Objective: To explore the effect of primary and acquired resistance to anti-human epidermal growth factor receptor 2 (HER-2) on the overall survival of patients with HER-2 positive advanced breast cancer. Methods: The clinical characteristics of HER-2 positive patients with advanced breast cancer admitted to Cancer Hospital of Chinese Academy of Medical Sciences from January 1998 to December 2018 were collected, and their neoadjuvant/adjuvant and advanced three-line chemotherapy were summarized. Among them, targeted drugs for HER-2 included trastuzumab, pertuzumab, T-DM1, RC48-ADC, lapatinib, pyrotinib, allitinib, sipatinib, seratinib. Based on the duration of benefit from anti HER-2 treatment, the patients were divided into two groups: primary anti HER-2 resistance group and acquired anti HER-2 resistance group. In this study, the overall survival (OS) was used as the main end point. Kaplan-Meier analysis and Cox proportional risk regression model were used to analyze the effects of different drug resistance mechanisms on the overall survival. Results: The whole group of 284 patients were included. The median age of recurrence and metastasis was 48 years old, 155 (54.6%) were hormone receptor (HR) positive and 129 (45.4%) were HR negative, 128 cases (45.1%) were premenopausal and 156 cases (54.9%) were postmenopausal, 277 cases (97.5%) had a score of 0-1 in ECoG PS and 7 cases (2.5%) had a score of more than 2 in the first diagnosis of relapse and metastasis. There were 103 cases (36.3%) in the primary drug resistance group and 181 cases (63.7%) in the secondary drug resistance group. The median overall survival time of the two groups was 24.9 months and 40.4 months, respectively, with statistical significance (P<0.001). Conclusion: Primary resistance to HER-2 is one of the factors of poor prognosis in HER-2 positive breast cancer, and its mechanism needs to be further explored.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Breast Neoplasms/pathology* ; Drug Resistance ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Prognosis ; Receptor, ErbB-2/metabolism* ; Trastuzumab/therapeutic use* ; Treatment Outcome

OBJECTIVE: To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province. METHODS: The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017. RESULTS: The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01). CONCLUSIONS Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
Anti-Bacterial Agents ; Birth Weight ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Surveys and Questionnaires

Objective:To analyze the changes of electroencephalogram (EEG) before and after treatment in patients with post-stroke cognitive impairment (PSCI). Methods:From October, 2018 to April, 2019, twelve PSCI patients received cognitive training and repetitive transcranial magnetic stimulation for six weeks. They were assessed with Mini-Mental State Examination, Montreal Cognitive Assessment and modified Barthel Index before and after treatment, while their closed-eye resting EEG were collected. Results:The scores of all the assessments improved after treatment (|t| > 3.507, P < 0.01); while alpha absolute power and alpha relative power increased (|t| > 2.522, P < 0.05), and brain symmetry index and DTABR decreased (t > 2.435, P < 0.05). Conclusion:The characteristics of EEG of PSCI patients changes with the recovery of cognitive function. Further research is needed about the relationship between EEG and cognitive function.

Purpose: The purpose of this study was to compare the survival and toxicities in cervical esophageal squamous cell carcinoma (CESCC) treated by concurrent chemoradiothrapy with either three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) techniques. Materials and Methods: A total of 112 consecutive CESCC patients were retrospectively reviewed. 3D-CRT and IMRT groups had been analyzed by propensity score matching method, with sex, age, Karnofsky performance status, induction chemotherapy, and tumor stage well matched. The Kaplan-Meier method and Cox proportional hazards model were used for overall survival (OS) and progression-free survival (PFS). Toxicities were compared between two groups by Fisher exact test. Results: With a median follow-up time of 34.9 months, the 3-year OS (p=0.927) and PFS (p=0.859) rate was 49.6% and 45.8% in 3D-CRT group, compared with 54.4% and 42.8% in IMRT group. The rates of grade ≥ 3 esophagitis, grade ≥ 2 pneumonitis, esophageal stricture, and hemorrhage were comparable between two groups, while the rate of tracheostomy dependence was much higher in IMRT group than 3D-CRT group (14.3% vs.1.8%, p=0.032). Radiotherapy technique (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.01 to 0.79) and pretreatment hoarseness (HR, 0.12; 95% CI 0.02 to 0.70) were independently prognostic of tracheostomy dependence. Conclusion No survival benefits had been observed while comparing IMRT versus 3D-CRT in CESCC patients. IMRT with fraction dose escalation and pretreatment hoarseness were considered to be associated with a higher risk for tracheostomy dependence. Radiation dose escalation beyond 60 Gy should be taken into account carefully when using IMRT with hypofractionated regimen.

Objective This panel study aimed to determine the acute effects of exposure to fine particulate matter (PM2.5) on schoolchildren's pulmonary function.Methods We selected 51 schoolchildren aged 9–12 years attending a full-time boarding school in Beijing, China, measured the indoor and outdoor PM2.5 concentrations for five consecutive days, calculated the PM2.5 time-weighted individual exposure levels based on the school micro-environmental concentrations and the time activity pattern recorded by schoolchildren, measured schoolchildren's pulmonary function on the fifth day. The survey was performed three times from December 2018 to April 2019. We used a linear mixed-effects model to evaluate the associations between PM2.5 and pulmonary function.Results During the three surveys, the median PM2.5 time-weighted individual exposure concentrations were 15.30 μg/m3, 48.92 μg/m3, and 42.89 μg/m3, respectively. There was a significant difference between the three surveys in vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (P <0.05). The relevance analysis found that PM2.5 had lag effect on schoolchildren's pulmonary function, each 10 μg/m3 increase in PM2.5 could cause largest decreases in FEF25％–75％, FEV1/FVC, FEF75％, and FEV1 on lag 0–1 d (80.44 mL/s, 35.85％, 78.58 mL/s, and 61.34 mL, respectively), and largest decreases in FEF25％ on lag 1 d (83.68 mL/s), in VC on lag 4 d (32.34 mL), and in FVC on lag 0–4 d (37.76 mL). Gender subgroup analysis revealed that the increase in PM2.5 caused a decrease in FEV1/FVC and VC on the day of physical examination only in boys, and on lag days it caused changes in different pulmonary function indicators, both for boys and girls, but most of the pulmonary function indicators decreased more in boys than in girls.Conclusion Our findings show that acute PM2.5 exposure has significant effects on pulmonary function within 0–4 d, on both small airway indicators and large airway indicators. Boys' pulmonary function is more sensitive to PM2.5 than girls.

OBJECTIVE: Obesity is recognized as a significant risk factor for diabetes and hypertension. The present study aimed to examine the associations between adults'obesity risk and childhood and parental obesity. METHODS: A total of 204 children aged 6-17 years were recruited in 2002 with an average follow-up period of 13.2 years. Height and body weight were measured by trained staffs. Overweight and obesity were defined based on the Chinese standard for children and adults. T-test, analysis of variance, and Chi-square analysis were used for single factor analysis. Multiple linear and logistic regression analyses were used to perform multifactor analysis. RESULTS: The percentage of non-obese children who grew up to be non-obese adults was 62.6%, and that of obese children who grew up to be obese adults was 80.0%. There was a significant association between childhood body mass index (BMI) and adulthood BMI with a β regression coefficient of 3.76 [95% confidence interval (CI): 1.36-6.16], and between childhood obesity and adulthood obesity with an odds ratio of 5.76 (95% CI: 1.37-24.34). There was no statistical difference between parental obesity at baseline and children's adulthood obesity, after adjustment of confounders. Male participants and those aged 10.0-13.0 years had a higher risk of adulthood obesity with odds ratios of 2.50 (95% CI: 1.12-5.26) and 3.62 (95% CI: 1.17-11.24), respectively. CONCLUSION Childhood obesity is an important predictor of adulthood obesity.
Adolescent ; Adult ; Body Mass Index ; Child ; China ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Obesity ; epidemiology ; etiology ; Odds Ratio ; Parents ; Pediatric Obesity ; epidemiology ; etiology ; Prevalence ; Prospective Studies ; Young Adult

BACKGROUNDThe prevalence of childhood asthma has been increasing in China. This study aimed to compare the prevalence, diagnosis, and treatment of asthmatic children from urban and rural areas in Beijing, China.

METHODSSchools, communities, and kindergartens were randomly selected by cluster random sampling from urban and rural areas in Beijing. Parents were surveyed by the same screening questionnaires. On-the-spot inquiries, physical examinations, medical records, and previous test results were used to diagnose asthmatic children. Information on previous diagnoses, treatments, and control of symptoms was obtained.

RESULTSFrom 7209 children in rural areas and 13,513 children in urban areas who completed screening questionnaires, 587 children were diagnosed as asthma. The prevalence of asthma in rural areas was lower than in urban areas (1.25% vs. 3.68%, χ2 = 100.80, P < 0.001). The diagnosis of asthma in rural areas was lower than in urban areas (48.9% vs. 73.9%, χ2 = 34.6, P < 0.001). Compared with urban asthmatic children (56.5%), only 35.6% of rural asthmatic children received inhaled corticosteroids (P < 0.05). The use of bronchodilators was also lower in rural areas than in urban areas (56.5% vs. 66.4%, χ2 = 14.2, P < 0.01).

CONCLUSIONThe prevalence of asthma in children was lower in rural areas compared with children in the urban area of Beijing. A considerable number of children were not diagnosed and inadequately treated in rural areas.

Adolescent ; Adrenal Cortex Hormones ; therapeutic use ; Asthma ; epidemiology ; Beijing ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Prevalence ; Surveys and Questionnaires

Objective To investigate the effect of triptolide on the proliferation, apoptosis and and H3K4me3 protein expression in multiple myeloma KM3 cell.Methods The MM KM3 cell line was cultured with triptolide.Cell proliferation was detected by MTT method .Apoptosis was evaluated by Annexin -V -FITC/PI -labeled flow cytometry and confocal microscopy.The expression of H3K4me3 in KM3cells was assayed by Western blotting and confocal microscopy.Results Triptolide had obvious inhibition on proliferation of KM 3 cells and showed a dose and time dependence.Triptolide had obvious inhibition on apoptosis of KM 3 cells,and with the increase of triptolide concentration , the apoptosis ratio increased gradually. The the total apoptosis rates were (48.97 ±1.78 )%, ( 53.72 ±2.21 )% and ( 60.75 ±2.43 )%.Confocal laser scanning microscopy showed H 3K4me3 accumulated in the nucleus, after 48 h intervention of 80 nmol· L-1 of triptolide, the mean value of fluorescence intensity of H3K4me3 in KM3 cells (21.96+0.34 ) was significantly lower than that in the control group ( 39.86 ±0.47 ) ( P <0.05 ) .Conclusion Triptolide inhibited cell proliferation, induced cell apoptosis, reduced the expression of H3K4me3 protein.

The paper is about the study on efficiency and operation cost of 11 research oriented CT systems in Shanghai zone. The study result include the average volume, annual operation cost, cost per scan and break-even-point. It reveals that the research oriented CT system purchase price and operation cost is high. The suggestion is that the hospital should be cautious to select the research oriented CT system with consideration of clinical research demand to avoid unsuitable investment.
Cost-Benefit Analysis ; Tomography, X-Ray Computed ; economics

OBJECTIVE: Five measurements of the calcaneus taken on digital radiography (DR) of adults of Han Population of Sichuan Province were selected to determine sex by multivariate discriminant analysis. METHODS: Lateral radiographs of calcaneus taken from 393 subjects were collected. The samples were randomly divided into the experimental group (148 males and 186 females) and the examined group (26 males and 33 females). Five measurements were taken from the radiography. The analysis of variance (AVON) was carried out to determine if there was significant difference between the male and female. The discriminant functions were drawn by Fisher discriminant analysis. The effects of all obtained functions were evaluated with the examined samples. RESULTS: There was statistically significant difference in the five measurements between the males and the females (P<0.05). Six groups of discriminant functions were obtained with an accuracy ranged from 78.4% to 88.9%. When applied on the examined samples, the sex discriminant accuracy varied from 79.7% to 86.4%. CONCLUSION These five measurements acquired from the lateral radiographs of calcaneus could be used for sex assessment during forensic identification of individuals.
Calcaneus/diagnostic imaging* ; Discriminant Analysis ; Female ; Forensic Anthropology/methods* ; Humans ; Male ; Radiographic Image Enhancement ; Sex Determination by Skeleton ; Young Adult