[Diagnosis and treatment of 11 patients with cevical spondylotic amyotrophy].

OBJECTIVE: To explore clinical features, treatment methods and clinical effects of cervical spondylosis with proximal muscular atrophy. METHODS: Eleven patients with proximal-type cervical spondylotic amyotrophy were retrospectively studied from September 2016 to November 2020, including 7 males and 4 females, aged 38 to 68 years old. Clinical symptoms, MRI and neuroelectrophysiological manifestations were analyzed, and patients were treated with conservative treatment or anterior cervical decompression fusion surgery, respectively. The efficacy was evaluated by manual muscle test (MMT) before and after treatment, and patients' satisfaction was followed up at the same time. RESULTS: All patients were followed up for 6 to 19 months. All 11 patients were unilateral, mainly manifested by atrophy of deltoid muscle, supraspinatus muscle and infraspinatus muscle, and may be accompanied by ipsilateral neck and shoulder pain at early stage. MRI showed lesions at C4,5, C5,6 segments were more common. Electrophysiological examination showed the affected muscle was denervated, and amplitude of compound muscle action potential (CMAP) of innervated nerve on the affected side was lower than that on the healthy side. All patients were obtained bone fusion. One patient who were underwent anterior cervical corpectomy and fusion (ACCF) occurred developed contralateral C5 nerve root paralysis after operation, which recovered completely after 10 weeks of symptomatic treatment. At 12 months after operation, the efficacy was evaluated according to MMT, 3 patients were treated conservatively, 2 patients excellent and 1 good;in 8 patients treated by operation, 3 patients were excellent, 4 good, and 1 moderate. CONCLUSION: The incidence of cervical spondylosis with proximal muscular atrophy is low, which is manifested as unilateral proximal muscle atrophy and may be accompanied by ipsilateral neck and shoulder pain in the early stage. Combined with MRI and neuroelectrophysiological examination, misdiagnosis could be reduced. In the early stage of disease, especially in the case of nucleus pulposus protrusion leading to nerve compression, conservative treatment could be taken. When the conservative treatment is ineffective or the pain cannot be tolerated, anterior decompression surgery is recommended, and the overall effect is satisfactory.

Diagnosis, Genetics, and Management of 24 Patients With Cardiac Paragangliomas: Experience From a Single Center.

Context: Paragangliomas located within the pericardium represent a rare yet challenging clinical situation. Objective: The current analysis aimed to describe the clinical characteristics of cardiac paragangliomas, with emphasis on the diagnostic approach, genetic background, and multidisciplinary management. Methods: Twenty-four patients diagnosed with cardiac paraganglioma (PGL) in Peking Union Medical College Hospital, Beijing, China, between 2003 and 2021 were identified. Clinical data was collected from medical record. Genetic screening and succinate dehydrogenase subunit B immunohistochemistry were performed in 22 patients. Results: The median age at diagnosis was 38 years (range 11-51 years), 8 patients (33%) were females, and 4 (17%) had familial history. Hypertension and/or symptoms related to catecholamine secretion were present in 22 (92%) patients. Excess levels of catecholamines and/or metanephrines were detected in 22 (96%) of the 23 patients who have completed biochemical testing. Cardiac PGLs were localized with 131I-metaiodobenzylguanidine scintigraphy in 11/22 (50%), and 99mTc-hydrazinonicotinyl-tyr3-octreotide scintigraphy in 24/24 (100%) patients. Genetic testing identified germline SDHx mutations in 13/22 (59%) patients, while immunohistochemistry revealed succinate dehydrogenase (SDH) deficiency in tumors from 17/22 (77%) patients. All patients were managed by a multidisciplinary team through medical preparation, surgery, and follow-up. Twenty-three patients received surgical treatment and perioperative death occurred in 2 cases. Overall, 21 patients were alive at follow-up (median 7.0 years, range 0.6-18 years). Local recurrence or metastasis developed in 3 patients, all of whom had SDH-deficient tumors. Conclusion: Cardiac PGLs can be diagnosed based on clinical manifestations, biochemical tests, and appropriate imaging studies. Genetic screening, multidisciplinary approach, and long-term follow-up are crucial in the management of this disease.

A Comparison of the Accuracy Between a Digital Fabrication Workflow and a Conventional Fabrication Workflow for Occlusal Appliances: A Pilot Study.

PURPOSE: To compare the accuracy of occlusal stabilization appliances fabricated by digital workflows to those fabricated by conventional workflows. MATERIALS AND METHODS: In total, 10 volunteers were recruited in this single-blinded crossover study. All volunteers received two types of occlusal stabilization appliances: a digital additively manufactured stabilization splint (DS) and a conventionally fabricated splint (CS). The accuracy was assessed using a 4-point rating scale addressing two aspects of the occlusal appliances: occlusal contact and basic performance. In addition, silicone impression materials were used to assess the gap between the appliance and the maxillary arch to ensure an accurate fit. Differences were quantitatively assessed with Mann-Whitney U test and independent-sample t test. RESULTS: The occlusal contact rating of DS (15.90 ± 1.73) was significantly higher than that of CS (14.10 ± 1.10, P < .05). The basic performance rating of DS (8.70 ± 0.48) was also significantly higher than that of CS (7.20 ± 0.92. P < .05). Quantitative evaluation of fit accuracy revealed a statistically significant difference (P < .05), with DS (636.29 ± 268.51 µm) being superior to CS (704.2 ± 306.05 µm). CONCLUSION: The stabilization splints fabricated with a digital workflow showed better accuracy than the conventionally fabricated splints in terms of occlusal contact, basic performance, and fit accuracy. Because this is a pilot study, formal trials with a completely digital fabrication workflow will be conducted in the future.

[Application of psychological scales recommended by DC/TMD in patients with temporomandibular joint disorders].

PURPOSE: To observe psychological conditions such as anxiety, depression and somatic symptoms of temporomandibular disorders(TMD) patients using psychological scales recommended by DC/TMD and evaluate their clinical significance as the psychological axis for TMD diagnosis. METHODS: The experimental group included 100 TMD patients, and the control group comprised 100 normal prosthodontics outpatients without TMD symptoms. General information were collected including age, gender, education level, and personal income. The anxiety disorder scale (Generalized Anxiety Disorder-7, GAD-7), depression symptom scale (Patient Health Questionnaire-9, PHQ-9) and Patient Health Questionnaire-15 (PHQ-15) were used to evaluate patients' psychological conditions. SPSS 20.0 software package was used for data analysis. RESULTS: Patients less than 30 years old and between 30-50 years had similar TMD occurrence rates, both significantly higher than those older than 50 years old(P＜0.05). The proportion of highly educated patients in TMD group was significantly higher than that in the control group(P＜0.05), while the income level was not a risk factor for TMD (P=0.642). The incidence and average scores of anxiety, not the depression or somatic symptoms, in experimental group were significantly higher than the control group(P＜0.05). The level of anxiety and depression in painful TMD patients was significantly higher than patients with joint disease(P＞0.05). CONCLUSIONS: Gender(female), age (＜50 years old) and high education level (undergraduate and above) are risk factors of TMD, but the income level is irrelevant. The incidence and scores of anxiety in TMD patients are higher than normal prosthodontics outpatients, while there is no significant difference in the incidence of depression and somatic symptoms between two groups.

[Ultrasound-guided Radial Artery Cannulation].

Arterial cannulation can be used to monitor blood pressure in real time and facilitate frequent arterial blood gas analysis.It is one of the commonly used clinical techniques in anesthesia,emergency,and intensive care units.Studies have demonstrated that ultrasound guidance can increase the success rate of arterial cannulation and reduce the incidence of related complications.In recent years,ultrasound guidance technology has developed rapidly and is increasingly used in clinical practice.This article reviews the latest advances in the application of ultrasound guidance in radial artery cannulation.

COVID-19-Related Knowledge and Practices of Cancer Patients and Their Anxiety and Depression During the Early Surge Phase of the Pandemic: A Cross-sectional Online Survey.

OBJECTIVE: We aimed to investigate the coronavirus disease 2019 (COVID-19)-related knowledge and practices of cancer patients and to assess their anxiety- and depression-related to COVID-19 during the early surge phase of the pandemic. METHODS: An online questionnaire survey of cancer patients was conducted from February 10-29, 2020. Knowledge and practices related to COVID-19 were assessed using a custom-made questionnaire. The Hospital Anxiety and Depression Scale was used to assess the presence of anxiety and depression, with scores beyond 7 indicating anxiety or depressive disorder. Univariate and multiple linear regression analyses were used to identify the high-risk groups according to the level of knowledge, practices, anxiety, and depression scores. RESULTS: A total of 341 patients were included. The rate of lower level of knowledge and practices was 49.9% and 18.8%, respectively. Education level of junior high school degree or lower showed a significant association with lower knowledge score (ß: -3.503; P < 0.001) and lower practices score (ß: -2.210; P < 0.001) compared to the education level of college degree and above. The prevalence of anxiety and depression among the respondents was 17.6% and 23.2%, respectively. A higher depression score was associated with older age, marital status of the widowed, and lower level of education, knowledge score, and practices score (P < 0.05). CONCLUSIONS: Targeted COVID-19-related education interventions are required for cancer patients with a lower level of knowledge to help improve their practices. Interventions are also required to address the anxiety and depression of cancer patients.

A rapidly magnetically assembled stem cell microtissue with "hamburger" architecture and enhanced vascularization capacity.

With the development of magnetic manipulation technology based on magnetic nanoparticles (MNPs), scaffold-free microtissues can be constructed utilizing the magnetic attraction of MNP-labeled cells. The rapid in vitro construction and in vivo vascularization of microtissues with complex hierarchical architectures are of great importance to the viability and function of stem cell microtissues. Endothelial cells are indispensable for the formation of blood vessels and can be used in the prevascularization of engineered tissue constructs. Herein, safe and rapid magnetic labeling of cells was achieved by incubation with MNPs for 1 h, and ultrathick scaffold-free microtissues with different sophisticated architectures were rapidly assembled, layer by layer, in 5 min intervals. The in vivo transplantation results showed that in a stem cell microtissue with trisection architecture, the two separated human umbilical vein endothelial cell (HUVEC) layers would spontaneously extend to the stem cell layers and connect with each other to form a spatial network of functional blood vessels, which anastomosed with the host vasculature. The "hamburger" architecture of stem cell microtissues with separated HUVEC layers could promote vascularization and stem cell survival. This study will contribute to the construction and application of structural and functional tissues or organs in the future.

Comparison of immediate response to four conservative treatment modalities for management of masticatory myalgia with limited mandibular movement: a retrospective study.

OBJECTIVE: Conservative treatment modalities are recommended for managing masticatory myalgia in individuals with temporomandibular disorders. The aim of this study was to retrospectively review and compare the effectiveness of four conservative treatments: counseling and occlusal splint therapy, counseling and manipulation integrated with electrophysiotherapy, the combination of the two treatments, and counseling only. METHOD AND MATERIALS: One hundred and sixty-eight patients who had myalgia with limited jaw movement were retrospectively observed in this study. Between January 2015 and December 2017, 63 patients received counseling and stabilization occlusal splint therapy (Group 1), 35 patients received counseling and manipulation integrated with electrophysiotherapy (Group 2), 33 patients received the combination of counseling, splint therapy, and manipulation integrated with electrophysiotherapy (Group 3), and 37 patients received counseling only (Group 4). All subjects were followed up for 12 weeks. The intensity of spontaneous pain, palpation pain, chewing pain in the masticatory muscles, and range of pain-free maximal mouth opening were recorded in the clinical assessments. Intragroup and intergroup differences were examined by using analysis of variance (ANOVA) and the Kruskal-Wallis test. RESULTS: Spontaneous pain in the masticatory muscles was relieved significantly in all groups at the 6-week visit (P < .05), and no significant difference was found among the groups (P > .05). Palpation pain was relieved significantly at the 9-week visit in the counseling + occlusal splint therapy group, counseling + manipulation + electrophysiotherapy group, and counseling + occlusal splint + manipulation + electrophysiotherapy group (P < .05). In the treatment group with counseling alone, significant palpation pain relief occurred at 12 weeks. Chewing pain was relieved significantly at the 6-week visit in the counseling + occlusal splint therapy group, counseling + manipulation + electrophysiotherapy group, and counseling + occlusal splint + manipulation + electrophysiotherapy group (P < .05), yet no significant difference compared to the baseline was observed in the counseling-only group (P > .05). A significant increase in the maximal range of pain-free mouth opening was observed at the 9-week visit in the counseling + occlusal splint therapy group, and at the 3-week visit in the counseling + manipulation + electrophysiotherapy group and counseling + occlusal splint + manipulation + electrophysiotherapy group (P < .05). Nevertheless, no significant change in the range of mouth opening was found throughout the follow-up period in the counseling-only group (P > .05). CONCLUSION: Each of the included treatment modalities relieved spontaneous pain and tenderness to palpation of the masticatory muscles during the follow-up intervals. Counseling alone did not help patients with chewing pain and limited mouth opening in the short term. Treatment protocols including counseling, occlusal splint therapy, and manipulation, integrated with electrophysiotherapy showed the best short-term outcomes for symptomatic improvement.

[Factors Contributing Successful Ultrasound-guided Radial Artery Cannulation and Its Complications When Using the Short-axis Out-of-plane Procedure].

Objective To identify the possible factors that may influence the success and the complications of ultrasound-guided out-of-plane radial arterial cannulation. Methods Multivariate Logistic regression analysis was used to analyze the clinical data of 131 patients undergoing elective surgery and ultrasound-guided out-of-plane radial artery cannulation,dynamic needle tip positioning(DNTP) technique or angular distance(AD) technique and to find out the factors associated with the one-attempt success rate,overall success rate,posterior arterial wall perforation,and local hematoma. Results The depth of the anterior arterial wall≥3 mm was the factor associated with posterior arterial wall perforation(OR=0.314,95%CI:0.143-0.691,P=0.004) and local hematoma(OR=0.250,95%CI:0.107-0.585,P=0.001).The use of DNTP method was significantly associated with posterior arterial wall perforation(OR=0.303,95%CI:0.138-0.667,P=0.003). Conclusions During ultrasound-guided out-of-plane radial cannulation,puncture at the arterial anterior wall sites with a depth of≥3 mm can reduce the incidence of posterior arterial wall perforation and local hematoma.Compared with AD,DNTP can lower the incidence of posterior arterial wall perforation.

[Mechanical properties and cytotoxicity of three-dimensional printing polycarbonate for occlusal splints].

PURPOSE: To evaluate the mechanical properties and cytotoxicity of a 3D printing polycarbonate material used in digital occlusal splints, and to use this material to manufacture a splint with CAD/CAM technology. METHODS: Specimen of two different materials, 3D printing polycarbonate(PC-plus) and transparent base resin (PMMA) were processed. The flexural strength, elastic modulus, microhardness, hygroscopicity and water-solubility of these materials then were evaluated. According to the standard of GBT16886.5-2003, cell culture and cytotoxicity test in vitro were conducted to evaluate the target materials on the morphology, growth and proliferation of cultured cells (L929). By using 3D printing technology, a splint was made of this 3D printing polycarbonate material. Statistical analysis was performed using SPSS 24.0 software package. RESULTS: For the group of PC-plus, the flexural strength ranged from 89.4 to 109.8 MPa, the elastic modulus from 1939.4 to 2470.9 GPa, the microhardness from 15.6 to 24.7 MPa, hygroscopicity from 2.43 to 11.42 µg/mm3 and water-solubility from 0.11 to 0.30 µg/mm3. For PMMA group, the flexural strength ranged from 75.2 to 88.4 MPa, the elastic modulus from 1349.2 to 2470.2 GPa, the microhardness from 17.5 to 35.3 MPa, hygroscopicity from 12.80 to 16.16 µg/mm3 and water-solubility from 4.74 to 7.44 µg/mm3. The difference between 3D printing PC-plus group and PMMA base resin group was statistically significant (P<0.05). L929 cells showed normal morphology and proliferation increased with culture time. The toxicity grade of all groups was 0-1, and the 3D printing splint was made successfully. CONCLUSIONS: The polycarbonate material for 3D printing has adequate mechanical properties and biocompatibility to meet the requiement of clinical application.

Walnut oil promotes healing of wounds and skin defects in rats via regulating the NF-kB pathway.

The effects of walnut oil on wound healing and skin injury repair was observed in Sprague-Dawley (SD) rats, and mechanism of action was investigated. Normal SD rats were divided into an experimental group and a control group. Each group was observed at4 time points (day [D]3, D7, D14, and D21). In both groups, a skin wound was created on the back of the rats, with the spine as the central axis. In the experimental group, the wound was covered with walnut oil, and then bandaged and fixed with sterile gauze. In the control group, the wound was bandaged with vaseline gauze. At each corresponding time point, the wound area and wound healing time of each rat were examined. Epithelial cells of the wound tissues were observed using haematoxylin and eosin staining and immunohistochemical analysis,and the numbers of inflammatory cells and capillaries were counted. A western blot method was used to detect the expression of nuclear factor (NF)-κB and epidermal growth factor (EGF) in the wound tissues of both groups. Meanwhile, enzyme-linked immunosorbent analysis (ELISA) was used to detect the expression of transforming growth factor (TGF)-ß1 and matrix metalloproteinase (MMP)-1 in rat sera. A total of 48 SD rats completed the experiment. Healing time of residual wounds in the experimental group was 10.0±3.5 days, which was significantly shorter than that in the control group (18.0±6.0 days) (p<0.05). The wound healing rates in the experimental group were 54.14 % (D3) and 91.2 3% (D7), whereas those in the control group were 22.12% (D3) and 54.84% (D7 (p<0.05).Histological examinations revealed no epithelial cells on D3, D7, D14, and D21 in both the experimental and control groups. However, the number of inflammatory cells decreased significantly and the number of capillaries increased significantly in the experimental group compared to control (p<0.05). NF-κB expression was significantly lower, EGF expression significantly higher in the in the experimental group. Conversely, ELISA showed a significant increase in the expression of TGF-ß1 and MMP-1 in rat sera in the experimental group. So we conclude that walnut oil has significant effects in promoting the healing of skin defect wounds in SD rats.

Long-term low-dose morphine for patients with moderate cancer pain is predominant factor effecting clinically meaningful pain reduction.

PURPOSE: Patients with cancer often experience pain that affects their daily activities and quality of life. The analgesic ladder recommended by the World Health Organization has proved insufficient for many, and its scientific basis has been questioned. This retrospective study investigated factors related to adherence to long-term opioid therapy for patients with moderate cancer pain, including an evaluation of low-dose morphine relative to tramadol. METHODS: Clinical data were collected of patients with moderate cancer pain (n = 353) who received either low-dose morphine or tramadol and were followed for ≥ 27 weeks. Factors related to regime adherence were investigated, including the analgesia type, cancer therapy (antitumor therapy or palliative care), pain type (nociceptive, neuropathic, or mixed), and living distance to the hospital. Factors related to clinically meaningful pain reduction (≥ 30% reduction in pain from baseline) were also investigated. RESULTS: Patients taking tramadol, receiving antitumor therapy, experiencing neuropathic pain, and living far from the hospital were more likely to change analgesic strategy compared with, respectively, patients receiving low-dose morphine, palliative care, experiencing nociceptive pain, and living nearby. Factors that increased the likelihood of adherence to the analgesic regime were also associated with the likelihood of clinically meaningful pain reduction. Among adverse effects, a significantly higher percentage of patients experienced constipation in the tramadol group compared with those given morphine. CONCLUSIONS: Among patients with moderate cancer pain, long-term low-dose morphine was safe and more effective than tramadol for clinically meaningful pain reduction, and patients were less likely to change the analgesic strategy.

Geometric isotope effect of deuteration in a hydrogen-bonded host-guest crystal.

Deuteration of a hydrogen bond by replacing protium (H) with deuterium (D) can cause geometric changes in the hydrogen bond, known as the geometric H/D isotope effect (GIE). Understanding the GIEs on global structures and bulk properties is of great importance to study structure-property relationships of hydrogen-bonded systems. Here, we report a hydrogen-bonded host-guest crystal, imidazolium hydrogen terephthalate, that exemplifies striking GIEs on its hydrogen bonds, phases, and bulk dielectric transition property. Upon deuteration, the donor-acceptor distance in the O-H···O hydrogen bonds in the host structure is found to increase, which results in a change in the global hydrogen-bonded supramolecular structure and the emergence of a new phase (i.e., isotopic polymorphism). Consequently, the dynamics of the confined guest, which depend on the internal pressure exerted by the host framework, are substantially altered, showing a downward shift of the dielectric switching temperature.

Knowledge, attitudes, and influencing factors of cancer patients toward approving advance directives in China.

PURPOSE: Many cancer patients do not have advance directives (ADs), which may lead to unwanted excessive or aggressive care when patients have lost decision-making capacity. The aim of this study was to investigate knowledge and attitudes of approving ADs and explore factors associated with willing to designate ADs among cancer patients in China. METHODS: We conducted semi-structured interview method investigating 753 in-patients with cancer in two cancer centers. RESULTS: Of those subjects, none of the cancer patients had an AD. Only 22.4 % (118 of 526) approved ADs. Comparing with the disapproved ADs group, the approved ADs group were more likely to discuss the AD with oncologist or nurse (χ (2) = 180.4, p < 0.001) in the cancer center (χ (2) = 244.1, p < 0.001), and they chose more comfort care (χ (2) = 18.8, p < 0.001). Most of cancer patients in the two groups wanted to die at home (72.8 %, 73.7 %, respectively). The older patients (OR, 1.04, 95 % CI, 1.02-1.07, p = 0.001), female (OR, 0.55, 95 % CI, 0.35-0.88, p = 0.013), with higher education levels (OR, 3.38, 95 % CI, 1.92-5.96, p < 0.001), with religious beliefs (OR, 2.91, 95 % CI, 1.71-4.94, p < 0.001), and with higher scores of ECOG (OR, 1.46, 95 % CI, 1.17-1.82, p = 0.001) were associated with desiring for ADs. CONCLUSIONS: Our findings indicate that there was a dearth of knowledge and different attitudes toward approving ADs among cancer patients, and some factors of demographic and clinical characteristics influenced their willing to designate ADs. This research highlights the importance of propagandizing the ADs to the public, especially to the patients, and further discussing with them when the time is ripe.

Predicting and Screening Dielectric Transitions in a Series of Hybrid Organic-Inorganic Double Perovskites via an Extended Tolerance Factor Approach.

Extended Goldschmidt tolerance factor t is applied to the hybrid double perovskites (MA)2 [B'B''(CN)6 ] (MA=methylammonium cation) to predict and screen dielectric transitions in 121 compounds through the correlations among t, the radius of the B component rB and the transition temperature Tc , based on experimental results from model compounds. For (MA)2 [B'Co(CN)6 ], it is concluded that: i) when t>0.873, the cubic phase would be stable below 298 K; ii) when 0.873>t>0.805, the cubic phase would be stable between 298 and 523 K; iii) the larger the rB , the higher the Tc of the perovskite (Tc (1/2) ∝rB ); and iv) the Tc of the hybrid perovskites can be well tuned by doping the B components.

[Risk Factors of Perioperative Cardiac Events in Elderly Patients with Coronary Heart Disease Undergoing Non-cardiac Surgery].

OBJECTIVE: To identify the incidence and risk factors of perioperative major adverse cardiac events (MACE) in elderly patients with coronary heart disease (CHD) undergoing non-cardiac surgery. METHODS: We prospectively analyzed the clinical data of 360 CHD patients who aged 75 years or older undergoing elective intermediate-to high-risk surgery in five medical centers across China from January 2008 to January 2010. The clinical variables included the 12-lead ECG and Troponin I levels after surgery. The combined outcome was defined as all the perioperative MACE in hospital. The risk factors of MACE and their indexes were analyzed with univariate analysis and multivariable logistic regression in SPSS software,together with a risk scoring and stratification system established. RESULTS: Perioperative MACE occurred in 11.94% of elderly CHD patients undergoing non-cardiac surgery. Seven independent risk factors of perioperative MACE for this population were identified,which included angina within 6 months (P=0.001), hypertension(P=0.014), preoperative haematocrit (HCT) <40% (P=0.050), serum creatinine (Scr)>150 mmol/L (P=0.014), ejection fraction(EF) <50% (P=0.019), intraoperative hyoxemia (P=0.019), and operative time>150 min (P=0.001). The risk indexes of these factors were 4,3,3,6,4,5, and 4, respectively. The rate of perioperative MACE increased significantly as the level of risk stratification elevated. CONCLUSIONS: Elderly CHD patients undergoing non-cardiac surgery are at high risk of perioperative MACE. Angina within 6 months,hypertension, preoperative HCT<40%, Scr>150 mmol/L, EF<50%, intraoperative hyoxemia, and operative time>150 min can increase the risk of MACE. The risk scoring and stratification system based on the risk factor index can be a valuable parameter for assessing the perioperative cardiac risk of noncardiac surgery for elderly CHD patients.

Diagnostic value of mutation-specific antibodies for immunohistochemical detection of epidermal growth factor receptor mutations in non-small cell lung cancer: a meta-analysis.

BACKGROUND: Various studies have assessed the diagnostic accuracy of EGFR mutation-specific antibodies in non-small cell lung cancer (NSCLC). We performed a meta-analysis of existing data to investigate the diagnostic value of mutation-specific antibodies for detection of EGFR mutations in NSCLC. METHODS: We systematically retrieved relevant studies from PubMed, Web of Knowledge, and Google Scholar. Data from studies that met the inclusion criteria were extracted for further exploration of heterogeneity, including calculation of the average sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and analysis of SROC(summary receiver operating characteristic) curves. RESULTS: Fifteen studies met our inclusion criteria. A summary of the meta-analysis of the efficacy of the anti-E746-A750 antibody was as follows: sensitivity, 0.60 (95% CI, 0.55-0.64); specificity, 0.98 (95% CI, 0.97-0.98); PLR, 33.50 (95% CI, 13.96-80.39); NLR, 0.39 (95% CI, 0.30-0.51) and DOR, 111.17 (95% CI, 62.22-198.63). A similar meta-analysis was performed for the anti-L858R antibody with results as follows: sensitivity, 0.76 (95% CI, 0.71-0.79); specificity, 0.96 (95% CI, 0.95-0.97); PLR, 24.42 (95% CI, 11.66-51.17); NLR, 0.22 (95% CI, 0.12-0.39) and DOR, 126.66 (95% CI, 54.60-293.82). CONCLUSION: Immunohistochemistry alone is sufficient for the detection of EGFR mutations if the result is positive. Molecular-based analyses are necessary only if the anti-E746-A750 antibody results are negative. Immunohistochemistry seems more suitable for clinical screening for EGFR mutations prior to molecular-based analysis.

[Impact factors of distress in patients with lung cancer-associated pain].

OBJECTIVE: To study the impact factors of psychological distress in patients with lung cancer-associated pain. METHODS: The cross-sectional study was applied to lung cancer pain patients received treatments in Cancer Center of West China Hospital of Sichuan University in Chengdu from July 2011 to December 2011 by distributed questionnaires. The general information of the patients, Brief Pain Inventory (BPI) and the Hospital Anxiety and Depression Scale (HADS) were included in the questionnaire to evaluate the states of distress, pain and the factors related to the total distress score. RESULTS: Totally 172 effective questionnaires were obtained in 200 delivered questionnaires. The average pain score of the patients was 3.67 +/- 1.27. The Spearman correlation analysis showed that depression score, anxiety score, distress score were positively correlated with the pain intensity (P < 0.05). Patients with positive anxiety symptom was 29.0%, the depression was 29.0%, and distress was 68.6%. Mutiple linear regression analysis showed that gender (p = 0.152, P = 0.024), age (beta = -0.150, P = 0.023), marital status (beta = -0.239, P = 0.000) could affect the total score of distress; gender (beta = 0.154, P = 0.013), age (beta = -0.165, P = 0.007), the clinical pathological stage (beta = 0.155, P = 0.011) could affect the anxiety score; marital status (beta = -0.133, P = 0.047) could affect the depression score. CONCLUSION: The genders, age, marital status of the patients are related to the psychological distress of lung-cancer-pain patients.

An organic-inorganic hybrid compound containing imidazolium cations and a one-dimensional lithium hexacyanidocobaltate-based anionic framework.

An organic-inorganic hybrid compound, catena-poly[bis(3H-imidazol-1-ium) [[tetracyanido-κ(4)C-cobalt(III)]-µ-cyanido-κ(2)C:N-[diaqualithium(I)]-µ-cyanido-κ(2)N:C]], {(C3H5N2)2[CoLi(CN)6(H2O)2]}n, was synthesized by the reaction of Li3[Co(CN)6] with imidazolium chloride in aqueous solution. The compound crystallizes in the monoclinic space group C2/c (data collected at 273 K). In the crystal structure, neighbouring [Co(CN)6](3-) anionic units are linked by Li(+) cations through the cyanide groups in a trans mode, forming a one-dimensional zigzag chain structure extending along the c axis. A three-dimensional supramolecular network is formed through hydrogen-bonding interactions and is further stabilized by weak CN···π interactions between the cyanide groups and the imidazolium cations.

An iron(III) complex salt containing pyrazole as both ligand and counter-ion: bis(1H-pyrazol-2-ium) pentacyanido(1H-pyrazole-κN(2))ferrate(III).

The title compound, (C3H5N2)2[Fe(CN)5(C3H4N2)], is composed of a mononuclear [Fe(CN)5(pyrazole)](2-) dianion and two 1H-pyrazol-2-ium cations. A three-dimensional supramolecular network is formed through a rich scheme of N-H...N hydrogen bonds and C-H...π interactions among the cations and anions.