Objective To observing the effects of health education on modified lifestyle and behavior patterns among migrant workers. Methods Individuals from two factories were randomly assigned to the intervention group ( n = 262 ; men 129, women 133 ; mean age 31.8) and the control group ( n = 147 ;men 75, women 72; mean age 31.8). The intervention group received 4-months' health education before changes of awareness of health knowledge, cigarette smoking, alcohol consumption, physical activities,mental health and medical consultation. Results In the intervention group, the awareness of the risk of cigarette smoking and alcohol consumption and normal levels of blood pressure and obesity was significantly improved at 4 months(χ2 =59.65, 47.69, 19.50, and 30. 17; all P＜0. 01 ). However, no significant improvement in awareness of AIDS was found in the intervention group. Of the intervention group, some unfavorable lifestyles and behavior patterns were modified ( cigarette smoking χ2 = 4.50 ; altitude toward clinic visit χ2 = 7.09 ; both P＜0. 05 ). Conclusion Health education could help to improve the awareness of health knowledge and modify lifestyle and behavior patterns of migrant workers.

Objective To evaluate the ultrasound(US) features of diffuse sclerosing variant (DSV) of papillary carcinoma of the thyroid. Methods The US and histopathlogical of 20 DSV patients were retrospectively assessed. Results Among the 20 cases,thyroid single lobe of 12 cases,bilateral lobes of 8 cases and cervical lymph nodes metastases of 18 cases (90%) were involved in DSV of papillary carcinoma of the thyroid. At ultrasound, echo diffuse abnormal change of single lobe or bilateral lobes of thyroid and diffuse scattered microcalcifications were seen in the DSV of papillary carcinoma of the thyroid. The blood flow signals of the abnormal lobes were occupied by 75% of one grade and 25 % of two grades. Conclusions DSV of papillary carcinoma of the thyroid is usually manifested as echo diffuse abnormal change,diffuse scattered microcalcifications and cervical lymphocytic infiltration on ultrasound in relatively young patients.

Objective To evaluate the effect of endoscopic surgery for maxillary sinus inverted papilloma.Methods From 2000 to 2011,50 patients with maxillary sinus inverted papilloma were treated with intranasal endoscopic surgery or combined approach.Among them,39 cases were primary and 11 cases were recurrent,which included 17 patients with Krouse stage Ⅱ and 33 cases with Krouse stage Ⅲ.Different surgical approaches were selected according to the range and positions of the lesions.One case with severe atypical hyperplasia received postoperative radiotherapy.Results All cases were followed up for 3-14 years,7 cases recurred.All occurrence within 2 years after operation.Malignant change and death was found in 1 case.After operation,epiphora occurred in 2 cases,maxillary sinus labiogingival groove fistula occurred in 2 cases,facial numbness occurred in 4 cases and incision hemorrhage occurred in 1 case.All the complications were cured after appropriate treatment.Conclusions Naso-endoscopic surgery or combined approach is a safe,effective and microinvasive treatment for patients with maxillary sinus inverted papilloma.Accurate selection of suitable approach according to the range and positions of the lesions and correct management of the base of the tumor are critical to the success of the operation.

OBJECTIVEThe decoction of Astragali Radix and Angelicae Sinensis Radix (A&A) has shown antifibrotic effects in rats with unilateral ureteral obstruction (UUO). The aim of this study was to track the effective parts of A&A for its renoprotective effects, according to the improvement of renal function and renal tubulointerstitial damage.

METHODA&A was sequentially extracted by using different solvents for three times and eleven different parts were gained. Wistar rats were randomly divided into Sham, UUO and the treatment groups with A&A or each part of A&A. After administration of A&A or its parts for 10 days, the levels of serum creatinin (Scr) and urea were measured. The morphological changes of kidneys were also semi-quantitatively analyzed by HE, Masson stained tissue sections, which including interstitial cell infiltration, tubular atrophy and interstitial fibrosis.

RESULTThe levels of Scr, urea were significantly increased, accompanied with severe renal damage in rats with UUO. As same as A&A, the part I in the first extraction and part IC in the second extraction were all shown to decrease the levels of Scr and urea and the index of renal interstitial damage. However, the following 4 parts extracted from IC in the third extraction were shown no effect on the above indexes.

CONCLUSIONThe extract part I and part IC could be considered as the predominant parts of A&A for its renoprotective effects, due to their improvement of renal damage in interstitial nephropathy.

Angelica sinensis ; chemistry ; Animals ; Astragalus Plant ; chemistry ; Chronic Disease ; therapy ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; isolation & purification ; Humans ; Kidney Diseases ; drug therapy ; physiopathology ; Male ; Protective Agents ; administration & dosage ; analysis ; isolation & purification ; Random Allocation ; Rats ; Rats, Wistar

Objective To investigate the expression of autophagy-related gene Beclinl and P62 in nasal polyps and its relationship with the pathogenesis of this disease.Methods The specimens were divided into two groups:nasal polyp tissue (n =50) and normal inferior turbinate mucosa (n =20).The general morphology was detected with hematoxylin-eosin(HE) staining,the expression of Beclin1 and P62 was examined with immunohistochemistry(IHC) and real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-PCR).SPSS 20.0 software was used to analyze the data.Results Protein level:The expression of Beclinl in nasal polyp tissue was lower than inferior turbinate mucosa (U =-13.36,P ＜0.01),in contrast,P62 in experimental group was higher than control group(U =12.99,P ＜0.01).mRNA level:The relative quantity of Beclinl and LC3B expressions in nasal polyp were 0.46 ±0.17and 0.46 ± 0.11,which was lower than those in turbinate mucosa 1.11 ± 0.47 and 0.96 ± 0.25.The differences were significant(t value was-4.61,-4.61,both P ＜0.01).But the relative quantity of P62 expression in nasal polyp was 2.19 ± 0.44,which was higher than that in turbinate mucosa (1.05 ± 0.33).The difference was all significant (t =6.16,P ＜ 0.01).Conclusions Compared with control group,the expression of Beclin1 was deficient and P62 was much more.Autophagy was deficient in nasal polyps,which might be in connection with the pathogenesis of the disease.

Objective:To observe the short-term efficacy and safety of apatinib in combination with dose-dense paclitaxel and carboplatin in locally advanced triple-negative breast cancer (TNBC) patients.Methods:From September 2018 to September 2019, 17 stage Ⅱ/Ⅲ TNBC patients were enrolled in this single arm, single center prospective phase Ⅱ study. They received neoadjuvant treatment of apatinib 250 mg per day, paclitaxel 175 mg/m 2 on 1 st day and a dose of carboplatin according to the area under curve (AUC)=4 on 2 nd day, every 14 days as a cycle. Results:By January 2020, 16 cases completed 4-7 cycles of apatinib treatment and 4-8 cycles of chemotherapy. The median cycles of apatinib treatment and chemotherapy were 5 cycles and 6 cycles, respectively. Two cases achieved complete responses (CR), 12 achieved partial responses (PR), 2 achieved stable diseases (SD) and no progressive disease was observed. The objective response rate (ORR) was 87.5%, disease control rate (DCR) was 100%. By January 2020, among 12 patients who received surgery, 8 achieved pathologic complete response (pCR, 66.7%). The grade Ⅲ/Ⅳ adverse events included: neutropenia, thrombocytopenia in 3 cases (18.8%) each, anemia, fatigue, arrhythmia and alanine aminotransferase (ALT) elevation in 1 case each. Apatinib was interrupted in 5 cases, and was discontinued in 3 cases; chemotherapy dosage was reduced in 1 case.Conclusion:Apatinib in combination with dose-dense paclitaxel and carboplatin neoadjuvant therapy are effective and well tolerated in locally advanced TNBC patients.

Objective:To observe the short-term efficacy and safety of apatinib in combination with dose-dense paclitaxel and carboplatin in locally advanced triple-negative breast cancer (TNBC) patients.Methods:From September 2018 to September 2019, 17 stage Ⅱ/Ⅲ TNBC patients were enrolled in this single arm, single center prospective phase Ⅱ study. They received neoadjuvant treatment of apatinib 250 mg per day, paclitaxel 175 mg/m 2 on 1 st day and a dose of carboplatin according to the area under curve (AUC)=4 on 2 nd day, every 14 days as a cycle. Results:By January 2020, 16 cases completed 4-7 cycles of apatinib treatment and 4-8 cycles of chemotherapy. The median cycles of apatinib treatment and chemotherapy were 5 cycles and 6 cycles, respectively. Two cases achieved complete responses (CR), 12 achieved partial responses (PR), 2 achieved stable diseases (SD) and no progressive disease was observed. The objective response rate (ORR) was 87.5%, disease control rate (DCR) was 100%. By January 2020, among 12 patients who received surgery, 8 achieved pathologic complete response (pCR, 66.7%). The grade Ⅲ/Ⅳ adverse events included: neutropenia, thrombocytopenia in 3 cases (18.8%) each, anemia, fatigue, arrhythmia and alanine aminotransferase (ALT) elevation in 1 case each. Apatinib was interrupted in 5 cases, and was discontinued in 3 cases; chemotherapy dosage was reduced in 1 case.Conclusion:Apatinib in combination with dose-dense paclitaxel and carboplatin neoadjuvant therapy are effective and well tolerated in locally advanced TNBC patients.

Objective: To discuss the application of Mohs microsurgery in nasal and facial basal cell carcinoma (BCC) and analyze the pathological and clinical features. Methods: The clinical data of 127 patients who were diagnosed by pathology as nasal and facial BCC in Qilu Hospital of Shandong University from January 2010 to January 2015 were retrospectively analysed. The value of Mohs microsurgery was discussed and the nasal & facial sites of BCC lesions, clinical and histopathology features were summarized. Results: The proportion of male and female was 1.27︰1 in 127 patients, the ages ranged from 27 to 91 years. The top three inflicted area in nasal and facial was followed by nasal dorsum, nasal root and upper lip.The most frequent clinical type was nodular ulcerative type.The most common pathological type was nodular and pigmented. Routine surgical resection was performed in 62 cases (48.8%) while Mohs micrographic surgery in 38 cases (29.9%). Follow-up duration was 37 months on average. Local recurrence occurred in 5 cases in routine surgical resection group while there was no recurrence in Mohs micrographic surgery group. There was no distant metastasis in all cases. Conclusions There are few specific clinical manifestation in nasal & facial BCC. Surgical treatment is prefered, especially by Mohs micrographic surgery, because it can strictly control the scope of surgical resection and obtain malformation repairment as well as beauty in nasal and facial region.

OBJECTIVE: To investigate the relationship between sleep parameters and suicidal ideation in patients with late-life depression (LLD). METHODS: Seventy-seven LLD patients over 60 years old from Sir Run Run Shaw Hospital of Zhejiang University during July 2017 and July 2018 were included in the study. All patients were assessed with Hamilton Depression Rating Scale (HAMD) and polysomnography (PSG) overnight. The suicidal score of item 3 in HAMD (HAM-D3)was used to define whether there was a suicidal ideation. Participants were subsequently grouped according to endorsement of presence (HAM-D3 score ≥1, =46) versus absence (HAM-D3 score=0, =31) of suicidal ideation symptoms. The sleep efficiency, total sleep time, wakefulness after sleep onset, rapid eye movement percent/latency, and non-rapid eye movement sleep stages 1-3 (N1-N3) were assessed. ANOVA analyses were conducted to explore the correlation of sleep parameters with suicidal ideation between the groups with and without suicidal ideation. In model 1, the HAM-D3 constituted the independent variable in separate ANOVA tests; in model 2 the impact of depressive symptoms were assessed as a covariate with sleep parameters. RESULTS: There was less stage N3 [(55±41)min, =-4.731, <0.05] and the reduced percentage of N3 [(15±11)%, =-4.194, <0.05] in LLD patients with suicidal ideation, compared with the LLD patients without suicidal ideation [(104±49) min, (26±11)%]. Correlation analyses revealed that there was a significant correlation between the suicidal ideation and the percentage of stage N3 and sleep time of stage N3 (both <0.05). CONCLUSIONS Suicidal ideation is associated with less N3 sleep in LLD patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.