Axillary lymph node status isone of the most important prognostic factors for the patients with breast cancer.Physical examination combining with ultrasound, mammography, CT, MRI and PET-CT can improve the predictive efficiency, but there is still high false negative rate.Ultrasound-guided fine-needle aspiration for axillary lymph node can improve preoperative diagnostic rate effectively.Using mathematical and statistical methods, building models for predicting sentinel lymph node or non-sentinel lymph node status with clinicopathological features helps to calculate the risk of lymph node involvement.Whether screening out patients with low risk of lymph node involvement avoiding axillary surgery is safe or not is still to be evaluated by relevant clinical trials.

Oral cancer represents a serious public health problem affecting oral and system health with a high global incidence.Treatment strategies for oral cancer vary in different disciplines and are likely to be limited to certain doctor's personal experience.While clinical practice guidelines are considered to enable doctors to determine the most appropri-ate and consistent treatment strategy according to the patient's situation.National Comprehensive Cancer Network(NCCN)clinical practice guidelines have become the most prevalent in global clinical oncology practice.This article mainly focuses on cases to discuss the normalized treatment strategy for oral cancer in different stages based on the NCCN Clinical Practice Guidelines in Oncology(NCCN Guidelines):Head and Neck Cancers,Version 3,2024.

Androgenetic alopecia is a distinctive condition associated with genetic factors and effect of androgens, usually adversely affects the appearance and mental health of patients. This review summarizes research progress in the pathogenesis, diagnosis, evaluation and clinical treatment of androgenetic alopecia in 2020.

Objective To analyze the content of active components in fresh Danshen Radix Salviae Miltiorrhizae,Red Sage Root) from different producing areas,and review reasonably the medicinal quality of fresh Danshen.Methods The content of 5 salvianolic acids and 12 tanshinones in fresh Danshen,from 7 different producing areas,were determined by applying LTQ-Orbitrap XL high-resolution mass spectrometer.On this basis,all content were analyzed by using principal component analysis (PCA) and partial least square (PLS) analysis.Results The content of active components in fresh Danshen from the same producing area were basically the same,and difference was significant in content of active components among fresh Danshen from different producing areas.The content of salvianolic acids was the highest in fresh Danshen from Hubei,and content of tanshinone Ⅰ and tanshinone ⅡA were the highest in fresh Danshen from Sichuan and Henan.The analysis results of PCA and PLS showed that the distribution of most active components had a distinct regional specificity.Conclusion The difference is significant in quality of fresh Danshen from different producing areas,and they have a distinct regional specificity.Using fresh Danshen as quality evaluation materials,that is a useful supplement to review quality of raw medicinal materials based on dry herbs.It explored a new and more comprehensive approach for reviewing other Chinese medicinal materials.

Objectives:The goal of the present study was to develop and validate a set of Mandarin Chinese adaptation of AzBio sentence test (CMnBio) used for the assessment of speech recognition in hearing-impaired listeners and cochlear implant (CI) users.Methords:Following the procedures of development of the English AzBio sentence materials, the present study was conducted in two stages. In the first stage, a total of 1 850 sentences were compiled and recorded by four Mandarin-speaking adult talkers (two males and two females), from which 1 020 sentences with better sound quality and higher naturalness were retained. All the 1 020 sentences were processed through a 5-channel noise vocoder and presented to 17 normal-hearing Mandarin-speaking adults for recognition. A total of 600 sentences (150 from each talker) in the range of approximately 62% to 92% correct were subsequently selected to compile 30, 20-sentence lists. In the second stage, 30 postlingually-deafened adult CI users were recruited to verify the list equivalency. Finally, the binomial distribution model was adopted to account for the inherent variability in the lists and to generate the lower and upper limits of the 95% critical differences.Results:The average sentence recognition of the 5-channel vocoder-processed 30 lists of Mandarin Chinese AzBio sentences (600 sentences total) by the 17 normal-hearing listeners was 78.0% correct. The validation based on the performance scores of the 30 CI participants revealed that 26 of the 30 lists were equivalent through a repeated-measures analysis of variance and a following post hoc Tukey′s test. The binomial distribution modelling indicated that the inter-list variability could be accounted for with a 65-item binomial distribution model. The lower and upper limits of the 95% critical differences for one-and two-list recognition scores were generated.Conclusions:The Mandarin Chinese adaptation of AzBio sentence test (CMnBio) is developed and validated for speech recognition assessment of CI users. The final set of 26, 20-sentence lists shows high inter-list reliability or equivalency. The elevated level of difficulties of the CMnBio sentences can help eliminate the ceiling effects when testing sentence recognition in Mandarin-speaking CI users. The lower and upper limits of the 95% critical differences derived from the binomial distribution modelling can provide guidance for detection of a significant difference in recognition scores in clinical settings.

Objective:To investigate the vaccination status, characteristics and prognosis of patients suffering from a combination of COVID-19 and chronic lymphocytic anemia (CLL) in China.Methods:Clinical data of 328 patients with chronic lymphocytic leukemia (CLL) who were first diagnosed with COVID-19 and treated in the Department of Hematology of Jiangsu Provincial People’s Hospital between November 2022 and February 2023 were retrospectively analyzed. Univariate and multivariate analysis of data of patients with severe/critical COVID-19 were conducted by applying the binary logistic regression model.Results:The median age of the CLL patients was 60 (24-87) years. 23.5% (77/328) of these patients suffered from severe/critical COVID-19 infection. Univariate analysis of the data demonstrated that a combination of factors including age >67 years ( OR=2.15, 95% CI 1.24- 3.73, P=0.006), diabetes ( OR=2.09, 95% CI 1.05-4.20, P=0.037), chronic hepatitis B ( OR=2.91, 95% CI 1.30-6.51, P=0.010), CLL progressive ( OR=3.79, 95% CI 1.57-9.15, P=0.003) and CD20 antibody-based treatments within three months prior to the COVID-19 infection ( OR=2.79, 95% CI 1.35-5.77, P=0.006) were the risk factors for severe/critical COVID-19. According to the multivariate analysis, CLL progressive ( OR=2.98, 95% CI 1.10-8.10, P=0.033) was an independent risk factor for severe/critical COVID-19 and administration of the BTK (Bruton tyrosine kinase) inhibitor monotherapy might exert a protective effect and influence a positive outcome of the COVID-19 infection ( OR=0.38, 95% CI 0.16-0.90, P=0.028). Among the 242 patients who were followed up until October 2023, 9.1% (22/242) had multiple subsequent COVID-19 infections (≥3), and 2.1% (5/242) had persistent COVID-19 infections (patients with persistent positive test for the SARS-CoV-2 antigen testing until missing follow-up for any reason). The peak value of the anti-SARS-CoV-2-IgG titres was observed between three and four months post symptom onset (median: 3.511 S/CO vs 1.047 S/CO, P<0.05). The levels of immunoglobulin A gradually decreased following infection with COVID-19, and its trough levels were attained between two to four weeks post infection (median: 0.30 g/L vs 0.74 g/L, P<0.05). According to this study the mortality of patients suffering from a combination of COVID-19 infection and CLL was 2.7% (9/328), and the main reason for their death was respiratory failure and heart failure. Conclusions:A low rate of COVID-19 vaccination and a high rate of severe/critical COVID-19 infection was observed in the CLL patients. CLL progressive was associated with severe/critical COVID-19. Anti-CD20-based treatments received within the past three months might be a risk factor for exacerbation of COVID-19 infection, whereas a monotherapy with BTK inhibitors exert a protective effect and improve outcome of COVID-19 infection.

Objective A HPLC-quantitative analysis of multi-components by single marker(QAMS)was established to determine 5 ingredients including uracil,uridine,hypoxanthine,inosine and guanosine in Periplaneta americana.Methods Separation took place on a Agilent ZORBAX SB-Aq column(250 mm×4.6 mm,5 μm)by gradient elution of methanol-0.01 mol·L-1 potassium dihydrogen phosphate at 20℃with a flow rate of 1.0 mL·min-1.The detection wavelength was 260 nm and the injection amount was 10 μL.The relative correction factors(fa/b)was calculated for the other four components with uridine as an internal standard.The content of 5 ingredients in 10 batches of Periplaneta americana was determined by QAMS.Results were compared with those of external standard method(ESM).Results Five nucleosides showed good linear relationships in their own ranges(r＞0.999 5),and the average recoveries ranged from 97.0%to 100.8%.The relative correction factors of uracil,hypoxanthine,inosine and guanosine were 0.908 0,1.005 3,1.969 5 and 1.303 4,respectively.Conclusion The established method is accurate and stable.It can provide theoretical reference for the quality control of Periplaneta americana.

Objective:To summarize clinical characteristics of and treatment experience with patients with critical illnesses in a dermatological ward.Methods:All patients with serious or life-threatening conditions, who were hospitalized at the dermatological ward of the Second Xiangya Hospital of Central South University from July 9, 2011 to December 31, 2020, were collected, and their clinical data were retrospectively analyzed. Demographic characteristics, disease types and proportions, main complications, causes of serious or life-threatening conditions, important treatment measures and outcomes were summarized, and causes of death were also analyzed and discussed.Results:A total of 1 057 patients with critical illnesses were collected, with a male-to-female ratio of 1∶1.11, and 64.81% of them aged 18 to 65 years. The types of diseases mainly included drug eruptions (332 cases) , connective tissue diseases (226 cases) , bullous skin diseases (104 cases) , psoriasis (57 cases) , erythroderma (45 cases) , infectious skin diseases (67 cases) , etc. Among them, psoriasis (39 cases) and erythroderma (32 cases) mostly occurred in males, and connective tissue diseases (168 cases) mostly occurred in females. Common complications mainly involved infections, important organ damage or dysfunction, hypoalbuminemia, and fluid, electrolyte and acid-base imbalances. A total of 94 patients were diagnosed with life-threatening conditions, which were found to be mainly caused by primary skin diseases, hematologic abnormalities, respiratory failure, nervous system abnormalities, renal failure, sepsis, fluid, electrolyte and acid-base imbalances, etc. During the management of critical illnesses, 43 patients were treated with high-dose glucocorticoid pulse therapy, 264 were treated with gamma-globulin pulse therapy, 355 were transfused with other blood products, and 34 received special therapies such as hemoperfusion/immunoadsorption therapy, plasma exchange, dialysis, artificial liver support therapy; 42 patients were transferred to the intensive care unit (ICU) , 12 were transferred to the department of surgery for operations, and 12 were transferred to the department of obstetrics and gynecology for delivery or induction of labor. After treatment, 989 patients (93.57%) achieved improvement and were discharged. A total of 14 patients (1.32%) died, of whom 7 died of secondary sepsis, 2 died of severe pulmonary infections, 2 died of asphyxia caused by respiratory mucosa shedding-induced airway obstruction, the other 3 died of gastrointestinal hemorrhage, cerebral hemorrhage and neuropsychiatric systemic lupus erythematosus, respectively.Conclusions:Critical cases in the dermatological ward mainly suffered from serious skin diseases such as severe drug eruptions, connective tissue diseases and bullous skin diseases, as well as complications such as severe underlying diseases, severe organ dysfunction, sepsis or severe fluid, electrolyte and acid-base imbalances. In terms of treatment, it is of critical significance to make a clear diagnosis and assess the severity of disease as early as possible, monitor and prevent possible complications, and to consult with specialists in relevant disciplines in time.