1.A cross-sectional survey of delivery room transitional care management for very/extremely preterm infants in 24 hospitals in Shenzhen City
Shenzhen Neonatal Data Network ; B-Q WU ; C-Z YANG
Chinese Journal of Contemporary Pediatrics 2024;26(3):250-257
Objective To investigate the current status of delivery room transitional care management for very/extremely preterm infants in Shenzhen City.Methods A cross-sectional survey was conducted in November 2022,involving 24 tertiary hospitals participating in the Shcnzhen Neonatal Data Network.The survey assessed the implementation of transitional care management in the delivery room,including prenatal preparation,delivery room resuscitation,and post-resuscitation management in the neonatal intensive care unit.Very/extremely preterm infants were divided into four groups based on gestational age:<26 weeks,26-28+6 weeks,29-30+6 weeks,and 31-31+6 weeks.Descriptive analysis was performed on the results.Results A total of 140 very/extremely preterm infants were included,with 10 cases in the<26 weeks group,45 cases in the 26-28+6 weeks group,49 cases in the 29-30+6 weeks group,and 36 cases in the 31-31+6 weeks group.Among these infants,99(70.7%)received prenatal counseling,predominantly provided by obstetricians(79.8%).The main personnel involved in resuscitation during delivery were midwives(96.4%)and neonatal resident physicians(62.1%).Delayed cord clamping was performed in 52 cases(37.1%),with an average delay time of(45±17)seconds.Postnatal radiant warmer was used in 137 cases(97.9%)for thermoregulation.Positive pressure ventilation was required in 110 cases(78.6%),with 67 cases(60.9%)using T-piece resuscitators and 42 cases(38.2%)using a blended oxygen device.Blood oxygen saturation was monitored during resuscitation in 119 cases(85.0%).The median time from initiating transitional care measures to closing the incubator door was 87 minutes.Conclusions The implementation of delivery room transitional care management for very/extremely preterm infants in the hospitals participating in the Shenzhen Neonatal Data Network shows varying degrees of deviation from the corresponding expert consensus in China.It is necessary to bridge the gap.through continuous quality improvement and multicenter collaboration to improve the quality of the transitional care management and outcomes in very/extremely preterm infants.[Chinese Journal of Contemporary Pediatrics,2024,26(3):250-257]
2.Clinicopathological features of olfactory carcinoma.
C C ZHANG ; H LI ; L Q CHENG ; H B WU
Chinese Journal of Pathology 2023;52(11):1138-1143
<b>Objective:b> To investigate the clinicopathological features and differential diagnosis of olfactory carcinoma (OC). <b>Methods:b> Twenty-one cases of sinonasal tumors, including those initially diagnosed as olfactory neuroblastoma (ONB) and those with uncertain diagnosis, were collected from the Department of Pathology, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from January 2016 to August 2022, among which 3 cases were reclassified as OC. The clinicopathological features were investigated, and the remaining 18 cases were used as control. <b>Results:b> Of the three OC patients, 2 were male and 1 was female, with an average age of 57 years ranging from 35 to 74 years. Microscopically, the tumor cells were arranged in solid, nested or lobulated patterns with occasional palisading around the solid nests. The stroma was highly vascular with focal neurofibrillary areas. There were prominent rosettes or pseudorosettes formation. The tumor cells were mainly ovoid to spindly with scant to moderate amount of cytoplasm, one or several small nucleoli, and fine chromatin content. Brisk mitotic figures were seen. In all 3 cases of OC, there were scanty atypical glands and some were ciliated. Immunohistochemically, at least one epithelial marker and neuroendocrine marker were diffusely expressed in the tumor. Some of the tumor cells were positive for p40 and p63, and the sustentacular cells showed the expression of S-100 protein. All cases tested were negative for NUT, CD99 and desmin, with intact expression of SMARCA4 (BRG1) and SMARCB1 (INI-1). Ki-67 proliferation index varied from 20% to 80%. Follow-up after 16-18 months showed no mortality with tumor recurrence from 1 patient after 16 months. <b>Conclusion:b> OC is a rare sinonasal tumor with neuroepithelial differentiation, its histomorphology is diverse, and the combination of immunohistochemical markers is essential for appropriate diagnosis.
Humans
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Male
;
Female
;
Middle Aged
;
Paranasal Sinus Neoplasms/chemistry*
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Biomarkers, Tumor/metabolism*
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Carcinoma/chemistry*
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Diagnosis, Differential
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S100 Proteins
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DNA Helicases/metabolism*
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Nuclear Proteins/metabolism*
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Transcription Factors/metabolism*
3.Clinicopathological and molecular features of metaplastic thymoma.
X WANG ; R S ZHANG ; R LI ; S B YE ; Q LI ; H CHEN ; Q Y XIA ; N WU ; Q RAO
Chinese Journal of Pathology 2023;52(12):1237-1243
<b>Objective:b> To investigate the clinicopathological features, and molecular genetic alterations of metaplastic thymoma (MT). <b>Methods:b> A total of ten MT cases, diagnosed from 2011 to 2021, were selected from the Department of Pathology of Jinling Hospital, Nanjing University Medical School, Nanjing, China for clinicopathological and immunohistochemical (IHC) examination and clinical follow-up. Fluorescence in situ hybridization (FISH), next-generation sequencing (NGS), and YAP1 C-terminus (YAP1-CT) IHC were performed to detect YAP1::MAML2 fusions. <b>Results:b> There were four males and six females, ranging in age from 29 to 60 years (mean 50 years, median 54 years). Microscopically, all tumors showed a typical biphasic morphology consisting of epithelial components and gradually or abruptly transitioning spindle cell components. The two components were present in varying proportions in different cases. Immunophenotypically, the epithelial cells were diffusely positive for CKpan, CK5/6 and p63. The spindle cells were diffusely positive for vimentin and focally positive for EMA. TdT was negative in the background lymphocytes. Ki-67 proliferation index was less than 5%. YAP1 and MAML2 break-apart FISH analyses showed that all ten cases had narrow split signals with a distance of nearly 2 signal diameters and may be considered false-negative. Using YAP1::MAML2 fusion FISH assays, abnormal fusion signals were observed in all the ten cases. NGS demonstrated YAP1::MAML2 fusions in all eight cases with adequate nucleic acids; in two cases the fusions were detected by DNA sequencing and in eight cases by RNA sequencing. All ten cases of MT demonstrated loss of YAP1 C-terminal expression in epithelioid cells. <b>Conclusions:b> MT is a rare and low-grade thymic tumor characterized by a biphasic pattern and YAP1::MAML2 fusions. Break-apart FISH assays may sometimes show false-negative results due to the proximity of YAP1 and MAML2, while YAP1 C-terminal IHC is a highly sensitive and specific marker for MT. Loss of YAP1 C-terminal expression can also be used to screen YAP1::MAML2 fusions for possible MT cases.
Male
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Female
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Humans
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Adult
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Middle Aged
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Thymoma/genetics*
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In Situ Hybridization, Fluorescence
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Transcription Factors/genetics*
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Mutation
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Thymus Neoplasms/genetics*
4.Development and validation of a prognostic prediction model for patients with stage Ⅰ to Ⅲ colon cancer incorporating high-risk pathological features.
K X LI ; Q B WU ; F Q ZHAO ; J L ZHANG ; S L LUO ; S D HU ; B WU ; H L LI ; G L LIN ; H Z QIU ; J Y LU ; L XU ; Z WANG ; X H DU ; L KANG ; X WANG ; Z Q WANG ; Q LIU ; Y XIAO
Chinese Journal of Surgery 2023;61(9):753-759
<b>Objective:b> To examine a predictive model that incorporating high risk pathological factors for the prognosis of stage Ⅰ to Ⅲ colon cancer. <b>Methods:b> This study retrospectively collected clinicopathological information and survival outcomes of stage Ⅰ~Ⅲ colon cancer patients who underwent curative surgery in 7 tertiary hospitals in China from January 1, 2016 to December 31, 2017. A total of 1 650 patients were enrolled, aged (M(IQR)) 62 (18) years (range: 14 to 100). There were 963 males and 687 females. The median follow-up period was 51 months. The Cox proportional hazardous regression model was utilized to select high-risk pathological factors, establish the nomogram and scoring system. The Bootstrap resampling method was utilized for internal validation of the model, the concordance index (C-index) was used to assess discrimination and calibration curves were presented to assess model calibration. The Kaplan-Meier method was used to plot survival curves after risk grouping, and Cox regression was used to compare disease-free survival between subgroups. <b>Results:b> Age (HR=1.020, 95%CI: 1.008 to 1.033, P=0.001), T stage (T3:HR=1.995,95%CI:1.062 to 3.750,P=0.032;T4:HR=4.196, 95%CI: 2.188 to 8.045, P<0.01), N stage (N1: HR=1.834, 95%CI: 1.307 to 2.574, P<0.01; N2: HR=3.970, 95%CI: 2.724 to 5.787, P<0.01) and number of lymph nodes examined (≥36: HR=0.438, 95%CI: 0.242 to 0.790, P=0.006) were independently associated with disease-free survival. The C-index of the scoring model (model 1) based on age, T stage, N stage, and dichotomous variables of the lymph nodes examined (<12 and ≥12) was 0.723, and the C-index of the scoring model (model 2) based on age, T stage, N stage, and multi-categorical variables of the lymph nodes examined (<12, 12 to <24, 24 to <36, and ≥36) was 0.726. A scoring system was established based on age, T stage, N stage, and multi-categorical variables of lymph nodes examined, the 3-year DFS of the low-risk (≤1), middle-risk (2 to 4) and high-risk (≥5) group were 96.3% (n=711), 89.0% (n=626) and 71.4% (n=313), respectively. Statistically significant difference was observed among groups (P<0.01). <b>Conclusions:b> The number of lymph nodes examined was an independent prognostic factor for disease-free survival after curative surgery in patients with stage Ⅰ to Ⅲ colon cancer. Incorporating the number of lymph nodes examined as a multi-categorical variable into the T and N staging system could improve prognostic predictive validity.
Male
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Female
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Humans
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Prognosis
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Neoplasm Staging
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Retrospective Studies
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Nomograms
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Lymph Nodes/pathology*
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Risk Factors
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Colonic Neoplasms/surgery*
5.Changes and significance of autophagy in rat lung injury induced by gas explosion.
R Y HOU ; J N WANG ; Q ZHOU ; Y GUAN ; H B LI ; X W DONG ; J LI ; W D WU ; W J REN ; S Q YAO
Chinese Journal of Industrial Hygiene and Occupational Diseases 2021;39(8):568-573
Acute Lung Injury
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Animals
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Autophagy
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Explosions
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Lung
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Rats
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Rats, Sprague-Dawley
6.Cost-effectiveness of lung cancer screening worldwide: a systematic review.
C C LIU ; J F SHI ; G X LIU ; W TANG ; X ZHANG ; F LI ; L WANG ; Y MA ; K SU ; S J ZHAO ; Y B GAO ; N LI ; W Q CHEN ; N WU ; M DAI
Chinese Journal of Epidemiology 2019;40(2):218-226
<b>Objective:b> From the economic point of view, this study was to systematically assess the status quo on lung cancer screening in the world and to provide reference for further research and implementation of the programs, in China. <b>Methods:b> PubMed, EMbase, The Cochrane Library,CNKI and Wanfang Data were searched to gather papers on studies related to economic evaluation regarding lung cancer screening worldwide, from the inception of studies to June 30(th), 2018. Basic characteristics, methods and main results were extracted. Quality of studies was assessed. Cost were converted to Chinese Yuan under the exchange rates from the World Bank. The ratio of incremental cost-effectiveness ratio (ICER) to local GDP per capita were calculated. <b>Results:b> A total of 23 studies (only 1 randomized controlled trial) were included and the overall quality was accepted. 22 studies were from the developed countries. Nearly half of the studies (11 studies) took 55 years old as the starting age of the screening program. Smoking history was widely applied for the selection of criteria on target populations (18). Low-dose computed tomography (LDCT) was involved in every study used to evaluate the economic effectiveness. Annual (17) and once-life time (7) screening were more common frequencies. 22 studies reported ICERs for LDCT screening, compared to no screening, of which 17 were less than 3 times local GDP per capita, and were considered as cost-effectiveness, according to the WHO's recommendation. 15 and 7 studies reported ICERs for annual and once-life time screening, of which 12 and 7 studies were in favor the results of their cost-effectiveness, respectively. Additionally, the cost-effectiveness of once-lifetime screening was likely to be superior to the annual screening. Differences of cost-effectiveness among the subgroups, by starting age or by the smoking history, might exist. <b>Conclusions:b> Based on the studies, evidence from the developed countries demonstrated that LDCT screening programs on lung cancer, implemented among populations selected by age and smoking history, generally appeared more cost-effective. Combined with the local situation of health resource, the findings could provide direction for less developed regions/countries lacking of local evidence. Low frequency of LDCT screening for lung cancer could be adopted when budget was limited. Data on starting ages, smoking history and other important components related to the strategy of screening programs, needs to be precisely evaluated under the situation of local population.
China
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Cost-Benefit Analysis
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Early Detection of Cancer/methods*
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Humans
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Lung Neoplasms/prevention & control*
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Middle Aged
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Quality-Adjusted Life Years
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Randomized Controlled Trials as Topic
7.Exposure to bisphenol A during maternal pregnancy and the emotional and behavioral impact on their preschool children.
X CHEN ; H H BAO ; W K WU ; S Q YAN ; J SHENG ; Y Y XU ; C L GU ; K HUANG ; H CAO ; P Y SU ; F B TAO ; J H HAO
Chinese Journal of Epidemiology 2018;39(2):188-193
<b>Objective:b> To explore the long-term effects of maternal pregnancy bisphenol A (BPA) exposure on emotional and behavioral problems appeared in their preschool children. <b>Methods:b> The study sample was a subset of the China-Anhui Birth Cohort Study (C-ABCS). A unified questionnaire was used to collect basic information on both pregnant women and their children. Free BPA concentration in maternal serum was determined by high-performance liquid chromatographytandem mass spectrometry (HPLC-MS/MS). The parent-report version of the Strengths and Difficulties Questionnaire (SDQ) was used to estimate the emotional and behavioral problems in preschool children. A total of 1 713 pairs of mothers and children were included in this study. Association between BPA exposure during pregnancy and the emotional and behavioral problems in preschool children was evaluated with multinomial logistic regression model. <b>Results:b> Prevalence rates in 1 713 preschool children appeared as: 6.48% of emotional problems, 8.11% for conduct problems, 8.35% for hyperactivity/inattention, 2.86% for peer problems, 11.38% for prosocial behaviors and 7.94% for total difficulties. Subjects were divided according to the degrees of exposure and the results showed as: low exposure group (≤0.120 ng/ml), medium exposure group (0.120
Benzhydryl Compounds/toxicity*
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Child Behavior Disorders/etiology*
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Child, Preschool
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China/epidemiology*
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Cohort Studies
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Emotions/physiology*
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Environmental Exposure
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Environmental Pollutants
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Female
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Gas Chromatography-Mass Spectrometry
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Humans
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Male
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Maternal Exposure
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Mothers
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Phenols/toxicity*
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Pregnancy
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Prenatal Exposure Delayed Effects
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Prevalence
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Risk Factors
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Surveys and Questionnaires
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Tandem Mass Spectrometry
8.Willingness and influencing factors related to "centralized slaughtering, fresh poultry listing and marketing" strategy among the household chefs in Guangzhou.
W H LIU ; Y MA ; J Y LU ; H C YAN ; J H ZHOU ; X L LIAO ; J H ZENG ; W Q LIN ; D WU ; Z B ZHANG ; Z C YANG ; Z Q CHEN ; J D CHEN ; T G LI
Chinese Journal of Epidemiology 2018;39(2):204-207
<b>Objective:b> To study the willingness and influence factors related to "centralized slaughtering, fresh poultry listing and marketing" strategy, among the household chefs, and provide reference for government to adjust and optimize the strategy on avian influenza prevention. <b>Methods:b> According to the geographical characteristics and regional functions, 6 'monitoring stations' were selected from 12 residential districts of Guangzhou, respectively. Another 21 meat markets which selling live poultry, were selected in each station and 5 household chefs of each market were invited to attend a face to face interview. Basic information, personal cognitive, willingness and influencing factors to the policy were under study. Univariate and multivariate logistic regression methods were used. <b>Results:b> A total of 664 household chefs underwent the survey and results showed that the rate of support to the "centralized slaughtering, fresh poultry listing and marketing" strategy was 44.6% (296/664). Results from the multi-factor logistic regression showed that those household chefs who were males (OR=1.618, 95% CI: 1.156-2.264, P=0.005), having received higher education (OR=1.814, 95% CI: 1.296-2.539, P=0.001), or believing that the existence of live poultry stalls was related to the transmission of avian influenza (OR=1.918, 95% CI: 1.341-2.743, P<0.001) were factors at higher risk. These household chefs also intended to avoid the use of live poultry stalls (OR=1.666, 95%CI: 1.203-2.309, P=0.002) and accept the "centralized slaughtering, fresh poultry listing and marketing" strategy. <b>Conclusion:b> Detailed study on this subject and, setting up pilot project in some areas as well as prioritizing the education programs for household chefs seemed helpful to the implementation of the 'freezing-fresh poultry' policy.
Animals
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Attitude to Health
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China
;
Humans
;
Influenza A Virus, H7N9 Subtype
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Influenza in Birds
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Influenza, Human/prevention & control*
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Male
;
Marketing
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Meat-Packing Industry
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Multivariate Analysis
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Pilot Projects
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Poultry/virology*
;
Surveys and Questionnaires
9.Identification and drug susceptibility testing of Mycobacterium thermoresistibile and Mycobacterium elephantis isolated from a cow with mastitis.
W B LI ; L Y JI ; D L XU ; H C LIU ; X Q ZHAO ; Y M WU ; K L WAN
Chinese Journal of Epidemiology 2018;39(5):669-672
<b>Objective:b> To understand the etiological characteristics and drug susceptibility of Mycobacterium thermoresistibile and Mycobacterium elephantis isolated from a cow with mastitis and provide evidence for the prevention and control of infectious mastitis in cows. <b>Methods:b> The milk sample was collected from a cow with mastitis, which was pretreated with 4% NaOH and inoculated with L-J medium for Mycobacterium isolation. The positive cultures were initially identified by acid-fast staining and multi-loci PCR, then Mycobacterium species was identified by the multiple loci sequence analysis (MLSA) with 16S rRNA, hsp65, ITS and SodA genes. The drug sensitivity of the isolates to 27 antibiotics was tested by alamar blue assay. <b>Results:b> Two anti-acid stain positive strains were isolated from the milk of a cow with mastitis, which were identified as non-tuberculosis mycobacterium by multi-loci PCR, and multi-loci nucleic acid sequence analysis indicated that one strain was Mycobacterium thermoresistibile and another one was Mycobacterium elephantis. The results of the drug susceptibility test showed that the two strains were resistant to most antibiotics, including rifampicin and isoniazid, but they were sensitive to amikacin, moxifloxacin, levofloxacin, ethambutol, streptomycin, tobramycin, ciprofloxacin and linezolid. <b>Conclusions:b>Mycobacterium thermoresistibile and Mycobacterium elephantis were isolated in a cow with mastitis and the drug susceptibility spectrum of the pathogens were unique. The results of the study can be used as reference for the prevention and control the infection in cows.
Animals
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Anti-Bacterial Agents/pharmacology*
;
Antitubercular Agents/pharmacology*
;
Cattle
;
Drug Resistance, Bacterial
;
Female
;
Humans
;
Mastitis, Bovine/microbiology*
;
Microbial Sensitivity Tests
;
Milk/microbiology*
;
Mycobacterium/isolation & purification*
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Mycobacterium Infections/veterinary*
;
Mycobacterium tuberculosis/drug effects*
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Nontuberculous Mycobacteria/isolation & purification*
;
Polymerase Chain Reaction
;
RNA, Ribosomal, 16S/genetics*
10.A novel prognostic index for oral cancer in Fujian province.
J F WU ; L S LIN ; F CHEN ; F Q LIU ; L J YAN ; X D BAO ; J WANG ; R WANG ; L K LIN ; Y QIU ; X Y ZHENG ; Z J HU ; L CAI ; B C HE
Chinese Journal of Epidemiology 2018;39(6):841-846
<b>Objective:b> To explore the survival factors and construct a prognostic index (PI) for oral squamous cell carcinoma (OSCC). <b>Methods:b> From January 2004 to June 2016, a total of 634 patients with pathologically confirmed OSCC were recruited in a hospital of Fujian. The clinical and follow-up data of all the patients with pathologically confirmed OSCC were collected to identify the factors influencing the prognosis of OSCC. All the patients were randomly divided into two groups: modeling group (modeling dataset, n=318) and validation group (validation dataset, n=316). Randomization was carried out by using computer-generated random numbers. In the modeling dataset, survival rates were calculated using Kaplan-Meier method and compared using the log-rank test. Cox regression model was used to estimate the hazard ratio (HRs) and 95% confidence intervals (CIs) of prognosis factors. An PI for OSCC patients prognostic prediction model was developed based on β value of each significant variable obtained from the multivariate Cox regression model. Using the tertile analysis, patients were divided into high-risk group, moderate-risk group, and low-risk group according to the PI, the Akaike information criterion (AIC) and Harrell's c-statistic (C index) were used to evaluated the model's predictability. <b>Results:b> Results from the multivariate Cox regression model indicated that aged ≥55 years (HR=2.22, 95%CI: 1.45-3.39), poor oral hygiene (HR=2.12, 95%CI: 1.27-3.54), first diagnosis of lymph node metastasis (HR=5.78, 95%CI: 3.60-9.27), TNM stage Ⅲ-Ⅳ (stage Ⅰ as reference) (HR=2.43, 95%CI: 1.10-5.37) and poor differentiation (well differentiation as reference) (HR=2.53, 95%CI: 1.60-4.01) were the risk factors influencing the prognosis of OSCC. The PI model had a high predictability in modeling group and validation group (AIC and C index were 1 205.80, 0.700 2 and 1 150.47, 0.737 3). <b>Conclusion:b> Age, poor oral hygiene, first diagnosis of lymph node metastasis, TNM stage and histological grade were factors associated with the prognosis of OSCC, and the PI model has a certain significance in the clinical treatment of OSCC.
Carcinoma, Squamous Cell/therapy*
;
China/epidemiology*
;
Humans
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Lymphatic Metastasis
;
Middle Aged
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Mouth Neoplasms/therapy*
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Prognosis
;
Proportional Hazards Models
;
Risk Factors
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Survival Rate
;
Treatment Outcome

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