[Objective]To analyze the prognostic factors of resectable acral melanoma patients ,then develop a novel prognostic model and examined its prognostic value.[Methods]The study retrospectively analyzed clinicopathological characteristics and inflam?matory markers of 232 acral melanoma patients who underwent radical surgical resection between 2000 and 2011 at the Sun Yat-sen University Cancer Center. Kaplan-Meier curves were plotted to estimate overall survival. Significantly predictive factors were identified by multivariate Cox regression analyses and a prognostic model based on these variables was constructed to predict survival.[Results]Cox regression analysis revealed that age,lactic dehydrogenase(LDH),stage,globulin(GLB)and C-reactive protein (CRP)were independently related to survival. After computing these scores ,patients were classified into three risk groups. The new prognostic model identified three categories of patients with different prognoses(P<0.001)and significantly stratify patient prognosis in different tumor stages. The 5-year survival rate was 42.9%,25.7%,and 3.7%in groups 1,2,and 3,respectively. The AUC of new prognostic model is 0.664(95%CI:0.599-0.724).[Conclusion]Age,LDH,stage,GLB and CRP were independently related to survival in our study population,and the prognostic model is useful to stratify patients into different risk groups and it is a useful complement to AJCC staging for Asian patients with acral melanoma.

Inosiplex is a compound formulation composed of inosine and p-acetaminobenzoic acid (PABA) salt of N,N-dimethylamino-2-propanol (DIP). This study was to investigate the clinical plasma pharmacokinetic properties of DIP and PABA after single and multiple oral doses of inosiplex tablets in healthy Chinese volunteers. The established LC/MS/MS method for plasma DIP determination had a linear range of 0.02-10 mg/mL, and the HPLC method for plasma PABA determination had a linear range of 0.05-40 mg/mL. Linear pharmacokinetic characteristics were found with single oral doses of 0.5, 1.0 and 2.0 g. No obvious accumulation effects were observed for DIP and PABA.

Compartment Syndromes ; etiology ; Crush Syndrome ; complications ; Fascia ; Hand Injuries ; complications ; Humans ; Infant, Newborn

OBJECTIVETo investigate the causes of acute respiratory distress (ARDS) after thoracotomy and to find out the measures to prevent ARDS.

METHODSThe characteristics of incidence, pathogenicity and treatment of ARDS after thoracotomy in 31 patients were analysed.

RESULTSThe patients who had chronic obstructive pulmonary disease, long history of smoking, hypertension were prone to ARDS. Injury to lung in operation, shock and pulmonary infection probably caused ARDS. Clearing away respiratory tract secretion, preserving of a clear airway, controlling pulmonary infection, alleviating pneumonedema by diuresis, early executing tracheotomy or mechanic assistant ventilation by tracheointubation were keys to rescuing patients successfully.

CONCLUSIONSIt is suggested that multi factors were related to ARDS after thoracotomy. Shock, injury to lung in operation, pulmonary infection, are important factors that lead to post-operative ARDS after thoracotomy. Early treatment can reduce mortality of ARDS.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Respiratory Distress Syndrome, Adult ; etiology ; prevention & control ; therapy ; Thoracotomy ; adverse effects

Adolescent ; Adult ; Dust ; analysis ; Female ; Health Status ; Humans ; Industry ; Male ; Middle Aged ; Occupational Exposure ; analysis ; Quartz ; Young Adult

OBJECTIVETo investigate the risk factors for early disseminated intravascular coagulation (DIC) in neonates with sepsis.

METHODSA retrospective clinical study was performed on 100 neonates with a confirmed diagnosis of sepsis between 2012 and 2013. The children were classified into normal coagulation group, non-overt DIC group (early DIC group), and overt DIC group (late DIC group) based on the ISTH overt DIC scoring system. The clinical manifestations and risk factors were analyzed statistically.

RESULTSEarly DIC occurred in 44 (44%) cases in the 100 neonates with sepsis. The incidence of sclerema showed significant differences between the three groups (P<0.05). Asphyxia, bleeding, and Gram-negative bacterial infection were independent risk factors for early DIC.

CONCLUSIONSCoagulation function should be actively monitored and early intervention measures should be taken for neonates with asphyxia, bleeding, and Gram-negative bacterial infection to prevent early DIC from progressing to late DIC.

Disseminated Intravascular Coagulation ; etiology ; Female ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Risk Factors ; Sepsis ; complications

OBJECTIVESTo evaluate the relationship between Modic change and disc height together with lumbar hyperosteogeny and study the role of Modic change in lumbar degeneration.

METHODSThe imaging data of 150 elderly patients with chronic low back pain were analysed retrospectively. All patients underwent MRI and lumbar lateral X-ray examination. The lumbar disc from L1-L2 to L5-S1 were selected for this study, including 750 discs, vertebral and endplate close to disc in 150 patients. The incidence rate of lumbar endplate Modic change, disc height and the degree of vertebral bone hyperplasia were recorded. The ratio of disc height/lumbar intervertebral disc height < 50% was defined as disc collapse. The patients were divided into 4 groups in the basis of imaging changes. Group A1:disc collapse without severe lumbar hyperosteogeny; Group A2: disc collapse with severe lumbar hyperosteogeny; Group B1: Neither disc collapse nor severe lumbar hyperosteogeny; Group B2: severe lumbar hyperosteogeny without disc collapse. The incidence rates of Modic change were compared between the 4 groups by χ(2) test. Finally, the influence of disc height and vertebral bone hyperplasia on the incidence rate of Modic change was analysed.

RESULTSFour groups of patients observed a total of 750 discs. The number of intervertebral discs in the group A1 was 208, the incidence rate was 54.3%. The number of intervertebral discs in the group A2 was 135, the incidence rate of group A2 was 34.8%. The number of intervertebral discs in the B1 group was 225, the incidence rate of group B1 was 16.9%. The number of intervertebral discs in the B2 group was 182, the incidence rate of group B2 was 29.7%. There was significant difference of lumbar endplate Modic change incidence rate among the 4 groups(χ(2) = 69.565, P < 0.05). The results of post hoc test showed that the incidence rate of Modic change in group A1 was higher than group A2, B1 and B2 (χ(2) = 12.524, 66.701 and 24.102, P < 0.00714). There was significant difference of Modic change incidence rate between group A2 and B1(χ(2) = 15.032, P < 0.00714), but there was no significant difference of Modic change incidence rate between group A2 and B2 (χ(2) = 0.945, P > 0.00714) . There was significant difference of Modic change incidence rate between group B2 and group B1 (χ(2) = 9.395, P < 0.00714).

CONCLUSIONSThe incidence rate of Modic change with disc collapse but without severe lumbar hyperosteogeny is high in elderly patients with chronic low back pain. There is no significant difference of Modic change incidence between patients with both disc collapse and severe lumbar hyperosteogeny and patients with severe lumbar hyperosteogeny but without disc collapse.

Aged ; Aged, 80 and over ; Female ; Humans ; Intervertebral Disc ; pathology ; Intervertebral Disc Degeneration ; pathology ; Low Back Pain ; pathology ; Lumbar Vertebrae ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo assess the distribution frequency of Gly82Ser polymorphism of receptor for advanced glycation end products (RAGR) gene and investigate its association with type 2 diabetic Chinese patients.

METHODSThe allele frequencies and genotype distribution of Gly82Ser polymorphism of RAGE gene were compared in a case-control study of 194 type 2 diabetic and 546 non-diabetic subjects. PCR-restriction fragment length polymorphism (PCR-RFLP) was used for detection of the genotype variants.

RESULTSIn general Chinese population and type 2 diabetic Chinese patients, the most frequent genotype and allele of RAGR gene Gly82Ser polymorphism were genotype GG and allele G, whose frequency distribution were significantly higher than those in other countries (P<0.01). No significantly difference in the genotype frequencies or allele frequencies of Gly82Ser polymorphism were found between the diabetic patients and non-diabetic subjects (P>0.05).

CONCLUSIONGly82Ser polymorphism of RAGE gene does not demonstrate any association with type 2 diabetes in Chinese patients, but high genotype and allele frequencies of Gly82Ser polymorphism occur in Chinese population and type 2 diabetic Chinese patients.

Aged ; Amino Acid Substitution ; Asian Continental Ancestry Group ; genetics ; China ; Diabetes Mellitus, Type 2 ; ethnology ; genetics ; Female ; Gene Frequency ; Genotype ; Glycine ; genetics ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length ; Receptor for Advanced Glycation End Products ; Receptors, Immunologic ; genetics ; Serine ; genetics

Objective To assess pertinent indicators of elderly-friendly city, so as to provide the basis for carrying out the related work. Methods There were 1 500 elderly people aged at and above 60 years old that were surveyed via questionnaires and structured interviews. Results The core indicators:79.8%reported that their neighborhood was convenient for walking;90.3% reported that bus, under-ground and taxi in Shanghai were suitable for all types of people ( including the physically handicapped, the blind, and the deaf);94.8%reported that there was no difficulty in the payment of housing;96.0%reported that the community had good atmosphere of respecting for the elderly; 56 .8% participated in community volunteer activities;6.7%participated in paid work;53.5%participated in social and cultural activities;99 .7% reported that they could obtain information on health and social services from the community;71.2%reported that they could obtain services for free or below market price when necessary at home.Some core indicators had obvious differences among different genders, age groups, culture, marital status, household types, income sources and income levels.Supplementary and optional indicators:98.6%thought there should be at least one item of house facilities for home-based care for the aged, while 75.6%thought there should be at least four items.26.3% reported to have participated in community team activities.55.2%reported to have participated at least one education or training project during the past one year.90.5% self-reported of good health conditions. Conclusion There is high coverage of barrier-free facility construction, good atmosphere of respecting for the elderly in the community, wide coverage of home-based care for the aged.The elderly people, to some extent, are involved in community activities and various types of training.However, there are still improvements of participation of the elderly in decision-making of local policies, and of senile transformation of the houses the elderly.At the same time, economic, social, demographical, cultural and other factors should be paid close attention to.

Objective To explore the relationship between esophagus cancer patients and both environmental and genetic factors,through analyzing the data on birth orders from esophagus cancer patients of Shanxi province.Methods Both Greenwood and Haldane methods on birth order were used to study the 1101 cases with esophagus cancer from Shanxi province.All the patients had received surgery and were diagnosed,by pathological evidence.First certificates of the patients were confirmed through the standard genetic epidemiologic investigation.Birth order was investigated on probands of the 1101 cases with esophagus cancer and their 44 siblings.Results Results form the Greenwood method showed that there was a tendency for cases with esophagus cancer in birth orders First to Third.However,the Haldane method showed that the results were quite different between actual value and the average theory value of 6A (6A(actual value)=17 118,(X)6A(average theory value) =19 290,X=∣6A-(X)6A∣/√V6A =7.63,X ＞ 2) which suggested that the birth order had some effects on the occurrence of esophagus cancer.In addition,the actual value of 6A was lower than the theoretic average value,and the parents at younger productive age or baby at the first birth was easy to develop esophagus cancer.Conclusion Esophagus cancer was related with the birth order,especially at early order,which was not consistent with the national reports on esophagus cancer.Results from this study suggested that there were certain effects of environmental risk factors on esophagus cancer patients.