Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective: To investigate the characteristics of non-alcoholic fatty liver disease (NAFLD) and its associated factors in rheumatoid arthritis (RA) patients. Methods: This cross-sectional study recruited 385 RA patients [including 72 (18.7%) male and 313 (81.3%) female] who received abdominal sonographic examination from August 2015 to May 2021 at Department of Rheumatology, Sun Yat-Sen Memorial Hospital. There were 28 RA patients at 16-29 years old and 32, 80, 121, 99, 25 at 30-39, 40-49, 50-59, 60-69, ≥ 70 years old, respectively. Demographic and clinical data were collected including age, gender, history of alcohol consumption, disease duration, body mass index (BMI), waist circumference, blood pressure, RA disease activity indicators and previous medications. Logistic regression analyses were used to identify the associated factors of NAFLD in RA patients. Results: The prevalence of NAFLD was 24.2% (93/385) in RA patients, 26.3% (21/80) in 40-49 age group and 33.1% (40/121) in 50-59 age group. There were 22.1% (85/385) and 3.6% (14/385) RA patients with overweight and obese, in which the prevalence of NAFLD was 45.9% (39/85) and 78.6% (11/14) respectively, which was 2.6 folds and 4.5 folds that of RA patients with normal BMI. Although there was no significant difference of age, gender and RA disease activity indicators between RA patients with or without NAFLD, those with NAFLD had higher proportions of metabolic diseases including obese (11.8% vs. 1.0%), central obesity (47.3% vs. 16.8%), hypertension (45.2% vs. 29.8%) and type 2 diabetes mellitus (24.7% vs. 12.0%), consistent with higher levels of total cholesterol [(5.33±1.31) mmol/L vs. (4.73±1.12) mmol/L], triglyceride [(1.51±1.08) mmol/L vs. (0.98±0.54) mmol/L] and low-density lipoprotein cholesterol [(3.37±0.97) mmol/L vs. (2.97±0.78) mmol/L, all P<0.05]. Multivariate logistic regression analysis showed that BMI (OR=1.314) and triglyceride (OR=1.809) were the independent factors positively associated with NAFLD in RA patients. Conclusion: NAFLD is a common comorbidity in RA patients, especially in those with middle-aged, overweight or obese, which is associated with high BMI or high triglyceride. Screening and management of NAFLD in RA patients especially those with overweight, obese or dyslipidemia should be emphasized.
Adolescent ; Adult ; Aged ; Arthritis, Rheumatoid/epidemiology* ; Cholesterol, LDL ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/epidemiology* ; Obesity/epidemiology* ; Overweight/epidemiology* ; Triglycerides ; Young Adult

Objective To evaluate the clinical efficacy and safety of memantine combined with olanzapine in treating Alzheimer's disease patients with behavioral and psychological symptoms of dementia (BPSD).Methods One hundred and seventy-six cases of Alzheimer's disease with BPSD were randomly divided into treatment group (n =87) and control group (n =89).The control group received oral administration of memantine 5-20 mg qd.The treatment group was given oral administration of olanzapine 2.5-10 mg qn on the basis of control group.The treatment course was two weeks.Both groups were treated for 6 courses.Clinical efficacy,neuropsychiatric inventory scale (NPI),activities of daily living (ADL) score,and the incidence of adverse drug reactions were compared between the two groups.Results After treatment,the total efficiency of the treatment group and the control group were 90.70％ (78/86 cases)and 75.29％ (64/85 cases) respectively,and the statistically significant difference was shown between the two groups (P＜0.01).Before treatment and at week 2,4,8,12,NPI-1 in the treatment group and were(25.18 ±4.17) (23.02 ± 3.98),(20.51 ± 3.65),(17.85 ± 3.08),(16.56 ± 2.95);NPI-2 were (46.86 ± 4.65) (45.78 ± 4.62),(43.53 ± 4.24),(40.53 ± 4.31),(38.91 ± 4.27);ADL were (44.34 ± 4.59),(44.25 ± 4.53) (42.85 ±4.01),(40.30 ± 3.98),(39.21 ± 3.48).NPI-1 in the control group were(25.27 ±4.23) (24.67 ±4.12),(23.68 ± 3.98),(21.36 ± 3.57),(19.92 ± 3.24);NPI-2 were (46.56 ± 4.72) (46.31 ± 4.51),(45.82 ± 4.42),(43.21 ± 4.37),(42.74 ± 4.33);ADL were (43.62 ± 4.61),(43.36 ± 4.49) (43.08 ±4.25),(42.18 ±4.31),(41.27 ±4.29).Statistical significant differences were found in NPI-1,NPI-2 and ADL between the two groups at week 2,4,8(P ＜0.01).The adverse drug reactions in the treatment group were hypersomnia,weight gain,dry mouth and constipation;and dizziness,sleeplessness,headache,nausea in the control group.The incidence of adverse drug reactions in treatment and control groups were 8.14％ (7/86 cases) and 7.06％ (6/85 cases),without statistically significant difference (P ＞ 0.05).Conclusion Memantine combined with olanzapine achieves better efficacy than memantine alone in treating patients with Alzheimer's disease and BPSD.

BACKGROUNDThe ankle brachial index (ABI) is a simple, inexpensive, noninvasive tool that correlates well with angiographic disease severity and functional symptoms. The aim of this study was to identify the manifestation of lower extremity atherosclerotic lesions in patients with high ABI by retrospective clinical study.

METHODSA cohort of 184 diabetic patients, (63 +/- 14) years old, 144 males, who underwent simultaneously ABI testing and low extremity arterial duplex ultrasound within one week, were enrolled randomly into this study. According to the ABI value, they were divided into three groups: the high, normal and low ABI groups. The severity and location of atherosclerotic lesions in the lower extremity were determined based on the results of low extremity artery duplex ultrasound. The chi-square test was used to compare the atherosclerosis severity grade and lesion location across the three groups.

RESULTSThe prevalence of low extremity artery occlusion was significantly lower in the high ABI group than in the low ABI group (3.3% vs. 63.5%, P < 0.01), and the main atherosclerotic lesions were diffuse dot-like hyperechogenicity spots or small plaques (86.7%). In addition, the atherosclerotic lesions were mostly found in the distal segment of the lower extremity in patients with high ABI (46.3%).

CONCLUSIONA high ABI may be an integrative marker for intimal and medial calcification, which has a high positive predictive value for artery calcification.

Aged ; Aged, 80 and over ; Ankle Brachial Index ; Arterial Occlusive Diseases ; diagnosis ; Atherosclerosis ; diagnosis ; Cohort Studies ; Female ; Humans ; Lower Extremity ; pathology ; Male ; Middle Aged ; Peripheral Vascular Diseases ; diagnosis

OBJECTIVETo study the genetic characterization of wild-type measles viruses isolated in Xinjiang in 2003 and 2004.

METHODSPeripheral blood mononuclear cells (PBMC) from 19 suspected measles cases collected between June 2003 and April 2004 were used to isolate measles virus by cocultivation with phytohemagglutinin (PHA)-stimulated cord blood mononuclear cells (CBMC). For positive samples, 676 nucleotides of the C-terminus of the nucleoprotein (N) gene of the measles virus genome were amplified by reverse transcription-polymerase chain reaction and then sequenced. These sequences were compared with those of other measles reference strains available in GenBank or measles isolates elsewhere in China using BLAST searches and phylogenetic analyses.

RESULTS6 measles virus strains were isolated with 3 strains (XJ03-26, XJ03-27, XJ03-74) from 2003 and 3 (XJ04-146, XJ04-150, XJ04-152) from 2004. The strain XJ03-26, differed from the Chinese measles vaccine strain S-191 (genotype A) by less than 1% at nucleotide level, and therefore appeared a vaccine-associated strain. The other 5 strains as XJ03-27, XJ03-74, XJ04-146, XJ04-150 and XJ04-152 were proved to be genotype H1 strains,among which XJ03-27, XJ03-74, XJ04-150 and XJ04-152, showing their nucleotide diversity were varied from 0.5% to 1.6%, when compared to the H1a reference strain China9322, and identified as H1a strains. XJ04-146 showed a nucleotide similarity of 98.7% when compared to H1b reference strain China9475, and was identified as H1b strain. Additionally, we found that there were two sets of strain (XJ03-27 and XJ04-150; XJ03-74 and XJ04-152), with almost identical nucleotide sequences, circulating in 2003 and 2004 and both having more nucleotide variability (up to 6.1%, 27 nucleotides).

CONCLUSIONGenotype H1 measles virus had been proven to have been circulated in Xinjiang, China during 2003 and 2004. H1a was the predominant epidemic strain while H1b strain stood the next.

China ; epidemiology ; Disease Outbreaks ; Genotype ; Humans ; Measles ; epidemiology ; Measles virus ; classification ; genetics ; isolation & purification ; Nucleoproteins ; genetics ; Phylogeny ; RNA, Viral ; genetics ; Sequence Analysis, RNA ; Viral Proteins ; genetics