Objective To investigate the relationship between cerebral 0, metabolism during coronary artery bypass graft (CABG) performed with cardiopulmonary bypass (CPB) and postoperative mental disorders (POMD) in the elderly.Methods Thirty patients (13 male,17 female) aged 65-76 yr undergoing CABG performed with CPB were studied. Patients with senile dementia were excluded. The patients were premedicated with scopolamine 0.3 mg and pethidine 50mg. Anesthesia was induced with midazolam 0.05-0.1 mg?kg_(-1), propofol 0.2-0.5 mg?g_(-1), fentanyl 10-15?g?g_(-1) and vecuronium 0.1-0.3 mg?g_(-1) and maintained with isoflurane inhalation and intermittent iv boluses of fentanyl. Nasopharyngeal temperature (T) was maintained at 26℃-28℃) during CPB. Radial artery was cannulated for BP monitoring and blood sampling.Swan-Ganz was placed via right internal jugular vein (UV).Another catheter was inserted into right UV and threaded retrogradely until J point for blood sampling. Blood samples were taken from artery and UV simultaneously for blood gas analyses and determination of blood glucose and lactate concentration before anesthesia (T_1 ),immediately after induction of anesthesia (T_2), during splitting of sternum (T_3) when T was reduced to 28℃ (T_4) and rewarmed to 35℃(T_5 ) and at the end of bypass (T_6 ).Cerebral O2 delivery (CDO2 ),cerebral oxygen consumption (CMRO2),cerebral glucose consumption (CMRglu) and lactic acid production (ADVL) were calculated. POMD was assessed using CAM-ICU chart.Results (1)Seven patients developed POMD (7/30 or 23.3% ).(2) Low jugular bulb 02 saturation (SjO2 ≤50% or PjO2≤25% mm Hg) was observed in 8 patients during rewarming. The incidence was significantly higher in POMD patients (3/7 or 42.96%) than that in non-POMD patients (5/23 or 21.74%). (3) CBF/CMRO2 was significantly lower in POMD patients than in non-POMD patients during rewarming.(4) CMRO2/CMRglu was significantly lower but ADVL was significantly higher in POMD patients than in non-POMD patients during hypothermia, rewarming and at the end of CPB.(P

Objective To investigate the efficacy and safety of low-dose ammonia sulfur-sulfur-resistant treatment.Methods 120 patients with initial depression were randomly divided into a group(40 cases), the estercalyptrin group(40)and the drug group(40).The treatment was treated by the treatment of the ammonia sulfonate, 20 mg/d, 20 mg/d, and 20 mg/d of escitaloplan tablet.The clinical efficacy and response scale(TESS)was evaluated with the Hamilton depression scale(TESS)in the treatment of 1, 2, 4 and 8 over the weekend.Results Three groups showed significant improvement(P<0.01)during the 8th weekend of treatment of the HAMD scores.Grade 1 and 2 weekend, combined treatment group compared with single drug group score had significant difference(P<0.01), and the contrast between the single drug groups had no significant difference, 4 score over the weekend, and comparison between the three way were significant differences(P<0.05), 8 scores over the weekend, and share with escitalopram phthalein general group is no difference, but tolbutamide will benefit group compared with the other two groups had significant difference(P<0.01).Conclusion Small doses of tolbutamide will benefit has antidepressant effect, but the long-term curative effect of treatment is better than the amount of escitalopram citalopram, and share small doses of escitalopram citalopram tolbutamide will benefit can obviously accelerate the antidepressant treatment work.

Objective　To study the clinicopathologic features of hepatic angiomyolipoma (AML) and to investigate the feasibility of a new antibody-A103 as a diagnostic aid for AML. Methods　Ten cases of AML were retrieved from hospital records and analyzed morphologically. Immunohistochemistry was performed on paraffin-embedded tissues with a panel of antibodies, including antibody-A103. Results　There were eight women and two men, with ages ranging from 38-58 years (median 45.7). Clinically, nine cases were asymptomatic and found by imaging techniques. None of the patients had associated tuberous sclerosis. All tumors were sharply demarcated from the surrounding liver parenchyma. Histologically they were composed of a heterogeneous mixture of three components: thick-walled blood vessels, spindle or epithelioid smooth muscle cells and adipose tissue. All tumors showed a strong immunoreactivity to A103, HMB-45 and smooth muscle actins. Follow-up information on all 10 cases showed a benign course with no signs of recurrence. Conclusions　Hepatic AML is a rare mesenchymal tumor of the liver. A103 is a promising marker for a pathologic diagnosis of hepatic AML.

OBJECTIVETo analyze the incidence trends and characteristics of lymphoma in Beijing, 1998-2010.

METHODSTotal of 9 763 new cases diagnosed as lymphoma in 1998-2010 were extracted from the population-based database of Beijing Cancer Registry, covering population of 151 601 066 person-years. Incidence, age-adjusted incidence, cumulative incidence, truncated incidence and annual percentage change (APC) were calculated. The gender-specific, age-specific and pathology-specific incidence trends were analyzed.

RESULTThe incidence rate of lymphoma was 6.48/100 000 (9 763/150 720 187) during the period of 1998-2010, increased from 3.78/100 000 (410/10 850 626) in 1998 to 8.88/100 000 (1 111/12 518 114) in 2010 with an increasing rate of 136.17% (APC = 5.21%, P < 0.05). The incidence rate of Hodgkin lymphoma increased from 0.25/100 000 (27/10 850 626) in 1998 to 0.47/100 000 (59/12 518 114) in 2010 with an increasing rate of 88.00% (APC = 4.33%, P < 0.05). The incidence rate of non-Hodgkin lymphoma was increased from 2.89/100 000 (314/10 850 626) in 1998 to 5.93/100 000 (742/12 518 114) in 2010 with an increasing rate of 105.19% (APC = 4.19%, P < 0.05) . During the period of 1998-2010, the incidence of lymphoma was 7.78/100 000 (7 125/91 621 898) in urban areas and 4.47/100 000 (2 638/59 098 289) in rural areas, 7.40/100 000 (5 632/76 121 672) in males and 5.54/100 000 (4 131/74 598 518) in females.

CONCLUSIONThe incidence of lymphoma keeps increasing in 1998-2010, and the incidence was higher in males than females, urban areas than rural areas. The incidence patterns of Hodgkin lymphoma and non-Hodgkin lymphoma were different.

Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Lymphoma ; Male ; Rural Population ; Urban Population

Objective: To analyze the temporal trends of lung cancer incidence between age, gender (male and female) and areas (urban and rural) in Beijing during 2000-2012. Methods: The lung cancer cases were collected by Beijing cancer registry between 2000 and 2012. We calculated the incidence and world age-standardized incidence rates (ASR) which standardized by World Segi's population. Also, the average age and median age of lung cancer incidence were calculated. The annual percent changes (APC) for the whole period, for the gender ratio and for the area ratio were evaluated with Joinpoint analysis. Result: Totally, 81 378 new cases of lung cancer were diagnosed in 2000-2012 with the average incidence rate of 52.67/100 000. The incidence rate increased by 4.84% per year from 38.99/100 000 to 65.33/100 000, but the APC of ASR was 1.69% (P<0.001) . The ASR increased 0.54% (P=0.029) per year in urban from 29.71/100 000 to 30.55/100 000 and 3.93% (P<0.001) in rural areas from 24.02/100 000 to 35.79/100 000. The incidence ratio of urban to rural decreased from 1.24 to 0.85 (APC=-3.29%, P<0.001). The incidence ratio of male to female decreased from 1.84 to 1.69 (APC=-0.45%, P=0.019).The average age of lung cancer incidence of male and female increased from 66.27 and 66.00 to 68.97 and 69.11 (P<0.001), respectively. Conclusion The incidence rate of lung cancer increased slightly in urban areas but increased significantly in rural areas during 2000-2012, the area ratio trend was declined. The average age of lung cancer occurrence gradually increased, but the temporal trends varied with age group. The gender ratio decreased from 2000 to 2012.

Objective:To conduct a quantitative and qualitative analysis of the issues found in quality management, establish a risk-based whole-process quality management model, and improve the quality of clinical trials.Methods:Based on the risk-based quality management theory, the issues found in the quality control of drug clinical trials in Beijing Cancer Hospital in 2020 were structured and classified by severity (mild to moderate to severe) and 10 categories, and the risk matrix was graded by a semi-quantitative method. Targeted quality control strategies for different levels of risk were carried out according to visual analysis of the informative quality analysis platform. Chi-square tests of the severity of quality control issues in our hospital in 2020 and 2021 and non-parametric tests of the number of issues per capita in each category were used to evaluate the effectiveness of the management model.Results:A risk matrix was established according to the severity and frequency of the issues found in the quality control in 2020. The issues with severe risks were categorized as protocol compliance and serious adverse events, and categories with moderate risks included informed consent, biological sample related, original records, and investigator folders. After using visual analysis and adopting the risk-based quality control strategy, the proportion of severe issues found in quality control in our hospital in 2021 was 0.92%, lower than that of 1.39% in 2020, and the difference was statistically significant. The average number of issues detected per capita in each category for each trial in 2021 was lower than that in 2020 with a statistical difference, indicating that the management model was effective.Conclusions:Using information technology to adopt risk-based quality management is helpful to improve the quality of hospital clinical trials.

Objective:To evaluate 5-years breast cancer-specific survival (CCS) by age, and the relationship of age at diagnosis and the risk of breast cancer mortality.Methods:Medical records of 3 470 resident patients diagnosed with primary, invasive female breast cancer between January 1, 2006 and December 31, 2010 in four hospitals in Beijing were reviewed and collected. All patients were followed up until December 31, 2018 to acquire survival outcome. Five-years breast CCS of the five subgroups was estimated by the life-table method. Cox proportional hazard regression models were used to estimate hazard ratios ( HRs) and 95% confidence intervals (CIs) of different levels of age stratification and breast cancer mortality, and restricted cubic spline (RCS) model was used to detect the dose-response relationship. Results:The median diagnosis age among 3 470 female breast cancer patients was 53.2 years. There were 1 289 patients in the age-group of 45~54 years, with the highest proportion of 37.15%. However, only 126 patients occurred in the age-group of less than 35 years, with the lowest proportion of 3.63%. A total of 528 (15.22%) patients died of breast cancer during the study period. Overall 5-year CCS was 90.72% (95% CI: 89.74%~91.70%), 88.68% (95% CI: 83.09%~94.27%) and 87.05% (95% CI: 84.27%~89.82%) for all of the patients, aged less than 35 years and those aged 65 years and older. Compared with patients with diagnosis age of 45~54 years, the multivariate-adjusted HRs for breast cancer mortality associated with patients in age-group of <35 years and those in the age-group of ≥65 years were 1.72 (95% CI: 1.06~2.81) and 1.89 (95% CI: 1.43~2.49), respectively. In addition, patients aged ≥65 years had significantly higher risk of breast cancer mortality in Luminal subtypes, with HR of 1.70 (95% CI: 1.17~2.46) for Luminal A breast cancer and HR of 3.84 (95% CI: 1.74~8.49) for Luminal B breast cancer. RCS analysis exhibited a non-linear ( "J-shaped" ) relationship between diagnosis age of female breast cancer and the risk of breast cancer mortality (nonlinear P<0.000 1). In addition, patients aged ≥65 years had significantly higher risk of breast cancer mortality in Luminal subtypes, with HR of 1.70 (95% CI: 1.17~2.46) for Luminal A breast cancer and HR of 3.84 (95% CI: 1.74~8.49) for Luminal B breast cancer. RCS analysis exhibited a non-linear ( "J-shaped" ) relationship between diagnosis age of female breast cancer and the risk of breast cancer mortality (nonlinear P<0.000 1). Conclusion:Age at diagnosis is an important prognostic factor for female breast cancer, with worse outcome for both young and old patients.

Objective:To evaluate 5-years breast cancer-specific survival (CCS) by age, and the relationship of age at diagnosis and the risk of breast cancer mortality.Methods:Medical records of 3 470 resident patients diagnosed with primary, invasive female breast cancer between January 1, 2006 and December 31, 2010 in four hospitals in Beijing were reviewed and collected. All patients were followed up until December 31, 2018 to acquire survival outcome. Five-years breast CCS of the five subgroups was estimated by the life-table method. Cox proportional hazard regression models were used to estimate hazard ratios ( HRs) and 95% confidence intervals (CIs) of different levels of age stratification and breast cancer mortality, and restricted cubic spline (RCS) model was used to detect the dose-response relationship. Results:The median diagnosis age among 3 470 female breast cancer patients was 53.2 years. There were 1 289 patients in the age-group of 45~54 years, with the highest proportion of 37.15%. However, only 126 patients occurred in the age-group of less than 35 years, with the lowest proportion of 3.63%. A total of 528 (15.22%) patients died of breast cancer during the study period. Overall 5-year CCS was 90.72% (95% CI: 89.74%~91.70%), 88.68% (95% CI: 83.09%~94.27%) and 87.05% (95% CI: 84.27%~89.82%) for all of the patients, aged less than 35 years and those aged 65 years and older. Compared with patients with diagnosis age of 45~54 years, the multivariate-adjusted HRs for breast cancer mortality associated with patients in age-group of <35 years and those in the age-group of ≥65 years were 1.72 (95% CI: 1.06~2.81) and 1.89 (95% CI: 1.43~2.49), respectively. In addition, patients aged ≥65 years had significantly higher risk of breast cancer mortality in Luminal subtypes, with HR of 1.70 (95% CI: 1.17~2.46) for Luminal A breast cancer and HR of 3.84 (95% CI: 1.74~8.49) for Luminal B breast cancer. RCS analysis exhibited a non-linear ( "J-shaped" ) relationship between diagnosis age of female breast cancer and the risk of breast cancer mortality (nonlinear P<0.000 1). In addition, patients aged ≥65 years had significantly higher risk of breast cancer mortality in Luminal subtypes, with HR of 1.70 (95% CI: 1.17~2.46) for Luminal A breast cancer and HR of 3.84 (95% CI: 1.74~8.49) for Luminal B breast cancer. RCS analysis exhibited a non-linear ( "J-shaped" ) relationship between diagnosis age of female breast cancer and the risk of breast cancer mortality (nonlinear P<0.000 1). Conclusion:Age at diagnosis is an important prognostic factor for female breast cancer, with worse outcome for both young and old patients.

OBJECTIVETo explore the relationship between female breast cancer incidence and the socioeconomic status in Beijing.

METHODSThe data of female breast cancer patients of Beijing residents diagnosed between 2001 and 2010 were sorted from the population-based surveillance database of Beijing Cancer Registry.28, 184 cases were included, covering 58, 427, 396 female person-years. Incidence rates, rates adjusted by world population in each year, mean and median age at diagnosis and the peak age group were calculated. JoinPoint software was applied to calculate the incidence trend and the annual percentage of changing (APC). Using the data from the Beijing Statistical Yearbook in 1991-2000, we calculated the gross output value of industry, the average wage of Beijing residents, the food expenditure level and the average wage in different districts in Beijing. The relationship between female breast cancer incidence, the average age (mean, median and the peak age groups) at diagnosis and the socioeconomic status in the last 10 years was also calculated.

RESULTSFrom 2001 to 2010, the incidence rate of female breast cancer in Beijing rose from 32.03/100 000 to 58.10/100 000, a total increase of 81.39% over the last 10 years and the annual percentage change was 5.76%, after adjusted by world population (APC = 5.76%, P < 0.05). The relationships between female breast cancer incidence from 2001-2010 and the gross output value of industry, the average wage of Beijing residents, the food expenditure level in 1991-2000 were significant (P < 0.05). The Pearson correlation coefficients were 0.928, 0.957, and 0.982, respectively. In terms of the data in different districts in Beijing, the relationships between the average age (mean, median and the peak age group) in 2001-2010 and the average wage of Beijing residence in 1991-2000 were also significant with a correlation coefficient of 0.806,0.785 and 0.754, respectively (P < 0.05).

CONCLUSIONSThe increase of female breast cancer incidence rate in Beijing is positively correlated with the socioeconomic status, especially with the food expenditure level of Beijing residents over the last 10 years. The higher the economic development, the peak age of onset of female breast cancer is more postponed.

Breast Neoplasms ; epidemiology ; Cell Movement ; China ; epidemiology ; Female ; Humans ; Incidence ; Menopause ; Social Class ; Socioeconomic Factors

Objective: To analyze the incidence trends and to describe the characteristics of soft tissue sarcoma (STS) among residents in Beijing from 1999 to 2013. Methods: Medical information of the cases diagnosed as STS(ICD10: C47&C49) from 1999 to 2013 in Beijing was extracted from the population-based database of Beijing Cancer Registry.Crude incidence rate, age-standardized incidence rates to Chinese population (ASRC)and the world population(ASRW) were calculated. The characteristics of the STS cases in different gender and age groups from urban and rural areas were respectively analyzed.The incidence trends and annual percentage changes (APC) during last 15 years were analyzed by using JoinPoint 3.4.3 software. Results: A total of 2 048 cases were diagnosed as STS during the study period and the incidence rate of STS was 1.15 per 100 000 person-years. The ASRC was 0.74 per 100 000 person-years and ASRW was 0.86 per 100 000 person-years, respectively. Except for the impact of changes in the age composition, the APC of ASRW from 1999 to 2013 was 3.95%. For males, the incidence rate was increased from 0.65 per 100 000 in 1999 to 1.51 per 100 000 in 2013, and the APC was 4.27% (P<0.05); For females, the incidence rate was increased from 0.61 per 100 000 in 1999 to 0.91 per 100 000 in 2013, and the APC was 3.38% (P<0.05). In urban area, the incidence rate increased from 1.14 per 100 000 in 2000 to 1.35 per 100 000 in 2013, and the APC was 2.70% (P=0.05); In rural area, the incidence rate increased from 0.57 per 100 000 in 2000 to 0.98 per 100 000 in 2013, and the APC was 4.66% (P=0.04). 85.89%cases were pathologically diagnosed.Among them, undifferentiated pleomorphic sarcoma was the most common subtype, which accounting for 19.22%, followed by liposarcoma (19.04%), malignantnerve sheath tumor (10.18%), fibrosarcoma (10.06%)and sarcoma without definite type(7.22%). Conclusions The incidence rate of STS is still increasing, especially in the rural area of Beijing. The most common subtypes of STS in different age-groups were different. Further study is needed to explore the high risks of STS in the population with specific characteristics.