Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Pneumoconiosis ; epidemiology

Mathematics ; Models, Theoretical ; Occupational Health Services ; organization & administration ; Risk Assessment ; methods

Objective To explore the early diagnostic values of serum alpha -fetoprotein (AFP),gamma -glutamyltransferase Ⅱ (GGTⅡ),and Golgi protein 73 (GP73)in patients with primary hepatocellular carcinoma (PHC).Methods The serum specimens of 100 pa-tients with liver diseases (50 cases of hepatitis and liver cirrhosis and 50 cases of PHC)and 50 healthy people were collected in our hospital from February 2013 to February 2014.Electrochemical luminescence technique,specific immuno -membrane adsorption assay,and enzyme-linked immunosorbent assay were used to measure the serum levels of AFP,GGTⅡ,and GP73.Comparison of continuous data between multiple groups was made by analysis of variance,and comparison between two groups was made by q test.The receiver operating character-istic (ROC)curves of single or combined test results were made,and the areas under the ROC curves (AUCs)were calculated.The sensi-tivity,specificity,and AUCs of AFP,GGTⅡ,GP73,and the combined test were analyzed and compared.Results The level of serum GGTⅡ in the PHC group was significantly different compared with those in the other two groups (F =16.224,P <0.05),but there was no significant difference between the normal group and the hepatitis and liver cirrhosis group (P >0.05).Significant differences in serum levels of AFP and GP73 were observed by paired comparison between the PHC group,hepatitis and liver cirrhosis group,and normal group (F =193.128,F =20.231,P <0.05 for both).When assayed alone,the specificities of GP73,GGTⅡ,and AFP were 69%,64% and 51%, respectively,and the sensitivities were 92%,84%,and 76%,respectively.In combined test,the specificity was 94.6% and the sensitivi-ty was 98.8%.Conclusion The GP73 test is the best performer in the single assays.Combined test of serum AFP,GGTⅡ,and GP73 shows a good diagnostic value for PHC with greatly improved specificity and sensitivity.

Objective To investigate the efficacy of docetaxel combined with capecitabine in the treatment of patients with locally advanced breast cancer and its effect on immune function.Methods 160 patients with locally advanced breast cancer were randomly divided into observation group and control group.The control group was treated with capecitabine.The patients in the observation group were treated with docetaxel combined with capecitabine.The clinical effective rate, median time to progress, median survival time, one year survival rate and immunoglobulin protein expression levels were observed.Results The clinical effective rate and stable rate in the observation group were 88.75% and 95.00%, which were significantly higher than 68.75% and 87.50% in the control group, the differences were statistically significant (x2=5.89,4.17,all P<0.05).After treatment, the median time to progression, median survival time and one year survival rate of the observation group were significantly higher than those of the control group (t=3.43,5.09,6.23,all P<0.05).Compared with before treatment, after treatment, the IgG,IgM and IgA levels in the observation group significantly decreased(t=2.34,3.16,3.27,all P<0.05), while those of the control group were not significantly changed (t=0.79,0.22,0.27,all P>0.05).Conclusion Docetaxel combined with capecitabine in the treatment of patients with locally advanced breast cancer can improve the clinical efficacy and stability, prolong the survival time of patients.Compared with using single agent chemotherapy, combined use has no significant effect on human immune function, the effect is better than the use of capecitabine alone, which is worthy of promotion in clinical use.

Objective To observe the efficacy and safety of oxycontin treatment in cancer patients with mod-erate to severe chronic cancer pain.Methods This study was performed by study group and control groups.120 cases of patients with moderate to severe chronic pain were enrolled in study group and treated with oxycontin(10mg/time, once every 12 hours).50 cases of patients with moderate to severe chronic pain were randomly allocated to control group and treated with tramadol hydrochloride sustained-release tablets(100mg/time,once every 12 hours).Clinical efficacy and adverse reactions of patients in the study group and control group were evaluated after therapy for three weeks.Results There was 35 cases of complete remission,80 cases of partial remission,and 5 cases of mild remis-sion,and the overall response rate was 95 .8% in the study group.In addition,there was 4 cases of complete remis-sion,4 0 cases of partial remission,4 cases of mild remission and 2 cases of no effect,and the overall response rate was 88.0%,there was statistically significant difference(P=0.004).Meanwhile,the rates of adverse reactions in the study group and the control group were 16.7% and 14.0%,respectively,there was no statistically significant differ-ence(χ2 =0.188,P>0.05 ).Conclusion Oxycontin can effectively safely treat cancer patients with moderate to severe chronic pain.

Objective To investigate and analyze clinical analysis of low molecular weight heparin calcium combined with psychological intervention in the treatment of diabetic foot patients. Methods 100 patients with type 2 diabetic foot who were treated in our hospital from February 2015 to November 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The patients in the control group and the experimental group were treated with anti infection therapy and insulin hypoglycemic therapy, and the dressing change was carried out. The experimental group was given subcutaneous injection of low molecular weight heparin for psychological intervention, pay attention to the patient's psychological status, strengthen communication with patients, and increase the patient's confidence and treatment compliance. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, 6 cases in the experimental group the wound healing is invalid. The number of ineffective wounds in the control group was 20. The effective rate of treatment in the experimental group was 88.0％, which was significantly higher than that in the control group, and the effective rate was 60.0％, with statistical difference (P<0.05). After treatment, the plasma viscosity and the blood flow velocity of the dorsalis pedis artery in the experimental group were significantly better than those in the control group, with statistical difference (P<0.05). Conclusion Low molecular weight heparin calcium combined with psychological intervention in the treatment of diabetic foot has a good clinical effect, and has the significance of promotion.

Objective To isolate and identify advanced oxidation protein products from human serum albumin (AOPP-HSA), expecting to search for a method of preparing highly purified and bioactive AOPP-HSA. Methods AOPP-HSA crude products were prepared in vitro by exposing HSA to HOCl. AOPP-HSA was isolated by gel chromatography and ion-exchange HPLC. Its structural features and biological activities were characterized by UV and fluorescence spectrum, SDS-PAGE, and the experiment of TNF-? release from monocytes. Results The isolated protein was purified up to 99.4% and was dityrosine-containing protein cross-linking products with molecular weight of 700?10 3. It possessed the ability of triggering the considerable release of TNF-? from monocytes. Conclusion Highly purified and bioactive AOPP-HSA can be successfully prepared by above-mentioned two-step chromatography from AOPP-HSA crude products, which builds a basis for further study of AOPP.

Objective To investigate the clinical value of Fluorine-18-fluorodeoxyglucose (18 F-FDG) PET/CT examination to predict the prognosis of patients after colorectal cancer operation.Methods The retrospective cross-sectional study was adopted.The clinicopathological data of 80 patients with colorectal cancer who were admitted to the First Hospital of Nanjing Medical University from March 2007 to October 2015 were collected.Eighty patients received first preoperative 18 F-FDG PET/CT examination and underwent operations under decisions of patients and their families,and then adjuvant chemotherapy were performed according to the patients' condition.Observation indicators included:(1) preoperative imaging examination,(2) situations of treatment and follow-up,(3) analysis of prognostic factors.The patients were followed up by outpatient examination and telephone interview once every 3 months within postoperative 1 year,once every half a year within postoperative 2 years and then once a year up to May 2016.The follow-up included tumor recurrence or progression and survival of patients.Tumor-free survival time was from postoperative day 1 to tumor recurrence or progression and death or end of follow-up.Overall survival time was from postoperative day 1 to death or end of follow-up.Measurement data with skewed distribution were represented as M (Qn) and M (range).The optimal cutoff point of tumor-free survival of maximum standardized uptake value (SUVmax),mean standardized uptake value (SUV),metabolism of volume (MTV) and total lesion of glycolysis (TLG) were investigated using the ROC curve analysis,and calculating area under the curve (AUC).The median was used as a cutoff point if there was smaller AUC.The Kaplan-Meier method and Log-rank test were respectively used for survival analysis and univariate analysis,and COX proportional hazards model for multivariate analysis.Results (1) Results of preoperative imaging examination:results of PET/CT in patients with colorectal cancer showed there were circumscribed thickening of bowel wall,intestinal cavity strictures,fuzzy fat space around the some lesions,enlarged lymph node and 18 F-FDG uptake increased abnormally.The SUV SUV MTV and TLG of 80 patients were 11.83(4.26,35.42),7.06(2.38,20.92),20.47 cm3 (1.29 cm3,161.50 cm3) and 138.58 (14.17,857.89),respectively.ROC curve showed that the AUC of SUV SUV MTV and TLG were 0.453,0.448,0.815 and 0.749 [95％ confidence interval (CI):0.307-0.600,P ＞0.05;0.303-0.594,P ＞ 0.05;0.717-0.913,P ＜ 0.05;0.635-0.863,P ＜ 0.05],respectively.The median SUVmax (11.83) and SUV (7.06) were used as the cutoff points due to smaller AUC of SUVmax and SUV.The cutoff point of MTV was 18.79 cm3 (sensitivity =86.2％ and specificity =68.3％),and the cutoff point of TLG was 142.05 (sensitivity =75.9％ and specificity =70.7％).(2) Situations of treatment and follow-up:among 80 patients,13 underwent the radical resection of colorectal cancer and resection of liver metastasis and 67 underwent radical resection of colorectal cancer.Sixty-two patients received postoperative chemotherapy,including 45 with chemotherapy regimens of capecitabine and 17 with fluorouracil.Eighty patients were followed up for 41.8 months (range,6.5-109.1 months).During the follow-up,29 patients had tumor recurrence or progression,and 19 patients were dead.The median tumor-free survival time,1-,3-and 5-year tumor-free survival rates in 80 patients were 19.5 months (range,2.0-109.1 months),73.7％,36.3％ and 18.8％,respectively.The median overall survival time,1-,3-and 5-year overall survival rates were 31.8 months (range,3.3-109.1 months),76.3％,37.5％ and 20.0％,respectively.(3) Analysis of prognostic factors:results of univariate analysis showed that tumor location,N staging,M staging,clinical staging,postoperative chemotherapy,MTV and TLG were relative factors affecting postoperative tumor-free survival rate (HR =3.469,5.325,5.295,8.605,2.630,7.388,5.155,95％ CI:1.522-7.906,2.256-12.568,2.405-11.657,2.969-24.937,1.063-6.504,2.550-21.403,2.178-12.204,P ＜ 0.05).The tumor location,tumor differentiation,N staging,M staging,clinical staging,MTV and TLG were relative factors affecting postoperative overall survival rate (HR =2.697,2.814,3.083,2.916,4.193,5.450,4.876,95％ CI:1.011-7.197,1.121-7.062,1.166-8.149,1.140-7.454,1.386-12.678,1.581-18.786,1.727-13.766,P ＜ 0.05).In multivariate analysis,stage Ⅲ-Ⅳ of clinical staging and TLG≥ 142.05 were independent risk factors affecting postoperative tumor-free survival rate (HR =9.879,3.569,95％ CI:1.854-22.836,1.127-11.306,P＜0.05).The stage M1,stage Ⅲ-Ⅳ of clinical staging and TLG≥ 142.05 were independent risk factors affecting postoperative overall survival rate (HR =4.522,9.315,10.120,95％ CI:1.223-16.717,1.338-24.864,2.385-12.947,P＜0.05).Conclusion TLG through 18 F-FDG PET/CT examination is an independent prognostic factor affecting postoperative tumor-free survival rate and overall survival rate in patients with colorectal cancer after curative resection,and it has certainly reference value for prognosis.

OBJECTIVE:To provide reference for rational use of antibacterials. METHODS:Taking 69 hospitals of Beijing, Tianjin,Shanghai,Hangzhou,Guangzhou,Chengdu as samples,the data about the purchase and application of antibacterials in outpatient department were collected during 2009 to 2013,and analyzed in terms of the proportion of the amount of antibacterials in all chemical drugs,the number of antibacterials among top 80% chemical drugs in the list of consumption sum and their variet-ies number,the utilization rate of antibacterials in outpatient prescription,the percentage of two and more antibiotics combination in outpatient antibiotics prescriptions,the proportion of antibiotics use,etc. RESULTS:The proportion of average purchase amount of antibacterials in chemical drugs decreased from 20.97 % in 2009 to 14.17 % in 2013;the number of antibacterials among top 80% chemical drugs in the list of consumption sum decreased from 43 in 2009 to 34 in 2013;the average utilization rate of outpa-tient antibacterials decreased from 23.22 % in 2009 to 16.11 % in 2013;there was statistical significance(P<0.05). The varieties of antibacterials decreased from 78 kinds in 2009 decreased to 54 kinds in 2012(P<0.05),but rise to 66 kinds in 2013;the per-centage of two and more antibacterials combination in outpatient antibacterials prescriptions decreased fron 9.02% in 2009 to 7.35% in 2012 (P<0.05),rise to 12.89% in 2013. The utilization ratio of antibacterials injection in outpatient antibacterials pre-scriptions had no significant change. The utilization of antibacterials in tertiary hospitals from 6 districts was analyzed;cephalospo-rin had ranked the first place,and almost occupied half part of antibacterials but declined;the utilization rate of antibacterials for special use was on the rise. CONCLUSIONS:After 3 years of antibacterials special rectification,and the utilization of antibacteri-als in 6 districts as Beijing have been improved significantly;however,several index have little improvements,and some rebound-ed in 2013,so this activities needs to establish long-term mechanism of continuous supervision.

Older people generally had low health literacy, age related cognition decline and some even progress into dementia, burden on society was aggravating. Cognition decline of the elderly could lead to the decrease of health literacy. Meanwhile, higher level of health literacy was a protective factor against cognition decline in the elderly. This paper aimed to explore the relationship between health literacy and cognitive function in the elderly population without dementia, and to provide a theoretical basis for improving the health literacy and cognitive function of the elderly.