Objective: To explore the risk factors of postoperative complications after radical gastrectomy + D2 lymphadenectomy and establish a predictive nomogram model. Methods: From July 2016 to June 2019, 1 705 patients who received radical gastrectomy + D2 lymphadenectomy in the Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine were collected. According to Clavien-Dindo grading system, the postoperative complications were graded, and the risk factors of postoperative complications ≥grade Ⅱ were analyzed by χ2 test. Multivariate Logistic regression was used to analyze the independent risk factors of postoperative complications ≥grade Ⅱ. According to the selected independent risk factors, the nomogram model was established. For verification, above patients were used as the training set, and 612 patients undergoing the same operation in this department from July to December 2019 were used as the validation set. Results: A total of 416 (24.4%) gastric cancer patients had postoperative complications. Multivariate Logistic regression analysis showed that male (OR=1.507, P=0.002), age ≥60 years old (OR=1.962, P=0.001), maximum diameter of tumor ≥5 cm (OR=1.456, P=0.002) and total gastrectomy (OR=1.313, P=0.026) were independent risk factors for postoperative complications ≥ grade Ⅱ. Based on these independent risk factors, the nomogram was established and presented good discrimination and predictive consistency in training set and validation set. Conclusion: The nomogram based on these four independent risk factors has a good predictive performance in predicting postoperative complications after radical gastrectomy for gastric cancer, and has a certain clinical application and reference value.

ObjectiveTo analyze past study on senile dementia in China, and shape the foundation for constructing social support system for elderly with dementia.MethodsA combination of qualitative and quantitative method was used to analyze 406 literatures related to the elderly with dementia published in China since 2000.ResultsDiagnosis method for the senile dementia has matured; but the causes of the disease is still not clear and there is no thorough remedy; study on early intervention, nursing care and social support are inadequate.ConclusionDiagnostic criteria should be standardized, community screening assessment should be done on a regular basis; etiology based on risk factors should be strengthened; systematic study on intervention should be carried out; training on home care techniques should be enhanced. Resolving the care of the elderly with dementia depends on the social support system construction eventually.

ObjectiveTo analyze application of screening and assessment scales for senile dementia in China.MethodsVarieties of screening and assessment scales were found in the studies on screening and assessment of senile dementia in China, as well as their common features and epidemiological results. A combination of qualitative and quantitative methods was used in the analysis.ResultsMini Mental State Examination (MMSE) is preferred tool in screening and Activity of Daily Living Scale (ADL) is the secondary.ConclusionThe future research direction should include: studying the appropriate boundary value in MMSE for China; optimizing the combination of screening scale and developing more appropriate screening tool.

ObjectiveTo explore the risk factors related to senile dementia to develop intervention method.MethodsA combination of qualitative and quantitative methods was used to analyze the factors and their degree related to the incidence of dementia for the elderly.ResultsAgeing was the deterministic factor to senile dementia, and vascular factor was common risk for Alzheimer's disease (AD) and vascular dementia (VD).ConclusionActive intervention in early life, concern about women's groups especially in the mental health, and detemination of value range of the risk factors are needed.

Objective To investigate the status and needs of professional training in the rehabilitation institutes associated to Shanghai Disabled Persons' Federation. Methods All the rehabilitation institutes associated to Shanghai Disabled Persons' Federation were surveyed with their theme, frequency and targeted participants of training in 2010. The intention of training of rehabilitation personnel were investigated and ranged as importance and urgency. Results There were some trainings in all the rehabilitation institutes, which varied with the property and level of the institutions. The theme of training did not meet the intention of the personnel. Conclusion A preliminary training system for the rehabilitation personnel has been established in Shanghai Disabled Persons' Federation system. It is needed to improve the needs assessment,curriculum, and teaching.

Objective: To summarize and investigate the characteristics, prognosis and treatments of chronic lymphocytic leukemia (CLL) patients with trisomy 12 by using FISH (CEP12). Methods: Clinical data of 330 CLL patients were analyzed retrospectively by using FISH (CEP12) to detect trisomy 12 from May 2003 to April 2015. The clinical data and laboratory characteristics of CEP12 positive patients (70 cases) were compared with those CEP12 negative patients (260 cases). Results: Compared with CEP12 negative CLL patients, the proportion of hepatomegaly (13.6% vs 4.0%, P=0.011) and LDH>247 U/L (43.3% vs 18.5%, χ(2)=15.892, P<0.001) in CEP12 positive CLL patients were much higher, respectively. There were no significant differences between age, sex, clinical stage, β(2)-microglobulin level, IGHV mutation ratio and splenomegaly/lymphadenopathy in these two subgroups. However, compared with CEP12 negative patients, CEP12 positive patients had higher ratio of FMC7 (23.8% vs 12.7%, χ(2)=4.730, P=0.030), and lower ratio of CD23 (95.2% vs 99.6%, P=0.033). The overall response rates (ORR) in Fludarabine (without Rituximab), Rituximab (with or without Fludarabine) and the traditional chemotherapy group (chlorambucil, CHOP or CHOP-like) were 77.5% (31/40), 84.8% (56/66) and 45.4% (50/110), respectively. The ORR of the traditional chemotherapy group was lower than that of the Fludarabine group and Rituximab group. For CEP12 positive patients, the ORR was inferior to CEP12 negative patients when only using Fludarabine (P<0.05). However, when using Rituximab, the difference could be eliminated, and the ORR was even a little higher in CEP12 negative patients (91.7% vs 81.0%, P=0.306). Compared with CEP12 negative patients, there were no significant differences in progression-free survival (PFS) (χ(2)=0.410, P=0.478) and overall survival (OS) (χ(2)=0.052, P=0.180) for CEP12 positive patients whom the median time from diagnosis to start treatment and OS time was 22.6 (95%CI 15.4-31.7) and 118.5 (95%CI 74.5-162.4) month while the 5-year PFS and OS were (52.9±7.6)% and (74.8±6.6)%. Conclusions: CEP12 positive CLL patients are more common in hepatomegaly and higher level of LDH. The traditional chemotherapy treatment had the lowest efficacy, and the curative effect of single use of fludarabine is not as good as that of CEP12 negative patients, however, when using Ritaximab, the efficacy could be comparable.
Antibodies, Monoclonal, Murine-Derived ; Antineoplastic Combined Chemotherapy Protocols ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; Retrospective Studies ; Rituximab ; Trisomy ; Vidarabine

OBJECTIVETo study the potential risk factors of human infecting with Streptococcus suis.

METHODS1: M matched case-control study was conducted. 29 human cases of Streptococcus suis infection in the early phase were included in the case group, Patients' family members, neighbors and peoples who had worked together with patients to handle deceased or sick pigs in the last week were recruited as matched controls. There were 147 controls in total. Both cases and controls received questionnaire investigation including the ways to contact sick/dead pigs. Conditional logistic regression was employed to analyze matching data.

RESULTSAccording to the results of multivariate analysis, slaughtering (OR = 11.978, 95% CI: 3.355-42.756), carcasses cutting and processing (OR = 3.008, 95% CI: 1.022-8.849) sick/dead pigs were associated with cases related to human Streptococcus suis infection. The attributable risk proportion were 91.65% and 66.76% respectively. The other types of exposures to sick/ dead pigs, including feeding, selling, burying and eating, were not associated with the human Streptococcus suis infection in our study population.

CONCLUSIONSlaughtering, carcasses cutting and processing sick/dead pigs were important risky behavior for humans to be infected by Streptococcus suis.

Adult ; Aged ; Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Occupational Exposure ; adverse effects ; statistics & numerical data ; Risk Factors ; Streptococcal Infections ; epidemiology ; etiology ; microbiology ; Streptococcus suis ; physiology

Objective To investigate whether elevated baseline levels of high sensitivity C-Reactive Protein (hsCRP) and neutrophil (NE) are associated with an increased risk of breast cancer in Kailuan female cohort. Methods Females from Kailuan cohort (2006-2007) were included in this study. Information on check-up, hsCRP and NE were collected at baseline for all subjects. Multivariable Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (95%CI) of association between baseline hsCRP and NE values and breast cancer risk. Results By December 31, 2015, a total of 18 866 participants were enrolled in this study. During the follow-up, 183 new cases of breast cancer were observed. All participants were divided into three groups according to the level of hsCRP (<1 mg/L, 1-3 mg/L and >3 mg/L). The cumulative incidence of breast cancer were 829/105, 1 211/105 and 1 495/105 in these 3 groups, respectively ( 2=12.08， P=0.002). Compared with participants with lower hsCRP levels (<1 mg/L), individuals with the highest hsCRP (>3 mg/L) levels had significantly increased risk of breast cancer (HR=1.71,95%CI: 1.18-2.47, P=0.005), howerver, we didn’t find the statistically significant association between NE level (<3.70×109/Lvs. ≥3.70×109/L) and the risk of brease cancer (P>0.05). Conclusions Elevated levels of hsCRP at baseline might increase the risk of breast cancer in females.

OBJECTIVETo describe the clinical and epidemiological features of dead cases with human Streptococcus suis infections, and to find the target population for preventing death and the related indicators.

METHODSEpidemiological investigation on human Streptococcus suis infections was implemented used unified questionnaires. Analysis on dead cases and survival cases (as contrast) was done.

RESULTSThe population with highest fatality rate was in 40-49 age group. 97.37% of dead cases had toxic shock syndrome. The mean interval from onset to admission was 0.76 days, and the mean course was 2.11 days. The progression among dead cases was faster than that among survival cases. Chief clinical manifestations of dead cases that are more frequent than survival cases are purpura (73.68%), diarrhea (50.0%), dyspnea (21.05%), conjunctival congestion (34.21%), etc. Renal impairment and liver involvement in dead cases were more significant than that in survival cases. No significant difference between mean incubation period, exposure rates of main risk factors in dead cases and in survival cases was found.

CONCLUSIONPreventing toxic shock syndrome might reduce the fatality rate. The target population for preventing death is aged > or = 40. Liver function and renal function testing might be indicators for monitoring the progression of human Streptococcus suis infections.

Adult ; Aged ; China ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Streptococcal Infections ; blood ; microbiology ; mortality ; pathology ; Streptococcus suis ; physiology ; Young Adult

OBJECTIVEIn mid-July 2005, five patients presented with septic shock to a hospital in Ziyang city in Sichuan, China, to identify the etiology of the unknown reason disease, an epidemiological, clinical, and laboratory study were conducted.

METHODSAn enhanced surveillance program were established in Sichuan, the following activities were introduced: active case finding in Sichuan of (a) laboratory diagnosed Streptococcus suis infection and (b) clinically diagnosed probable cases with exposure history; supplemented by (c) monitoring reports on meningococcal meningitis. Streptococcus suis serotype 2 infection was confirmed by culture and biochemical reactions, followed by sequencing for specific genes for serotype and virulence factors.

RESULTSFrom June 10 to August 21, 2005, 68 laboratory confirmed cases of human Streptococcus suis infections were reported. All were villagers who gave a history of direct exposure to deceased or sick pigs in their backyards where slaughtering was performed. Twenty six (38%) presented with toxic shock syndrome of which 15 (58%) died. Other presentations were septicaemia or meningitis. All isolates were tested positive for genes for tuf, species-specific 16S rRNA, cps2J, mrp, ef and sly. There were 136 clinically diagnosed probable cases with similar exposure history but incomplete laboratory investigations.

CONCLUSIONAn outbreak of human Streptococcus suis serotype 2 infections occurred in villagers after direct exposure to deceased or sick pigs in Sichuan. Prohibition of slaughtering in backyards brought the outbreak to a halt. A virulent strain of the bacteria is speculated to be in circulation, and is responsible for the unusual presentation of toxic shock syndrome with high case fatality.

Animals ; Bacteremia ; epidemiology ; microbiology ; China ; epidemiology ; Disease Outbreaks ; Humans ; Meningitis, Bacterial ; epidemiology ; microbiology ; Shock, Septic ; epidemiology ; microbiology ; Streptococcal Infections ; epidemiology ; microbiology ; veterinary ; Streptococcus suis ; isolation & purification ; Swine ; Swine Diseases ; microbiology