Adolescent ; Cochlear Implantation ; Cochlear Implants ; Humans ; Male ; Otitis Media, Suppurative ; rehabilitation ; Postoperative Period

Objective To explore the relationship between the obstetric factors defined by Robson Ten-Group Classification System (RTGCS) and cesarean section rate (CSR),and to evaluate the validity of predictive models established based on the RTGCS for cesarean section.Methods Clinical data of 41 295 cases delivered in Shanghai First Maternity and Infant Hospital from January 1,2012 to September 30,2014 were retrospectively collected.CSR of different groups categorized by the RTGCS was analyzed by descriptive epidemiological methods by three models.Model 1 was obstetrics factors (parity,history of cesarean section,number of fetus,mode of labor,fetal presentation and gestational age);model 2 was obstetrics factors (model 1) + demographic characteristics and severity (maternal age and with/without treatment in intensive care unit);model 3 was defined as model 2+ complications (placenta previa,placental abruption,chronic or gestational hypertension,preeclampsia,renal disease,or human immunodeficiency virus infection).The relationship between obstetrics factors classified by the RTGCS and CSR was analyzed by the logistic regression model (the potential confounders were controlled).The validity of predictive models was evaluated by analyzing the area under the receiver operative characteristic (ROC) curve.Results (1) There were statistical differences in total CSR and CSR before labor among those cases respectively grouped by age,medical insurance,parity,signal/multiple pregnancy,fetal presentation and gestational age (all P＜0.05).(2) The recruited cases were categorized into ten groups according to the RTGCS and among them,the second group (single,cephalic presentation,nulliparous,≥ 37 gestational weeks,induced labor or cesarean section before labor) accounted for most of the cesarean section cases (61.2％,11 217/18 322),followed by the fourth group (single,cephalic presentation,multiparous,no previous cesarean section,≥ 37 gestational weeks,induced labor or cesarean section before labor),which were 11.2％ (2 061/18 322).(3) Obstetrical parameters,including parity,number of fetus,mode of delivery,history of cesarean section,fetal presentation and gestational weeks at delivery were related to CSR,even after adjustment for maternal age and medical insurance,or obstetrical complications,or both above factors (all P＜0.05).(4) Areas under the ROC curves and the 95％ confidence intervals of model 1,2 and 3 were 0.867 (0.863-0.870),0.875 (0.872-0.878) and 0.881 (0.878-0.885),respectively (all P＜0.01).Conclusion Related variables of RTGCS highly correlate with CSR and could be used as promising indicators for prediction of cesarean section.The RTGCS is of great application value to those research subjects.

Objective To study intermediate and long term efficacy of uterine arterial embolization (UAE)with sodium alginate microspheres(KMG)at diameters 500-700μm in treatment of diffuse adenomyosis.Methods Totally 40 patients with standard difluse adenomyosis were enrolled and treated with UAE.KMG at diameters 500-700 μm for vascular embolization were used to embolize the arteries.The degree of dysmenorrhea,amount of menorrhea and uterine volume,as well as the level of serum CA125,follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)were investigated before andafter UAE.Results The follow up rates were 100%(40/40),100%(40/40),80%(32/40),68%(27/40),58%(23/40)after uterine arterial UAE 12,24,36,48 and 60 months respectively.The early,intermediate and long-term effective rates were 90%(36/40),88%(28/32),83%(19/23).The degree of dysmenorrhea,the amount of menorrhea and the uterine volume,as well as serum CA125 all decreased significantly 3 mouths after UAE at varying degrees(P＜0.05).Compared with other follow-up time,thedegree of dysmenorrhea and the amount of menorrhea declined to their lowest point at 6 month after UAE (P＜0.01).Paralleled with the decrease of volume of uterine,serum CA125 also decreased significantly and reached the lowest level 12 months later compared with other follow-up times(P＜0.01).Even at the 12th month after UAE serum CA125was not normal and FSH,LH and E2 did not change all the times after UAE(P>0.05).No recurrence was found during the 60 months after UAE.Condusion KMG used in UAE at diameters 500-700 μm has good intermediate and long term effectiveness in treatment of diffuse adenomyosis with no side effects.

The present study was performed to investigate competitive interaction between arenobufagin and verapamil hydrochloride with serum albumin.

Objective To evaluate the treatment of aneurysms rupture during endovascular embolization.Methods Nine aneurysms ruptured during the embolization and were treated with endovascular embolization.The reasons of aneurysms rupture during embolization,the prevention and the first aid after aneurysms rupture were analysed.Results Seven patients recovered and 2 died.Conclusions The optimal treatment of aneurysms rupture during endovascular embolization is effective,(J Intervent Radiol,2007,16: 132-134)

Objective To explore the effectiveness of voice training on professional voice users with voice disorders. Methods Thirty one professional voice users suffering from voice symptoms without organic disorder were treated with a four-week voice training program, including vocal hygiene education, respiratory training and resonant therapy. Voice handicap index, maximum phonation time, noise to harmonic ratio,jitter and shimmer were compared before and after the training. Results The voice handicap index ((-x) ± s)decreased from 33.7 ± 19. 2 to 18. 8 ± 18.4 after the training and the difference was significant (t =6. 14,P ＜ 0. 05 ). Maximum phonation time ( (-x) ± s) increased significantly from ( 15. 5 ± 5. 8 ) s to ( 18.6 ± 6.0) s (t = - 3.43, P ＜ 0. 05 ). jitter ( M [P25; P75] ) decreased significantly after the training from 0. 42%[0.36%; 0.62%] to0.35% [0.29%; 0.47%] (Z= -2.51, P＜0.05), while there was no significant change in shimmer and noise to harmonic ratio. Conclusion Voice training can effectively reduce the vocal symptoms in professional voice users, decrease the handicap degree and increase the respiratory support during phonation, thus improve the voice quality.

Objective To evaluate left atrial(LA) function in patients with prophase type 2 diabetes mellitus(T2DM) combinated with or without hypertension using left atrial volume tracking method(LAVT). Methods Thirty-one simple T2DM(T2DMI group) ,21 T2DM accompany with hypertension(T2DM2 group) and forty-five healthy subjects (control group) were enrolled in this study. Ultrasound LAVT(EUB-6500, Hitachi Medical Corporation) was applied to display and analyzed the LA volume loop imaging on the standard LV apical two and four chamber views. The maximal and the minimal LA volume (LAVmax, LAVmin) and the volume before LA contraction (LAVp) were recorded from the LA volume loop. The body surface area was used to correct these volume indexs. The LA reservoir function was assessed by calculating the total of LA filling volume (LAVItotal) and the expansion index(iLAVIe). The passive and active emptying percentage of the total emptying volume(LAVIpass, LAVIact) and the emptying index(iLAVIpass,iLAVIact) were caculated as the parameters of the LA conduit and booster pump function. Results Compared with the values in the control group, the LAVhotal,LAVIact were significantly higher and the LAVlpass,iLAVlpass were lower in the T2DM group (all P<0.05) ,while the iLAVIact was higher only seen in the T2DM2 group(P<0. 05). The LAVlact, iLAVIact were higher and the LAVIpass was lower in T2DM2 group than those in the T2DM1 group (all P<0.05). Conclusions The LA conduit hypofunction in primary in the prophase T2DM,when combinated with hypertension the LA constriction function compensatorily increased, LAVT can evaluate the function of LA in patients with T2DM accurately and rapidly.

OBJECTIVETo assess the effect of neoadjuvant chemotherapy and the factors related with pathological complete response (pCR) of neoadjuvant chemotherapy in breast cancer.

METHODSThe data of 159 primary breast cancer patients who had received neoadjuvant chemotherapy and operation with complete MRI data and histopathology evaluation in this center from January 2009 to December 2011 was analyzed. All the patients were female, aging from 28 to 70 years with a median of 50 years. The neoadjuvant chemotherapy regimens were based on anthracyclines or taxanes, and trastuzumab was used in almost half of the human epidermalgrowth factor receptor 2 positive patients. The response of neoadjuvant chemotherapy was comprehensively evaluated based on RECIST 1.1 and Miller-Payne grading system. SPSS 18.0 was used for statistical analysis.

RESULTSAmong the 159 patients, 10.1% patients had achieved complete response according to the MRI evaluation, and the rate of partial response, stable disease, and progressive disease was 65.4%, 24.5%, and 0 respectively. According to the Miller-Payne grading system, 27.7% patients had pathological response evaluated as G5 (pCR), and the response evaluated as G4, G3, G2, and G1 were 28.3%, 18.9%, 12.6%, and 12.6% respectively. The higher histological grade were correlated with pCR statistically (Z = -2.820, P = 0.005). Meanwhile strong expression of Ki67 (Z = -1.989, P = 0.047) and p53 (Z = -2.457, P = 0.014) were related to pCR in a significant statistically way.

CONCLUSIONSThe response of neoadjuvant chemotherapy can be predicted. The histological grade and the immunohistochemistry results of Ki67 and p53 are related to pCR of neoadjuvant chemotherapy for primary breast cancer. Basal-like breast cancer had a higher pCR statistically.

Adult ; Aged ; Anthracyclines ; administration & dosage ; Antibodies, Monoclonal ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; Female ; Humans ; Ki-67 Antigen ; metabolism ; Middle Aged ; Neoadjuvant Therapy ; Taxoids ; administration & dosage ; Tumor Suppressor Protein p53 ; metabolism

Aged ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; immunology ; Prognosis ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo investigate the correlation between mutation in EGFR tyrosine kinase domain and tumor response as well as prognosis in advanced stage non-small cell lung cancer (NSCLC) treated with iressa.

METHODSFrom May 2002 to Feb. 2005, iressa was orally administered at a dose of 250 mg once daily for 106 advanced stage NSCLC patients until occurrence of disease progression or intolerable toxicity. Cancer tissue was obtained from these patients, and DNA was extracted for analysis of mutation in exon 18 to 24 of EGFR. Exon 18 to 24 of EGFR were amplified by nest PCR, sequenced and analyzed from both sense and antisence directions.

RESULTSPrimary NSCLC tissue specimens consisted of 25 frozen tissue blocks and 81 paraffin-embedded tumor tissue blocks from 106 consecutive NSCLC patients. Mutation was found to be more frequent in the adenocarcinoma than in the squamous cell carcinoma (35.9% vs 14.3%, P =0.033). Mutation was identified in 32 patients (30.2%). Response rate to iressa was 71.9% in the patients with EGFR mutation versus 13.5% in those without mutation (P <0.01). Compared with the patients without EGFR mutation, those with mutation had longer overall survival (median, 13.45 vs. 5.25 months; P<0.01) and median time to progression (median, 8.35 vs. 3.0 months; P <0.01).

CONCLUSIONEGFR mutation may be positively correlated with the response and survival in advanced stage Chinese NSCLC patient treated with iressa.

Adenocarcinoma ; drug therapy ; genetics ; pathology ; Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; genetics ; pathology ; Carcinoma, Squamous Cell ; drug therapy ; genetics ; pathology ; Exons ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms ; drug therapy ; genetics ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Point Mutation ; Prognosis ; Quinazolines ; therapeutic use ; Receptor, Epidermal Growth Factor ; genetics ; Sequence Deletion