Objective To investigate the safety of argon plasma coagulation (APC) with submucosal injection for colon polyps.Methods A total of 30 sets of fresh sigmoid colon from healthy pigs were assigned to control group to receive direct APC,and to treatment group to receive APC with submucosal injection,respectively.After same time and energy of APC,each specimen was sampled for pathological evaluation and the damage extent was determined as mucosa,submucosa (superior 1/3,middle1/3,inferior 1/3),and muscularis propria.Ten cases of colon sessile polyps with diameter of about 1-2 cm,elevated within 3mm by endoscopic ultrasonography(EUS).Direct APC or APC with submucosal injection were performed,respectively,and the difference was observed by EUS.Results In 30 cases of control group,the injury depth of 5 cases reached to the muscularis propria and of 25 cases to submucosa layer,among which 4 cases showed damage to superior submucosa 12 middle submucosa and 9 inferior submucosa.In 30 cases of treatment group,there was no damage to muscularis propria.The injury depth of 26 cases reached submucosa layer,among which 22 cases showed damage to superior submucosa,4 middle submucosa.The results showed significant difference between two groups (P ＜0.01).In patients who underwent APC with submucosal injection,EUS showed effective isolation of mucosa and muscularis propria.It confined the injury to the mucosal layer.Without treatment of submucosal injection in advance,it seemed easier to damage the submucosa and muscularis propria.Conclusion Submucosal injection can protect the colon injured by APC,and may reduce the risk of colon perforation by APC for colon polyps.

Unlike other vulnerable groups, rehabilitation is the most urgent problem to be resolved for the disabled. Good working onrehabilitation for the disabled is the foundation to improve the basic living condition and enhance the ability to participate in the society, andcommunity-based rehabilitation is the key to achieve "Rehabilitation for All" for the disabled. The goal "Rehabilitation for All" can beachieved only if "rehabilitation in community and service in family" be reached.

This paper introduced the framework and approach, explained the new categories, and elaborated the implementation of International Classification of Functioning, Disability and Health (Children and Youth Version) (ICF-CY) in fields of rehabilitation for children with disabilities. The publishing and distribution of ICF-CY international Chinese version would be a big thing for the Chinese to implement ICF in related fields.

Objective To comparatively analyze the acute adverse reactions of helical tomotherapy ( HT) and intensity-modulated radiation therapy ( IMRT) for nasopharyngeal carcinoma ( NPC) . Methods A total of 100 NPC patients treated with radiotherapy were selected and divided into the HT group ( n=50) and IMRT group ( n=50) . All patients were treated with concurrent chemoradiotherapy. The prescription dose of radiotherapy was DT 68.2-73.8 Gy/30-34F. The severity of acute adverse reactions of skin, oral mucosa, salivary glands and esophagus was evaluated with the established RTOG criteria. The differences between two groups were evaluated by paired t-test. Results The dose of organs at risk ( OARs) in the HT group was significantly lower than that in the IMRT group ( P<0.05) , whereas the dose of target area of PTVnx, PTVnd ( left) and PTVnd ( right) did not significantly differ between two groups ( all P>0.05) . In the HT group, the incidence rate of grade 0-3 acute adverse reactions in the skin, oral mucosa, salivary glands and esophagus were ( 14%, 68%, 18%, 0%) , ( 10%, 54%, 36%, 0%) , ( 0%, 74%, 26%, 0%) and ( 10%, 60%, 28%, 2%) , respectively. In the IMRT group, the corresponding results were ( 0%, 52%, 48%, 0%) , ( 0%, 58%, 42%, 0%) , ( 0%, 28%, 72%, 0%) and ( 0, 40%, 60%, 0%) , respectively. The severity of acute adverse reactions of skin, salivary glands and esophagus in the HT group was slighter than those in the IMRT group ( all P<0.05) , the acute adverse reactions in the oral mucosa were similar between two groups ( P>0.05) . In the HT group, the onset time of acute adverse reactions in the skin was later than that in the IMRT group ( P<0.05) , and the onset time of other adverse reactions was similar between two groups ( all P>0.05) . Conclusions Both HT and IMRT can meet the requirements of the dose distribution in the target area for NPC, whereas HT is superior to IMRT in terms of the protection of OARs protection, the severity and onset time of acute adverse reactions.

Objective To evaluate the effect of helical tomotherapy (HT) megavoltage CT (MVCT) under different acquisition pitch and registration conditions upon the accuracy of radiotherapy for used nasopharyngeal carcinoma,aiming to provide reference for image-guided radiotherapy (IGRT) for nasopharyngeal carcinoma.Methods MVCT scans were performed on an anthropomorphic head& neck phantom which was simulated the positioning errors in the x,y and z direction.The obtained images were registered with the planning CT images.Acquisition pitch was set as the coarse,normal and fine modes.Registration conditions were set as bone registration,bone and soft tissue registration and full-image registration.Registration accuracy was determined by comparing the measured value with the preset value.The accuracy of radiotherapy under different acquisition pitch and registration conditions was statistically compared.Results The 3D errors of bone,bone and soft tissue and full-image registration under different acquisition pitch (coarse,normal and fine) were (1.51±0.47,1.54±0.35,1.81±0.53) mm and (1.41± 0.37,1.53±0.36,1.56±0.39) mm and (1.51±0.27,1.57±0.32,1.73±0.33) mm,respectively.The bone registration yielded the highest accuracy (P＜0.05).When the registration condition was set as bone registration,the accuracy of three acquisition pitch did not significantly differ (all P＞0.05).The fine mode of acquisition pitch possessed the highest stability,whereas required the longest time.Conclusion The acquisition pitch and registration conditions should be selected during HT MVCT based on the clinical requirement of each patient with nasopharyngeal carcinoma.

Objective To investigate the risk factors of hyperbilirubinemia in late preterm infants. Methods The clinical data of 815 late preterm infants (449 males and 366 females) from 25 hospitals in Beijing were collected from October 2015 to April 2016, including 340 cases(41.7％) with hyperbilirubinemia (hyperbilirubinemia group), and 475 cases without hyperbilirubinemia (control group). The clinical data of two groups were compared, and the maternal factors influencing hyperbilirubinemia in late preterm infants were analyzed with logistic regression. Results There were no significant differences in gender ratio (M:F 1.39 vs. 1.12, t=1.811,P=0.172)and birth weight[(2502.6±439.6)g vs. (2470.2±402.9)g,χ2=2.330,P=0.127)]between two groups. The incidence rates of hyperbilirubinemia in infants of 34 wks, 35 wks and 36 wks of gestational age were 22.9％(87/174), 35％(119/300) and 42.1％(143/341) respectively (χ2=1.218,P=0.544). The multivariate logistic regression analysis indicated that the maternal age(OR=1.044,95％ CI:1.010-1.080,P=0.011)was independent risk factor and multiple births(OR=1.365,95％CI:0.989-1.883,P=0.048), premature rupture of membranes(OR=2.350,95％ CI:1.440-3.833,P=0.001), cesarean section(OR=1.540,95％CI:0.588-4.031,P=0.014)were risk factors for hyperbilirubinemia in late preterm infants. Conclusions The incidence of hyperbilirubinemia in late preterm infants is relatively high. Maternal age, multiple births, premature rupture of membranes and cesarean section are risk maternal factors related to hyperbilirubinemia in late preterm infants.

Objective:To study the change pattern of neck diameter and relevant factors in nasopharyngeal carcinoma (NPC) patients treated with helical tomotherapy, aiming to provide reference for clinical practice.Methods:Fifteen NPC patients treated with helical tomotherapy at Sun Yat-Sen University Cancer Center from November 2020 to February 2021 were enrolled in this study. The transverse diameters of NPC patients' neck contours and body weight of all patients during radiotherapy were recorded weekly. We used descriptive statistics to explore the distribution of transverse diameters of NPC patients' neck contours during radiotherapy. And Spearman correlation analysis was used to assess the association between weight loss and changes in neck contour transverse diameter.Results:During radiotherapy, the distribution of transverse diameters of NPC patients' neck contours was completely different from the initial values. Specifically, the transverse diameters were significantly reduced at the 4th week of the radiotherapy. Moreover, the reduction of transverse diameter of neck contour was highly correlated with the weight loss ( r=0.803, P<0.05), and moderately correlated with gender ( r=0.523, P<0.05). However, there was no statistical correlation between the alteration of neck diameter and age, TNM stage, and the mean dose of GTV nd-L, GTV nd-R, PTV nd-L and PTV nd-R (all P>0.05). Conclusions:The neck contours of NPC patients are altered regularly during helical tomotherapy, which are narrowed the most obviously in the 4th week. Extensive attention should be paid to the changes of neck contour during radiotherapy in clinical practice.

Objective:To study the respiratory morbidity and the risk factors of respiratory complications in late-preterm infants.Methods:The data of 959 late-preterm infants in 21 hospitals in Beijing from October 2015 to April 2016 were collected.These infants were divided into the respiratory morbidity group (237 cases) and the control group (722 cases) according to whether they had short-term respiratory morbidity after birth.Clinical data of the two groups were compared.Results:Among the 959 late-preterm babies, 530 were male and 429 were female.Two hundred and thirty-seven cases (24.7%) developed short-term respiratory morbidity after birth.Infectious pneumonia developed in the most cases (81 cases, 8.4%), followed by transient tachypnea (65 cases, 6.8%), amniotic fluid aspiration (51 cases, 5.3%), and respiratory distress syndrome (24 cases, 2.5%) successively.All the infants recovered and discharged.There were no differences between gender and maternal age between 2 groups (all P>0.05). Compared with the control group, more late-preterm infants were delivered by cesarean section (73.4% vs.59.7%, χ2=14.43, P<0.001) and the 1-minute Apgar score was lower [(9.41±1.66) scores vs.(9.83±0.53) scores, t=5.40, P<0.001] in the respiratory morbidity group.The differences were statistically significant.There were more cases with maternal complications in the respiratory morbidity group that in the control group (66.7% vs.58.6%, χ2=4.877, P=0.027), but no difference in various complications between 2 groups was observed ( P>0.05). In the respiratory morbidity group, the most frequent complications were maternal hypertension and preeclampsia (27.8% vs.22.6%, χ2=2.728, P=0.099). There were no differences between 2 groups in gestational age, birth weight and birth length (all P>0.05). There were more infants small for gestational age and large for gestational age in the respiratory morbidity group than in the control group (18.8% vs.14.1%, 6.3% vs.2.4%, χ2=8.960, P=0.011). The duration of hospitalization of the respiratory morbidity group was significantly longer than that of the control group [(9.00±4.42) d vs.(6.82±4.19) d, t=6.676, P<0.001] since the infants with respiratory morbidity needed to be hospita-lized. Conclusions:Respiratory diseases occur in about 1/4 of late-preterm infants.Infants who are delivered by cesarean section and whose mothers are complicated with the maternal hypertension and preeclampsia should be monitored closely.Respiratory support should be provided for infants not appropriate for gestational age who are more likely to suffer from respiratory diseases, so that they can successfully pass through the transition period.

Objective:To analyze the related factors affecting the dose to the small intestine exposure to preoperative radiotherapy for rectal cancer, aiming to provide reference for alleviating the adverse reactions of radiotherapy for rectal cancer.Methods:Medical record data and radiotherapy plan information of 138 rectal cancer patients who received intensity-modulated arc radiotherapy at Sun Yat-sen University Cancer Center from May 2021 to February 2023 were retrospectively analyzed. Tumor staging, tumor location, gender, age, planned bladder volume, body mass index (BMI), and small intestine irradiation dose volume were subject to Spearman correlation analysis. Further grouping and comparison were conducted based on the correlation results. Independent sample non parametric tests were used for inter group comparison.Results:The main factors related to the small intestine irradiation dose volume were tumor location, gender, planned bladder volume, and BMI. Tumor location was weakly correlated with the small intestine V 5 Gy-V 45 Gy. Gender was weakly correlated with the small intestine V 30 Gy-V 45 Gy. Planned bladder volume was weakly negatively correlated with the small intestine V 20 Gy-V 45 Gy. BMI was weakly negatively correlated with the small intestine V 10 Gy-V 45 Gy. Grouping comparison analysis showed that the small intestine V 5 Gy-V 45 Gy of rectal cancer patients in the low position group was significantly smaller than those in the middle and high position groups (both P<0.05), and there was no significant difference between the middle and high position groups ( P>0.05). Female rectal cancer patients had higher V 30 Gy-V 45 Gy levels than male counterparts ( P<0.05). The small intestine V 20 Gy and V 25 Gy levels in the planned bladder volume <200 ml group were significantly higher than those in the 200-400 ml and >400 ml groups (all P<0.05), whereas there was no difference between the 200-400 ml and >400 ml groups ( P>0.05). The small intestine V 30 Gy-V 45 Gy levels in the 200-400 ml group were significantly lower than those in the <200 ml group, but higher than those in the >400 ml group, and the differences were statistically significant (all P<0.05). Regarding BMI comparison among groups, the small intestine V 15 Gy-V 45 Gy in the low body weight group was significantly higher than those in the other three groups (all P<0.05). There were no significant differences among the normal, overweight, and obese groups (all P>0.05). Conclusion:In preoperative radiotherapy for rectal cancer, more attention should be paid to the dose to the small intestine in patients with middle and high position rectal cancer, female patients, and patients with low body weight.

BACKGROUND: Lung cancer is the main cause of cancer-related death globally. Single nucleotide polymorphism (SNP) is one of the important factors leading to the occurrence of lung cancer, but its mechanism has not been elucidated. This study intends to investigate the relationship between SNPs of CDH1, FANCB, APC genes and lung cancer genetic susceptibility. METHODS: The case-control study design was used. We collected blood samples from 270 lung cancer cases in the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, as well as blood samples from 445 healthy volunteers as controls, and extracted genomic DNA for genotyping using the Taqman® SNP genotyping kit. The distribution of three SNP loci of CDH1 gene rs201141645, FANCB gene rs754552650 and APC gene rs149353082 in Chinese population was analyzed. Chi-square test and Logistic regression were used to analyze the relationship between different genotypes and the risk of lung cancer. RESULTS: The distribution frequencies of AA, A/G and GG genotypes at rs754552650 of FANCB gene in the control group were 27.2%, 52.6% and 20.2%, respectively. The distribution frequencies of AA and A/G genotypes were 93.7% and 6.3% in the case group, respectively, and no GG genotype was detected. The A/G genotype of the rs754552650 locus of the FANCB gene was significantly different between the case group and the control group. Compared with the carriers of AA genotype, the individuals with FANCB rs754552650 A/G genotype had a lower risk of lung cancer (OR=0.035, 95%CI: 0.020-0.062, P<0.001). CDH1 gene rs201141645 A/C and CC genotypes only existed in the control group. In addition, only 1 sample was found to have APC rs149353082 genotype in the case group. CONCLUSIONS In the Chinese population, the lung cancer risk of the individuals with FANCB rs754552650 A/G genotype was significantly decreased.
Antigens, CD/genetics* ; Cadherins/genetics* ; Case-Control Studies ; China ; Fanconi Anemia Complementation Group Proteins/genetics* ; Gene Frequency ; Genes, APC ; Genetic Predisposition to Disease ; Genotype ; Humans ; Lung Neoplasms/genetics* ; Polymorphism, Single Nucleotide