ObjectiveTo investigate the mental health of pediatricians in Guangzhou and its influencing factors， and to provide countermeasures for improving the mental health of pediatricians. MethodsA stratified random sampling method was used to randomly select 400 pediatricians in 11 districts of Guangzhou， and they were surveyed using the Symptom Check List（SCL-90） and the Job Stressor Scale. ResultsThe top three job stressors scored by pediatricians in Guangzhou were external environment （3.23±0.59）， workload （3.19±0.56）， and organizational management （2.74±0.55）. All factor scores were higher than those of the clinician group except for career interest， and the difference was statistically significant （P<0.01）. The number of pediatricians with mental health problems was 109， accounting for 27.25%. All factor scores were higher than the physician norm except for anxiety and paranoia. The correlations between each factor of work stressors and each factor of SCL-90 were positive and statistically significant （P<0.05）， except for two pairs of factors， workload and terror as well as external environment and terror. The results of univariate analysis showed statistically significant differences in the mental health scores of pediatricians with different health status， years of work experience， job satisfaction， job stress， and career prospects （P<0.05）. The results of multiple linear regression showed that health status， years of work experience， professional interest， interpersonal relationship， and doctor-patient relationship were influential factors in the mental health of pediatricians （P<0.05）. ConclusionThe mental health of pediatricians in Guangzhou is unsatisfactory， and the factors affecting them are mainly external objective factors such as workload and organizational management.

Objective: To evaluate the long-term outcomes, failure patterns and prognostic factors of definitive radiotherapy in patients with cervical esophageal carcinoma (CEC). Methods: We retrospectively reviewed the clinical data of 148 CEC patients who treated with definitive radiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from January 2001 to December 2017. The median radiation dose was 66 Gy (59.4-70 Gy) and 33.1% of patients received concurrent chemotherapy. The Kaplan-Meier method was used to calculate survival rates. The log rank test was used for survival comparison and univariate prognostic analysis. The Cox model was used for multivariate prognostic analysis. Results: The median follow-up time was 102.6 months. The median survival time, 2- and 5-year overall survival (OS) were 22.7 months, 49.9% and 28.3%. The median, 2- and 5-year progression-free survival were 12.6 months, 35.8% and 25.8%. The 2- and 5-year locoregional recurrence-free survival were 59.1% and 50.8%. The 2- and 5-year distant metastases-free survival were 74.6% and 65.9%. Multivariate analysis showed that EQD(2)>66 Gy was the only independent prognostic indicator for OS (P=0.040). The median survival time and 5-year OS rate significantly improved in patients who received EQD(2)>66 Gy than those who received≤66 Gy (31.2 months vs. 19.2 months, 40.1% vs. 19.1%, P=0.027). A total of 87 patients (58.8%) developed tumor progression. There were 50 (33.8%), 23 (15.5%) and 39 (26.4%) patients developed local, regional recurrence and distant metastases, respectively. Eleven patients (7.4%) underwent salvage surgery, and the laryngeal preservation rate for entire group was 93.9%. Conclusions: Definitive radiotherapy is an effective treatment for cervical esophageal carcinoma with the advantage of larynx preservation. Local recurrence is the major failure pattern. EQD(2)>66 Gy is associated with the improved overall survival.
Humans ; Retrospective Studies ; Esophageal Neoplasms/pathology* ; Carcinoma/drug therapy* ; Prognosis ; Treatment Outcome ; Chemoradiotherapy/methods* ; Radiotherapy Dosage

ObjectiveTo investigate the role of host immune system in the pathogenesis of encephalitis induced by Angiostrongylus cantonesis （A.C.） infection. MethodsThe definitive hosts of A.C. are rats and the intermediate hosts are mice. SD rats and BALB/c mice infected with A.C. were used to observe the changes of central immune organ thymus and peripheral immune organ spleen after 21 days of infection. Flow cytometry was used to detect the changes of cell subtypes in the thymus and spleen of rats and mice . ResultsAfter 21 days of infection with A.C. in rats， there was no obvious change in the appearance of spleen and thymus gland， and no obvious change in the thymus cell total count and in the proportion and number of thymocyte subtype cell （CD4⁺T， CD8⁺T， CD4⁺ CD8⁺T and CD4^- CD8^-T cells） between control groups and infected groups were found（P>0.05）； The proportion and number of CD4⁺T cells in spleen was increased（P=0.016；P=0.023）， while the change of CD8⁺T cells was not obvious（P>0.05）. After 21 days of infection， the spleen and thymus of mice were severely atrophied， the total number of thymus cell was decreased sharply（P<0.000 1）；The proportion and number of CD4⁺CD8⁺T cells were decreased obviously（P<0.000 1；P<0.000 1）； Infection resulted in a decrease in the total number of mononuclear cells in the spleen of mice（P<0.000 1）；The number of CD4⁺T cells and CD8⁺T cells in spleen was increased（P<0.000 1； P=0.003 8）. ConclusionsA.C. infection severely suppressed the immune system of mice， but had little effect on rats. A.C. infection induced immunosuppression in the host， in turn reduced the ability of the host to clear and resist parasites， which may be an important mechanism of immune escape of parasites. This study revealed that the immune system plays an important role in the pathogenesis of encephalitis caused by A.C. infection， which provides a new idea for the prevention and treatment of encephalitis caused by A.C. infection.

Objective To investigate the protection mechanism of dexmedetomidine against retinal ischemia-reperfusion injury (RIRI) in mice.Methods Forty-eight male C57BL/6 mice born 8 weeks were randomly into sham group,model group and experimental group.Each group had 16 mice.Mice model of RIRI were prepared.Before modeling 15 min,dexmedetomidine 25 μg · L-1 was injected into the abdominal cavity in experimental group,and the same dose of 0.9％ normal saline was injected into the abdominal cavity in sham group and model group.The RIRI model was established successfully then these mice were killed after reperfusion 24 h.The superoxide dismutase (SOD) was detected by WST-1 method,the malondialdehyde (MDA) was detected by TBA method,and the glutathione peroxidase (GSH-PX) was determined by colorimetry.The tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),1-methylcyclopropene (MCP-1) and interleukin-10 (IL-10) were detected by ELISA.Results Compared with the sham group,the levels of SOD (45.47 ± 8.16) U · mg-1 and GSH-PX (264.64 ± 27.31) U · mg-1 in the retinal tissue of the model group were decreased significantly (P ＜ 0.05).While MDA (1.56±0.41) nmol · mg-1,TNF-α (2.67±0.23) ng · mL-1,IL-6 (2.84±0.34) ng · mL-1,MCP-1 (0.68 ±0.06) ng · mL-1 and IL-10 (0.21 ±0.02) ng · mL-1 in the retinal tissue of the model group were decreased significantly (P ＜ 0.05).Compared with the model group,the levels of SOD (71.05 ± 9.34) U · mg-1,GSH-PX (382.20 ±31.56) U · mg-1 and IL-10 (0.44 ±0.07) ng · mL-1 in the retina tissue of the experimental group were decreased significantly (P ＜ 0.05).while MDA (1.02 ± 0.23) nmol · mg-1,TNF-α (1.53 ± 0.20)ng· mL-1,IL-6 (1.6 ±0.07) ng · mL-1 and MCP-1 (0.41 ±0.07) ng · mL-1 of the experimental group experimental group were decreased significantly (P ＜ 0.05).Conclusion Dexmedetomidine can significantly reduce RIRI,the mechanism may be related to inhibit oxygen free radical-induced lipid peroxidation injury and inhibit the secretion of inflammatory cytokines.

OBJECTIVETo evaluate the clinical efficacy of Jianpi Liqi Yiliu Formula (JLYF) combined with cytokine-induced killer (CIK) cells for treating patients with advanced hepatocellular carcinoma (HCC).

METHODSBetween January 2011 and January 2014, 60 advanced HCC patients were enrolled in this study, who were assigned to the treatment group and the control group according to their willingness for taking JLYF, 30 cases in each group. All patients received CIK cell treatment: 1 x 10⁹-3 x 10⁹ each time, by intravenous dripping from the 1st day to the 3rd day, once per day. Besides, patients in the treatment group took JLYF decoction, while those in the control group took Chinese medical decoction by syndrome typing. All patients received treatment of at least two cycles. The time to progression (TTP) , overall survival (OS), disease control rate (DCR), performance status scale (PS), Child-Pugh scale, and adverse reactions were observed, and subgroup analyzed.

RESULTSTo May 31, 2014, all patients reached the clinical endpoint. TTP was 3.5 months (95% Cl: 3.30-4.10) in the treatment group, better than that (2.5 months, 95% CI: 2.32-2.68) of the control group (P < 0.05). DCR was 36.7% in the treatment group and 30.0% in the control group (P > 0.05). OS was 5.2 months (95% CI: 4.53-5.87) in the treatment group and 4.6 months (95% CI: 4.06-5.14) in the control group (P > 0.05). The PS scale was 1.60 ± 0.10 after treatment, lower than that (1.80 ± 0.09) before treatment in the treatment group (P < 0.05). When the PS scale was 0-2 or Child-Pugh scale was class A, TTP was longer in the treatment group than in the control group (P < 0.05). No adverse reaction occurred in the two groups during the treatment course.

CONCLUSIONSThe combination of JLYF with ClK cell treatment could prolong advanced HCC patients' TTP, improve PS scale, as compared with syndrome typed Chinese medical decoction treatment group. Besides, when the PS scale was 0-2 or Child-Pugh scale was class A, it was a better treatment program for advanced HCC patients.

Carcinoma, Hepatocellular ; therapy ; Cell- and Tissue-Based Therapy ; Cytokine-Induced Killer Cells ; cytology ; Disease Progression ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Neoplasms ; therapy

OBJECTIVETo analyze the risk factors of postoperative complications in gastric carcinoma patients complicated with liver cirrhosis.

METHODSA retrospective research of 41 gastric cancer patients with liver cirrhosis who underwent surgical therapy was performed. The multivariate Logistic regression analysis was carried out to determine risk factors of postoperative complications.

RESULTSThere were no postoperative death in this cohort. Twenty-seven(65.9%) patients developed postoperative complications. As determined by the Logistic regression analysis, Child-Pugh score(OR=27.96, 95% CI:1.16-672.23), albumin level(OR=17.98, 95% CI:1.28-253.36) and intraoperative blood loss(OR=10.60, 95% CI:1.21-92.82) were independent risk factors of postoperative complications.

CONCLUSIONAs for gastric cancer patients with liver cirrhosis, positive perioperative management, adjustment of Child-Pugh classifications score, following damage control principle during operation and reducing the intraoperative bleeding may decrease the morbidity of postoperative complications.

Factor Analysis, Statistical ; Humans ; Liver Cirrhosis ; Morbidity ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms

Objective To analyze the risk factors of postoperative complications in gastric carcinoma patients complicated with liver cirrhosis. Methods A retrospective research of 41 gastric cancer patients with liver cirrhosis who underwent surgical therapy was performed. The multivariate Logistic regression analysis was carried out to determine risk factors of postoperative complications. Results There were no postoperative death in this cohort. Twenty-seven (65.9%) patients developed postoperative complications. As determined by the Logistic regression analysis , Child-Pugh score (OR=27.96, 95% CI:1.16-672.23), albumin level (OR=17.98, 95% CI:1.28-253.36) and intraoperative blood loss (OR=10.60, 95%CI:1.21-92.82) were independent risk factors of postoperative complications. Conclusion As for gastric cancer patients with liver cirrhosis, positive perioperative management, adjustment of Child-Pugh classifications score, following damage control principle during operation and reducing the intraoperative bleeding may decrease the morbidity of postoperative complications.

Objective To analyze the risk factors of postoperative complications in gastric carcinoma patients complicated with liver cirrhosis. Methods A retrospective research of 41 gastric cancer patients with liver cirrhosis who underwent surgical therapy was performed. The multivariate Logistic regression analysis was carried out to determine risk factors of postoperative complications. Results There were no postoperative death in this cohort. Twenty-seven (65.9%) patients developed postoperative complications. As determined by the Logistic regression analysis , Child-Pugh score (OR=27.96, 95% CI:1.16-672.23), albumin level (OR=17.98, 95% CI:1.28-253.36) and intraoperative blood loss (OR=10.60, 95%CI:1.21-92.82) were independent risk factors of postoperative complications. Conclusion As for gastric cancer patients with liver cirrhosis, positive perioperative management, adjustment of Child-Pugh classifications score, following damage control principle during operation and reducing the intraoperative bleeding may decrease the morbidity of postoperative complications.

OBJECTIVETo evaluate the efficacy and optimal re-implantation time of two-stage revision for management of periprosthetic infection following hip arthroplasty.

METHODSWe retrospectively analyzed the clinical data of 15 patients (15 hip joints) undergoing two-stage ipsilateral total hip arthroplasty (THA) revision from January, 2006 to January, 2010. In the first stage, after surgical debridement and thorough removal of all the implants, a self-made Vancomycin-loaded cement spacer was implanted. The second stage operation was performed 3-6 months later for debridement and removal of the antibiotic-loaded spacer, followed by re-implantation of Vancomycin-loaded bone cement prosthesis in 9 cases and cementless prosthesis in 6 cases. The patients were followed up for 9-46 months (mean 25 months) after the operation.

RESULTSNo reinfection or prosthesis loosening/displacement was found in these cases after the operation. The Harris score increased from 40.3 before the operation to 54.0 after the first-stage operation, and to 88.2 at the last follow-up.

CONCLUSIONTwo-stage revision is effective for treatment of periprosthetic infection following hip arthroplasty, and 3-6 months can be the optimal interval between the two the first-stage and second-stage operation for re-implantation.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Prosthesis-Related Infections ; surgery ; Reoperation ; Retrospective Studies ; Treatment Outcome

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; complications ; pathology ; physiopathology ; Liver ; pathology ; physiopathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult