Post-COVID-19 Epidemic: Allostatic Load among Medical and Nonmedical Workers in China.

BACKGROUND: As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. OBJECTIVE: During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. METHODS: An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. RESULTS: There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; p = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18-1.31; p < 0.01), depression (OR = 1.23; 95% CI 1.17-1.29; p < 0.01), somatization (OR = 1.20; 95% CI 1.14-1.25; p < 0.01), hostility (OR = 1.24; 95% CI 1.18-1.30; p < 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34-1.66; p < 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78-0.89; p < 0.01), subjective support (OR = 0.84; 95% CI 0.80-0.88; p < 0.01), utilization of support (OR = 0.80; 95% CI 0.72-0.88; p < 0.01), social support (OR = 0.90; 95% CI 0.87-0.93; p < 0.01), and global well-being (OR = 0.30; 95% CI 0.22-0.41; p < 0.01) were negatively associated. CONCLUSIONS: In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.

Synergistic effects of bevacizumab in combination with ß-elemene on subcutaneous xenografts derived from HCT-116 human colon cancer cells.

BACKGROUND: To observe the effect of bevacizumab in combination with ß-elemene on subcutaneous xenografts established from HCT-116 human colon cancer cells, explore the underlying mechanisms involved, and provide more options for the treatment of advanced colorectal cancer. METHODS: Mice were randomly divided into four groups: control, ß-elemene, bevacizumab and combination treatment. Tumor volume was measured and the tumor inhibition rate and coefficient of drug interaction (CDI) were calculated. The pathological and morphological features of the tumor tissues were observed. Protein expression levels of ki-67, CD31, vascular endothelial growth factor (VEGF) and bcl-2 were measured by immunohistochemistry. RESULTS: The tumor volumes in the four groups were 0.991±0.131, 0.833±0.145, 0.563±0.131 and 0.324±0.066 cm3, respectively. The tumor inhibition rates in the ß-elemene, bevacizumab and combination groups were 15.9%, 43.2% and 67.3%, respectively. The degree of tumor reduction in the combination group was the most significant (P<0.05), with a CDI of 0.697. Immunohistochemistry showed that the ki-67 proliferation indexes in the four groups were 30.06%±3.37%, 19.79%±3.75%, 27.51%±2.16% and 16.9%±1.09%, the microvessel densities (MVDs) were 45.86±9.28, 31.14±5.58, 27.57±6.11 and 12.14±3.53, the rates of positive VEGF expression were 39.48%±6.72%, 28.86%±3.54%, 25.04%±2.64% and 19.5%±2.68%, and the rates of positive bcl-2 expression were 33.95%±6.38%, 20.11%±9.49%, 24.28%±6.57% and 11.18%±2.72%, respectively. Compared with the control group, the three experimental groups displayed different degrees of reduction in the above indicators (P<0.05), with the combination group exhibiting the lowest values (P<0.05). CONCLUSIONS: Bevacizumab exerts a synergistic effect with ß-elemene in suppressing the growth of tumors derived from HCT-116 cells, and the related mechanisms may include the inhibition of tumor cell proliferation and tumor angiogenesis and the promotion of tumor cell apoptosis.

Crizotinib-induced acute fatal liver failure in an Asian ALK-positive lung adenocarcinoma patient with liver metastasis: A case report.

BACKGROUND: Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient. CASE SUMMARY: The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase (AST) (402 IU/L), alanine aminotransferase (ALT) (215 IU/L) and total bilirubin (145 µmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST (1075 IU/L), ALT (240 IU/L) and total bilirubin (233 µmol/L) continued to rapidly increase, and he died on day 60. CONCLUSION: Physicians should be aware of the potential fatal adverse effects of crizotinib.

Adaptive sampling rate control for networked systems based on statistical characteristics of packet disordering.

This paper investigates an adaptive sampling rate control scheme for networked control systems (NCSs) subject to packet disordering. The main objectives of the proposed scheme are (a) to avoid heavy packet disordering existing in communication networks and (b) to stabilize NCSs with packet disordering, transmission delay and packet loss. First, a novel sampling rate control algorithm based on statistical characteristics of disordering entropy is proposed; secondly, an augmented closed-loop NCS that consists of a plant, a sampler and a state-feedback controller is transformed into an uncertain and stochastic system, which facilitates the controller design. Then, a sufficient condition for stochastic stability in terms of Linear Matrix Inequalities (LMIs) is given. Moreover, an adaptive tracking controller is designed such that the sampling period tracks a desired sampling period, which represents a significant contribution. Finally, experimental results are given to illustrate the effectiveness and advantages of the proposed scheme.

[A preliminary study on the measurement of (1,3)-ß-D-glucan in bronchoalveolar lavage for the diagnosis of pulmonary fungal infections].

OBJECTIVE: To explore the measurement of (1,3)-ß-D-glucan bronchoalveolar lavage fluid (BALF) for the diagnosis of pulmonary fungal infections. METHODS: A total of 135 patients in the General Hospital of Tianjin Medical University from February 2010 to February 2011 were enrolled. There were 34 cases of confirmed or clinically diagnosed pulmonary fungal infections, 53 cases of bacterial pneumonia, and 48 cases of non-infection diseases. All patients underwent BAL and the BALF samples were obtained. (1,3)-ß-D-glucan content (G test), in BALF and plasma were tested and the data were analyzed statistically by Mann-Whitney while the receiver operating characteristic curve (ROC curve) was established, from which the best threshold of the 2 G tests was derived. RESULTS: The median of BALF G test in the fungal infection group, pneumonia group and non-infection group was 281, 28 and 10 ng/L, respectively; the level in the fungal infection group being significantly higher than those of the other 2 groups (P < 0.001), but no significant difference being observed between the pneumonia group and the non-infection group (P > 0.05). The median of plasma G tests in the fungal infection group, the pneumonia group and the non-infection group was 27, 10, and 5 ng/L, respectively; the level in the fungal infection group being significantly higher than those in the other 2 groups (P < 0.001), but there was no significant difference between the pneumonia group and the non-infection group (P > 0.05). The best threshold of BALF G test was 67 ng/L, while the best threshold of G test of plasma was 17 ng/L. CONCLUSION: As compared to G test of plasma, G test of BALF may be more accurate, and have a higher clinical value for the earlier diagnosis of pulmonary fungal infections.

CT-guided radioactive seed implantation for recurrent rectal carcinoma after multiple therapy.

The recurrent carcinoma has been difficult to manage after surgery and radiotherapy, extensive resection of locally recurrent rectal cancer is associated with significant morbidity and mortality. Re-irradiation, even in combination with chemotherapy has shown very short survival. We assess the feasibility and efficacy of CT-guided interstitial permanent brachytherapy with (125)I or (103)Pd seeds for recurrent rectal cancer after multiple treatments. Fifteen patients with locally recurrent rectal carcinoma received (125)I or (103)Pd seed implants under CT guidance. The minimal peripheral dose of seed implants was 110-165 Gy (median 150 Gy). Two weeks after seed implantation, a 50 Gy of stereotactic radiotherapy was given to one patient; four patients received 2-4 cycles of chemotherapy. A median follow-up was 8 months (range 4-50 months). The duration of pain-free survival was 0-50 months (median 7 months). Local control was maintained for 3-50 months (median 7 months). The 1- and 2-year local controls were 16.2 and 8.1%, respectively. Eleven patients died: two (18.2%) of local recurrence, seven (63.6%) of local recurrence and metastases, and two (18.2%) of metastases. Four patients (26.7%) survived the median survival was 9 months. The 1- and 2-year actuarial overall survival rates were 42.9% and 10.7%, respectively. One patient (7.6%) experienced a grade 4 toxic event; there was no associated neuropathy. CT-guided radioactive seed implantation is feasible and safe as a salvage or palliative pain relief treatment for patients with recurrent rectal cancers after surgery and radiotherapy.

Interstitial permanent implantation of 125I seeds as salvage therapy for re-recurrent rectal carcinoma.

PURPOSE: To assess the feasibility, efficacy, and morbidity of (125)I seeds interstitial permanent implant as salvage therapy for re-recurrent rectal cancer. METHODS AND MATERIALS: From September 2003 to October 2007, (125)I seeds implant procedures were performed under CT or ultrasound guidance for thirteen patients with locally re-recurrent rectal carcinoma. The minimal peripheral doses (MPD) of (125)I seeds implanted ranged from 120 to 160 Gy, with a median MPD of 140 Gy to total decay. Three patients also received two to four cycles of chemotherapy after seed implantation. RESULTS: After a median follow-up of 10 months (range 3-45), the pain-free interval was 0-14 months with a median of 7 months (95% CI: 3-11 months). The response rate of pain relief was 46.2% (6/13). Local control was 3-14 months with a median of 7 months (95% CI: 3.5-10.5 months). The 1- and 2-year local control rates were 14.4% and 0%, respectively. Three (23.1%) patients died of local recurrence; seven (53.8%) patients died of local recurrence and metastases; one (7.7%) patient died of metastases. Two (15.4%) patients survived to follow-up. At the time of analysis, the median survival was 10 months (95% CI: 3.9-16.1 months). The 1- and 2-year actuarial overall survival rates were 46.2% and 11.5%, respectively. Two (15.4%) patients experienced a grade 4 toxic event. Seed migration to the pelvic wall was observed in one (7.7%) patient. There was no associated neuropathy. CONCLUSION: (125)I seed implantation is feasible, effective, and safe as a salvage or palliative treatment for patients with re-recurrent rectal cancer.