OBJECTIVETo evaluate the efficacy and safety of Chinese herbal medicine combined with systemic chemotherapy and/or regional arterial perfusion for pancreatic cancer with liver metastases (PCLM).

METHODSWe retrospectively selected 292 patients with PCLM who were treated by Chinese herbal medicine combined with systemic chemotherapy and/or regional arterial perfusion at Tianjin Medical University Cancer Hospital from January 2001 to December 2010. All patients were assigned to the Western medicine treatment group (157 cases) and the integrative medicine treatment group (135 cases). Patients in the Western medicine treatment group were treated with gemcitabine (GEM)-based chemotherapy, and partial of them received regional arterial perfusion. Those in the integrative medicine treatment group additionally took Chinese herbs of clearing heat and eliminating mass for at least 4 weeks. The median survival time (MST) , adverse reactions and the incidence of complications were observed.

RESULTSThere was no statistical significance in general data between the two groups (P > 0.05). There was statistical difference in MST between the two groups (4.8 months vs 5.5 months, P < 0.05). No death occurred during chemotherapy or regional arterial perfusion. All toxic or adverse reactions were tolerable.

CONCLUSIONChinese herbal medicine combined with systemic chemotherapy and/or regional arterial perfusion was effective and safe, and it could be optimally selected as palliative therapy for PCLM.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Complementary Therapies ; methods ; Deoxycytidine ; analogs & derivatives ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Neoplasms ; drug therapy ; secondary ; Pancreatic Neoplasms ; drug therapy ; pathology ; Retrospective Studies

Objective: To evaluate the accuracy of automated classification of ICD-O-3 morphology code from pathology reports by text-mining and support vector machine ( SVM ) , in order to provide basis for automated tumor coding in Chinese. Methods: The tumor report cards of Zhejiang residents from 2017 to 2019 were collected from Chronic Disease Surveillance Information Management System of Zhejiang Province. According to ICD-O-3, the keywords of the pathology reports were extracted, and SVM was used for automatic classification. The classification results were compared with those of 16 professionals with more than two years of experience in tumor coding, and the accuracy rate, recall rate and F-score were calculated for effect evaluation. Results: Totally 83 082 cases from 2017 to 2019 were included and were categorized into 17 morphological classifications, with 52 877 ( 63.65% ) cases of adenocarcinoma, squamous carcinoma and transitional cell carcinoma. A total of 1 090 keywords were enrolled into main corpus. The total F-score, accuracy rate and recall rate are 85.69, 77.20% and 96.27%, respectively. Conclusion Text-mining combined with SVM can improve the efficiency of ICD-O-3 morphology coding; however, the accuracy needs to be further improved.

Objective To investigate the application of fetuses with talipes equinovarus (TE) using chromosomal microarray analysis (CMA) technology. Methods From May 2012 to June 2015, 54 fetuses were found with TE and with or without other structural anomalies by prenatal ultrasound. Karyotyping was taking for them all, and the fetuses with normal karyotypes took another CMA test. The data were analyzed with CHAS software. Finally all the cases were followed up to know about their pregnancy outcomes. Results One of the 54 cases was detected with abnormal karyotype which was trisomy 18 (2%, 1/54). CMA was undertaken to the remaining fetuses, they were divided into 2 groups, including isolated TE group (n=38) and complex TE group (n=15). The detection rate of clinical significant copy number variations (CNV) by CMA was 11% (6/53), while isolated and complex TE group were 5% (2/38) and 4/15, respectively (P=0.047). Of the 53 cases, 51 cases were successfully followed up. Eleven cases were found without TE after birth, and the false positive rate (FPR) of TE was 22%(11/51). Conclusions Whole-genome high-resolution CMA increased the detection rate by 11% in fetuses with TE. With the FPR and the detection rate of the clinical significant CNV of 2 groups, whole-genome CMA could be recommended to the fetuses with complex TE group but normal karyotypes. A series of ultrasonic tests should be suggested to the isolate TE group, while with the abnormal ultrasound, fetuses would be suggested to have CMA test for decreasing the rates of invasive prenatal diagnosis and FPR.

Objective To understand of work status and professional ability of ICU specialist nurse,test their specialist ability level,improve and enhance the specialist nurse management to maximize their roles in promoting the development of clinical nursing.Methods 38 ICU nurse specialists who have got the nursing credentials more than one year were surveyed through self-questionnaire about working conditions,including general conditions,work status,income,self-assessment of specialist ability in future.Results 100％ ICU trained the younger nurses,and discuss the nursing management and problems.36.8％ nurses participated clinical nursing and night shift,5.3％ nurses have never joined ward inspection.Rates of reaching the standard were higher and above the 90％ in those three aspects: practice in clinical work,guided teaching and providing information for family member.Grasp of academic knowledge (86.8％),theory teaching (86.8％) and providing academic knowledge for nursing (86.8％) needed to be improved.Paper searching and reading (65.8％),paper writing (57.9％) and research design (47.4％) were relatively lower.Conclusions Culturing and using the specialist nurses in ICU lack the program and rationality; Specialist nurses have vague role; talent team was lacked; pay status needs increased; research ability needed enhanced; admittance,training and using criteria were lacked.

Objective To explore the risk factors of lung cancer among non -smoking women.Methods A total of 229 new cases of lung cancer among non -smoking women from 2005 to 2008 were collected.The design method of 1 to 2 matching case -control study was used controlling age,sex and smoking conditions.The data was analyzed by univariate and multivariate conditional logistic regression analysis.Results Single factor analysis identified 13 risk factors (all P <0.05).The multivariate conditional logistic regression and factor analysis showed that respiratory disease history,family history of cancer,poor interpersonal relationship,psychological problems,feeling heavy smoke when cooking,consumption of salty and dry food,later menarche and passive smoking were risk factors (OR =24.427,5.539,3.041,2.622,1.856, 1.724,1.565 and 1.598 respectively),high income level and high consumption of vegetables were protective factors (OR =0.650 and 0.683 ).Conclusion respiratory disease history, family history of cancer, poor interpersonal relationship and psychological problems are main risk factors of lung cancer among non -smoking women.

Objective To explore the impact of bundle prevention strategies on the CRBSI incidence.Methods Patients admitted to ICU with central venous catheter were given daily assessment and target monitor from 2008.2 to 2010.2,and divided into infected (117 cases) and non-infected ( 1 288 cases) group according to whether there was CRBSI.Analysis the relationship between the measures of bundle prevention strategies and the incidence of CRBSI,all data applications SPSS 10.0 for windows statistical software package for statistical analysis.Results In the study,1405 cases were collected,and 117 cases were infected while 1288 cases were non-infected.The total number of catheter day was 17 317 days,and the average was 12.85 d.Infection rate was 6.8 per 1 000 catheter days.Sex,age,type of skin plaster and time of changing skin plaster and infusion TPN were not different between the two groups (P＞0.05).The single variable analysis has shown that the in the infection group,severity of clinical patients (APACHE Ⅱ ＞ 20 points) was 78.63％,ICU stay time( ＞ 30days) was 38.46％,emergency intubation method was 17.95％,patients received the frequency of invasive procedures( ＞4 times) was 83.76％,catheter day longer than 7 days was 78.63％ were higher than those in the non-infection group (51.86％,15.53％,7.84％,35.02％ and 31.13％,respectively) and the difference was significant ( x2 =8.071,23.750,10.781,36.56,44.886,respectively; P ＜ 0.05 ) ; the pass rate of maximum sterile barrier (45.30％),the timeliness of joint disinfection on normal operation (68.38％) and catheterization in subclavian vein (40.17％ ) in infection group were lower than non-infeclion group (75.93％,94.33％ and 59.94％,respectively) and the difference was significant (x2 =9.303,4.604,5.076,respectively;P ＜0.05).Multiple regression analysis showed that the joint disinfection timeliness on normal operation was the independence factor of affecting CRBSI incidence ( OR =4.992,P ＜ 0,01 ).Conclusions The implementation of bundle prevention strategies and strengthening the management of catheter connector can reduce the incidence of CRBSI.

Objective To study the reasonable replacement time for closed suction tube.Methods Totals of 147 patients who had artificial airway for mechanical ventilation and closed suction tube for aspiration of sputum were randomly divided into 3 groups:Group A of 54 cases with replacement time of 24 hours,Group B of 52 cases with replacement time of 72 hours,and Group C of 41 cases with replacement time of 120 hours.Rates of bacterial colonization cultured in closed sputum aspirator tip and incidence rate of VAP were compared between three groups.Results The rate of bacterial colonization cultured in closed sputum aspirator tip in three groups was respectively 63.0％,71.2％ and 100％,and there was statistically significant difference (x2 =6.182,P =0.023).The incidence rate of VAP in three groups was respectively 7.4％,5.7％,4.9％,there was no statistically significant difference (x2 =0.244,P ＞ 0.05).Conclusions Replacement of closed suction tube every 72 hours can ensure patients' safety as well as save the cost.

Objective To analyze the characteristics and trend of incidence and mortality of thyroid cancer in Zhejiang Province from 2007 to 2011.Methods Data from cancer registry and death registry in Zhejiang province were used to calculate the crude incidence and mortality,age -specific incidence and mortality,China - and World -standardized incidence and mortality of thyroid cancer.Trend Chi -square test was used to analyze the trend of incidence and mortality. Results From 2007 to 2011,the reported incidence rate of thyroid cancer in Zhejiang Province was 8.37 /100,000 (China -and World -standardized incidence were 5.28 /100,000 and 6.14 /100,000 respectively).The mortality rate was 0.34 /100,000 (China -and World -standardized mortality were 0.17 /100,000 and 0.24 /100,000 respectively). The incidence and mortality were both significantly higher in females and urban residents than in males and rural residents (both P <0.01).With age increased,the mortality increased.However,the incidence increased at the beginning and then declined with a peak age of 30 -59.From 2007 to 2011,the incidence of thyroid cancer increased rapidly with a speed of 29.95% per year while the mortality did not show the similar trend.Conclusion The incidence of thyroid cancer in Zhejiang Province is growing rapidly and the relative risk factors should be taken into consideration in future researches.

OBJECTIVETo investigate genetic etiology of Dandy-Walker syndrome with array-based comparative genomic hybridization (array-CGH).

METHODSEight fetuses with Dandy-Walker malformations but normal karyotypes by conventional cytogenetic technique were selected. DNA samples were extracted and hybridized with Affymetrix cytogenetic 2.7 M arrays by following the manufacturer's standard protocol. The data were analyzed by special software packages.

RESULTSBy using array-CGH technique, common deletions and duplication on chromosome 7p21.3 were identified in three cases, within which were central nervous system disease associated genes NDUFA4 and PHF14.

CONCLUSIONCopy number variations (CNVs) of chromosome 7p21.3 region are associated with Dandy-Walker malformations which may be due to haploinsufficiency or overexpression of NDUFA4 and PHF14 genes.

Chromosomes, Human, Pair 7 ; Comparative Genomic Hybridization ; methods ; Cytogenetic Analysis ; methods ; Dandy-Walker Syndrome ; genetics ; Female ; Gene Deletion ; Humans ; Karyotyping ; methods ; Male ; Pregnancy ; Prenatal Diagnosis ; methods

OBJECTIVETo establish a predictive scoring system which may serve for the prediction of sustained response to conventional interferon-alpha (IFN-alpha) treatment on chronic hepatitis B.

METHODSA total of 474 IFN-alpha treated hepatitis B virus e antigen (HBeAg)-positive patients were enrolled in the present study. The patients' baseline characteristics, such as age, gender, aminotransferases, activity grading (G) of intrahepatic inflammation, score (S) of liver fibrosis, hepatitis B virus (HBV) DNA and genotype were evaluated; therapy duration and response of each patient at the 24th wk after cessation of IFN-alpha treatment were also recorded. A predictive scoring system for a sustained complete response (CR) to IFN-alpha therapy was established based on genetic algorithm. About 10% of the patients were randomly drawn out as the test set. Responses to IFN-alpha therapy were divided into CR, partial response (PR) and non-response (NR). The mixed set of PR and NR was recorded as PR + NR.

RESULTSFor the scoring system, the sensitivity and specificity were 78.8% and 80.6%, respectively.

CONCLUSIONThis SCR scoring system has satisfying prediction efficiency and is easily employed in clinical practice. With this scoring system, practitioners can propose individualized decisions that have an integrated foundation on both evidence-based medicine and personal characteristics.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Child ; Dose-Response Relationship, Drug ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Sensitivity and Specificity ; Treatment Outcome ; Young Adult