Objective To evaluate the feasibility of fecal occult blood test(FOBT).combined with colonoseopy,in screening of colorectal cancer.Methods From September 2006 to May 2007.healthv volunteers without any colorectal cancer(CRC)related symptoms in Songjiang District of Shanghai,aging from 40 to 49 or older than 50 years,were recruited.The subjects were firstly screened by FOBT with immunohistochemieal method in two of three consecutive stool samples,and colonoscopy was performed in those with positive FOBT in any of the stool samples.The number.type and distribution of detected polyps were recorded.Results Of 2692 subjects over 50 years old,FOBT was positive in 184(6.8%).in which 1 rectal cancer and 64 polyps,including 34 adenomatous polyps,15 inflammatory polyps and 15 hyperplastic polyps.Of 582 subjects aging from 40 to 49 years,FOBT was positive in 28(4.8%),in which 2 adenocarcinoma and 6 polyps,including 1 adenomatous polyp.Most polyps,including adenomatous polyp and high-risk polyp,were mainly found on the left side of colon.Conclusion CRC screening with FOBT and colonoscopy in asymptomatic average-risk people could detect colon polyps at an early stage.Colonoscopy in patients with positive FOBT would be suitable in large scale CRC screening in communities and rural areas.

Objective To investigate the relationship of programmed cell death 4(PDCD4) with the invasion of astrocytic glio-mas .Methods Using the immunohistochemical method to detect the expression of PDCD4 in astrocytic gliomas in different grades . Measuring the peritumoral low-density area on MRI scan ,then compared with the results of immunohistochemical expression .Re-sults The downregulation of PDCD4 was with the increasing of the malignant grade of astrocytic gliomas .The tumor grade malig-nancy was positively correlated with the grade of the peritumoral low-density area on MRI scan(P<0 .05) ,while the expression of PDCD4 was negatively correlated with the grade of astrocytic gliomas (P<0 .01) .Conclusion PDCD4 might serve as one of the in-dicators of invasion and malignant phenotype for astrocytic gliomas .

Objective:To compare the application of preoperative planning of pediatric hepatoblastoma between three-dimensional and two-dimensional imaging of computer-assisted surgery system.Methods:From Jan 2016 to Oct 2019, surgical resection plans on 25 cases were made by the operator team through the observation of two-dimensional CT images. Then, the team will make a thorough analysis and revise the previous preoperative plan for the children patient according to three-dimensional imaging of the computer-assisted surgery system.Results:All the patients had the tumor successfully removed and achieved R 0 resection based on the preoperative plan assisted by three-dimensional imaging. All the children patients were doing well as found by postoperative short-term follow-up. Among them, preoperative plans were finally revised in 10 cases due to the disparity with the original ones in three-dimensional relationship between tumor and blood vessels, in vascular variation and in the volume of remnant liver after the evaluation of three-dimensional reconstruction images, which account for 40% variation of the original operation scheme. Conclusions:Three dimensional imaging of computer-assisted surgery system is superior to two-dimensional imaging in preoperative planning of pediatric hepatoblastoma.

Objective:To analyze the dimensional structure and the item characteristics of the Chinese version of the cerebral palsy quality of life questionnaire for children (CPQOL-child).Methods:Multi-dimensional and single-dimensional item response models were used. Ninety children aged 4 to 12 with cerebral palsy were evaluated using the CPQOL-child. The internal consistency was determined by analyzing the correlations among the different dimensions using a multi-dimensional response model. Dimensions were merged or split based on a one-dimensional Rasch analysis of the primary and secondary dimensions to revise the main and additional questionnaires.Results:The multi-dimensional item response model analysis found greater than 0.90 correlation among the four dimensions of social well-being and tolerance, function, participation ability and physical health, and emotional health and self-esteem, showing that they have good internal consistency and could be analyzed as the primary dimension. The correlation coefficients relating the other three dimensions were relatively low and could be analyzed as secondary dimensions. A single-dimension Rasch analysis was used to form a revised CPQOL main questionnaire consisting of 40 items, with three additional questionnaires for pain and disability impact consisting of 8 items, for access to services consisting of 6 items, and for family health consisting of 3 items. Compared with the original 65 items, the 8 items deleted were mainly about relationships between children and with siblings, providing respite services, as well as community and school services.Conclusions:Applying the Chinese version of the CPQOL-Child in Shanghai requires appropriate adjustments based on the children′s cultural background.

Objective:To analyze and summarize the application and significance of the computer-assisted surgery system in precision surgery of mediastinal tumors in children.Methods:The clinical data of 54 children that underwent mediastinal tumor resection surgery in the Affiliated Hospital of Qingdao University from August 2008 to November 2021 were collected.According to whether the Hisense CAS computer-assisted surgery system was used before the operation, the patients were divided into three-dimensional (3D) reconstruction group (29 cases, 53.70%) and two-dimensional (2D) CT group (25 cases, 46.30%). The surgical indicators, postoperative hospital stay, and the incidence of surgical complications were compared between the two groups.The t-test, Mann- Whitney U test, χ2 test or Fisher′ s exact test were carried out for statistical analysis.Simulated surgery and actual surgery were compared for both 3D reconstruction and 2D CT groups. Results:There were no significant differences in gender, age, height, weight, maximum tumor diameter and tumor location between the 3D reconstruction group and 2D CT group (all P>0.05). The operation time of the 3D reconstruction group was [(125.14±41.37) min] was shorter than that of the 2D CT group [(149.24±44.53) min] ( P=0.044). The intraoperative blood loss in the 3D reconstruction group [15.00(13.50, 25.00) mL] was less than that in the 2D CT group [36.00(30.00, 75.00) mL] ( P<0.001). In addition, the indwelling time the closed thoracic drainage tube [4.00 (3.00, 5.50) d] and postoperative hospitalization days [(8.83±3.39) d] in the 3D reconstruction group were shorter than those in the 2D CT group [7.00(5.00, 11.50) d, (11.00±4.10) d] ( P=0.001, 0.038). No significant difference in postoperative complication rates was found between the 3D reconstruction group and 2D CT group ( P>0.05). The simulated operation was consistent with the actual operation in the 3D reconstruction group. Conclusions:3D reconstruction by the computer-assisted surgery system can truly reveal the anatomical relationship between tumors and surrounding organs and blood vessels, and improve the accuracy and safety of surgical resection of mediastinal tumors in children.

OBJECTIVES: The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States. METHODS: The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures. RESULTS: For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001). CONCLUSIONS From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.

OBJECTIVE To analyze the chemical constituents and components absorbed into plasma of the extract of Ardisia crenata and to elucidate its possible pharmacodynamic material basis. METHODS Overall， 12 rats were randomly assigned to the blank group （n＝6） and A. crenata group （n＝6） by the paired comparison method. The drug was administered once daily in the morning and afternoon for three days. Serum samples were prepared from serum after redosing on 4th day. The UPLC-QE-HF-MS/ MS was used to analyze and identify the chemical constituents in A. crenata extract and serum samples. Compound Discoverer 3.0 was employed for retention time correction， peak identification， and peak extraction. According to the secondary mass spectrometry information， the Thermo mzCloud online and Thermo mzVault local databases， referring to the relevant literature and control quality spectrum information were used to preliminarily identify the chemical constituents and components absorbed into plasma of A. crenata. RESULTS A total of 34 compounds were identified from the extract of A. crenata， mainly coumarins， flavonoids， organic acids， amino acids， including bergenin， quercetin， gallic acid， L-pyroglutamic acid， etc. Besides， 5 components absorbed into plasma were identified from serum samples: L-pyroglutamic acid， syringic acid， bergenin， cinnabar root saponin A， and mycophenolic acid. CONCLUSIONS L-pyroglutamic acid， syringic acid， bergenin， cinnabar root saponin A， and mycophenolic acid may act as the pharmacodynamic material basis of A. crenata.