rate of SHS among adolescent girls in 2019 in China was 62.8%, with 60.8% in junior high and 65.3% in senior high school, meanwhile, higher SHS exposure was correlated to higher grade levels, senior high school over junior high school, urban areas, those with more pocket money, those who've attempted smoking, exposure to tobacco advertisements, those with parents who smoke, those with close friends who smoke, use of e-cigarettes, and belief that SHS exposure is detrimental to health. What are the implications for public health practice?: The rate of SHS exposure among adolescent girls in China still remains extraordinarily high. Targeted public health initiatives to curb SHS exposure among adolescent girls are urgently needed in China.

China's Changing Alcohol Market and Need for an Enhanced Policy Response: A Narrative Review.

This study describes trends in alcohol consumption in the context of an expanding commercial context, current policy responses, and flaws in relation to international best practice for alcohol control in China. We surveyed the literature and other documents in Chinese or English up to December 2020 on policy responses to alcohol consumption and harm, industry structure, and marketing practices in China. Databases searched included PubMed, China National Knowledge Internet, Wanfang Data, Web of Science, and Baidu Scholar. We also scanned the official websites of government organizations and gathered information using snowballing. We analyzed existing alcohol policy against evidence-based, cost-effective policies for reducing alcohol harm. Our findings show that although some restrictive policies have been enacted with potential impacts on alcohol harm, they are not comprehensive, and some are poorly executed. The long history of alcohol use remains an important element in alcohol consumption by the Chinese population. However, alcohol marketing and promotion, ease of access, and affordability have become increasingly prominent. The gaps identified in alcohol policy suggest improved strategies and measures to reduce the harmful use of alcohol are urgently needed in China.

The industrial feasibility of low temperature DeNO x in the presence of SO x : a project case in a medium coking plant.

Catalyst poisoning by SO x has hindered the industrial application of selective catalytic reduction (SCR) technology for the DeNO x of low temperature flue gas for many decades. The current engineering process of placing the SCR unit after the desulphurization and dedusting units can lead to high project and operational costs owing to low DeNO x efficiency at low temperatures. Based on our previous pilot results, a DeNO x project case was built before the desulfurization unit in a medium coking plant to explore the industrial feasibility of low temperature DeNO x in the presence of SO x . A new engineering process was considered and designed to overcome the problem of SO x , including the elimination of SO3 with NH3 before the SCR reactor, the filtration of ash by a foam metal plate and in situ regeneration technology. The project case could run continuously for six months with above 70% DeNO x efficiency and less than 10 ppm NH3 slip at 250 °C and a space velocity of 4000 h-1 in the presence of 260-300 mg m-3 SO x . The activity loss for the catalyst itself was not obvious after it had been running for six months, but blocking of the honeycomb channels by the sedimentary ash on the honeycomb catalyst modules owing to the low linear velocity resulted in decreased DeNO x efficiency and an increased pressure drop. A improved DeNO x process with gravitational dust collectors was also proposed to upgrade the present DeNO x project case for further continuous and stable operation.

[High dose tamoxifen in the reversal treatment of multidrug resistance to EP regimen in patients with non-small cell lung cancer].

BACKGROUND: To evaluate the reversal effect of high dose tamoxifen on multidrug resistance to EP regimen in patients with non-small cell lung cancer. METHODS: A total of 41 patients with NSCLC were studied, who were resistant to EP regimen and were proved to have P-gp protein overexpression. All patients were randomizedly divided into two arms. Reversal group (n=21) received oral tamoxifen 100?mg, 2 times everyday on D1-5, together with EP regimen. Control group (n=20) were only given EP regimen. RESULTS: In reversal group, complete response occurred in 1 patient, and partial response in 5; disease remained stable in 11 patients, and tumor progression occurred in 4 patients. The response rate was 28.6%(6/21). In control group, no response occurred; 9 patients had stable diseases, and the other 11 progressed. There was a significant difference in response rate between the two groups (P=0.012?1). In reversal and control groups, the median survivals were 8.4 and 4.6 months respectively (P < 0.01), and 1-year survial rates were 38.1% and 35.0% respectively. Reversal of P-gp occurred in 7 cases of reversal group (33.3%),and none in control group (P= 0.005?2) . There was no significant difference in toxicities between the two groups (P > 0.05). CONCLUSIONS: High dose tamoxifen can remarkably downregulate the expression of P-gp and partially reverse the multidrug resistance to EP regimen for non-small cell lung cancer.