Preoperative Neutrophil to Lymphocyte Ratio Predicts Complications After Esophageal Resection That can be Used as Inclusion Criteria for Enhanced Recovery After Surgery.

Background: The neutrophil to lymphocyte ratio (NLR) has been reported as an indicator for poor prognosis in many cancers including esophageal cancer. However, the relationship between the NLR and postoperative complications after esophageal cancer resection remains unclear. At present, enhanced recovery after surgery (ERAS) lacks inclusion criteria. The aim of this study is to determine whether the preoperative NLR (preNLR) can predict complications after esophageal cancer resection, which could represent the criteria for ERAS. Methods: This was a retrospective study on 171 patients who underwent esophagectomy at Hospital between November 2020 and November 2021(68 patients from Changhai Hospital, 65 patients from Shanghai General Hospital and 38 patients from Affiliated Hospital of Qingdao University). Univariate and multivariate logistic regression analyses were performed to demonstrate that the preNLR could predict complications after esophagectomy. Results: A preNLR cutoff value of 2.30 was identified as having the greatest ability to predict complications with a sensitivity of 76% and specificity of 65%. Moreover, the Chi-squared test results showed that the preNLR was significantly associated with complications (x2 = 13.641, p < 0.001), and multivariate logistic regression analysis showed that body mass index (BMI), p stage and preNLR were independent variables associated with the development of postoperative complications (p < 0.05). Conclusion: The preNLR can predict complications after esophagectomy, and these predicted complications can represent the criteria for recruiting patients for ERAS.

Clinical study on the short-term outcome of asymptomatic bacterial vaginosis / 中国实用妇科与产科杂志

OBJECTIVE: To explore the method of management of asymptomatic bacterial vaginosis,and to evaluate the effect of probiotics on asymptomatic bacterial vaginosis and analyze the benefit gained by those patients.METHODS: A multicenter,randomized,double-blind,controlled study was performed with probiotics in test group,and placebo in control group,from september 2013 to september 2016 in 4 hospitals.Forty five patients in test group were treated with vaginal capsule probiotics,and placebo was used in forty-five patients in control group.The follow-up in both groups lasted for 4 weeks.Cure rate,relapse rate and progression rate in both groups were analyzed to evaluate the effect and the benefits gained by patients.RESULTS: Ninty patients were recruited in the study,and seventy-nine patients finished the study and were followed up with complete information.Two weeks after the treatment,in FAS the cure rate in test group was significantly higher than that of the control(44.4% vs. 6.7%,P0.05).In PPS,the cure rate in test group was significantly higher than that of the control(52.5% vs. 2.6%,P0.05).After 2 weeks of treatment,there was no relapsed patient.Four weeks after the treatment,in FAS the cure rate in test group was significantly higher than that of the control(46.7% vs. 8.9%,P0.05).In PPS,the cure rate in test group was significantly higher than that of the control(57.5% vs. 5.1%,P0.05).Four weeks after the treatment,there was no relapsed patient,either.CONCLUSION: Vaginal capsule probiotics can be used to treat asymptomatic BV with high cure rate,less side effect and low relapse rate.

Testes-specific protease 50 as an independent risk factor for poor prognosis in patients with non-small cell lung cancer.

Testes-specific protease 50 (TSP50) is normally expressed in the testes and is overexpressed in various types of human cancers, including breast cancer, colorectal carcinoma and laryngocarcinoma. However, little has been reported on the association between TSP50 and non-small cell lung cancer (NSCLC). The present study aimed to detect TSP50 expression in 198 strict follow-up cases of paired NSCLC and 15 cases of normal lung parenchymal specimens using immunohistochemical staining. The expression levels of TSP50 were then correlated with the clinicopathological factors of NSCLC to assess its potential diagnostic and prognostic value. The relationship between TSP50 expression and the clinicopathological parameters of NSCLC was evaluated using χ2 and Fisher's exact tests. Survival rates for the overall population (n=198) were calculated using the Kaplan-Meier method, and univariate and multivariate analyses were performed using the Cox's proportional hazards regression model. P<0.05 was considered to indicate a statistically significant difference. The expression of TSP50 was significantly increased in NSCLC tissue compared with in adjacent non-tumor or normal lung parenchymal tissue (P<0.001). A significant association was revealed between high expression levels of TSP50 and clinicopathological characteristics including tumor differentiation (P=0.012), late tumor status (P=0.004) and late tumor node metastasis stage (P=0.026), as well as a reduced disease free survival (P=0.009) and overall survival rate (P=0.002) in all patients with NSCLC. Multivariate analyses demonstrated that high TSP50 expression in tumor tissues was significantly associated with a shorter disease-free survival rate [hazard ratio (HR) =1.590, 95% confidence interval (CI): 1.035-2.441], and with a shorter overall survival rate (HR=1.814; 95% CI: 1.156-2.846). In conclusion, the present data demonstrated that increased TSP50 protein expression may be a potential predictor of early recurrence and poor prognosis in NSCLC, and that TSP50 expression levels possess the potential to be used as a biomarker and therapeutic target for the treatment of patients with NSCLC.

A review on the management of tic disorders in children: psychoeducation and behavioral intervention / 中国当代儿科杂志

Tic disorders (TD) are a group of neurodevelopmental disorders that are characterized by motor and/or vocal tics in children and adolescents. The etiology and pathogenesis of TD remain unclear, and it is believed to be caused by a combination of genetic, biological, psychological, and environmental factors. The major treatment for TD includes psychoeducation, behavioral intervention, and drug treatment. To further explore the management of TD, this article reviews the research advances in psychoeducation and behavioral intervention for patients with TD.

Species Distribution and In Vitro Antifungal Susceptibility of Vulvovaginal Candida Isolates in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vulvovaginal candidiasis (VVC) was a common infection associated with lifelong harassment of woman's social and sexual life. The purpose of this study was to describe the species distribution and in vitroCandidaCandida spp.) isolated from patients with VVC over 8 years.</p><p><b>METHODS</b>Species which isolated from patients with VVC in Peking University First Hospital were identified using chromogenic culture media. Susceptibility to common antifungal agents was determined using agar diffusion method based on CLSI M44-A2 document. SPSS software (version 14.0, Inc., Chicago, IL, USA) was used for statistical analysis, involving statistical description and Chi-square test.</p><p><b>RESULTS</b>The most common strains were Candida (C.) albicans, 80.5% (n = 1775) followed by C. glabrata, 18.1% (n = 400). Nystatin exhibited excellent activity against all species (<4% resistant [R]). Resistance to azole drugs varied among different species. C. albicans: clotrimazole (3.1% R) < fluconazole (16.6% R) < itraconazole (51.5% R) < miconazole (54.0% R); C. glabrata: miconazole (25.6% R) < clotrimazole (50.5% R) < itraconazole (61.9% R) < fluconazole (73.3% R); Candida krusei: clotrimazole (0 R) < fluconazole (57.7% R) < miconazole (73.1% R) < itraconazole (83.3% R). The susceptibility of fluconazole was noticeably decreasing among all species in the study period.</p><p><b>CONCLUSIONS</b>Nystatin was the optimal choice for the treatment of VVC at present. The species distribution and in vitroCandida spp. isolated from patients with VVC had changed over time.</p>

Three-dimensional vs two-dimensional video assisted thoracoscopic esophagectomy for patients with esophageal cancer.

AIM: To define the benefits of three-dimensional video-assisted thoracoscopic esophagectomy (3D-VATE) over 2D-VATE for esophageal cancer. METHODS: A total of 93 patients with esophageal cancer including 45 patients receiving 3D-VATE and 48 receiving 2D-VATE were evaluated. Data related to patient and cancer characteristics, operating time, intraoperative bleeding, morbidity and mortality, postoperative inflammatory markers, Numerical Rating Scale for postoperative pain, Constant-Murley rating system for shoulder recovery and oxygenation index (OI) were collected. All medical records were retrieved from a prospectively maintained oncological database at our institution. A retrospective study was performed to compare the short-term surgical outcomes between the two groups. RESULTS: No significant differences were found between the two groups in either morbidity or mortality (P = 0.328). An enhanced surgical recovery was noted in the 3D group as indicated by shortened thoracoscopic operation time (3D vs 2D: 68 ± 13.79 min vs 83 ± 13 min, P < 0.01), minor intraoperative blood loss (3D vs 2D: 68.2 ± 10.7 mL vs 89.8 ± 10.4 mL, P < 0.01), earlier chest tube removal (3D vs 2D: 2.67 ± 1.01 vs 3.75 ± 1.15 d, P < 0.01), shorter length of hospital stay (3D vs 2D: 9.07 ± 2.00 vs 10.85 ± 3.40 d, P < 0.01), lower in-hospital expenses (3D vs 2D: 74968.4 ± 9637.8 vs 86211.1 ± 8519.7 RMB, P < 0.01), lower pain intensity (P < 0.01) and faster recovery of the left shoulder function (P < 0.01). Better preservation of the pulmonary function was also found in the 3D group as the decline of the OI post operation was significantly lower than that of the 2D group (P < 0.01). Changes of postoperative inflammatory markers, including procalcitonin [postoperative days (PODs) 4 and 7: P < 0.01], peripheral granulocytes (PODs 1, 4 and 7: P < 0.01) and hypersensitive C-reactive protein (POD 4: P < 0.01) in 3D-VATE patients were less than those in the 2D group. Moreover, utilization of the 3D technique extended the dissection of the thoracic lymph nodes (P < 0.01), with better exposure of nodes in the left recurrent laryngeal nerve (P = 0.031). CONCLUSION: 3D-VATE could be a more viable technique over 2D-VATE in terms of short-term outcomes for patients with esophageal cancer.