OBJECTIVE: This study aimd to evaluate the application and clinical effect of improved submental island flap in hypopharyngeal cancer reserved laryngeal function surgery. METHOD: A retrospective review of clinical data was performed on 38 patients of hypopharyngeal cancer reserved laryngeal function using sumental island flaps, by the way of improving in design of vascular pedicle, reconstructive mode of laryngeal and hypopharyngeal function and closing of wound of neck following hypopharyngeal cancer resection. Meanwhile, the effect and prognosis was comprehensively assessed on patients with hypopharyngeal cancer reserved laryngeal function using improved submental island flaps. RESULT: The submental flaps kept alive in all 38 cases. During the follow-up period, 18 cases were dead, and of them, 7 cases died of the second primary carcinoma, included 4 cases of esophagus cancer, 1 case of cancer of soft palate, 2 cases of nasopharyngeal carcinoma; and 5 cases died of cervical or parapharyngeal lymph nodes recurrence; 2 cases died of hepatic metastasis; and 4 cases died of pulmonary metastasis. The overall 5-years survival rate was 52.6%. CONCLUSION Improved submental island flap repairing postoperative defect of hypopharyngeal cancer reserved laryngeal function has many advantages including higher success rate, more security, easy and simple to operate as well as good clinical effects, and is worth to widespread using.
Humans ; Hypopharyngeal Neoplasms ; surgery ; Hypopharynx ; surgery ; Larynx ; Neck ; surgery ; Neoplasm Recurrence, Local ; Prognosis ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surgical Flaps ; Survival Rate

Objective To investigate the incidence rate and assess the disease burden of respiratory illness associated with influenza among pregnant women in Suzhou , China. Methods As a subproject of“The Sino-US Emerging and Re-emerging Infectious Diseases Program”,pregnant women were recruited in-to the cohort since October , 2015 and follow-ups were carried out .Throat swab for influenza was taken for laboratory test when the pregnant women got influenza-like symptoms . Results In total 4438 pregnant women recruit up to 24th July 2016, among which1 539 are early-pregnancy, middle-pregnancy accounted 2 174 and late-pregnancy took 726.Lost to follow-up rate was 5.5%.And 995 cases of throat swabs was taken and tested (80.83%), of which 68 cases were positive (6.8%).The incidence density was 0.08 per hundred person-weeks . Conclusion This prospective cohort study took laboratory test of influenza virus to investigate the incidence rate of respiratory illness associated with influenza among pregnant women can provide credible data about the incidence of influenza .To a certain extent , this study makes up the blank of such research .

Objective To investigate the basic distribution of endemic areas in the type of drinking water arsenism and in Xiantao City,Hubei Province,and to offer a scientific basis for control and prevention.Methods According to"the Chinese Scheme of Implementing Surveillance of Distribution of Endemic Arsenism",considering with the special geography feature of Xiantao,both sampling and overall survey were used in 7 towns chosen.The water arsenic content was determined by half quantitative fast reagent-box method.We began to search for clues and patients according to the endemic areas and the families with high arsenic wells.Results High endemic arsenic water sources were distributed in 7 the towns(districts or farms).In 81 villages of Xiantao City,35 villages had drinking water arsenic content exceeding 0.05 mg/L,accounting for 43.21%(35/81).In 4020 screened wells,269 had arsenic content higher than the national standard,the detective rate of high arsenic wells(more than 0.05 mg/L)was 6.69%(269/4020),with the highest rate in Shahu Seed Plant being 13.56%(115/848).The population exposed to high arsenic was 1091,in a rate of 5.75%(1091/18 975),in which 281 children were exposed in a rate of 5.82%(281/4826).In Shahu Seed Plant,467 people including 129 children were exposed to high arsenic, accounting for 13.26%(467/3522)and 12.91%(129/999),respectively.Conclusions High arsenic sources widely exist in Xiantao City,especially in Shahu Seed Plant,where arsenic content,the exposed rate of population and children are high.Therefore,prevention and control should be carried out in the southeast as soon as possible,as well as in other places where situation is less serious.

OBJECTIVETo compare the serological characters of an outbreak of hepatitis E and evaluate sensitivity and specificity of anti-HEV E2-IgM.

METHODSThe sera collected from the employees of an outbreak unit were detected for anti-HEV E2-IgM and IgG, and the serum samples from a neighboring department were used as control. The results detected with anti-HEV E2-IgM, IgG and Genelab anti-HEV IgM, IgG in some samples were compared.

RESULTSThe positive rate of anti-HEV E2-IgM in the control group was 0.11%. The results between the positive and the negative samples can be distinguished easily. The specificity of anti-HEV E2-IgM is about 99.89%. The positive rate of anti-HEV E2-IgM in outbreak stricken population was 8.66%, significantly higher than that in the control group (P < 0.001). The results from HEV patients' serial samples in the outbreak unit showed that the anti-HEV E2-IgM titer was high 30-60 days after the infected and then declined clearly. The positivity seemed unrelated to neither sex nor age. Among the 115 positive to anti-HEV E2-IgM, 27 were negative to Genelab anti-HEV IgG, the fact indicated a rather high risk of misdiagnosis of about 23.48%. In the 179 randomized samples of the control group, the positive rate of Genelabs anti-HEV IgG was about 11.17%. In 110 samples for the positive anti-HEV E2-IgM, the positive ratio of Genelabs anti-HEV IgG was about 76.36%, and that of Genelabs anti-HEV IgM only 69.09%. There were 16 samples negative for both Genelabs anti-HEV IgG and IgM. The ratio of the difference between the Genelabs anti-HEV IgG and IgM was about 25.45%.

CONCLUSIONThe specificity of anti-HEV E2-IgM was about 99%, and false positive rate was low. The sensitivity of anti-HEV E2-IgM in acute hepatitis E infection was 25%-30% higher than that of Genelabs anti-HEV IgM,IgG. The infected persons in the outbreak unit can be preferably distinguished from the non-infected persons by anti-HEV E2-IgM. Anti-HEV E2-IgM can image the characters of the outbreak of HEV and played a great role in the control of outbreak and in the early diagnosis for hepatitis E.

Antibodies, Viral ; blood ; China ; epidemiology ; Disease Outbreaks ; Enzyme-Linked Immunosorbent Assay ; Hepatitis E ; blood ; epidemiology ; virology ; Hepatitis E virus ; immunology ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood

BACKGROUNDEndovascular therapy is a treatment option for localized occlusion of the subclavian artery. In this report the long-term experience with 59 patients is presented.

METHODSBetween June 1998 and September 2008, we used endovascular therapy to treat 61 subclavian arterial obstructive lesions in 59 patients (46 males and 13 females, 34 - 82 years of age with a mean age (61.9 + or - 11.0) years). Twenty patients (34%) had clinical symptoms due to vertebrobasilar insufficiency, 26 (44%) had disabling arm ischemia, and 13 (22%) had both symptoms. We performed all procedures under local anesthesia. The approaches were from the femoral artery (n = 47), brachial artery (n = 1, involving bilateral subclavian disease) or both (n = 11). Sixty stents were implanted. All patients were followed-up at 1, 3, 6, and 12 months post-procedure, and annually thereafter.

RESULTSWe achieved technical success in 58 (95.1%) arteries, all of which were stented. There were three technical failures; two were due to the inability to cross over an occlusion, necessitating the switch to an axillo-axillary bypass, and the third was due to shock after digital subtraction angiography and prior to stenting. Arterial stenosis pre- and post-stenting was (83.6 + or - 10.8)% and (2.5 + or - 12.5)% (P < 0.01). Clinical success was achieved in 55 of the 59 patients (93.4%). Of the four clinical failures, three were technical and the remaining patient had a stent thrombosis. Systolic blood pressure difference between the two brachial arteries was (44.7 + or - 18.5) vs. (2.2 + or - 3.9) mmHg (P < 0.01). Primary patency was 98% at 12 months, 93% at 24 months, and 82% at 5 years. Five patients were lost to follow-up by 12 months post-stenting. Significant recurrent obstruction developed in five patients with resumption of clinical symptoms. The overall survival rate was 98.2% at 12 months, 89.5% at 24 months, and 84.5% at 5 years.

CONCLUSIONSEndovascular therapy for proximal subclavian arterial obstructive lesions is effective and successful. This minimally invasive treatment may be the first choice of treatment for proximal subclavical arterial obstructive lesions.

Adult ; Aged ; Aged, 80 and over ; Arterial Occlusive Diseases ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stents ; Subclavian Artery ; pathology ; Subclavian Steal Syndrome ; pathology ; therapy ; Vertebrobasilar Insufficiency ; pathology ; therapy

OBJECTIVETo study the status of infection and risk factors on Brucellosis among workers in Jiangsu province so as to provide related preventive and control measures.

METHODSA cross-sectional survey was conducted on 238 workers at three butcheries, one trading market and one stockyard. Related risk factors on the different exposures to the disease were also analyzed.

RESULTS50 workers were identified to have had the infection, with a infection rate as 21% (50/238). No significant differences in gender, age, working length and occupations were found. Jobs as slaughtering (RR = 1.80, 95%CI:1.1-3.1), particular on bleeding (RR = 1.90, 95%CI:1.1-3.3) were risk factors. Habit as hand-washing before eating was a protective factor (RR = 0.25, 95% CI: 0.14-0.44).

CONCLUSIONWorkers from butcheries, trading markets and stockyards were seriously infected with Brucellosis in Jiangsu province and related. Control measures and education should be implemented to the workers in that trade.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brucellosis ; epidemiology ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Occupational Exposure ; Prevalence ; Risk Factors

OBJECTIVETo develop a public health index related to the comprehensive assessment on the impact caused by floods.

METHODSA Analytic hierarchy process (AHP) theory was used to establish the initial evaluation system on the impact of floods. Modified-Delphi process was used to screen and determine the indicators and their weights while synthetical scored method was used to establish the comprehensive assessment model. Percentile was used to differentiate the degree of floods. Finally, analysis of variance (ANOVA) and correlation analysis were used to test the differentiability of the model for different degree of floods and the independence of these indicators.

RESULTSThe model of comprehensive assessment on the impact of floods was set up, including six first-ranking indicators and twenty-four sub-indicators. The values of comprehensive assessment were divided into five grades by the percentiles. Verified results indicated that there were significant difference among the five grades (F = 76.11, P < 0.01) and all indicators were independent.

CONCLUSIONAn index of comprehensive assessment on the impact of floods was established, which could be used to evaluate the impact of floods and to differentiate the degree of flood, which seemed to have the characteristic of reliability, comprehensiveness and practicability.

Analysis of Variance ; China ; Delphi Technique ; Disasters ; Health Status Indicators ; Humans ; Models, Theoretical ; Public Health ; standards ; statistics & numerical data ; Research ; statistics & numerical data ; Research Design

OBJECTIVETo investigate the diagnostic value of computerized tomographic angiography (CTA) and magnetic resonance angiography (MRA) for intracranial traumatic aneurysms (TAs).

METHODSCTA and MRA of six patients with intracranial TAs verified by digital subtraction angiography (DSA) and surgery were retrospectively analysed. All patients were examined by nonenhanced computerized tomography (CT) and two by CTA. The source data were reconstructed by volume rendering (VR) and multi-planar reconstruction (MPR) from CTA. Four of them had maximum intensity project (MIP) from MRA.

RESULTSOf the six patients, a total of seven TAs were detected by CTA and MRA examinations. Five cases had only one TA and one case had two TAs. The average diameter was 2.3 cm (1.1-3.3 cm). CTA demonstrated two TAs appeared at the cavernous segment of the internal carotid artery (ICA) and the middle cerebral artery (MCA) respectively. MCA TA was definitely and clearly demonstrated on VR images, whereas VR images failed to depict the cavernous ICA TA, which was detected on MPR images. Two TAs were found irregular saccular shape, irregular margin of parent artery and wide neck on CTA. Four MRA examinations demonstrated five TAs, including the cavernous segment ICA TAs (2 cases), the supraclinoid segment ICA TA (1 case), and the cavernous segment associated with opposite side of the petrosal segment ICA TA (1 case). In a cavernous ICA TA, MRA only revealed aneurysm body, whereas aneurysm neck and distal segment of the parent artery were not revealed. In the remaining cases, MRA clearly depicted aneurysm body and parent artery, whereas the neck was not displayed. ICA TAs showed irregular capsule-like high signal intensity on MRA images. Four TAs exhibited irregular distal segment of the parent artery. TAs at the supraclinoid segment or MCA failed to find fracture signs on nonenhanced CT.

CONCLUSIONSBoth CTA and MRA examinations are the effective non-invasive method of imageology for diagnosing intracranial TAs, while CTA is more eligible for diagnosing TAs after nonenhanced CT has demonstrated skull base fractures.

Adult ; Aged ; Brain Injuries ; diagnosis ; Cerebral Angiography ; Female ; Humans ; Intracranial Aneurysm ; diagnosis ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed

Biomarker identification is crucial for the selection of patients who might benefit from radiotherapy. To explore potential markers for response and prognosis in patients with locally advanced esophageal carcinoma treated with radiotherapy followed by surgery, we evaluated the expression of cell cycle checkpoint-related proteins Chk2, Cdc25C, and Cyclin D1. A total of 56 patients with locally advanced esophageal squamous cell carcinoma were treated with radiotherapy followed by surgery. Pretreatment tumor biopsy specimens were analyzed for Chk2, Cdc25C, and Cyclin D1 expression by immunohistochemistry. High expression of Chk2, Cyclin D1, and Cdc25C was observed in 44 (78.6%), 15 (26.8%), and 27 (48.2%) patients, respectively. The median survival was 16 months (range, 3-154 months), with a 5-year overall survival rate of 19.6%. Overexpression of Chk2 was associated with smoking (P = 0.021), overexpression of Cdc25C was associated with patient age (P = 0.033) and tumor length (P = 0.001), and overexpression of Cdc25C was associated with pathologic complete response (P = 0.038). Univariate analysis demonstrated that overexpression of Cdc25C and pathologic complete response was associated with better survival. In multivariate analysis, Cdc25C was the most significant independent predictor of better survival (P = 0.014) for patients treated with radiotherapy followed by surgery. Overexpression of Cdc25C was significantly associated with pathologic complete response and better survival of patients with locally advanced esophageal cancer treated with radiotherapy followed by surgery. These results suggest that Cdc25C may be a biomarker of treatment response and good prognosis for esophageal carcinoma patients. Thus, immunohistochemical staining of Cdc25C in a pretreatment specimen may be a useful method of identifying optimal treatment for patients with esophageal carcinoma.
Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; radiotherapy ; surgery ; Checkpoint Kinase 2 ; metabolism ; Combined Modality Therapy ; Cyclin D1 ; metabolism ; Esophageal Neoplasms ; metabolism ; pathology ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Particle Accelerators ; Proportional Hazards Models ; Smoking ; Survival Rate ; cdc25 Phosphatases ; metabolism

Nuclear factor of activated T cells (NFAT) is an important family of transcription factors that can be activated by calmodulin and calcineurin in human cells. To investigate the expression and clinical significance of NFAT isoforms and calcineurin in non-small cell lung cancer (NSCLC), we collected tumor and adjacent normal tissues from 159 NSCLC patients and assembled them in a tissue microarray. Protein levels of NFAT1, NFAT2, NFAT3, NFAT4, and calcineurin were determined using immunohistochemistry. Correlations between NFAT and calcineurin expression and clinicopathologic characteristics were analyzed. We found that the positive rates of NFAT1 (52.8%, 84/159), NFAT2 (11.3%, 18/159), NFAT3 (28.3%, 45/159), NFAT4 (47.2%, 75/159), and calcineurin (47.8%, 76/159) expression were significantly higher in tumor tissues than in adjacent normal lung tissues (P<0.001), respectively. The positive rate of NFAT1 expression was significantly higher in patients with adenocarcinoma (63.5%, 47/74) than in those with squamous cell carcinoma (43.5%, 37/85) (χ2=6.340, P=0.012); with lymph node metastasis (61.6%, 53/86) than without lymph node metastasis (42.5%, 31/73) (χ2=5.818, P=0.016); and with stage-II and -III diseases (61.8%, 55/89) than with stage-I disease (41.4%, 29/70) (χ2=6.524, P=0.011). Moreover, the overexpression of NFAT1 was associated with poor survival of NSCLC patients (χ2=5.006, P=0.025). The positive rate of NFAT4 was significantly higher in patients with squamous carcinoma (57.6%, 49/85) than in those with adenocarcinoma (35.1%, 26/74) (χ2=8.045, P=0.005) and with high and moderate differentiation (54.9%, 61/111) than with low differentiation (29.2%, 14/48) (χ2=8.943, P=0.003). Calcineurin overexpression was significantly associated with histologic type (higher in squamous carcinoma than in adenocarcinoma, χ2=8.897, P=0.003), differentiation grade (higher in high-moderation grade than in low grade, χ2=9.566, P=0.002) and gender (higher in male than in female, χ2=5.766, P=0.016). Furthermore, calcineurin expression was significantly correlated with NFAT4 level (r=0.429, P<0.001). These results suggest that NFAT1 expression is associated with lung adenocarcinoma progression, and NFAT4 expression, which was higher in squamous lung cancer, is associated with calcineurin expression and differentiation grade.
Adenocarcinoma ; metabolism ; pathology ; Adult ; Aged ; Aged, 80 and over ; Calcineurin ; metabolism ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Lung ; metabolism ; Lung Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; NFATC Transcription Factors ; metabolism ; Neoplasm Grading ; Neoplasm Staging ; Protein Isoforms ; metabolism ; Sex Factors ; Survival Rate ; Tissue Array Analysis