Objective To explore the diagnostic value of 18F-FDG PET/CT in primary peritoneal papillary serous carcinoma (PPPSC).Methods Ten postmenopausal female cases of pathologically diagnosed PPPSC from March 2009 to October 2011 were retrospectively reviewed (age range:61-81 years,mean:(69.4±6.2) years).All cases underwent 18F-FDG PET/CT.The CT characteristics and SUVmax of lesions on PET images were analyzed.Serum CA125 levels were measured before or after PET/CT within one week.The patterns of PPPSC on PET/CT were compared with histopathological results.Linear correlation analysis was used to evaluate the correlation between the CA125 and the maximum SUVmax of lesions presented in parietal peritoneum,greater omentum or mesentery.Results The PET/CT uptake pattern of the 10 PPPSC cases was described as floccus,multi-nodular or cake-like in greater omentum (SUVmax =6.32±2.87),and as diffuse or localized nodules,or non-uniform strip-like thickening in 9 parietal peritoneum and 8 mesentery cases (SUVmax =5.96±2.14 and 5.70± 1.69,respectively).The most commonly involved sites were pelvic wall of peritoneum and mesentery of small intestine.All 10 cases had different degrees of ascites,mainly intrapelvic and perihepatic.Hypermetabolic ovarian enlargement (all ＜5 cm) was bilateral in 2 patients and right-sided in 1 patient.Four patients had retroperitoneal lymph node metastasis and others were found with punctate calcifications in metastatic lymph nodes,small pleural effusions,liver metastasis,as well as portal node metastasis.CA125 concentration was elevated in all cases ((51.25±26.40) ×104 U/L),but there was no significant correlation between CA125 and the maximum SUVmax of lesions found in parietal peritoneum,greater omentum or mesentery (r=0.05,P＞0.05).Conclusion 18F-FDG PET/CT could show the positions and metabolic status of PPPSC lesions.It may be an effective imaging modality in the diagnosis and assessment of PPPSC.

OBJECTIVE: To investigate the differences of IL-4, IFN-gamma gene promoter methylation of allergic rhinitis patients between Uygur and Han people of Xinjiang. METHOD: Methylation-specific PCR (MSP) detected IL-4, IFN-gamma gene methylation of each of 50 patients with allergic rhinitis in Uygur and Han. RESULT: Complete IL-4 gene promoter methylation rate was 44% (22/50) and 48% (24/50) in Uygur and Han AR patients, un-methylation was 26% (13/50) and 22% (11/50), coexistence rate of methylation and un-methylation was 30% (15/50) and 30% (15/50). Complete IFN-gamma gene promoter methylation rate was 12% (6/50) and 16% (8/50) in Uygur and Han AR patients, un-methylation was 8% (4/50) and 10% (5/50), coexistence rate of methylation and unmethylated was 80% (40/50) and 74% (37/50). Distribution of IL-4 gene methylation between Han and Uygur AR patients had no statistically significant (P > 0.05). Distribution of IFN-gamma gene methylation between Han and Uygur AR patients had no statistically significant (P > 0.05). CONCLUSION There is no difference of IL-4, IFN-gamma gene methylation in patients between the Han and Uygur.
Adult ; China ; epidemiology ; DNA Methylation ; Epigenesis, Genetic ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Humans ; Interferon-gamma ; genetics ; Interleukin-4 ; genetics ; Male ; Promoter Regions, Genetic ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; epidemiology ; genetics

BACKGROUNDThe effects of anxiety and depression on the recurrence of persistent atrial fibrillation (AF) after circumferential pulmonary vein ablation (CPVA) are not clear. Whether CPVA can alleviate the anxiety and depression symptoms of persistent AF patients is unknown.

METHODSOne hundred and sixty-four patients with persistent AF, of which 43 treated with CPVA (CPVA group) and 103 treated with anti-arrhythmics drugs (medicine group), were enrolled. The Zung Self-Rating Anxiety Scale (SAS), and Zung Self-Rating Depression Scale (SDS) were assessed before and 12 months after treatment in all patients.

RESULTSThe scores of SAS (40.33 ± 7.90 vs. 49.76 ± 9.52, P < 0.01) and SDS (42.33 ± 8.73 vs. 48.17 ± 8.77, P < 0.01) decreased 12 months after CPVA. Over 12 months follow-up, AF relapsed in 17 patients in CPVA group. Compared with the data in the recurrent group (17 patients), the scores of SAS and SDS were significantly lower in the non-recurrent group (26 patients) at baseline. The results of multivariate Logistic regression analysis showed normal scores of SAS and SDS were the independent risk factors of AF recurrence after CPVA.

CONCLUSIONSAnxiety and depression increase the recurrence risk of persistent AF after CPVA. CPVA can ameliorate the anxiety and depression symptoms in patients with persistent AF.

Aged ; Anti-Asthmatic Agents ; therapeutic use ; Anxiety ; complications ; Atrial Fibrillation ; drug therapy ; pathology ; psychology ; surgery ; Catheter Ablation ; Depression ; complications ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; surgery ; Treatment Outcome

Objective To determine the incidence of non-fatal injuries and related influencing factors among children under 5 years old in China. Methods Data involving 10 819 children under 5 years old was from the Fourth National Health Service Survey of China. Injury-related indicators include: history of ever having had an injury, its frequency, cause, location and severity of the injury.A two-level Poissun regression was used to examine the significance of related socio-economic variables. Results The overall incidence rate of nonfatal injuries among children under 5 years old was 16.0 per 1000 population in the prior 12 months. The first three leading causes of non-fatal injuries were falls,animal bite, fire/bum among children under 1 year old,with the rates as 3.9, 1.8 and 1.8 per 1000 population, respectively. For children aged I to 4 years old, the first three leading causes were animal bite, fall, fire/burn with rates as 6.5,6.0 and 2.9 per 1000 population, respectively. 83.0% and 69.0% of last injuries occurred at home for the above said two age groups. No disability was found among children younger than 1 year old who suffered from a nonfatal injury while for the 1-4 age group, the disability accounted for 1.0% of injury-induced outcomes. After adjusting other variables,boys had 1.57 times the risk of injury compared with girls in the 1-4 age group (P＜0.05). The differences on the effects regarding ethmicity,per capita household income, and place were insignificant (P＞0.05). None of the socio-economic variables was found that significantly related to the non-fatal injury risk among children under 1 year old (P＞0.05). Conclusion The incidence of nonfatal injuries among children under 5 years old was 16.0 per 1000 population in the prior 12 months. The three leading causes of injuries were animal bite, falls, fire/bum respectively. Home was the most common place that non-fatal injuries occurred. Boys had a higher risk of injury compared with girls among children aged 1 to 4 years old and the difference was significant.

To simulate intervention measures in controlling an outbreak of acute hemorrhagic conjunctivitis on one school campus by using the Susceptible-Infected-Recovered (SIR) model, to provide evidence for preparedness and response to the epidemic. Classical SIR model was used to model the epidemic. Malthusian exponential decline method was employed to estimate the infective coefficient β for interventions. The initial value of parameters was determined based on empirical data. The modeling was implemented using Matlab 7.1 software. Without interventions, the outbreak was expected to experience three phrases: (1)early stage (the first 5 days) in which the epidemic developed slowly and could be intervened easily; (2) rapid growing stage (6-15 days) in which the number of infected cases increased quickly and the epidemic could not be well controlled;and (3) medium and late stage (16 days and later) in which more than 90% of the susceptible persons were infected but the intervention measures failed to prevent the epidemic. With the implementation of interventions, the epidemic was predicted to be controlled in the early stage, under the SIR model. The simulation based on the SIR model kept an acceptable consistency with the actual development of epidemic after the implementation of intervention measures. The SIR model seemed effective in modeling interventions to the epidemic of acute hemorrhagic conjunctivitis in the schools.

Objective To determinate the prognostic value of etiology in patients with chronic systolic heart failure (CSHF).Methods Data of in-hospital patients with CSHF were investigated between 2000 and 2010 from 12 hospitals in Hubei province.All patients were followed up through telephone calls.Univariate and multivariate Cox proportional hazards analyses were then used to explore the differences in the all-cause mortality,heart failure (HF) mortality and sudden cardiac death (SCD) among patients caused by different etiologies.Kaplan-Meier curve were then constructed and Univariate and multivariate Cox regression analyses were used to select demographic and clinical variables in predicting the all-cause mortality,HF mortality and SCD in CSHF patients.Multivariate logistic models and ROC curve were developed with or without the cinfirmed etiology to assess the incremental additive information related to different etiologies.Results (1)Over the median 3 (2-4) years follow-up program,6453 (38.69％) patients died,including 5505 (33.00％) due to HF prognosis and 717 (4.30％) died of SCD.All-cause mortality rates accounted for 34.50％,54.30％,41.48％ and 15.76％,with HF mortality rates as 30.11％,44.95％,36.25％ and 13.10％.SCDs accounted 8.46％,8.45％,9.84％ and 1.05％ in patients with CHD,DCM,HHD and RHD,respectively.(2) Compared with RHD patients,the adjusted HRs for all-cause mortality were 1.554 (1.240 to 1.947;P＜0.001),1.405(1.119 to 1.764;P=0.003) and 1.315(1.147 to 1.467;P=0.005) while the adjusted HRs and 95％CIs for HF mortality were 1.458( 1.213-1.751 ;P＜0.001 ),1.763( 1.448-2.147;P＜0.001 ) and 1.281 ( 1.067-1.537; P=0.008),in patients with CHD,DCM and HHD,respectively.There were no significant differences in CHD (HR 3.345; 95％ CI,1.291 to 8.666; P=0.013 ) or HHD (HR 2.062; 95％CI,0.794 to 5.352; P=0.137 ),while only DCM ( HR 4.764; 95％CI,1.799 to 12.618;P=0.002) remained significant in SCD despite of the multivariate adjustment.(3) Etiology increased the sensitivity and specificity of predicting models for all-cause mortality(AUC 0.839,95％CI,0.832to 0.845 vs.0.776,95％CI,0.768 to 0.784) and HF mortality(AUC 0.814,95％CI,0.806 to 0.822 vs.0.796,95％CI,0.788 to 0.804) but not with SCD (AUC 0.777,95％CI,0.749 to 0.809 vs.0.747,95％CI,0.727 to 0.766).Conclusion CSHF due to CHD,DCM and HHD carried a worse prognosis than that of RHD.Different etiologies provided significant incremental prognostic information beyond readily available clinical variables for all-cause mortality and HF mortality.

Objective To investigate the prevalence and related factors of medicinal therapy in patients with chronic systolic heart failure (CSHF).Methods Data on in-hospital patients with CSHF were studied from 12 hospitals in Hubei province,in 2000 and 2010.Differences on gender and age were calculated and Multivariate Cox regression analysis was performed to determinate the independent risk factors of all-cause mortality.Results (1) 16 681 patients were enrolled in this study.Among which,6453 died during the 5.82 ± 1.63 years of follow-up.The annual medical expenditure was larger in the survival group than in the dead ones (3.19 ± 0.65 vs.3.32 ± 0.57,P＜0.01).(2)The prevalence of Angiotensin Ⅱ receptor blocker increased along with age which accounted as 7.73％,7.35％,12.26％,14.29％,17.19％,19.87％ and 20.49％,respectively,in the ＜30,30-39,40-49,50-59,60-69,70-79 and ≥80-year groups.The distribution of digitalis,diuretics,β-receptor blocker,Angiorensin- converting enzyke inhibitors showed inversed U shape.(3)The annual medical expenditure increased as patients got older,with age groups ＜30,30-39,40-49,50-59,60-69 and 70-79 years old as 2.96 ± 0.70,3.09 ± 0.62,3.15 ± 0.58,3.30 ± 0.59 and 3.25 ±0.58,respectively (P＜0.01).It reduced to the same level as in the 50-59 year-old group.The distribution of annual medical expenditure showed similar pattern in males.However,the trends were only found in patients at 50-59,60-69,70-79 and ≥80 years-old groups in female.Conclusion More attention should be paid to medicinal therapy in patients with CSHF.Medicinal therapy shifted with age and gender,of which females had more adverse trend than in males.

Abdomen ; Hernia ; Humans ; Prostheses and Implants ; Prosthesis Implantation ; Treatment Outcome

Objective To determinate the prognostic value of red cell distribution width (RDW) and the relationships between RDW and clinical characteristics in patients with chronic heart failure (CHF).Methods A total of 16 681 in-hospital patients with chronic systolic HF and LVEF ＜50％ from 12 hospitals in Hubei province,China were enrolled.All patients were followed up with telephone call.Patients were divided into RDW ≤ 13.2％ (n =3981 ),13.3％ - 14.1％ (n =3996),14.2％ - 14.8％ ( n =4319) and ≥14.9％ (n =4385 )groups.Multivariate Cox regression analysis was performed to determine whether RDW is an independent risk factor of all-cause mortality in overall patients,patients with various etiologies.Multivariate Cox proportional hazard analysis was performed to determine the risk of all-cause mortality among various RDW groups.Results ( 1 ) Compared with RDW ≤ 13.2％ group,adjusted hazard ratios (HRs) and 95％ confidence intervals (CIs) of all-cause mortality for RDW 13.3％ -14.1％,14.2％ -14.8％ and ≥ 14.9％ were 0.892 (95 ％ CI 0.818-0.973,P =0.01 ),0.859 (95 ％ CI 0.793 -0.931,P ＜0.01) and 1.034 (95％ CI 0.961 - 1.111,P =0.373) respectively. (2) Compared with MCV normal group,the adjusted HRs of MCV elevation and MCV decline groups were 1.351 (95％ CI 1.063 - 1.718,P ＜0.01 ) and 1.316 (95％ CI 1.034 - 1.675,P ＜ 0.01 ),respectively.(3) Compared to patients with rheumatic heart diseases,the adjusted HR for all-cause mortality in patients with coronary heart disease,dilated cardiomyopathy and hypertensive heart disease with RDW ＞ 16％ were 1.437 (95％ CI 1.141 -1.810,P＜0.01),1.651 (95％ CI 1.276 -2.138,P＜0.01) and 1.276 (95％ CI 1.004- 1.621,P ＜ 0.01 ),respectively.(4) The RDW is independently correlated with BMI ( r =- 0.345,P ＜ 0.01 ),diastolic blood pressure( r =- 0.321,P ＜ 0.01 ),albumin ( r =- 0.411,P ＜ 0.01 ),blood urine nitrogen ( r =0.476,P ＜ 0.01 ),right ventricular end-diastolic diameter( r =0.383,P ＜ 0.01 ),LVEF ( r =- 0.463,P ＜0.01 ) and heart rate( r =0.379,P ＜0.01 ).Conclusions There is a J shape relationship between allcause mortality and RDW.The elevation or decline of MCV with increased RDW is hnked with increased allcause mortality in CHF patients.

OBJECTIVETo investigate the prevalence of rheumatic heart disease (RHD) among schoolchildren in Guangdong Province and Xinjiang Uygur Autonomous Region.

METHODSUsing a cluster sampling method, an epidemiological survey of RHD was conducted in 16 682 primary and high school students by auscultation in Guangdong Province and Xinjiang Uygur Autonomous Region from 2005 to 2006. Review of the clinical records, RHD survey in adults, and examination of the positivity rate of group A beta-hemolytic Streptococcus (GAS) by throat swab cultures in the students aged between 9 and 12 years in the sampled schools were also carried out.

RESULTSNo RHD patient was found in the sampled population. In Xinjiang, the prevalence of RHD was 12.9/1000 among adults, higher than that (2.2/1000) in Guangdong Province. The GAS-positive rate in the schoolchildren in Xinjiang ranged from 9.8% to 12.6%, higher than that in Guangdong (2.3%-3.9%).

CONCLUSIONThe GAS-positive rate among children and incidence of RHD in adults are higher in Xinjiang than in Guangdong. The prevalence of RHD among the schoolchildren shows a reduction compared with that in 1994.

Adolescent ; Adult ; Child ; China ; epidemiology ; Cluster Analysis ; Female ; Heart Valve Diseases ; epidemiology ; Humans ; Male ; Mass Screening ; Prevalence ; Rheumatic Heart Disease ; epidemiology ; microbiology ; prevention & control ; Streptococcal Infections ; epidemiology ; Streptococcus agalactiae