Objective    To introduce the surgical and perioperative strategy for giant mediastinal mass. Methods    The clinical data of 21 patients with giant mediastinal mass who underwent surgical treatment in Xinhua Hospital of Shanghai from January 2007 to July 2016 were retrospectively reviewed. There were 14 males and 7 females, with a mean age of 34.62 ± 22.95 years (range: 11 months to 79 years), and mean weight of 58.07±22.24 kg (range: 10.8 to 90.5 kg). Their clinical manifestation, anesthesia methods, surgical treatment and the prognosis were analyzed. Results    The tumor volume ranged from 8 cm×6 cm×6 cm to 25 cm×25 cm×8 cm. For surgical approach, 12 patients received median sternotomy, 5 anterior lateral incision, 1 posterior lateral incision, 2 "L"-shape sternotomy, 1 cervical and thoracic "]"-shape incision. All patients were given mass radical resection, except one patient with two-stage resection. Twelve patients needed other tissues resection besides the single tomor resection. The operation time was 55-480 (207.86±87.67) min, blood loss volume 700 (10-4 000) ml, intraoperative blood transfusion 800 (0-4 100) ml, postoperative mechanical ventilation time 4.75 (0-87) h, postoperative drainage time 3-12 (7.43±2.66) d, the total drainage volume 295-4 940 (1 584.76±1 173.98) ml, average daily drainage volume 62-494 (204.90±105.76) ml, and postoperative hospital stay 7-47 (11.86±8.51) d. The postoperative complications included pericardial effusion in 1 patient, Horner   syndrome in 1, left recurrent laryngeal nerve injury with the left phrenic nerve injury in 1, right phrenic nerve injury in 1 and delayed wound healing in 1. The remaining patients recovered well. All patients were followed up for 1 month to 9 years. Till September 1, 2016, 5 patients died and 2 suffered recurrent tumor. Conclusion    It is safe to perform surgical treatment after comprehensive evaluation of patients with giant mediastinal mass, perioperative mortality is low, and prognosis in patients with benign tumor is good.

Illegally paid blood donation was a risk factor for HIV acquisition exclusively in Henan and Hubei Provinces of China, and not in Shanghai. Nucleotide sequences in the gag and env genes of HIV-1 were compared between isolates from Henan and Shanghai regions of China to test whether an expected higher degree of a common source of infections from this unique blood donation transmission risk would be evident as decreased variation among Henan isolates in an exploratory cross-sectional analysis. Among 38 isolates studied, 23 of 23 (100%) from Henan and 8 of 15 (54%) from Shanghai were subtype B. In addition, fewer sequence differences were found in gp41 of subtype B isolates from Henan than from Shanghai isolates. Further studies with additional controls are therefore warranted to confirm the role of the degree of a common source of infections in differences in HIV variation across populations.

INTRODUCTIONPolymerase chain reaction (PCR)-based molecular techniques are useful adjunctive tools in the diagnosis of cutaneous T-cell lymphomas (CTCL). This study compares the sensitivity of PCR analysis of the T-cell receptor-gamma (TCR-gamma) gene rearrangements using conventional polyacrylamide gel electrophoresis (PCR-PAGE) and fluorescent capillary electrophoresis (PCR-FCE).

MATERIALS AND METHODSA total of 22 paraffin blocks were analysed using PCR-PAGE and PCR-FCE. There were 17 cases of mycosis fungoides (MF), 4 cases of non-MF CTCL and 1 case of lymphoblastic leukaemia.

RESULTSComplete agreement was obtained between PCR-PAGE and PCR-FCE in 19 of the 22 cases, giving a concordance rate of 86.4%. PCR-FCE had a higher sensitivity of 77.3%, compared to 63.6% for PCR-PAGE, allowing the detection of 3 additional cases of clonal T-cell rearrangements, which had equivocal or polyclonal bands on PAGE. Two of these 3 cases were in erythrodermic MF patients. PCR-FCE also allowed the detection of matching clones in serial specimens taken from different sites and at different time intervals in patients with MF. However, matching clones from different specimens can be achieved qualitatively in PCR-PAGE by running and comparing these on the same polyacrylamide gel block.

CONCLUSIONSBoth PCR-PAGE and PCR-FCE are useful in detecting T-cell clones in CTCL, with both methods being comparable in sensitivity and showing a high concordance rate of 86.4%. PCR-FCE has the added advantage of exhibiting semiquantitative properties, which may be important in early or erythrodermic MF cases, but the requirement for sophisticated and costly machinery limits its availability to high-capacity laboratories. The well-established PCR-PAGE method is a suitable alternative in routine clinical applications.

Base Sequence ; Electrophoresis, Agar Gel ; Electrophoresis, Capillary ; methods ; Electrophoresis, Polyacrylamide Gel ; Fluorescence ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Humans ; Lymphoma, T-Cell ; diagnosis ; Mycosis Fungoides ; Polymerase Chain Reaction ; methods ; Sensitivity and Specificity

OBJECTIVETo compare the effects of dust exposure and smoking on mortality.

METHODSBased on the Guangzhou Occupational Health Surveillance Record System established in 1989-1992, 80 987 factory workers, aged > or = 30, occupationally exposed to dust and non-exposure to dust, were included in a prospective cohort study.

RESULTS(1) The mean age of the cohort was 43.5. Most subjects were workers, with secondary education, and married. Out of them 16.3% having ever exposed to dust, 43.7% ever smoked and 33.5% drank alcohol. (2) The cohort were traced for 8 years on average, but 35 were lost for follow-up. Malignant neoplasm was most commonly seen among 1539 deaths. (3) The adjusted relative risk (RRs) of death of all causes, malignant neoplasm and cerebro-cardiovascular diseases for dust exposed workers were close to those for smokers. However, the adjusted RRs of death of nasopharynx cancer and respiratory system diseases for dust exposed workers were higher than those for smokers. The adjusted RRs of death of lung cancer and stomach cancer for smokers were 2.2 times and 1.5 times of that for dust exposed workers respectively. Dust exposure combined with smoking caused significantly higher death RR. (4) In males, the adjusted RRs of death of all causes, malignant neoplasm and respiratory system diseases for silica dust exposed workers and the adjusted RR of death of cerebro-cardiovascular diseases for wood dust exposed workers were higher those in smokers. (5) The population attributable risk percentage (PARP) of all causes of death for smokers was 2.5 times of that for dust exposed workers. (6) In males, the risks of death for all causes, malignant neoplasm, lung cancer and stomach cancer increased with the amount of smoking per day and the duration of smoking. The risks of death caused by coronary heart disease and respiratory system diseases were increasing with the amount of smoking per day and the duration of smoking respectively.

CONCLUSIONSThe adjusted RRs for dust exposed workers were close to those for smokers with dust exposure and smoking having synergistic effects. Some of the adjusted RRs for smokers were higher than those for dust exposed workers PARP for smokers was higher than that for dust exposed workers. Our findings suggested that there was a significant dose-effect between smoking and risk of deaths.

Adult ; Cause of Death ; China ; epidemiology ; Coal ; Cohort Studies ; Dust ; Female ; Humans ; Male ; Occupational Exposure ; adverse effects ; Prospective Studies ; Risk Factors ; Silicon Dioxide ; Smoking ; adverse effects

OBJECTIVEA quantitative method was developed for the determination of tenuifolin in Tianwang Buxinwan and Guipiwan by HPLC.

METHODThe samples were separated by Alltima C18 column (4.6 mm x 250 mm, 5 microm) using methanol--0.05% phosphoric acid (65:35) as a mobile phase, flow rate was 1.0 mL x min(-1) and wavelength was set at 202 nm.

RESULTTenuifolin was detected in both Chinese preparations. The number of theoretical plates calculated by tenuifolin peak was 2 500. The regression equation of tenuifolin was Y = 5.239 x 10(6) X-6.247 x 10(5) (r = 0.9994) and the liner range was 10-500 g x mL(-1). The average recovery of tenuifolin was 97.5% (RSD less than 3.0%). The LOD of tenuifolin was 5.50 g x mL(-1).

CONCLUSIONThe method is sensitive, rapid and accurate.

Chromatography, High Pressure Liquid ; methods ; Codonopsis ; chemistry ; Diterpenes, Kaurane ; analysis ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; Plants, Medicinal ; chemistry ; Polygala ; chemistry ; Reproducibility of Results ; Salvia miltiorrhiza ; chemistry ; Saponins ; analysis ; Triterpenes ; analysis

OBJECTIVETo examine electrocardiogram (ECG) change of workers after leaving occupational noise exposure.

METHODSIn the first phase of the Guangzhou Biobank Cohort Study, 10413 Guangzhou residents aged 50 years or more received a face-to face interview including noise exposure history, a full medical check-up and laboratory tests in 2003 - 4. ECG examination was carried out using 12-lead MAC-CS ECG machine made in HP Ltd, Shanghai, China. ECG of every subject was independently diagnosed by two doctors who had obtained ECG diagnosis qualification.

RESULTS(1) Among 10413 subjects, 70% were female, and more than half were aged 60-69 years. The mean age and education level in males were higher than those in females. (2) 2119 subjects (21.0%) were previously exposed to noise and were retired now. (3) The prevalence of ECG abnormality was respectively 82.4% and 79.1% in females and males. Rate of ECG abnormality increased with age in both females and males (P = 0.000), and was lower in females with higher education level (P = 0.000). There was not significant difference in ECG abnormality between workers previously exposed or unexposed to noise in both females and males (P > 0.05). 4 Comparing workers previously exposed to those unexposed to noise in both females and males, after adjusting for age, educational level and smoking status, the rates of arrhythmia, axes deviation, atria and ventricle hypertrophy, ST-T change and coronary artery syndrome were not significantly different (P > 0.05).

CONCLUSIONOur study showed that the prevalence of ECG abnormality was not significantly increased in workers previously exposed to noise and had left exposure now compared to those never exposed to noise. Because our study was cross section and occupational history was obtained from a questionnaire but was not confirmed by the companies, further study is needed.

Aged ; Aged, 80 and over ; China ; Cohort Studies ; Cross-Sectional Studies ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Noise, Occupational ; Occupational Exposure

Objective To identify the levels of exposure to second-hand smoking (SHS)among Chinese adults living in the urban areas and their knowledge on the risks of SHS,to support for the Smoke-free policy.Methods Data from the Global Adult Tobacco Survey (GATS) and the International Tobacco Control Policy Evaluation China Survey (ITC China Survey) was analyzed and SAS was used to calculate the rates and 95％ CI.Results In the two surveys,less than 40％ of the respondents reported that their workplaces had completely stopped smoking.Participants who reported that they had seen people smoking at various public places with different rates,also they could reflect the levels to SHS exposure.Restaurants were the venue with the heaviest overall exposure (83.4％-95.6％),followed by the workplace (53.3％-84.0％).Exposure was low in health facilities,schools and public transport venues.In the GATS survey,60.6％ smokers and 68.5％ non-smokers believed that SHS could cause lung cancer,but only one-third of the participants believed that SHS could cause heart diseases in adults.Participants in the ITC China survey reported a comparatively higher level of awareness on the harm of SHS,but only 58.2％ smokers believed that SHS could cause heart diseases in adults.Overall,data from the ITC China survey showed that participants' support for a comprehensive smoke-free policy in schools,health-related facilities,government buildings and in taxi were high (over 70％).However,the proportion of participants supporting comprehensive smoking-free policy at workplaces (50.9％-60.9％) was relatively low.Conclusion The proportion of indoor workplaces with complete smoking ban was low in urban areas but levels to SHS exposure were high.People's awareness of harms related to SHS and their attitude on setting up a comprehensive smoke-free workplace need to be improved.

Objective: To optimize the warning threshold values of common communicable diseases in Gansu province, and improve the early warning effect. Method: An early warning model was set up for influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method. By calculating the sensitivity, specificity, predictive value of positive test, predictive value of negative test, Youden' index and receiver-operating characteristic curve, the optimum early warning threshold values for communicable diseases in Gansu were selected. Results: The optimum early warning boundary values of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, and viral hepatitis type E were P(90), P(80), P(95), P(90), P(80) and P(90) respectively. The optimum early warning parameters of HFMD were k=1.2, H=5σ. Under the optimum early warning boundary values/parameters, the early warning sensitivities of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and HFMD were 86.67%, 100.00%, 91.67%, 100.00%, 100.00%, 100.00% and 100.00%, the specificities were 86.49%, 62.22%, 75.00%, 100.00%, 97.92%, 89.13% and 74.47%. The predictive values of positive test were 72.22%, 29.17%, 52.38%, 100.00%, 80.00%, 54.55% and 29.41%, and the predictive values of negative test were 94.12%, 100.00%, 96.77%, 100.00%, 100.00%, 100.00% and 100.00%, and the Youden' indexes were 0.73, 0.62, 0.67, 1.00, 0.98,0.89 and 0.74. Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram. Conclusion: The early warning thresholds of influenza, other infectious diarrheal diseases, dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.
China ; Communicable Disease Control/methods* ; Communicable Diseases/epidemiology* ; Disease Notification ; Disease Outbreaks/prevention & control* ; Humans ; Models, Theoretical ; Population Surveillance/methods*

Purpose: Clomiphene citrate (CC) is prescribed off-label in men to improve testosterone and sperm parameters, but the duration of treatment needed to reach maximal benefit remains unclear. Our objective was to examine temporal effects of CC on total testosterone (TT) and semen analysis (SA) using longitudinal follow-up data in treated men.   Materials and Methods: We analyzed an IRB-approved database of men treated with CC (25 mg q.d. or 50 mg q.o.d.) from January 2016 through May 2021. We identified patients with 3, 6, 9, and 12 month follow-up data for TT and 3, 6, and 9 month follow-up SA. Mean absolute changes in TT and sperm concentration compared to baseline were calculated, along with 95% confidence intervals. Men with prior genitourinary procedures or hormone therapy were excluded. Paired t-tests were used to compare TT and sperm concentration at each time point to baseline (alpha=0.05).  Results: One hundered thirty-four men received CC, mean age 37.7 years (SD 6.7, range 24–52). TT at all follow-ups (3, 6, 9, and 12 months) were available for 25 men, and SA at 3, 6, and 9 months for 26 men. Baseline TT was 358±145 ng/dL and sperm concentration was 13±17.2 M/mL. Significant improvement in TT was identified at 3 months (62.7 ng/dL, 95% CI: 0.49–125.0, p=0.048), additional benefit at 6 months (181.8 ng/dL, 95% CI: 114.1–249.5, p<0.01), and plateau at 9 and 12 months. Improvement in sperm concentration was first observed at 9 months (20.7 M/mL, 95% CI: 10.2–31.2, p<0.01). Semen volume and sperm motility did not change.   Conclusions Duration of treatment with clomiphene may impact testosterone and sperm concentration, and the historical 3 month milestone may be insufficient for clinical and research evaluation. Men taking CC may experience plateau in TT at 6 months and first benefit in sperm concentration at 9 months.

Objective: To analyze and reveal the distribution, research hotspots and study trend of worldwide published articles correlated with HIV/AIDS post-exposure prophylaxis (PEP), and provide information for related studies in China. Methods: CiteSpace software 5.1 was used to visualize all related papers in the web of science database published during 2000-2017. Results: The average growth rate of international PEP-related papers was 10.78%,and number of published papers in 2016 was highest (n=34), relevant research hotspots have shifted from the prevention of occupational HIV exposure to the prevention of non-occupational HIV exposure in group at high risk, such as MSM, in recent years. Clustering analysis classified research hotspots into three categories, including risk reduction through enhanced intervention, current status of global HIV PEP and German-Austrian Recommendation. Conclusions: Non-occupational HIV PEP in groups at high-risk, especially MSM, has received increasing attention in recent years, the research of PEP mainly focus on improving the awareness and use of PEP in MSM and compliance in the course of medication. In the context of severe HIV epidemic in MSM without effective control in China, PEP should be strengthened to assess and explore the risk of HIV infection in MSM to provide reference for medical personnel and related departments to implement HIV non-occupation exposure blockade and formulate PEP medication.
Anti-HIV Agents/administration & dosage* ; Bibliometrics ; Biomedical Research ; China ; HIV ; HIV Infections/prevention & control* ; Homosexuality, Male ; Humans ; Male ; Periodicals as Topic ; Post-Exposure Prophylaxis/methods*