Background: Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC. Methods: Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method. Results: CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]). Conclusions Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.

Background: Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC. Methods: Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method. Results: CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]). Conclusions Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.

Background: Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC. Methods: Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method. Results: CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]). Conclusions Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective To analyze the clinical characteristics of patients with presbycusis by using disyllabic mandarin speech test materials (MSTMs).Methods A total of 59 subjects (23 men and 36 women) with presbycusis,from 61 to 84 years old with the average as 71.3±6.7.They were divided into three groups:the mild group (10 subjects),the moderate group (35 subjects)and the severe group (14 subjects)according to the pure tone average (PTA) thresholds at 0.5,1,2 and 4 kHz from the better ear.In addition,11 subjects of elderly persons with normal hearing were used as the control group.All the subjects enrolled in this study could speak Mandarin well in their daily lives.Nine lists of disyllabic mandarin speech test materials were utilized to test speech recognition threshold (SRT) and P-I function for these groups respectively.Results The PTA(51.65±11.98)and SRT (50.98±16.05)from presbycusis group were much higher than the control group(PTA 19.55± 4.55,SRT 18.79± 7.45),while the average slope of the P-I function 2.63％/dB from the presbycusis group was lower than the control group 4.65％/dB (P＜0.01).The SRT of male patients (56.54±17.23) was higher than the females(47.99± 15.63) (P＜0.05).The PTA and SRT in these three groups divided by degrees of hearing loss were higher than the control group obviously.The PTA and SRT had significantly increased as the degree of hearing loss increased.The differences among these groups were significant (P＜0.01).The average slope of P-I function of these three groups divided by degrees of hearing loss (mild group:2.47％/dB,moderate group:2.76％/dB,severe group:2.42％/dB) was smaller than the slopes in the control group which was 4.65 ％/dB (P＜0.01).The average slope of P-I function among these groups had no significant difference (P＞0.05).Conclusion The SRT of patients with presbycusis increased and the SRT of male was higher than the females.The average slope of P-I function decreased and the curve moved to right side and became a gradual curve.As hearing loss became more severe,the SRT rose more apparently.

Objective To compare the performance of Mandarin screening version of hearing handicap inven-tory in elderly (HHIE-S)and the single question of hearing loss in the hearing screening in the old adults.Methods A total of 570 participants,aged from 50~85 years,of native Mandarin speakers were tested with standard pure tone audiometry (PTA),HHIE-S and single questionAre you now having difficulty in hearing?.HHIE-S>8 was taken as an indicator of hearing handicap.Sensitivity,specificity,negative predictive values and positive predic-tive values of both HHIE-S and single question inquiry when 0.5~4 kHz PTA average > 25 dB,>40 dB and >60 dB were compared.Results The prevalence was 83.9% (478)measured by PTA.The prevalence was 55.3%and 52.5% for HHIE-S and positive answer for single question,respectively.The sensitivity of HHIE-S when the participants grouped with 0.5~4 kHz PTA average > 25 dB,>40 dB and > 60 dB was 61%,85% and 96%, respectively,whereas the sensitivity of single question of the above 3 conditions was 58%,81% and 100%,respec-tively.The specificity of HHIE-S decreased with greater hearing loss.It was 72%,88% and 47% respectively for HHIE-S and 75%,61% and 50% for the single question.There was no significant difference either for sensitivity and specificity between the HHIE-S and the single question.Conclusion Both the Mandarin version of HHIE-S and single question are effective in the hearing screening of old adults.Depending on the purpose and availability of resources,one or both of them can be adopted.

OBJECTIVE: The purpose of the present study was to investigate the prevalence of hearing loss by studying the current status of hearing loss, risk factors of hearing loss, exposure level of noise, and everyday habit of hearing in a group of university students, so as to provide information for hearing loss prevention in university students. METHOD: According to the purposive sampling method, 642 freshmen students participated in the study. Pure tone audiometry, and exposure level of noise scale were performed in all participants. RESULT: (1) According to the hearing loss criterion of WHO/PDH97.3, high frequency hearing loss, and noise induced threshold shifts, the hearing loss prevalence was 0.36%, 20.91% and 6.73%, respectively. (2) Multivariant Logistic regression analysis of high-frequency hearing loss indicated that traffic noise exposure and ear infection were risk factor of high frequency hearing loss. CONCLUSION There is a high prevalence of high frequency hearing loss in university students (20.91%), which was high related with traffic noise exposure and ear infection.
Audiometry, Pure-Tone ; Cross-Sectional Studies ; Hearing Loss, High-Frequency ; epidemiology ; Humans ; Noise ; adverse effects ; Prevalence ; Risk Factors ; Students ; Universities

To improve the effect of teaching practice of blood cell morphology,typical cases of peripheral blood erythrocyte,granulocyte and platelet were chosen,case show and problem-based teaching way were applied to encourage students to find information of autonomous learning.Then teacher organized the class discussion,and the information was analyzed and summarized.In the implementation of the case teaching,we should pay attention to improving students' learning initiative.At the same time,teachers need to have knowledge,comprehensive ability and ability in organization and leadership,to promote students' active participation in discussion in the teaching,pay attention to the information feedback,and improve the teaching details

OBJECTIVE: To provide a clinical reference by comparing the conventional 226 Hz tympanometry with 1000 Hz tympanometry in two groups of young children with otitis media effusion evidenced by CT scan. METHOD: One hundred and seventy-seven young children (226 ears), from 1 to 60 months, with otitis media effusion were involved in this study. They were divided into six groups by age: 0-6 months group, 6-12 months group, 12-18 months group, 18-24 months group, 24-36 months group, 36-60 months group. They were tested with tympanometry of 2 probe-tones of 226 and 1 000 Hz. Type A tympanogram was defined as a normal middle ear function in 226 Hz and single-or double-peak in 1 000 Hz tympanometry. One hundred and fifty-eight normal young children (266 ears) were selected as control group. The results were analysed with Chi square test. Receiver operator characteristic (ROC) analysis was performed to evaluate the two methods. RESULT: In the young children with otitis media effusion, the detection rate of 226 Hz tympanogram in six groups was 21.1%, 35.2%, 46.9%, 42%, 62.5% and 68% respectively, while 94.7%, 98.1%, 96.9%, 91.2%, 95.8% and 88% respectively in 1 000 Hz tympanogram. In the young children with normal middle ear function, the detection rate of 226 Hz tympanogram in six groups was 95.1%, 88.6%, 85.1%, 93.3%, 88.5% and 93.5%, while 87.8%, 94.3%, 89.4%, 95.6%, 94.2% and 97.8% respectively in 1 000 Hz tympanogram. The detection rate was significantly different between 226 and 1 000 Hz tympanogram in the young children under 36-month old. CONCLUSION A single-or double-peak 1000 Hz tympanometric patterns as normal criteria was a simple way to evaluate young children s' middle ear function. 1 000 Hz tympanometry should be given priority to the children within 36-month old in detection middle ear function,the 226 and 1 000 Hz tympanometry should be done at the same time within 36-60 months old.
Acoustic Impedance Tests ; methods ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Otitis Media with Effusion ; diagnosis ; Sensitivity and Specificity

Objective To explore the law of wide band typanometry energy reflectance (WBTER) in Chinese infants of Han nationality with normal outer and middle ears,and to provide the normal values for the clinical application of WBTER.Methods Ninety four infants (170 ears) of Han nationality with normal outer and middle ears evidenced by temporal bone CT,and 226 Hz and 1 000 Hz tympanometry at the ages between three and 48 months (median age:14 months) were selected and divided into four groups:3-6 months(32 ears),7-12 months(53 ears),13-24 months(46 ears) and 25-48 months(39 ears).WBTER was conducted on these infants,and the basic law of energy reflectance under different frequencies,as well as the influence of age on energy reflectance were analyzed using SPSS 15.0.Results The normal value of energy reflectance was higher at low frequency,gradually decreased with the increase of frequency,reached the minimum near 4 000Hz,followed by constantly increased till 8 000Hz.In the scope of frequency below 1 000Hz and above 6 350 Hz,the energy reflectance values of infants in the group of 3-6 months were significantly lower than those of infants in other age groups (P ＜ 0.05).In comparison to the group below six months,the groups over six months generally had higher energy reflectance and lower fluctuation.Conclusions The pattern of energy reflectance across frequency range for Chinese infants and children was consistent with that of other races reported in foreign countries.The WBTER changes with the growing of age,which tends to be stable after the first six months of birth.