10.3969/j.issn.1007-3969.2013.05.005

Background and purpose: Current colorectal cancer patient-derived xenografts (PDXs) models were established by samples taken during surgery. However, metastatic colorectal cancer (mCRC) patients have less surgical opportunities, and it was difcult to obtain enough tumor fragment. The aim of the present study was to es-tablish mCRC PDXs by image-guided biopsy. Methods: A total of 12 patients with colorectal cancer who underwent surgery were included. All patients had recurrent lesions or metastatic lesions needed to be histologically confirmed, and none of them had contraindication to biopsy. Tumor tissues not required for clinical diagnosis were used to establish mCRC PDXs. Results: Seven PDXs grew sufficiently for transfer into mice. The success rate was 77.8%. Conclusion:The PDXs established by image-guided biopsy had the advantage of convenient operation, good reproducibility, high achievement ratio, short experimental periodicity and reliably retain specific genetic and morphological features of the primary patient tumors.

Objective: To assess the value of non-invasive prenatal testing (NIPT) for the identification of fetal chromosomal aneuploidies. Methods: For 9470 pregnant women with a moderate-to-high risk by conventional serological screening or advanced maternal age, peripheral venous blood samples were collected and, following extraction of free fetal DNA, subjected to large-scale parallel sequencing on a Illumina Hiseq2000 platform. Those with a high risk by NIPT were validated by invasive prenatal diagnosis. Results: Out of the 9470 samples, 194 cases (2.0%) were positive by NIPT testing. These included 50 trisomy 21, 11 trisomy 18, 17 trisomy 13, 44 other autosomal aneuploidies, 55 sex chromosomal aneuploidies, and 17 chromosomal copy number variations. As validated by amniotic fluid or umbilical blood chromosomal karyotyping analysis, NIPT has a false positive rate of 2.0%, 18.2%, 41.2%, 97.7%, 81.8%, 94.1%, respectively. The test has a sensitivity of 100% and a specificity of 98.79%. Conclusion For common chromosomal aneuploidies such as trisomy 21 and trisomy 18, NIPT has a good sensitivity and specificity, therefore has good value for clinical application.

Multiple sclerosis has a long course of disease, a high recurrence rate, and is disabling and fatal. Nurse practitioners play an important role in the management of patients with multiple sclerosis. This article reviews the role of nurse practitioners abroad in multiple sclerosis disease modifying treatment, medication nursing, psychological nursing, and assessment and management of palliative care, so as to provide a reference and inspiration for nurse practitioners in China to manage multiple sclerosis patients.

Objective To explore the risk factors,prevention and treatments for liver failure after hepatectomy for hepatic alveolar echinococcosis.Methods Clinical data of 117 patients with hepatic alveolar echinococcosis admitted to the Affiliated Hospital of Qinghai University from August 2016 to August 2017 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among 117 patients,47 cases were male and 70 female,aged (36±13) years on average.According to whether liver failure occurred after operation,the patients were divided into liver failure group (n=28) and non-liver failure group (n=89).The risk factors of liver failure after hepatectomy were analyzed by univariate and multivariate logistic regression.Results The incidence of postoperative liver failure was 24％ (28/117) and its mortality was 21％ (6/28).21 patients were classified as Child-Pugh grade A,4 grade B and 3 grade C.Multivariate logistic regression analysis showed that Child-Pugh grading,complicated with primary liver diseases,AST,operation time,intraoperative blood loss and intraoperative blood transfusion were the independent factors affecting the occurrence of liver failure (OR=0.089,7.412,1.010,7.926,5.961,11.341;P＜0.05).Conclusions The risk of liver failure after hepatectomy is high in patients with hepatic alveolar echinococcosis.Child-Pugh liver function grading,complicated with primary liver diseases,AST,operation time,intraoperative blood loss and intraoperative blood transfusion are the independent factors for liver failure.Preoperative comprehensive assessment of liver function reserve,shortening the operation time,managing intraoperative bleeding and timely diagnosis and treatment after operation are important measures to prevent the postoperative liver failure.

Objective:To investigate the clinical efficacy of non-drug interventions in hospice and palliative care(HPC)for improving cancer-related fatigue(CRF)in elderly individuals and its impact on quality of life.Methods:This study presents findings from a single-center randomized controlled trial conducted at Zhejiang Hospital, focusing on 40 elderly patients experiencing cancer-related fatigue(CRF)between February 2022 and February 2023.The participants were randomly assigned into a control group and an intervention group, each consisting of 20 individuals, using the random number table method.Both groups received routine comprehensive treatment, with the intervention group additionally receiving hospice and palliative care(HPC)non-drug intervention.Following 6 weeks of continuous treatment, the study compared the clinical efficacy, changes in CRF, and quality of life before and after treatment between the two groups.Results:Comparing the baseline data of the two groups of patients, the difference was not statistically significant(all P>0.05).After 6 weeks of treatment, patients in the intervention group reported lower levels of current fatigue, general fatigue, worst fatigue in the past 24 hours, and impact of fatigue on various aspects of their lives compared to the control group(all P<0.01).The clinical remission rate of cancer-related fatigue(CRF)in the intervention group was 60%, significantly higher than the 5% in the control group( P<0.01).Additionally, the intervention group showed improvement in overall quality of life and emotional function with decreased symptom areas scores(fatigue, nausea and vomiting, shortness of breath, sleep disorders, and loss of appetite)( P<0.01 for quality of life and emotional function, P<0.05 for symptom areas). Conclusions:Non-pharmacological interventions within the context of hospice and palliative care have been shown to alleviate cancer-related fatigue in elderly cancer patients, ultimately improving their quality of life.These interventions have demonstrated positive effects on various aspects such as overall quality of life, functional status, fatigue, nausea and vomiting, shortness of breath, sleep disorders, and decreased appetite.Furthermore, these interventions are considered safe and effective in the treatment of elderly cancer patients experiencing fatigue.

OBJECTIVETo assess the value of combined chromosomal karyotyping and BACs-on-Beads(BoBs) assay for the prenatal diagnosis of high risk gravida from Ningbo.

METHODSFor 2779 women, results of conventional karyotyping analysis and BoBs assay were compared.

RESULTSFor common aneuploidies involving chromosomes 13, 18, 21, X and Y, the two methods have yielded a concordance rate of 98.78%. Eight cases detected with microduplication by BoBs were missed by karyotyping analysis. On the other hand, 17 structural chromosomal abnormalities, 10 chimeras and 1 triploidy detected by karyotyping analysis were missed by BoBs.

CONCLUSIONThe BoBs technology has featured high throughput and rapidity, and can detect 9 microdeletion syndromes, which can improve the quality of prenatal diagnosis and provide an ideal complementary for conventional chromosomal karyotyping.

Adult ; Chromosome Aberrations ; Chromosome Deletion ; Chromosomes, Artificial, Bacterial ; genetics ; Female ; Humans ; Karyotyping ; methods ; Pregnancy ; Prenatal Diagnosis ; methods

Objective:To train a deep convolutional neural networks (CNN) using a labeled data set to classify the metaphase chromosomes and test its accuracy for chromosomal identification.Methods:Three thousand and three hundred individuals undergoing surveillance for chromosomal disorders at the Laboratory for Comprehensive Prevention and Treatment of Birth Defects, Ningbo Maternal and Child Health Care Hospital from January 2013 to July 2019 were enrolled. A total of 3 300×46 chromosome images were included, of which 70% were used as the training set and 30% were used as the test set for the deep CNN. The accuracy of chromosome counting and "cutting + recognition + arrangement + automatic analysis" of the model were respectively evaluated. Another 80 images were collected to record the time and accuracy of chromosome classification by geneticists and the model, respectively, so as to assess the practical value of the model.Results:The CNN model was used to count the chromosomes with an accuracy of 61.81%, and the "cutting + recognition + arrangement + automatic analysis" accuracy of the model was 96.16%. Compared with manual operation, the classification time of the CNN model has been greatly reduced, and its karyotyping accuracy was only 3.58% lower than that of geneticists.Conclusion:The CNN model has a high performance for chromosome classification and can significantly reduce the work load involved with the segmentation and classification and improve the efficiency of chromosomal karyotyping, thereby has a broad application prospect.

Objective To study the relationship between bronchial asthma and smoking status in Chinese people.Methods Asthma epidemiological survey and stratified-cluster-random method survey were performed in residents over 14 years in 8 provinces (cities) of China from February 2010 to August 2012.Asthma was diagnosed based upon case history,clinical signs and lung function test.Smoking status was investigated by questionnaire.Results Sampling population was 180 099 and 164 215 were valid.A total of 2 034 subjects were diagnosed as asthma including 79 692 men and 84 523 women.The overall prevalence rate of asthma was 1.24％ (2 034/164 215).Smokers were 23.8％ (39 137/164 215) in the whole population.Smokers were 34.5％ (702/2 034) in asthmatic patients,compared with 23.7％ (38 435/ 162 181) in no-asthmatic population.The incidence of asthma was 1.79％ and 1.06％ in smokers and nonsmokers respectively (P ＜0.001),suggesting that OR of smoking was 1.70 (95％ CI 1.55-1.86,P ＜ 0.001).According to asthma control test (ACT) score,the level of asthma control in non smoking group was higher than that in smoking group(43.2％ vs 35.3％).The times of hospitalization due to acute exacerbations (0.51 vs 0.41 events/person/year),total hospitalization rate (27.35 ％ vs 20.12％),annual emergency room visits (0.80 vs 0.60 events/person/year) and emergency room visit rate (31.77％ vs 24.47％) were all much higher in smoking asthmatic patients than those in non smoking asthmatic patients,indicating that the level of asthma control in smoking patients was significantly worse than in non smoking patients.Conclusions The smoking rate in Chinese people over 14 years is still high.The prevalence rate of asthma in smokers is significantly higher than that of non-smokers.The level of asthma control in smokers is significantly worse than that in non smokers.