Application of digital health in the management and control of chronic noncommunicable diseases / 中华全科医师杂志

Chronic noncommunicable diseases are heavily burdened in China. In recent years, the digital health has developed rapidly in the medical and health industry, which provides new ways for the prevention, control and management of chronic diseases. The application of digital health includes the electronic health records, remote diagnosis and treatment, monitoring and management of the health status, the development of digital medicine and the digital medical insurance. This article reviews the connotation of digital health and its main applications in the prevention, control and management of chronic diseases, and also discusses the future directions and challenges of digital health.

Coffee intake and cancer： an umbrella review of meta-analyses / 上海预防医学

ObjectiveWith the increase in coffee consumption， its impact on health has garnered significant attention. However， the relationship between coffee intake and cancer risk remains controversial in epidemiological studies. To summarize the most reliable evidence on coffee consumption and cancer risk， we conducted a comprehensive review of meta-analyses examining the association between coffee consumption and cancer risk in various populations. MethodsMeta-analyses of observational studies were conducted， utilizing searches of the PubMed and Web of Science databases to identify associations between coffee intake and cancer risk. ResultsA total of 24 observational studies comprising 76 non-overlapping associations were included in this umbrella review. Coffee intake was found to be associated with a reduced risk of breast cancer， brain cancer， colon cancer， colorectal cancer， endometrial cancer， liver cancer， melanoma， non-melanoma， oral cancer， and oral/pharyngeal cancer. Conversely， coffee intake was associated with a high risk of urothelial carcinoma and bladder cancer. ConclusionModerate consumption of coffee has a wide range of potential benefits in reducing the risk of cancer. Further well-designed randomized controlled trials， taking into account other factors that may have contributed to bias， are needed to investigate the association between coffee consumption and cancer in other anatomical sites.

Review on data analysis and application of high-throughput peptide arrays / 上海预防医学

This article introduces a high-throughput molecular screening chip： peptide arrays. As a kind of biochip， the peptide arrays are easy to synthesis， stable in probe chemistry， high-throughput in screening and highly specific compared with other biochips. To analyze the new high-throughput data， researchers have recently proposed a series of deep learning and bioinformatics methods to study the binding characteristics of peptide probes and target molecules. Those algorithms could be used to predict the binding affinity of protein targets against peptides. Moreover， peptide arrays could also play important roles in analyzing protein-protein interactions，screening novel drug peptides， disease diagnosis and general health assessment based on recent reports. The application of this new technology could provide novel insights into public health research.

PLC, PTH and NF-κB increased during orthodontic bone remodeling in chronic stress rats.

This study was designed to investigate the potential effects of chronic stress on periodontal bone remodeling and its mechanism during orthodontic tooth movement in rats. Forty-eight male SD rats aged 8 weeks were randomly divided into control group and chronic stress group. Chronic unpredictable mild stress model (CUMS) was established in the stress group, which was validated by behavioral experiment as well as cortisol (CORT) and adrenocorticotropic hormone (ATCH) levels. Then, the two groups were further divided into three distinct groups, namely group with no orthodontic force, group with 30 g orthodontic force and group with 50 g orthodontic force respectively to construct orthodontic tooth movement model. The rats were sacrificed after 14 days and maxilla on the loading side was obtained to measure tooth movement distance. It was found that compared with the control group, the chronic stress group displayed increased parathyroid hormone (PTH), amino terminal peptide of type I procollagen (PINP) and c-terminal peptide of type I collagen branch (CTX) levels as measured by enzyme-linked immunosorbent assay (ELISA). Hematoxylin and Eosin (HE) and TRAP staining showed fewer osteoblasts and more number of osteoclasts. The results of western blot showed no significant change in expression of Adenylate cyclase (AC) but increased phospholipase C (PLC) levels were noted. In addition, increased NF-κB expression was observed by immunohistochemistry. Overall, chronic stress can affect bone remodeling during orthodontic tooth movement by increasing the content of PTH in the blood and increasing PLC and NF-κB.

Implementation of informatization construction and auxiliary decision-making of COVID-19 designated hospitals based on agile business intelligence system / 中华医院管理杂志

In order to complete the information statistics and submission work of designated hospitals with high quality, a hospital uses the agile business intelligence system to carry out information construction, and realize the statistics, analysis and auxiliary management decision-making of COVID-19 patients′ admission data. Based on the low-load and full-volume data capture mechanism, relevant basic data in the background of the hospital information system was extracted, and the admission information visualization and early warning analysis system was built by establishing data relations, data modeling and other methods. The hospital completed 634 batches of data statistics and reporting tasks of 2 943 patients in a timely and efficient manner, and assisted clinical diagnosis and treatment improvement and hospital leadership decision-making by using data analysis, early warning feedback and other functions.

Study on the construction of modular and multidisciplinary nutrition innovation platform in Shanghai / 上海预防医学

ObjectiveTo determine the situation and challenges of innovation platforms in China， and to explore the construction strategy of Shanghai Nutrition Innovation Platform， which is suitable for Shanghai and may achieve the research and transformation of nutrition innovation and population health， so as to coordinate， unite and gather the superior resources of all parties and promote nutrition innovation. MethodsConstruction scheme and operational mechanism of Shanghai Nutrition Innovation Platform were explored by literature review， expert consultation and questionnaire. ResultsThere were various forms of innovation platforms in China. However， challenges were identified， such as decentralizing force， resource rearrangement and insufficient sharing effect. Shanghai Nutrition Innovation Platform adopted a modular organizational structure， which was divided into central group， node group， and subject group. Shanghai Center for Disease Control and Prevention， as the central organization， is responsible for the platform operation management. The expert database as an academic committee selected key organizations from nutrition-related universities， research institutes， academic associations， centers for disease control and prevention， hospitals and the industry. Based on the opening of its own innovation resources， the platform made effective use of external innovation resources and formed a closely integrated nutrition innovation network of multiple disciplines. ConclusionThis study promotes the construction of innovation platform model of cooperation， co-construction and resource sharing， and provides reference for the construction of innovation platform in China.

Application of nanopore sequencing in environmental microbiology research / 生物工程学报

The development of high-throughput sequencing techniques enabled a deeper and more comprehensive understanding of environmental microbiology. Specifically, the third-generation sequencing techniques represented by nanopore sequencing have greatly promoted the development of environmental microbiology research due to its advantages such as long sequencing reads, fast sequencing speed, real-time monitoring of sequencing data, and convenient machine carrying, as well as no GC bias and no PCR amplification requirement. This review briefly summarized the technical principle and characteristics of nanopore sequencing, followed by discussing the application of nanopore sequencing techniques in the amplicon sequencing, metagenome sequencing and whole genome sequencing of environmental microorganisms. The advantages and challenges of nanopore sequencing in the application of environmental microbiology research were also analyzed.

Analysis of PARP inhibitors induced anemia in advanced and relapsed epithelial ovarian cancer / 中华妇产科杂志

Objective:To explore the clinical features of poly ADP-ribose polymerase (PARP) inhibitor-related anemia in advanced and relapsed epithelial ovarian cancer (EOC).Methods:Patients diagnosed with advanced or relapsed EOC and treated with PARP inhibitor at National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2015 to October 2020 were accrued. The data included PARP inhibitors, treatment details, and lab tests before treatment and during treatment were collected and the clinical characteristics of PARP inhibitor-related anemia were analyzed.Results:(1) A total of 98 patients with a median age of 56.5 years old (30-82 years old) were enrolled in this study. All patients were treated with PARP inhibitor (65 cases of olaparib, 17 cases of niraparib, and 16 cases of fluzoparib). The median treatment duration was 37.5 weeks (4-119 weeks). (2) The anemia rate was 40% (39/98), including 5% (5/98) of grade Ⅰ, 14% (14/98) of grade Ⅱ, 11% (11/98) of grade Ⅲ, and 9% (9/98) of grade Ⅳ. Fourteen patients with pre-treatment grade Ⅰ anemia had a higher rate of anemia events than the 80 patients without pre-treatment anemia, 7/14 vs 35% (28/80; χ2=4.281, P=0.039). (3) The median anemia occurrence time was 7.0 weeks (1-52 weeks), including 41% (16/39) of anemia cases occurred in 1-4 weeks, 26% (10/39) occurred in 5-8 weeks, 13% (5/39) occurred in 9-12 weeks, 3% (1/39) occurred in 13-16 weeks, 10% (4/39) occurred in 17-20 weeks, 8% (3/39) occurred ≥21 weeks. At the time of the lowest hemoglobulin tested, the median value of mean corpuscular volume (MCV) was 106 fl,which was higher than the up limit of normal range (100 fl), 74% (29/39) of anemia patients had an elevated MCV level; the median value of mean corpuscular hemoglobin (MCH) was 36 pg, 54% (21/39) of anemia patients had an elevated MCH level; the median value of mean corpuscular hemoglobin concentration (MCHC) was 320 g/L, 69% (27/39) of anemia patients had a higher MCHC level; 92% (36/39) of anemia patients had a normal level of serum iron; 79% (31/39) of anemia patients had a normal level of transferrin. 74% (29/39) of the anemia patients were macrocytic orthochromatic anemia. (4) Among the 39 patients with anemia, 20 patients (51%, 20/39) withhold the treatment of PARP inhibitor due to grade Ⅲ or Ⅳ anemia, including 10 patients (50%, 10/20) who resumed the PARP inhibitor treatment by suppling iron, folate, and vitamin B 12. The median stopping time of PARP inhibitor was 5.5 weeks (2-10 weeks), while the other 10 patients terminated the PARP inhibitor treatment for not recovering from severe anemia. Conclusions:One of the common adverse effects of PARP inhibitors is anemia, which mostly happened in the first 3 months of treatment. In the treatment of EOC, PARP inhibitor-related anemia mainly manifest as macrocytic orthochromatic anemia, and most patients with normal serum iron and transferrin.

Expert Consensus for Thermal Ablation of Pulmonary Subsolid Nodules (2021 Edition) / 中国肺癌杂志

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Prevalence and clinical features of 2019 novel coronavirus disease (COVID-19) in the Fever Clinic of a teaching hospital in Beijing: a single-center, retrospective study

BackgroundWith the spread of COVID-19 from Wuhan, Hubei Province to other areas of the country, medical staff in Fever Clinics faced the challenge of identifying suspected cases among febrile patients with acute respiratory infections. We aimed to describe the prevalence and clinical features of COVID-19 as compared to pneumonias of other etiologies in a Fever Clinic in Beijing. MethodsIn this single-center, retrospective study, 342 cases of pneumonia were diagnosed in Fever Clinic in Peking University Third Hospital between January 21 to February 15, 2020. From these patients, 88 were reviewed by panel discussion as possible or probable cases of COVID-19, and received 2019-nCoV detection by RT-PCR. COVID-19 was confirmed by positive 2019-nCoV in 19 cases, and by epidemiological, clinical and CT features in 2 cases (the COVID-19 Group, n=21), while the remaining 67 cases served as the non-COVID-19 group. Demographic and epidemiological data, symptoms, laboratory and lung CT findings were collected, and compared between the two groups. FindingsThe prevalence of COVID-19 in all pneumonia patients during the study period was 6.14% (21/342). Compared with the non-COVID-19 group, more patients with COVID-19 had an identified epidemiological history (90.5% versus 32.8%, P<0.001). The COVID-19 group had lower WBC [5.19x109/L ({+/-}1.47) versus 7.21x109/L ({+/-}2.94), P<0.001] and neutrophil counts [3.39x109/L ({+/-}1.48) versus 5.38x109/L ({+/-}2.85), P<0.001] in peripheral blood. However, the count of lymphocytes was not different. On lung CT scans, involvement of 4 or more lobes was more common in the COVID-19 group (45% versus 16.4%, P=0.008). InterpretationIn the period of COVID-19 epidemic outside Hubei Province, the prevalence of COVID-19 in patients with pneumonia visiting our Fever Clinic in Beijing was 6.14%. Epidemiological evidence was important for prompt case finding, and lower blood WBC and neutrophil counts may be useful for differentiation from pneumonia of other etiologies. FundingNone.

Experience of the support of medicine in Harmonious Mission -2018 / 药学实践杂志

Objective Through the statistics of drug consumption in the task of Harmonious Mission -2018, sort out the process of medication supply of overseas medical services, analyze and evaluate the medication supply services. Methods Count the types and quantities of medicines consumed by marine hospitals in the Harmonious Mission-2018, analyze whether the preparation of medicines is sufficient, effective, and economically reasonable, and find way to improve the process of medicine supply in overseas medical services. Results Statistics on the consumption of drugs in the Harmonious Mission-2018 show that the number of drugs consumed accounted for 68.21% of the total kinds of medicine carried, that the total amount of drugs consumed accounted for 40.61% of the total costs of medicine carried, and that the total number of boxes of drugs consumed (the number of the smallest packages) accounted for 21.72% of the total number of boxes of medicine carried. Conclusion The medicine support services in the Harmonious Mission-2018 was sufficient and effective. But, the workflow and the processes of the services still need to be further improved.

Summary of the 30th International Symposium on Amyotrophic Lateral Sclerosis-Motor Neuron Disease / 中华神经科杂志

The 30th International Symposium on Amyotrophic Lateral Sclerosis-Motor Neuron Disease was held in Perth, Australia from December 4 to 6, 2019. This article mainly introduces the clinical research of this meeting, including epidemiology, non-motor symptoms, auxiliary examinations and biomarkers, etc., while the basic research includes genomics and genetics, protein metabolism abnormalities, neuroimmunity and inflammation, synapse pathology and preclinical treatment strategies,

Diagnosis and treatment of primary thyroid lymphoma: a single center analysis / 中华内分泌外科杂志

Objective:To summarize the experience of diagnosis and treatment of primary thyroid lymphoma (PTL) and improve the level of diagnosis and treatment.Methods:The clinical and pathological data of 19 patients with PTL admitted to the Department of Breast and Thyroid Surgery, Daping Hospital, Army Medical University From Mar. 2000 to Jul. 2019 were retrospectively reviewed.Results:among the 19 PTL patients, 4 were male and 15 were female, with an average age of 69 years (51-88 years) . 15 cases showed rapid enlargement of neck mass, 9 cases with swallowing obstruction, 7 cases with hoarseness and 5 cases with dyspnea. 13 cases were diagnosed by intervention, the other 6 cases were diagnosed by biopsy. There were 1 case of Hodgkin’s lymphoma and 18 cases of non Hodgkin’s lymphoma, including 13 cases of diffuse large B cell lymphoma and 4 cases of mucosa associated lymphoid tissue lymphoma. 12 cases received chemotherapy and 1 case received radiotherapy. The median follow-up period was 28 months (0-88 months) , 5 cases were lost, 6 cases died, 3 cases died of recurrence and spread of lymphoma, 3 cases died of others.Conclusions:PTL is more likely to occur in the elderly women, which is characterized by sudden enlargement of cervical mass and its related compression symptoms. The diagnosis can be confirmed by coarse needle biopsy or surgical intervention. PTL needs comprehensive treatment including surgery, chemotherapy and targeted treatment.

Etiologic characteristics of adults with community-acquired pneumonia / 中华急诊医学杂志

Objective:To investigate the etiologic characteristics of adults with community acquired pneumonia (CAP).Methods:Respiratory tract specimens were collected from 246 cases of community acquired pneumonia in Peking University Third Hospital after excluding tuberculosis, pulmonary tumor, non-infectious pulmonary interstitial disease, pulmonary edema, pulmonary atelectasis, pulmonary embolism, pulmonary eosinophil infiltration and pulmonary vasculitis. Nineteen respiratory pathogens were tested by multiple real-time fluorescent quantitative PCR to investigate the distribution of respiratory pathogens.Results:The positive rate of nucleic acid detection in respiratory pathogens was 46.7%, among which 25.6% was virus, 19.9% atypical pathogens and 18.7% bacteria. The most prevalent viruses were influenza virus (14.6%), parainfluenza virus (2.8%) and rhinovirus (2.8%). The three most prevalent bacteria were Streptococcus pneumoniae (8.5%), Haemophilus influenzae (6.1%)and Klebsiella pneumoniae (2.4%). The positive rate of Mycoplasma pneumoniae was higher in patients <65 years than that in patients≥65 years (21.3% vs 2.6%, χ 2=10.376, P=0.001). Conclusions:Respiratory virus is the leading respiratory pathogens in community acquired pneumonia exceeding bacteria and Mycoplasma pneumoniae, Influenza virus and Streptococcus pneumoniae are the top three pathogens in CAP.

Effects of wearing a mask on oxygenation of subjects with spontaneous breathing during supplementary oxygen through facemask / 生物医学工程学杂志

During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows. However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask. This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods ('disposable medical mask + anesthetic facemask' and 'anesthetic facemask only') on the oxygenation of subjects. Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation; however, compared with the group without mask, the arterial oxygen partial (PaO

Analysis of treatment and prognosis of 59 cases of vulvar melanoma / 中华妇产科杂志

Objective:To assess the treatment and prognosis of vulvar melanoma.Methods:A total of 59 cases of primary vulvar melanoma admitted to Cancer Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences from January 1st, 1981 to November 30th, 2019 were collected. The clinical characteristics, treatment, survival and prognostic factors of vulvar melanoma were analyzed retrospectively. The end date of follow-up was January 15th, 2020.The median follow-up time was 26.0 months (range:2-198 months).Results:(1) Clinical characteristics: the median age of 59 patients with vulvar melanoma was 56 years old (range:18-83 years old). According to the American Joint Committee on Cancer stage manual, there were 18, 7, 26 and 8 cases of stage Ⅰ, Ⅱ, Ⅲ and Ⅳ respectively. The lesion of 38 cases was single and the other 21 cases were multiple. The largest diameter of the tumor ranged from 0.3 to 17.0 cm.The surface of the lesion was ulcerated in 17 cases. (2) Treatment: a total of 59 cases with vulvar melanoma, 56 patients received surgery, 36 cases of them received radical resection of vulva and 20 received local extended resection of vulvar tumor due to unilateral vulva lesion. Three patients did not receive surgery,one received chemotherapy combined with interferon, one received interferon, and one received radiotherapy. Lymph node management: among the 56 patients treated by surgery, 37 patients received inguinal lymphadenectomy, 24 (65%, 24/37) of whom were confirmed with inguinal lymph node metastasis by postoperative pathological examination. Inguinal lymph nodes enlargement were not found in 19 cases by preoperative imaging and clinical examination. In these 19 patients, three patients received inguinal lymph node biopsy, among them, one (1/3) patient was confirmed with inguinal lymph node metastasis by postoperative pathological examination, and the remaining 16 patients did not receive inguinal lymph node surgery. Postoperative adjuvant treatment: among the 56 patients who received surgery, 31 received adjuvant chemotherapy，one received adjuvant radiotherapy, four received interferon therapy, 17 received combination therapy including chemotherapy, and three did not receive postoperative adjuvant therapy. (3) Survival:during the follow-up period, the median survival time of 59 patients with vulvar melanoma was 30.0 months (range:2.0-198.0 months). The 3-year survival rate was 42.5%, and the 5-year survival rate was 23.8%. The median survival time of stage Ⅰ, Ⅱ, Ⅲ and Ⅳ were 72.0, 45.0, 24.0 and 23.0 months, respectively. The difference among stage Ⅰ, Ⅱ and stage Ⅲ, Ⅳ were statistically significant （ P<0.01）. The median survival time of patients undergoing radical resection of the vulva (35.0 months) and local enlarged tumor resection (29.0 months) were significantly longer than that of patients without surgery (9.0 months, P<0.01). The median survival time of the patients who underwent inguinal lymphadenectomy, lymph node biopsy and those who did not undergo surgery were 35.0, 32.0 and 30.0 months, respectively. There were no significant differences among the 3 groups ( P>0.05). The median survival time of postoperative adjuvant chemotherapy patients (49.0 months) were significantly longer than that of postoperative adjuvant radiotherapy, interferon,and combination therapy including chemotherapy (9.0, 14.0 and 26.0 months, respectively, all P<0.01). (4) Prognostic factors: the univariate analysis showed that stage, vulvar operation and postoperative adjuvant treatment were the risk factors affecting the prognosis of patients with vulvar melanoma ( P<0.01). Multivariate analysis revealed that stage alone was an independent risk factor affecting the prognosis of patients with vulvar melanoma ( P<0.01). Conclusions:The prognosis of patients with vulvar melanoma is poor, and stage is an independent prognostic factor.Surgery combined with postoperative adjuvant chemotherapy may achieve relatively good results.

Role of transcatheter arterial embolization in the management of refractory hematuria of prostatic origin / 中华放射学杂志

Objective To evaluate the safety and efficacy of transcatheter arterial embolization (TAE) in the management of refractory hematuria of prostatic origin (RHPO). Methods This retrospective study from 6 hospitals in china consisted of 31 patients (mean age 75.0±7.5 years, range 58 to 84 years) who underent transcatheter arterial embolization (TAE) for RHPO between February 2011 and January 2017. Patients with RHPO who had complete imaging and clinical data were enrolled. Patients with incomplete clinical data, inability to assess hemostasis, and contraindications to TAE were excluded. The cause of RHPO was benign prostatic hyperplasia (BPH) in nine patients, prostate cancer in twelve, transurethral resection of prostate in four, open prostatectomy in two and prostatic sarcoma in four. Superselective arterial embolization, non-superselective arterial embolization or intra-arterial infusion chemotherapy was performed according to the etiology and angiography. Angiographic findings, technical success rate, clinical success rate, complications were recorded. Results Of the 31 patients, 6 patients (19.4％) were with active bleeding, 4 (12.9％) with aneurysm and 27 (87.1％) with abnormal neovascularization on the angiogram. The 31 patients underwent a totle of 37 TAE, the technical success rate was 100.0％(37/37) and the recent hemostasis success rate was 90.3％(28/31). The incidence of mild complications was 38.7％(13/31), there was no serious complication associated with TAE. Conclusion TAE is a safe and effective method for the treatment of refractory hematuria of prostatic origin.

Summary of the Twenty-ninth International Symposium on Amyotrophic Lateral Sclerosis-Motor Neuron Disease / 中华神经科杂志

The 29th International Symposium on Amyotrophic Lateral Sclerosis (ALS)-Motor Neuron Disease was held in Glasgow from December 7 to 9, 2018. The symposium was divided into 23 topics, with 109 special reports and paper′s exchange and 515 posters exchange. This article briefly introduces some topics of the symposium, involving basic researches, clinical researches and clinical trials. Among these, basic researches include genetics and genomics, axonal degeneration, disease models, and preclinical therapeutic strategies; Clinical researches include epidemiology, clinical progression, cognitive and psychological change, neuropathology, neurophysiology, neuroimaging and biomarkers.

Analysis of effects and postoperative clinicopathological prognosis factors of neoadjuvant chemotherapy in patients with stage Ⅰb2 and Ⅱa2 squamous cell carcinoma of the cervix / 中华妇产科杂志

Objective@#To explore the effects and postoperative prognostic factors in cervical cancer patients received neoadjuvant chemotherapy combined with surgery and post-operative adjuvant therapy.@*Methods@#A total of 177 patients with cervical cancer at International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ b2, Ⅱ a2 who underwent neoadjuvant chemotherapy (NACT) followed by surgery with and without adjuvant therapy in Cancer Hospital, Chinese Academy of Medical Sciences were included. Univariate and multivariate analyses of 5-year overall survival (OS) rate and 5-year disease-free survival (DFS) rate were performed.@*Results@#Of 177 patients, 133 (75.1%) had stage Ⅰb2 and 44 (24.9%) had Ⅱa2 cancers. After NACT, overall response rate was 63.3% (112/177) including 12 cases of complete response (CR), 100 of partial response (PR) and no progressive disease (PD) case. At a median follow-up of 59.2 months, the 5-year DFS rate was 73.6% and the 5-year OS rate was 86.8%. Univariate analysis revealed that lymph node metastasis, deep stromal invasion and tumor size after NACT significantly affected 5-year DFS rate (P<0.05). Lymph node metastasis, deep stromal invasion and tumor size after NACT significantly affected 5-year OS rate (P<0.05). The multivariate analysis showed that, stromal invasion (outer 1/3 or outer 1/2) was independent risk factor of 5-year DFS rate (P<0.05), and 5-year OS rate was significantly affected by tumor size >3 cm after NACT (P<0.05).@*Conclusions@#The effect of NACT in Ⅰ b2, Ⅱ a2 squamous carcinoma of the uterined cervix is confirmed. The independent risk factor for 5-year DFS rate in patients received NACT and hysterectomy is deep stromal invasion of the cervix. The presence of tumor size >3 cm after NACT adversely affect 5-year OS rate.

Clinical efficacy and safety of CT-guided percutaneous microwave ablation for elderly patients with early-stage non-small cell lung cancer / 中华老年医学杂志

Objective To investigate the clinical efficacy and safety of CT-guided percutaneous microwave ablation (MWA)in elderly patients with early-stage lung cancer who were unable to underwent surgery,and to evaluate the risk factors for prognosis.Methods A total of 51 patients with early stage(stages Ⅰ and ⅡA)non-small cell lung cancer (NSCLC)who underwent MWA in Beijing hospital from January 2016 to December 2018 were collected as the MWA group.And 50 patients with similar age and gender receiving lobectomy surgery were collected as the control group.In a retrospective follow-up study,the clinical efficacy and safety of treatment were compared between the study(n=51)and control(n=50)groups.Kaplan-Meier survival analysis was used to assess the overall survival and local recurrence-free survival.COX analysis was used to evaluate the risk factors.Results Of the 101 patients,62 were male(61.4％),aged 60-85 years(average,72.3± 11.6 years).There was no significant difference in baseline characteristics,including age,gender,smoking,medical history,lung function,tumor size,pathological type and histological grading,tumor position and clinical stage between the two groups(P＞0.05).There were no serious complications in the MWA group during perioperative period,and 14 cases (27.5％)had a small amount of pneumothorax after operation,which were absorbed after special treatment.Five cases (9.8％)had a small amount of hemoptysis,7 cases(13.7％)had a small amount of pleural effusion,9 cases(17.6％)had low fever (＜ 38.5 ℃),and 9 cases (17.6 ％) had postoperative mild pain.There were no serious complications in the control group.The follow-up period was up to December 31,2018,and the median follow-up time was 11.7 months(4.5 20.3 months).During the follow-up,local recurrence occurred in 10 patients(9.9％),including 7 patients(13.7％)in the MWA group and 3 patients(6.0％)in the control group.There was no significant difference between the MWA group and the control group in the 1-year overall survival rate(92.2％ or 47 cases vs.96.0％ or 48 cases,P =0.313),tumor-specific survivalrate(100.0％ vs.100.0％,P=1.00),local recurrence free survival rate(86.3％ or 44 cases vs.94.0％ or 47 cases,P =0.156).Multivariate COX regression analysis showed age (HR =1.22,95 ％CI:1.06-1.38,P =0.004),tumor size (HR =1.75,95 ％ CI:1.14-2.36,P =0.005) and clinical stage of tumor(HR =1.53,95 ％ CI:1.17-1.89,P =0.001) were risk factors for the local recurrencefree survival.Conclusions MWA is an effective and safe treatment for elderly patients with early-stage lung cancer who are not suitable for surgery.Age,tumor diameter and clinical stage are risk factors for local recurrence-free survival.