Objective To evaluate the Chinese version of Benefit Finding Scale (BFS) for breast cancer patients.Methods After consent of the author,according to the flow path of scales,we established the psychometric properties of the Chinese version of BUS,a convenience sample of 293 patients were recruited for evaluation.Results The Chinese version of BFS was comprised of 19 items,Cronbach's α coefficient was 0.911,test-retest reliability was 0.812,I-CVI was 0.833～1.000,S-CVI was 0.955.Meanwhile,exploratory analysis showed that the most interpretable solution consisted of 3 factors,the accumulative variance contribution which explained 55.101％ of variance of the total scale.The related validity showed that the correlative coefficient of Chinese version of BUS and Posttraumatic Growth Inventory (PTGI) was 0.745.Conclusions It suggests that the 19-item Chinese version of the BFS has good reliability and validity,which could be used as a research tool for measuring breast cancer patients' benefit finding.

Objective To compare efficacy of small incision cataract surgery whether combined with nucleus chopping or not in the treatment of cataract. Methods From March 2014 to September 2015,125 cases of age-related cataract(146 eyes) in the the First People′s Hospital of Xiantao were divided into 60 cases(75 eyes) of observation group and 65 cases(71 eyes) of control group by method of random sampling. The observation group accepted small incision cataract surgery combined with chopping nucleus. The control group only underwent small incision cataract surgery. The postoperative visual acuity,corneal astigmatism and operation time,and complications and so on in the two groups were compared. Results There was statistically significant difference in postoperative visual acuity after 1 week between the two groups(Z = -2. 078,P <0. 05),but there was no statistically significant difference in postoperative visual acuity after 1 month or 3 months between the two groups(Z= -0. 960,-0. 743,all P>0. 05). The postoperative corneal astigmatism after 1 week or 1 month between the observation group and the control group had statistically significant differences[(1. 33 ± 0. 45) D vs. (1. 52 ± 0. 49) D,(1. 03 ± 0. 42) D vs. (1. 18 ± 0. 44)D,t=2. 442,2. 108,all P<0. 05)],but there was no statistically significant difference in postoperative corneal astigmatism after 3 months between the two groups(t =0. 432,P >0. 05). There was no statistically significant difference in the operation time between the observation group and the control group[(11. 28 ± 2. 32) min vs. (11. 87 ± 2. 52)min,t=1. 473,P>0. 05]. One case of posterior capsular rupture occurred in the two groups,respec-tively. But serious complications such as lens nucleus escaped into vitreous cavity, explosive haemorrhage from the choroid or corneal endothelial decompensated had not been found. Conclusion The small incision cataract surgery combined with nucleus chopping has advantages in acquiring fast visual rehabilitation acuity in the early stage after operation,lower corneal astigmatism compared to that without nucleus chopping. Therefore,the small incision cataract surgery combined with nucleus chopping is worthy of clinical popularization and application.

Objective To investigate the changes and the clinical significance of serum concentration of soluble Fas (sFas) and Fas ligand (FasL) in the elderly. Methods Fifty elderly subjects and forty-seven adults were recruited. Serum concentration of sFas and EasL were detected by enzyme-linked immunosorbent assay (ELISA) . Psychosocial stress and coping styles were also evaluated. Results The sFas level of the elderly was significantly higher than that in control group,whereas the EasL level was decreased with ageing (P<0.01). A positive correlation between sFas level and psychosocial stress, and a negative correlation between sFas level and positive coping were also found (all P<0. 05). Conclusions Age-related changes occur in serum sEas and EasL levels.The interaction of sFas/FasL system with psychosocial stress and coping styles seems to play important roles in immunosenescence. Our results also suggest that during aging a subtle balance between sFas and FasL could exist.

Objective To analyze clinical features and prognosis of primary intestinal T cell lymphoma (ITCL)which was misdiagnosed as Crohn′s disease (CD),and summarized the key points of differentiation between ITCL and CD.Methods From January 2003 to January 2014,clinical data of patients with ITCL once misdiagnosed as CD were retrospectively analyzed,which included demographic,clinical,pathological and prognostic data.The data of 177 patients diagnosed as CD from January 2012 to January 2014 were collected. The demographic,clinical,pathological and prognostic data of these two groups were analyzed and compared. The continuous variables were compared with t test or Mann-WhitneyU test,and the differences of classification variables between two groups were analyzed by Chi-square test or Fisher exact probability method.Results A
total of 18 patients (17 males and one female)with ITCL misdiagnosed as CD were enrolled in the study,and the median age at diagnosis was 38.5 (28.8 to 42.5)years and the median duration of diagnosis was 6.00 (3.75 to 13.25)months.The common primary symptoms were abdominal pain (12/18),diarrhea (13/18)and anemia (13/18).Intestinal perforation was primary symptom in two cases (2/18).However,B symptoms of lymphoma was observed in 16 patients,which included fever in 13 patients,weight loss in 16 patients and night sweat in one patient.One or more serious complications appeared in 12 patients,which included intestinal perforation in nine patients,severe gastrointestinal bleeding in seven patients and intestinal obstruction in two patients.In 177 patients with CD,104 patients were male (58.8%),and the median age at diagnosis was 22.0 (18.0 to 29.0) years.The primary symptoms were abdominal pain (88.7%,157/177),diarrhea (55.9%,99/177),anemia (63.8%,113/177),fever (33.3%,59/177)and weight loss (59.9%,106/177).During the disease course,30 patients (16.9%)had intestinal perforation (mainly chronic),12 patients (6.8%)had intestinal obstruction and seven patients (4.0%)had severe gastrointestinal bleeding.Compared to CD patients,male patients were more common in ITCL (χ2 =8.837,P <0.01),age at diagnosis was older (χ2 =314.5,P <0.01),the disease course was shorter (U=385.0,P <0.01),weight loss (χ2 =5.867,P <0.05)and fever (χ2 =10.609,P <0.01)were more common in clinical symptoms and intestinal perforation and severe gastrointestinal bleeding were more common in complications (χ2 =9.185,24.908,both P <0.01).The lesions of ITCL were multiple lesions, small bowel involved in eight cases,colon involved in 14 cases and one case with esophagus involved.Under endoscopy examination,most lesions appeared as ulcerations and were segmentally distributed.Compared to CD, lymphocyte proliferation was more common in the intestinal histopathological findings of ITCL (17/18 vs 19.7%(35/177);χ2 =42.844,P <0.01)and granuloma was rare (0 vs 42.8%(76/177),χ2 =12.665,P <0.01). Among 18 patients with ITCL,nine received chemotherapy and the median survival time was two months. Conclusions Primary ITCL had non-specific symptoms and was easily misdiagnosed as CD.More attention should be paid to the differential diagnosis of the two disease.

OBJECTIVETo estimate the biological exposure limit (BEL) using benchmark dose (BMD) based on two sets of data from occupational epidemiology.

METHODSCadmium-exposed workers were selected from a cadmium smelting factory and a zinc product factory. Doctors, nurses or shop assistants living in the same area served as a control group. Urinary cadmium (UCd) was used as an exposure biomarker and urinary beta2-microgloburin (B2M), N-acetyl-13-D-glucosaminidase (NAG) and albumin (ALB) as effect biomarkers. All urine parameters were adjusted by urinary creatinine. Software of BMDS (Version 1.3.2, EPA.U.S.A) was used to calculate BMD.

RESULTSThe cut-off point (abnormal values) was determined based on the upper limit of 95% of effect biomarkers in control group. There was a significant dose response relationship between the effect biomarkers (urinary B2M, NAG; and ALB) and exposure biomarker (UCd). BEL value was 5 microg/g creatinine for UB2M as an effect biomarker, consistent with the recommendation of WHO. BEL could be estimated by using the method of BMD. BEL value was 3 microg/g creatinine for UNAG as an effect biomarker. The more sensitive the used biomarker is, the more occupational population will be protected.

CONCLUSIONBMD can be used in estimating the biological exposure limit (BEL). UNAG is a sensitive biomarker for estimating BEL after cadmium exposure.

Acetylglucosaminidase ; urine ; Albuminuria ; urine ; Biomarkers ; urine ; Cadmium ; toxicity ; urine ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Occupational Exposure ; Spectrophotometry, Atomic ; beta 2-Microglobulin ; urine

OBJECTIVEBased on two sets of data from occupational epidemiology, Benchmark dose (BMD) was applied to estimate biological exposure limit (BEL).

METHODSCadmium exposed workers were selected from a cadmium smelting and a zinc products factory and control group was selected from doctors or nurses and staff from shops living in the same area; Urinary cadmium (UCd) was used as exposure biomarker and urinary beta(2) microglobulin (UBM), NAG (UNAG) and albumin (UALB) were as effect biomarkers. All urine parameters were adjusted by urinary creatinine. Software of BMDS (Version 1.3.2, EPA.U.S) was used to calculate BMD.

RESULTSCalculated abnormal prevalence was based on the upper limit of 95% of effect biomarkers in control group; There are significant dose response relationship between the prevalence of effect biomarkers (UBM, UNAG and UALB) and exposure biomarker (UCd); BEL was 5 microg/g creatinine for UBM as effect biomarker, It consists with the recommendation of WHO; BEL was 3 microg/g creatinine for UNAG as effect biomarker; BEL can be estimated by using the method of BMD; the more sensitive biomarker would used, the more occupational people would protected.

CONCLUSIONThe application of BMD in estimating biological exposure limit (BEL) is proper. UNAG is suggested as most sensitive biomarker to be used to estimate BEL for cadmium exposure.

Acetylglucosaminidase ; urine ; Albuminuria ; urine ; Biomarkers ; urine ; Cadmium ; adverse effects ; urine ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Occupational Exposure ; Reference Values ; beta 2-Microglobulin ; urine

OBJECTIVESTo evaluate the efficacy of integration of metabolism images into multimodal neuronavigation for frameless stereotactic biopsy.

METHODSFrom January to December 2012, 32 patients with brain lesions underwent frameless stereotactic biopsy guided by positron emission tomograph (PET) and proton magnetic resonance spectroscopy ((1)H-MRS)-based multimodal neuronavigation and intraoperative magnetic resonance imaging (iMRI). The cohort consisted of 16 male and 16 female patients, with a mean age of 45 years (range: 7 - 62 years). Biopsy targets were identified according to PET and (1)H-MRS. Biopsy was performed with Varioguide frameless biopsy system. Diagnostic yield and complications were assessed.

RESULTSMetabolism images-based multimodal neuronavigation and iMRI were successfully implemented in all cases. iMRI confirmed accuracy of biopsy targets. All the specimens obtained pathological diagnosis, the diagnostic yield was 100%. In 1 patient, iMRI found small hematoma (< 5 ml), surgical evacuation wasn't needed with intraoperative complication rate 3.1%. With the help of multimodal neuronavigation, no patients had new or worsened neurologic deficits.

CONCLUSIONSIntegration of metabolism images into multimodal neuronavigation provide not only anatomical, but also metabolic and functional information for frameless stereotaxy, increasing diagnostic yield and avoiding postoperative neurologic deficits.

Adolescent ; Adult ; Biopsy ; methods ; Brain ; pathology ; Brain Neoplasms ; pathology ; Child ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neuronavigation ; Positron-Emission Tomography ; Stereotaxic Techniques ; Young Adult

Objective:To investigate the treatment and prognosis of children with propionic acidemia (PA).Methods:This study involved 82 children with PA treated in the Department of Pediatric Endocrinol-ogy and Genetic Metabolism, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from December 2002 to June 2020. Clinical data, including manifestations, laboratory test results, treatment strategy, and follow-up data, were summarized and analyzed using t-test or Mann-Whitney U test. Results:(1) Among the 82 cases consisting of 50 (61.0%) boys and 32 (39.0%) girls, 59 (72.0%) were diagnosed after clinical onset; 22 (26.8%) were diagnosed by newborn screening, including eight asymptomatic ones; the other one (1.2%) was asymptomatic but confirmed after the diagnosis of PA in the patient's sibling. The average age at first onset was 4.5 months (2 d-5 years) in 73 subjects, of which 28 (38.4%) were early-onset PA (within three months after birth). (2) Cranial MRI was performed on 26 cases, and abnormality was identified in 19 (73.1%) cases. (3) Hyperlactatemia was found in 16 cases among 30(53.3%) who underwent relevant examination with the average lactic acid level of 3.5 (2.1-4.3) μmol/L, while 35 out of 40 patients (87.5%) had hyperammonemia with an average blood ammonia level of 105.4 (34-907) μmol/L. (4) Among the 28 early-onset PA cases, 16 (57.1%) died, and 12 (42.9%) survived. There was no significant difference in the serum propionylcarnitine level, propionylcarnitine to acetylcarnitine ratio, urine 3-hydroxypropionic acid, or methylcitrate level between the survival and death cases. (5) Genetic mutations were detected in 75 patients (91.5%), among which 26 (34.7%) carried PCCA gene mutations and 48 (64%) with PCCB gene mutations. One patient (1.3%) harbored one known pathogenic mutation in each of the PCCA and PCCB genes. All mutations were inherited from the parents. (6) Followed up to June 2020, 57 (69.5%) patients survived, and 25 (30.5%) died from multiple organ failure secondary to severe acidosis, including 16 early-onset and nine late-onset cases. Conclusions:The primary treatment of PA is dietary control. Most PA patients are diagnosed after clinical onset, but symptoms may recur and even have developmental retardation despite treatment. Some of those diagnosed through newborn screening are asymptomatic after treatment. Newborn screening using tandem mass spectrometry is recommended for early diagnosis and treatment of PA.

Objective To investigate the application value of deep learning optical coherence tomography ( OCT) on wet age-related macular degeneration ( wAMD) assisted diagnosis. Methods Weakly supervised deep learning algorithms was applied on the premise that only disease or not can be provided as a marker. The OCT image automatically assisted in the diagnosis of diseased areas of wAMD,and thermograms were applied to provide a basis for doctors to detect disease areas. Based on the deep learning of weak supervision,a new network algorithm structure was proposed for detecting disease area in ophthalmic OCT images. At the same time, thermograms were adopted to improve the accuracy of the lesion map,which is the location of the lesion area. This study followed the Declaration of Helsinki. This study protocol was approved by Ethic Committee of Ningbo Eye Hospital ( No. 2018-YJ05 ) . Written informed consent was obtained from each subject before entering study cohort. Results Resnet-based deep learning algorithm gave a diagnostic accuracy rate of 94. 9％ for the disease, which was much higher than that of AlexNet 85. 3％,VGG 88. 7％, and Google-Net 89. 2％. The thermograms with different colors provided a more convenient auxiliary diagnosis basis for doctors. Conclusions Compared with the original classification network,which needs disease area markers as empirical knowledge, deep learning algorithm model not only provides better results in the classification of retinal diseases,but also marks potential disease areas. The lesion area provides a basis for judging the area of the lesion for the diagnosis of wAMD.

AIM: To investigate the protective effect of huoxuehuayu decoction on macula after phacoemulsification. Into A, B groups. The 80 eyes of A group were treated by conventional phacoemulsification; the patients (60 eyes) of B group were given huoxuehuayu decoction orally for two courses after phacoemulsification. Best-corrected visual acuity(BCVA), corneal and aqueous conditions ,thickness of macular central fovea and changes of macular retinal tissue in A, B groups were observed before surgery, 1 day; 1 week,2,4,6,8 weeks and 3 months after surgery. Was significantly higher than that of group A. One week after surgery the ratio of mild aqueous flare in group B was significantly lower than that of group A. The thickness of central fixation was significantly increased in both groups 1 week, 2, 4, 6, 8 weeks and 3 months after phacoemulsification; the difference between 2 to 8 weeks after surgery and pre-operation showed statistical significance in both groups. 11 eyes in A group had macular edema during 2 to 6 weeks after surgery, including 9 eyes with fovea thickened and 2 eyes with cystoid macular edema, and seven eyes' edema disappeared in 3 months. 2 eyes in B group had macular edema, including 1 eye fovea thickened and 1 eye cystoid macular edema, during 4 to 6 weeks after surgery, and the two eyes' edema disappeared 3 months after surgery. The fovea thickness in group B during 2 to 8 weeks after surgery was statistically lower than group A. Phacoemulsification.