OBJECTIVETo investigate the predictors of local recurrence and survival in primary retroperitoneal leiomyosarcoma (PRLS).

METHODSA retrospective analysis was conducted on 46 cases of PRLS between August 2006 and April 2012. There were 9 male and 37 female patients, and they were 30-79 year old (median 49 year old). Kaplan-Meier estimations and Cox regression analyses were performed.

RESULTSThe tumor size were 5-36 cm, and 29 cases (63.1%) of this group was more than 10 cm. Local 3- and 5-year control rates after complete resection were 47% and 30%. FNCLCC (Fédération Nationale des Centres de Lutte Contre le Cancer) grading (RR = 3.10, 95%CI: 1.59-6.04), gender (RR = 5.30, 95%CI: 1.64-17.13) and blood loss (RR = 3.12, 95%CI: 1.28-7.60) were independent prognostic factor of local recurrence in multivariable analysis (P < 0.05). The 5-year disease-free survival rates after complete resection of PRLS was 26%; and the 5-year disease-specific survival (DSS) rates after complete resection was 48%. The median DSS was 60 months in negative margin of resection and 50 months in positive margin. However, by multivariate analysis, only FNCLCC grading was significant independent predictors of DSS (RR = 2.01, 95%CI: 1.16-3.49, P = 0.013).

CONCLUSIONSGender, FNCLCC grading and blood loss were independent prognostic factor of local recurrence. The disease-specific survival in PRLS varied significantly according to FNCLCC grading.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Leiomyosarcoma ; pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; Prognosis ; Retroperitoneal Neoplasms ; pathology ; Retrospective Studies ; Survival Rate

Acquired Immunodeficiency Syndrome ; HIV Infections ; Humans

Objective To investigate and analyze the mineral and bone disorder (MBD) in the patients with chronic kidney disease (CKD),reveal the change of related indexes of CKD-MBD.Methods A cross-sectional study was carried out in the First Affiliated Hospital of Harbin Medical University.From October 2011 to May 2014,1318 inpatients and hemodialysis outpatients were enrolled.Parameters related to MBD,including serum phosphorus (P),total calcium (t-Ca),intact parathyroid hormone (iPTH) and alkaline phosphatase (AKP) were analyzed.Last,it was analyzed with multiple regression analysis to related factors of the secondary hyperparathyroidism (SHPT) in patients with CKD.Results Serum calcium,phosphorus and iPTH had no obvious abnormalities at the early stages of CKD [GFR ＞ 60 ml· min-1· (1.73 m2)-1],and relatively stable before GFR ＞ 30 ml· min-1· (1.73m2)-1.After entering the CKD4 stage,serum phosphorus,iPTH increased sharply and serum calcium decreased obviously along with the decreased glomerular filtration rate (GFR).Serum P,t-Ca and iPTH levels were statistically significant in CKD 1 to 5D patients,respectively,serum P:(1.13±0.20) mmol/L,(1.14±0.22) mmol/L,(1.26±0.23) mmol/L,(1.48±0.34) mmol/L,(2.05±0.61) mmol/L and (2.08±0.58)mmol/L;serum t-Ca (mmol/L) (2.35±0.13) mmol/L,(2.35±0.12) mmol/L,(2.35±0.15) mmol/L,(2.26± 0.18) mmol/L,(2.07±0.29) mmol/L and (2.31±0.26) mmol/L;iPTH:57.8(45.6,91.8) ng/L,54.1(37.8,74.6) ng/L,71.6(45.8,102.2) ng/L,131.1(81.7,205.1) ng/L,277.5(173.6,395.3) ng/L and 354.9 (194.4,720.3) ng/L;The stepwise logistic regression analysis showed:hypocalcemia (OR=3.32,P ＜ 0.01) and decreased GFR (OR=5.28,P ＜ 0.01) were independent risk factors of iPTH elevation at stage CKD3～ 5.Conclusions From the beginning of the CKD3 stage,serum t-Ca,P,iPTH level began to be relatively abnormal as renal function declined.Hyperphosphatemia,SHPT has not been improved significantly in CKD5D stage patients even with hemodialysis.The regulation of hemodialysis on serum calcium showed overcorrecting phenomenon.

Objective To evaluate the treatment outcome, prognostic factors, radiation dose, and toxicities in patients with early-stage primary diffuse large B-cell lymphoma of Waldeyer's ring (WR-DLBCL) treated with intensity-modulated radiotherapy (IMRT).Methods This study included 80 patients with a confirmed diagnosis of stage Ⅰ-Ⅱ primary WR-DLBCL who were admitted to our hospital from 2008 to 2015.Only 3 patients received radiotherapy alone, and the other patients received radiotherapy and chemotherapy.After chemotherapy, 24 patients achieved complete remission (CR), and 53 patients achieved partial remission (PR).IMRT was given to the primary lesion and cervical lymphatic drainage region.Survival analysis was performed using the Kaplan-Meier method and log-rank test.The Cox model was used for analysis of prognostic factors.The toxicities were scored using the RTOG criteria.Results The median follow-up was 64 months.The 5-year locoregional control (LRC), overall survival (OS), and progression-free survival (PFS) rates were 94%, 88%, and 84%, respectively.The dose-volume histogram showed that the maximum, mean, and minimum doses to primary gross tumor volume were 54.47 Gy, 52.27 Gy, and 38.83 Gy, respectively.Prognostic analysis showed that age>60 years and increased lactate dehydrogenase (LDH) were influencing factors for OS (P=0.009 and 0.002), and that aged>60 years, IPI ≥2, and increased LDH were influencing factors for PFS (P=0.001, 0.035, and 0.007).Among all patients, 12, 53, and 8 experienced grade 1-3 radiation-induced acute oral mucositis, respectively, and 16 and 13 experienced grade 1 and 2 xerostomia as the late toxicity, respectively.Conclusions For patients with early-stage primary WR-DLBCL, IMRT results in satisfactory OS, PFS, and LRC and has tolerable early or late radiation-induced toxicities.

Objective To investigate the changes of β-adrenergic receptor (βAR) in peripheral lymphocytes and β2AR mRNA levels at different stages of bronchial asthma. Methods β2AR density and β2AR mRNA level in peripheral lymphocytes, cAMP and cGMP levels in blood plasma were estimated by radioligand binding assay, radioimmunoassay and RT-PCR.Results (1) Maximum bound volume (Bmax) and equilibrium dissociation constant (Kd) of β2AR of lymphocyte in asthma patients at remission stage were markedly higher than that in normal subjects, while cAMP levels in blood plasma showed no difference. Bmax of β2AR and cAMP levels in asthma patients at acute exacerbation stage were significantly lower than that in normal subjects, and Kds between these two groups were not much different. (2) Expression of β2ARmRNA in peripheral lymphocytes of asthmatics at remission stage was not significantly different compared with that in normals. Conclusions Amount and function of βAR and β2ARmRNA levels are related to asthmatic conditions. Changes of βAR and β2ARmRNA in asthma might rather be a pathological change accompanied by the course of the disease than a primary defect.

Objective To evaluate the value of human epididymis secretory protein 4(HE4)and CAl25 in the diagnosis of ovariall malignancy.Methods HF4 and CA125 in the serum specimens of malignant ovarian tumor group(30 cases),benign ovarian diseases(110 cases;45 benign ovarian tumor,57endometriotic diseases and 8 pelvic inflammation were included) and healthy women group( 137 cases)were assayed double blindly . The levels and the diagnosis efficiency of the HE4 and CA125 were analyzed.Results (1) The median levels of HE4 and CA125 were significantly higher in malignant ovarian tumor group (244 pmoi/L and 601 kU/L respectively) than those of the benign ovarian diseases group( 32 pmol/L and 22 kU/L respectively)and healthy women group (32 pmoi/L and 11 kU/L respectively) (P =0. 000-0. 029). The median levels of CA125 were also higher in endometriotic diseases and pelvic inflammation groups(53 and 41 kU/L respectively) than those of benign ovarian tumor group and healthy women group (12 and 11 kU/L respectively;P = 0. 000-0. 031 ). (2) The positive rate of HE4 was lower than that of CA12s in malignant ovarian tumor group ( P = 0. 036 ). HE4 was negative in benign diseases and healthy women groups. But the positive rates of CA125 were 56. 1% and 5/8 respectively in endometriotic diseases and pelvic inflammation groups and there were significant differences compared with HE4( P =0. 000). (3)The HE4 assay had advantage over the CA125 assay in receiver operating characteristic-area under the curve (ROC-AUC) and sensitivity with a specificity of 100% when ovarian malignancy was compared with controls having benign diseases and healthy women, benign tumor or benign diseases groups respectively. The CA125 assay had advantage over the HE4 assay in ROC-AUC and sensitivity with the same specificity when ovarian cancers were compared with controls having healthy women group. (4) Combined assay of HE4 and CA125was better than CA125 alone when ovarian malignancy was compared with controls having any group. (5)Combined assay was better than HE4 alone in ROC-AUC and sensitivity with the same specificity when ovarian cancers were compared with controls having benign diseases and healthy women or healthy women groups. And combined assay was lower in the ROC-AUC and the sensitivity with specificity of 100% than HE4 when ovarian cancers were compared with controls having benign tumors or benign diseases groups respectively. (6) The diagnosis efficiency of the HE4 assay at the level 86 pmol/L determined in ROC curve with controls having benign diseases and healthy women group and at the 95% reference level 50 pmol/L of healthy women or 150 pmol/L recommended by the kit respectively was compared. The sensitivity of 50 pmol/L was 73% higher than 150 pmol/L and 86 pmoi/L, while the specificity and positive predictive value were lower ( P = 0. 002, P = 0. 000 ). The specificity, accuracy and positive predictive value of HE4 assay at the set point of 150 pmol/L and 86 pmol/L were 100%, 96% and 96%. The set point of 86 pmol/L had advantage over 150 pmol/L at the sensitivity of diagnosis, 70% and 63% respectively. But the positive predictive value was 95% lower than 150 pmol/L, being 100%. There was no significant difference( P =0. 883, P = 0. 883 ). Conclusions The specificity of HF4 assay is higher than CA125 assay in the diagnosis of ovarian cancer and HE4 combined with CA125 assay can improve the diagnoses. The set point of 150 pmol/L is advantageous for the accurate diagnosis, while the set point of 86 pmol/L is advantageous for the screening of malignant ovarian cancer.

Temporomandibular joint disorder (TMD) is one of the common diseases in stomatology caused by a variety of factors, with a high incidence rate, especially among the young people with great pressure, and difficult to treat this disease. it was easy to relapse directly affects the physical and mental health and quality of life of the patients. Psychological factors had been proved to be one of the causes of temporomandibular joint disorder, and cognitive behavioral therapy was a form of psychological therapy that has been applied to a variety of problems, including mental illnesses such as depression, anxiety, and physical symptoms like pain. Cognitive behavioral therapy (CBT) was also used in stomatology department. This paper reviewed the origin, concept formation, theory formation, characteristics and application of CBT in TMJ disorders, in order to provide more evidence for clinical practice and reduce pain for patients.

Objective To observe the value of SimGrid(SG)and S-Enhance(SE)for improving image quality of low-dose X-ray films in children.Methods Data of 344 children in intensive care unit who underwent 410 times bedside X-ray examinations,including 290 times of chest X-ray,51 of abdominal X-ray and 69 of chest and abdominal combined X-ray were enrolled.SG and SE were respectively used for post-processing,and the quality of post-processed images were analyzed.Results Among 410 SG post-processing images,250 images were classified as 2-point,147 as 1-point and 13 as 0-point.SG could significantly improve image quality of children≥1 year and body mass≥10 kg(all P＜0.05),with better ability for displaying bones,trachea,peripheral blood vessels,foreign objects,psoas major muscle and intestinal gas(all P＜0.05).Among 410 SE post-processing images,250 images were classified as 2-point,58 as 1-point and 102 of 0-point.SE could significantly improve image quality of children≥0.5 years and with body mass＞4 kg(all P＜0.05),with better ability for displaying bones,trachea,large blood vessels,peripheral vessels,heart posterior blood vessels and foreign objects(all P＜0.05).Conclusion SG could significantly improve displaying of bones,trachea,peripheral blood vessels,foreign objects,psoas major muscle and intestinal gas in children≥1 year and body mass≥10 kg,while SE could improve displaying of bones,trachea,large blood vessels,peripheral blood vessels,heart posterior blood vessels and foreign objects in children aged≥0.5 years and body mass＞4 kg on low-dose X-ray films.

Objective: To evaluate the long-term efficacy and prognostic factors of childhood acute lymphoblastic leukemia (ALL) enrolled in Shanghai Children's Medical Center-Acute Lymphoblastic Leukemia-2005(SCMC-ALL-2005) multicenter study. Methods: Between May 2005 and December 2014, 1 497 newly diagnosed ALL patients were enrolled and treated in 5 hospitals of SCMC-ALL-2005 study group, using risk-stratified SCMC-ALL-2005 protocol. Risk group classification and treatment intensity were based on clinical features, genetic abnormalities, early response to treatment and levels of minimal residual disease (MRD). Kaplan-Meier method was used to generate overall survival (OS) and event-free survival(EFS) curves. Cox proportional hazards models were used for multivariate analyses. Results: The patients were followed up to December 31, 2016, the median follow-up time was 69 months (24-141 months). The 5-year and 10-year OS rates were (80.0±1.0)% and (76.0±2.0)%. The 5-year and 10-year EFS rates were (69.0±1.0)% and (66.0±2.0)%. The 5-year and 10-year relapse rates were (23.0±1.0)% and (25.0±2.0)%. The 5-year OS and EFS for low risk (LR), intermediate risk (IR) and high risk (HR) were (91.1±1.4)% and (83.3±1.8)%, (79.2±1.5)% and (68.9±1.7)%, (52.9±4.4)% and (30.0±3.8)%, respectively. MRD negative status (<0.01%) on day 55 was seen in 792 patients (82.8%) and positive MRD on day 55 was associated with poor prognosis (OR=1.9, 95%CI: 1.3-2.7, P=0.001). Twenty-four HR patients received allogeneic hematopoietic stem cell transplantation and 17(70.8%) of them were alive and in remission. A total of 164 severe adverse events occurred, 46 of them died, treatment-related mortality was 3.1%. Conclusions In this large sample research, the overall outcome for multi-center SCMC-ALL-2005 study was favorable. This helps to promote the standardized treatment of childhood ALL to the whole country. MRD results on day 55 of induction therapy have important prognostic and therapeutic implications.

Objective:To obtain the genome sequences of SARS-CoV-2 in respiratory specimens in Guangdong Province with next-generation sequencing (NGS) and analyze the factors influencing sequencing.Methods:Eight upper and lower respiratory tract specimens were collected from patients with SARS-CoV-2 infection in Guangdong Province in January 2020. RNA library construction was used to obtain the genome sequences of SARS-CoV-2. A bio-informatics software package (CLC Genomics Workbench 12.0) was used to analyze and compare the genomic sequences.Results:Five SARS-CoV-2 genome sequences were obtained from the eight specimens and two were obtained from lower respiratory tract specimens. The nucleotide homology to SARS-CoV-2 was 97.74%-99.90%. The Ct values were lower, while the sequencing depth, coverage, relative abundance and genome integrity were higher in sequencing the SARS-CoV-2 in lower respiratory tract specimens.Conclusions:The low Ct value of SARS-CoV-2 in the samples was good for sequencing.