Objective To study the effect of drug combined with psychological intervention on mental status and quality of life in patients with multi drug resistant pulmonary tuberculosis.MethodsIn Jiashan Second People's Hospital from January 2011 to December 2016 were 100 cases of multi drug resistant tuberculosis patients as the research object in the course of the study, were randomly divided into control group and experimental group two were 50 cases each.Patients in the control group were given routine drug treatment, and the patients in the experimental group were treated with psychological intervention on the basis of drug treatment.Comparison of the experimental group and the control group after 12 months of treatment, depression score and quality of life score.ResultsBefore treatment, there was no significant difference between the experimental group and the control group in the scores of life quality and the scores of depression and anxiety, which was not statistically significant.After treatment in December, the anxiety score of the patients in the experimental group was (41.2±8.2), and the score of depression was (36.4±4.5).The total score of quality of life was (75.2±11.2).The anxiety score of the control group was (52.3±7.4), and the score of depression was (45.4±5.6).The total score of QOL was (64.2±9.3).Thus, after the corresponding treatment, the experimental group of patients with depression and anxiety scores were significantly lower than those in the control group, the quality of life scores of the control group was significantly lower than the experimental group, with statistical difference (P<0.05).ConclusionThe drug combined with psychological intervention in treatment of multi drug resistant pulmonary tuberculosis can improve the therapeutic effect to a great extent, help the patients to relieve anxiety and depression and other negative emotions, improve the quality of life, with further clinical promotion and application significance.

Objective To investigate the imaging presentation of T-and NK/T-cell lymphomas with different pathology subtypes on 18F-FDG PET/CT.Methods A total of 95 patients (66 males, 29 females, average age 38.42 years) with T-and NK/T-cell lymphoma proved by pathology from June 2006 to February 2016 were retrospectively analyzed.18F-FDG uptake (SUVmax), nodal invasion, nodal distribution, extra-nodal involvement and staging were compared among 7 pathological subtypes of T-and NK/T-cell lymphomas.One-way analysis of variance, Fisher exact test and Kruskal-Wallis H test were used for data analysis.Results There were significant differences in terms of 18F-FDG uptake, nodal invasion, nodal distribution, extra-nodal involvement and staging among different pathological subtypes of T-and NK/T-cell lymphomas (F=2.937, P<0.05;Fisher exact test,all P<0.01;H=19.883, P<0.01).NK/T-cell lymphoma was found to be prone to invade the nasal cavity and nasopharynx, enteropathic type T-cell lymphoma was specific to the intestine, and subcutaneous panniculitis-like T-cell lymphoma presented with subcutaneous infiltration.All those 3 subtypes were quite specific in their extra-nodal involvement.Most patients with angioimmunoblastic T-cell lymphoma (ATCL), peripheral unspecified T-cell lymphoma (PUTCL) and T immunoblastic lymphoma (TIBL) presented as stage Ⅳ disease.Widespread lymph node disease associated with splenic, parotid and serous membrane involvement were often seen in ATCL patients (most commonly to involve the parotid glands and serous membrane among the 7 subtypes).Nodal involvement was found in PUTCL patients, but extranodal involvement was rather non-specific.TIBL had a non-specific pattern of nodal involvement with low 18F-FDG uptake, lower than ATCL and the other 5 subtypes.Anaplastic large cell lymphoma subtypes had the highest 18F-FDG uptake when compared with the other 6 subtypes, but were less often to manifest as stage Ⅳ disease despite their preponderance for marrow and nodal infiltration.Conclusion Different pathological subtypes of T-and NK/T-cell lymphoma manifest different imaging presentations on 18F-FDG PET/CT, which are useful for understanding their biological characteristics.

Objective To evaluate the clinical value of 18 F?FDG PET/CT in the diagnosis of recur?rent and metastatic endometrial cancer. Methods A total of 62 patients with endometrial cancer from October 2004 to February 2014 were retrospectively analyzed. The diagnostic efficiency of 18 F?FDG PET/CT for the de?tection of recurrent and metastatic endometrial cancer was evaluated based on the results of pathological biopsy or clinical follow?up. Results There were 28 endometrial cancer cases with recurrence and metastasis, 9 ca?ses with a second primary cancer and without recurrence and metastasis of endometrial carcinoma. PET/CT imaging had false positive findings in 3 cases, false negative findings in 2 cases. The overall sensitivity, speci?ficity and accuracy of PET/CT for detection of recurrence and metastatic endometrial carcinoma were 93.3%(28/30), 90.6%(29/32), 91.9%(57/62), respectively. The sensitivity and specificity of PET/CT for the diagnosis of vaginal stump recurrence, lymph node metastasis and distant metastasis were 9/10 and 98. 1%(51/52), 95.7%(22/23) and 92.3%(36/39), 15/18 and 95.5%(42/44), respectively. Conclusion 18F?FDG PET/CT is a useful diagnostic tool for the detection of recurrent and metastatic endometrial cancer and a second primary cancer.

Objective To assess the clinical value of 18F-FDG PET/CT for the prediction of postoperative recurrence and metastasis in patients with NSCLC.Methods Eighty-five patients (64 males,21 females; average age:58.0 years) with NSCLC were enrolled.All patients underwent 18 F-FDG PET/CT within one week before surgical operation and 3 months after the operation.The diagnosis of recurrent cancer and metastasis was confirmed by pathologic findings,other imaging modalities and clinical follow-up.The diagnostic efficacy of PET/CT was calculated and the predictors for postoperative recurrence and metastasis were analyzed.x2 test and two-sample t test were used for statistical analysis.Results Among 85 patients,43 had recurrence and metastasis post operation.The postoperative recurrence and metastasis were detected by 18F-FDG PET/CT in 9.3％(4/43) within 6 months,30.2％(13/43) within 1 year,76.7％(33/43) within 2 years and 97.7％(42/43) after 2 years.The sensitivity,specificity,accuracy of 18F-FDG PET/CT for the detection of recurrent tumor and metastasis were 97.7％ (42/43),95.2％ (40/42),96.5％ (82/85) respectively.The preoperative cancer staging,size and SUVmax of primary tumor were significant factors for the prediction of postoperative tumor recurrence and metastasis within 2 years (x2 =12.360,t=3.281 and 2.465,all P＜0.05),but not gender,age or pathological findings (x2 =0.639,0.012 and 3.800,all P＞0.05).Conclusions 18F-FDG PET/CT has an important role for the detection of postoperative recurrence and metastasis in patients with NSCLC.Preoperative cancer staging,size and SUVmax of the primary tumor might be the predictive factors for postoperative tumor recurrence and metastasis within 2 years.

2018 witnessed the 40^th anniversary of the Alma-Ata Declaration. On October 25, 2018, the World Health Organization issued a new Astana Declaration, which reiterates and further develops the concept and core elements of primary health care. It is also proposes that the implementation of the primary health care concept will facilitate to cope with the increasing burden of non-communicable diseases in different countries. Based on the analysis on the policies and practices of the prevention and control of non-communicable diseases in China, this paper points out that the "government-leading, multi-sectoral collaboration, social mobilization and participation by all people" which we have always emphasized is just the application of this primary health care concept, and the Astana Declaration also brings a new and important inspiration to the prevention and control of non-communicable diseases in China.

OBJECTIVETo compare the value of ¹⁸F-FDG PET/CT performed in the interim and later phase of chemotherapy in predicting the prognosis of diffuse large B-cell lymphoma (DLBCL).

METHODS¹⁸F-FDG PET/CT was performed in 71 patients with DLBCL in the interim phase of chemotherapy (3-4 cycles) and in another 71 patients in the later phase of chemotherapy (5-8 cycles). The patients were followed up for an average of 28.73 months (18-114 months) to compare the progression-free survival (PFS) and the PFS rate.

RESULTSThe positive finding rate was similar between ¹⁸F-FDG PET/CT performed in the interim and the later phase (36.6% vs 33.8%, X²=12.423, P>0.05). The PFS was much longer in patients with negative findings than in those with positive findings in both the interim (63.56 vs 19.23 months, P=0.000) and later phase groups (65.78 vs 24.32 months, P=0.000), but showed no significant difference between the negative patients (P>0.05) or between the positive patients (P>0.05) in the two groups. The PFS rate was significantly greater in patients with negative than those with positive findings in the interim group (73.3% vs 15.4%, P=0.000) and in the later phase group (74.5% vs 16.7%, P=0.000), but comparable between the negative (P>0.05) and between the positive patients (P>0.05) in the two groups.

CONCLUSIONS¹⁸F-FDG PET/CT in the interim and later phase of chemotherapy has similar value for predicting the prognosis of DLBCL, and we therefore recommend that ¹⁸F-FDG PET/CT be performed in the interim but not in the later phase.

Antineoplastic Combined Chemotherapy Protocols ; Disease-Free Survival ; Fluorodeoxyglucose F18 ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; drug therapy ; Positron-Emission Tomography ; Prognosis ; Tomography, X-Ray Computed

OBJECTIVETo establish the specific 16S-23S rRNA gene spacer regions in different bacteria using polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), DNA cloning and sequences analysis.

METHODSA pair of primers were selected from highly conserved sequences adjacent to the 16S-23S rRNA spacer region. Bacterial DNA from sixty-one strains of standard bacteria and corresponding clinical isolates representative of 20 genera and 26 species was amplified by PCR, and further analyzed by RFLP, DNA cloning and sequences analysis. Furthermore, all specimens were examined by bacterial culturing and PCR-RFLP analysis. The evaluation of these assays in practical clinic practice was also discussed.

RESULTSRestriction enzyme analysis revealed one, two or three bands or more observed among the 26 different standard strains. The sensitivity of PCR reached 2.5 colony-forming unit (CFU), and there was no cross reaction with human genomic DNA, fungus or virus. Fourteen species could be distinguished immediately by PCR, while another 10 species were further identified by Hinf I or Alu I digestion. The only difference between K.pneumoniae and E. durans was located at the site of the 779th nucleotide according to the sequence analysis and only XmaIII digestion could distinguish one from another. Of 42 specimens from septicemic neonates, 15 were identified as positive by blood culture at a rate of 35.7%. However, 27 specimens identified as positive by PCR, with a rate of 64.2%, a method significantly more effective than blood culture (P < 0.01). Of 6 cerebrospinal fluid (CSF) specimens, one tested positive for S.epidermidis was also positive by PCR, two culture negative were positive by PCR and diagnosed as S.epidermidis according to the DNA pattern. One positive for C.neoformans was negative by PCR. The other two specimens were negative by both PCR and culture.

CONCLUSIONSThe method of detecting bacterial 16S-23S rRNA spacer regions using PCR-RFLP techniques was specific, sensitive, rapid and accurate in providing a new technique for detecting pathogens in clinical bacterial infections.

Bacteria ; genetics ; isolation & purification ; DNA, Bacterial ; analysis ; chemistry ; DNA, Ribosomal ; analysis ; chemistry ; Genes, rRNA ; Humans ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 16S ; genetics ; RNA, Ribosomal, 23S ; genetics ; Sensitivity and Specificity ; Sequence Analysis, DNA

OBJECTIVETo investigate the status quo and influence factors of self monitoring of blood glucose (SMBG) and self-efficacy of diabetes patients' that participated in community diabetes self management group.

METHODSBeijing, Shanghai, Chongqing, Jiangsu, Guangdong, and Zhejiang were selected as the study sites considering patients management experiences they had. 1 401 adult diabetes patients were recruited from communities via health records system screening, telephone notification, poster advertisement, letters invitation ways. Face to face questionnaire survey was applied to obtain patients' general information, diabetes history, diabetes knowledge awareness, SMBG, and self-efficacy information. Multiple linear regression was used to analyze the relationship between factors and self efficacy.

RESULTSThere were 519 male patients (37.0%) and 882 female patients (63.0%) with an average age of (64.9 ± 8.9) years old. Patients lived in city accounted for 48.0% (672/1 401) and rural patients accounted for 52.0% (729/1 401). Patients who conducted SMBG accounted for 79.9% (1 120/1 401) and 33.3% (446/1 401) patients conducted blood glucose monitoring 1-3 times per month. Rural patients, primary school educated, and new rural cooperative medical system (NCMS) covered patients had a higher proportion of never conducting SMBG which were 21.9% (160/729), 24.2% (160/662), and 26.3% (125/475) , respectively. Scores of self-efficacy was (69.24 ± 16.30) (hundred-mark system) with a relative lower score in monitoring of blood glucose (64.09 ± 20.08) and foot care (63.63 ± 21.40), as well as a highest score in taking medicine and insulin injections (76.10 ± 22.00). Multiple regression analysis on self-efficacy and its related factors show a negative correlation between patients' place of residence and self-efficacy (β' = -0.076) and a positive correlation between education and self-efficacy (β' = 0.114) as well as between diabetes knowledge awareness and self-efficacy (β' = 0.193)(t = -2.46, 3.71, 7.18, P < 0.05).

CONCLUSIONCommunity diabetes patients had a low self-efficacy and it was even lower among low economic and education degree patients. The worst parts were SMBG and foot care. Place of residence, education, and diabetes knowledge awareness are factors that influence patients' self efficacy.

Aged ; Aged, 80 and over ; Blood Glucose ; Blood Glucose Self-Monitoring ; statistics & numerical data ; China ; epidemiology ; Diabetes Mellitus ; therapy ; Female ; Foot ; Humans ; Insulin ; Male ; Medication Adherence ; statistics & numerical data ; Middle Aged ; Regression Analysis ; Self Efficacy ; Surveys and Questionnaires

Objective To assess the disease burden for gynecological disease in China in 2016. Methods Data were extracted from the global burden of disease study 2016(GBD 2016). The burden of gynecological disease among age groups and provinces groups was assessed by prevalence rate, mortality rate, years lived with disability (YLD), years of life lost due to premature mortality (YLL) and disability-adjusted life years(DALY). An average world population age-structure for the period 2010-2035 was adopted to calculate age-standardized rates. Results In 2016, the prevalence rate of gynecological disease in women aged 15 years and above in China was 24.94%, of which was 36.71%to women of childbearing age. The number of DALY from gynecological disease was 2727637.82 life years in 2016, with the DALY rate was 411.12/100000 and standardized DALY rate was 341.80/100000. The first three gynecological diseases with highest DALY and DALY rate among Chinese women aged ≥15 years were premenstrual syndrome(815004.64 life years, 122.84/100000), uterine fibroids(281976.67 life years, 42.5/100000) and endometriosis (154792.89 life years, 23.33/100000). The DALY caused by gynecological disease in Guangdong (220871.19 life years), Shandong (190968.72 life years), Henan (171273.92 life years), Jiangsu(168404.27 life years)and Sichuan(144358.5 life years)were higher than other provinces. The standardized DALY rate attributable to gynecological disease were highest in Xinjiang Uygur Autonomous Region(404.00/100000), Shanghai(394.90/100000), Heilongjiang(382.00/100000), Beijing(365.70/100000)and Jiangsu (357.50/100000). Conclusions Gynecological disease is a great threat to women' s reproductive health. Effective measures should be taken to address the issue, especially to women of childbearing age.

Objective: To assess the disease burden for low back pain in China in 2013 and analyzed the change of it between 1990 and 2013. Methods: Data was from the Global Burden of Disease Study 2013 (GBD 2013). The burden of low back pain (LBP) among age groups, gender groups, provinces (excluding Taiwan China) groups was assessed by years lived with disability (YLD), including YLD, YLD rate, proportion of YLD due to LBP. The change of the YLD for LBP was analyzed between 1990 and 2013 by age-standardized YLD rate using the world standard population of 2000-2025 WHO. Results: In 2013, The YLD for LBP was 16 347 thousand (the leading cause of YLD in China), and the proportion of YLD in age group 30-59 years old was 54.6% (8 929/16 347) . The age-standardized rate in China was 1 072.6/100 000, and the rates in Guangdong (1 742.2/100 000) , Shanghai (1 227.8/100 000) and Beijing (1 136.6/100 000) were higher than in other provinces. The proportion of YLD due to LBP was 11.8%. LBP was the leading cause of YLD in China. Compared with 1990, the growth rates of age-standardized rate, proportion of YLD and YLD, were 5.6%, 25.5% and 72.1%, desperately. Conclusion Low back pain was the leading cause of YLD in China in 2013. Compared with 1990, the disease burden for low back pain increased rapidly.