[摘 要] 目的：探讨脾多肽联合FOLFOX4或XELOX方案用于Ⅲ/Ⅳ期结肠癌患者术后治疗的疗效及安全性。方法：回顾性收集选择2017年1月至2020年6月期间在广东省惠州市第六人民医院接受晚期结肠癌根治术的患者160例临床资料。将患者分为脾多肽注射液、奥沙利铂、亚叶酸钙联合氟尿嘧啶组[脾多肽+FOLFOX4组（脾F组），n=80]与脾多肽注射液、奥沙利铂联合卡培他滨组[脾多肽+XELOX组（脾X组），n=80]，两组患者均于手术后8周开始进行6个疗程的治疗，治疗结束1个月后对两组患者的临床疗效、免疫水平、营养状况、生存质量及不良反应等方面进行为期2年的随访观察。结果:与脾F组相比，脾X组患者的ORR和DCR均显著提高（均P<0.05）；CD3+ T、CD4+ T、NK细胞百分率、EORTC QLQ-C30评分和PNI水平均显著升高（均P<0.05），NLR、LMR、CA125、CA199、CEA均显著下降（均P<0.05）。脾X组患者白细胞或粒细胞减少、神经毒性、口腔黏膜炎和手足综合征等毒性作用和不良反应发生率均明显下降（均P<0.05）。两组患者2年PFS和OS无明显差异（均P>0.05）。结论: 在Ⅲ/Ⅳ期结肠癌术后患者的治疗中，脾多肽注射液联合XELOX方案比联合FOLFOX4方案在改善不良反应发生率和生活质量方面具有明显优势。

<b>Objective:b> To analyze the relationship between medication taken during pregnancy and congenital heart disease of the newborns. <b>Methods:b> A large cross-sectional survey was conducted between August and November 2013. A questionnaire survey was conducted among the childbearing aged women, selected through multistage stratified random sampling in Shaanxi from 2010 to 2013. All of the childbearing aged women under study were in pregnancy and with definite pregnancy outcomes. Multivariable Poisson regression was conducted for data analyses. <b>Results:b> A total of 28 680 cases were included in this study. The proportion of medication taken at any time during pregnancy was 16.0%, and the prevalence of congenital heart disease among the newborns was 67.9/10 000. After adjustment for factors as general demographic characteristic, history of heart disease and drug allergy and the situation of disease during pregnancy of these women, results from the multivariable Poisson regression showed that, factors as taking drugs (RR=1.95, 95%CI: 1.42- 2.68), cold medicine (RR=1.68, 95%CI: 1.07-2.64), antibiotics (RR=1.90, 95%CI: 1.25-2.90), salicylates (RR=5.01, 95%CI: 1.84-13.64) and antifungal drugs (RR=10.22, 95%CI: 3.25-32.19) during pregnancy were all related to congenital heart disease, and with the history of taking cold medicine (RR=1.90, 95%CI: 1.01-3.61), antibiotics (RR=2.18, 95%CI: 1.17-4.06), salicylates (RR=6.07, 95%CI: 1.45-25.41), antifungal drugs (RR=21.01, 95%CI: 4.17-105.87) and other drugs (RR=2.31, 95%CI: 1.19-4.47) during early pregnancy. These factors were with higher risks for congenital heart disease. <b>Conclusion:b> Women of childbearing age who took cold medicine, antibiotics, salicylic acid drugs, antifungal drugs and other drugs during early pregnancy would increase the risks related to congenital heart diseases.
Adult ; Cross-Sectional Studies ; Drug Therapy ; Drug-Related Side Effects and Adverse Reactions ; Female ; Heart Diseases/epidemiology* ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; Prevalence ; Surveys and Questionnaires

Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation ; Consensus ; Humans ; Lung ; Smoke Inhalation Injury ; diagnosis ; therapy

Humans ; Carcinoma, Verrucous/pathology* ; Carcinoma, Squamous Cell/pathology* ; Bone Neoplasms ; Toes/pathology* ; Skin Neoplasms/pathology*

<b>Objective:b> To investigate the effects of high iodine intake on thyroid function in pregnant and lactating women. <b>Methods:b> A cross sectional epidemiological study was conducted among 130 pregnant women and 220 lactating women aged 19-40 years in areas with high environment iodine level (>300 μg/L) or proper environment iodine level (50-100 μg/L) in Shanxi in 2014. The general information, urine samples and blood samples of the women surveyed and water samples were collected. The water and urine iodine levels were detected with arsenic and cerium catalysis spectrophotometric method, the blood TSH level was detected with electrochemiluminescence immunoassay, and thyroid stimulating hormone (FT(4)), antithyroid peroxidase autoantibody (TPOAb) and anti-thyroglobulin antibodies (TGAb) were detected with chemiluminescence immunoassay. <b>Results:b> The median urine iodine levels of the four groups were 221.9, 282.5, 814.1 and 818.6 μg/L, respectively. The median serum FT(4) of lactating women in high iodine area and proper iodine area were 12.96 and 13.22 pmol/L, and the median serum TSH was 2.45 and 2.17 mIU/L, respectively. The median serum FT(4) of pregnant women in high iodine area and proper iodine area were 14.66 and 16.16 pmol/L, and the median serum TSH was 2.13 and 1.82 mIU/L, respectively. The serum FT(4) levels were lower and the abnormal rates of serum TSH were higher in lactating women than in pregnant women in both high iodine area and proper iodine area, the difference was statistically significant (FT(4): Z=-6.677, -4.041, P<0.01; TSH: Z=8.797, 8.910, P<0.01). In high iodine area, the abnormal rate of serum FT(4) in lactating women was higher than that in pregnant women, the difference was statistically significant (Z=7.338, P=0.007). The serum FT(4) level of lactating women in high iodine area was lower than that in proper iodine area, the difference was statistically significant (Z=-4.687, P=0.000). In high iodine area, the median serum FT(4) in early pregnancy, mid-pregnancy and late pregnancy was 16.26, 14.22 and 14.80 pmol/L, respectively, and the median serum TSH was 1.74, 1.91 and 2.38 mIU/L, respectively. In high iodine area, the serum FT(4) level in early pregnancy was higher than that in mid-pregnancy and late pregnancy, and the serum TSH level was lower than that in mid-pregnancy and late pregnancy, the difference was statistically significant (FT(4): Z=-2.174, -2.238, P<0.05; TSH: Z=-2.985, -1.978, P<0.05). There were no significant differences in the positive rates of serum thyroid autoantibodies among the four groups of women and women in different periods of pregnancy (P>0.05). The morbidity rates of subclinical hyperthyroidism in pregnant women and lactating women in high iodine area were obviously higher than those in proper iodine areas, the difference was statistically significant (χ(2)=5.363, 5.007, P<0.05). <b>Conclusions:b> Excessive iodine intake might increase the risk of subclinical hypothyroidism in pregnant women and lactating women. It is suggested to strengthen the iodine nutrition and thyroid function monitoring in women, pregnant women and lactating women in areas with high environmental iodine.
Adult ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Hypothyroidism/epidemiology* ; Iodides/administration & dosage* ; Iodine/urine* ; Lactation ; Nutritional Status ; Pregnancy ; Prevalence ; Thyroid Diseases/epidemiology* ; Thyroid Function Tests ; Thyroid Gland/physiology* ; Young Adult

Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation ; Consensus ; Humans ; Lung ; Practice Guidelines as Topic ; Smoke Inhalation Injury ; diagnosis ; therapy

Humans ; Herpesvirus 4, Human ; Epstein-Barr Virus Infections/complications* ; Cholangiocarcinoma/pathology* ; Carcinoma, Squamous Cell ; Bile Ducts, Intrahepatic/pathology* ; Bile Duct Neoplasms/pathology*

Case-Control Studies ; Genetic Predisposition to Disease ; Genotype ; Hearing Loss, Noise-Induced ; Humans ; Male ; MicroRNAs ; Noise, Occupational ; Polymorphism, Single Nucleotide ; STAT3 Transcription Factor

<b>Objective:b> To study the relations between famine exposure and the risk of chronic diseases as diabetes mellitus, obesity, hypertension, coronary heart disease and stroke in the population of Harbin. <b>Methods:b> Our data was collected from the baseline survey-the China Kadoorie Biobank project (CKB) in Harbin. Retrospective cohort study design was used. Related risks on chronic diseases including diabetes mellitus, obesity, hypertension, coronary heart disease and stroke, were compared among the famine exposed or non-exposed people, respectively by logistic analysis method. <b>Results:b> After adjusted for factors as age, sex, physical activity, smoking, alcohol intake, diet, family history of diseases, it appeared that the factor 'famine exposure' had increased the risks of diseases as obesity (OR=1.204, 95%CI: 1.104-1.313, P<0.01), hypertension (OR=1.315, 95%CI: 1.210-1.429, P<0.01) and coronary heart disease (OR=1.495, 95%CI: 1.369-1.632, P<0.01). The lower the age of population being exposed to famine, the greater the risk of the development of all kinds of chronic diseases. <b>Conclusions:b> Famine exposure appeared a risk factor for obesity, hypertension, and coronary heart disease. It is of great significance to ensure the life-long nutrition of the people, especially in the early and adolescent stages, to prevent obesity, hypertension, and coronary heart disease in their later lives.
Adolescent ; China/epidemiology* ; Chronic Disease/epidemiology* ; Coronary Disease/epidemiology* ; Diabetes Mellitus/epidemiology* ; Female ; Humans ; Hypertension/epidemiology* ; Obesity/epidemiology* ; Pregnancy ; Prenatal Exposure Delayed Effects/epidemiology* ; Retrospective Studies ; Socioeconomic Factors ; Starvation/epidemiology*

<b>Objective:b> To explore the association between maternal respiratory infection in early pregnancy and gestational age of single live birth. <b>Methods:b> A face to face questionnaire survey was conducted among child bearing aged women in 30 counties (district) of Shaanxi province selected through stratified multistage sampling. Propensity score (PS) matched (1∶1) analysis was used to match participants with respiratory infections to those without respiratory infections. A multilevel linear model was used to investigate the association between respiratory infections and gestational age. Through the control of the confounders step by step, three models were established in this study: model 1 for the variable of respiratory infections before PS matching, model 2 was adjusted for variables in model 1 plus some other individual differences of mother and baby, and model 3 for the variable of respiratory infections after PS matching. <b>Results:b> Of 28 848 child bearing aged women surveyed, 3 676 (12.74%) had respiratory infections in early pregnancy. After PS matching, 2 762 pairs were matched. Analysis with model 1 indicated that a decrease of 0.111 week (P<0.001) in gestational age was associated with a respiratory infection during the first trimester. Analysis with model 2 and model 3 indicated that a decrease of 0.058 week (P=0.025) and a decrease of 0.076 week (P=0.036) were associated with respiratory infection during the first trimester, respectively. <b>Conclusion:b> The respiratory infection during the first trimester was associated with the decrease of the gestational age of newborn.
Bacterial Infections/epidemiology* ; Child ; China/epidemiology* ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Mothers ; Pregnancy ; Pregnancy Trimester, First ; Propensity Score ; Respiratory Tract Infections/epidemiology*