Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.

ObjectiveTo use the maternal morbidity WOICE Tool（Chinese version）to investigate the maternal morbidity in Shanghai， and to examine the current situation and associated factors of adverse symptoms and impaired functioning in the third trimester and postpartum period. MethodsPregnant women who made their initial visit and established a medical record at a tertiary obstetrics and gynecology hospital in Shanghai from March to August 2021 were recruited and a baseline survey was completed. The prevalence of maternal morbidity was surveyed in the third trimester and first 6 weeks postpartum. ResultsSelf-reported adverse physical symptoms were observed in 89.8% of women in the third trimester and 86.1% in first 6 weeks postpartum. The prevalence rates of anxiety and depression were 4.1% and 6.2% in the third trimester， and 6.2% and 7.5% in first 6 weeks postpartum， respectively. The proportions of women reporting impaired functioning were 80.3% in the third trimester and 64.1% in first 6 weeks postpartum， respectively. Physical symptoms were associated with parity， education， the newborn’s health status， and risk of experiencing violence. Psychological symptoms were associated with age， household responsibilities， employment status， the newborn’s health status， pre-pregnancy body mass index （BMI）， and risk of experiencing violence. Functionality was associated with the type of registered residence， education level， household responsibilities， and risk of experiencing violence. ConclusionThe physical health status of pregnant and postpartum women in Shanghai is better than that in the middle-income regions abroad， with anxiety and depression at average levels compared to national statistics in China. Physical， psychological， and functional status are affected by multiple factors including personal， health， family， and work conditions. Preventive measures should be taken from various perspectives to mitigate adverse symptoms and impaired functioning， and to improve the positive experience of pregnancy and childbirth.

Objective:To investigate the feasibility and safety of right-sided abdominal evisceration in retroperitoneal liposarcoma.Methods:The clinical data of 16 cases of retroperitoneal liposarcoma performed with right-sided abdominal evisceration at Sarcoma Center of Peking University Cancer Hospital from Sep 2015 to Feb 2019 were analyzed retrospectively.Results:Complete resection were successfully performed in all 16 cases.The median tumor size was 29cm(13-43 cm), the median operative time was 660 min(429-940 min), the median estimated blood loss was 2 000 ml(300-6 000 ml). The major postoperative complications rate (Clavien-Dindo classification Ⅲ-Ⅴ) was 38%. Median overall survival is 41.0 months while the median disease-free survival is 32.6 months.Conclusions:Right-sided abdominal evisceration is a favorable procedure to attain complete resection with acceptable complication rate.

The borderline resectable pancreatic cancer is high a controversial hotspot in the field of pancreatic surgery,and the controversy mainly focuses on definition and treatment.Five famous experts and their teams in pancreatic surgery discussed present situation and dilemmas in treatment of borderline resectable pancreatic cancer based on clinical experiences.Professor Hao Chunyi has reviewed and analyzed origin of the definition and treatment model of borderline resectable pancreatic cancer,and proposed that high-level pancreatic disease center and multidisciplinary collaboration diagnosis and treatment may be the best choice for resectable pancreatic cancer.Professor Liu Xubao suggested surgical treatment for most of borderline resectable pancreatic cancer,and whether or not tumor invades adjacent blood vessels and invasion level will be used to decide direct surgery or neoadjuvant therapy.Professor Sun Bei proposed 6 causes,and direct surgery may be more realistic and feasible option for borderline resectable pancreatic cancer.Professors Liang Tingbo and Bai Xueli recommended that neoadjuvant therapy should be performed due to defeat hiding micrometastasis lesions and reduce tumor burden,and there was a higher R0 resection rate and lower lymph node metastasis rate after neoadjuvant therapy,meanwhile,it can also increase cure rate and is benefited to survival.

Background and purpose:Life expectancy has continuously improved in recently years with the development of medical level. In 2012, the amount of people who were above 60 years old has reached 810 million and account for 11% of worldwide population. The worldwide population shift towards older ages will inevitably lead to more elderly patients being diagnosed with non-small cell lung cancer (NSCLC). It still remains controversial whether sublobar resection is effective in such cases. In order to solve this question, we need to understand the clinical characteristics of these tumors. Methods:From 2006 to 2012, a total of 310 patients with NSCLC who were above 65 years old underwent surgical resection in Department of Thoracic Surgery, the First Afifliated Hospital of China Medical University and the Second Department of Thoracic Surgical Oncology, Jilin Province Tumor Hospital. The clinical data were retrospectively analyzed in sex, stage, histology, smoking status, smoking amount, drinking status, surgical approaches, multimodality therapy and overall survival. Survival was analyzed by Kaplan–Meier method and log-rank test. Results:There were 256 (82.6%) elderly patients who underwent standard lobectomies and 54 (17.4%) patients who underwent sublobar resections. The overall 5-year survival rate was 52.9%. Patients with different surgical approaches (lobectomy and sublobar resection) had nearly the same 5-year survival rates (60.5%vs 60.8%, P=0.381). The prognosis were signiifcantly inlfuenced by gender (P=0.024), stage of disease (P=0.028), smoking status (P=0.034) and smoking amount (P=0.028). The multivariate Cox proportional hazards analysis revealed that the smoking status was associated with the hazard ratio of 1.660 (1.058-2.606;P=0.028). Conclusion:In elderly NSCLC patients, sublobar resection is considered to be an appropriate treatment in comparison with lobectomy, as this procedure provides an equivalent long-term survival. The survival of elderly patients with lung cancer is closely related to the smoking status.

Infectious bronchitis virus (IBV) poses a severe threat to the poultry industry and causes heavy economic losses worldwide. Vaccination is the most effective method of preventing infection and controlling the spread of IBV, but currently available inactivated and attenuated virus vaccines have some disadvantages. We developed a chimeric virus-like particle (VLP)-based candidate vaccine for IBV protection. The chimeric VLP was composed of matrix 1 protein from avian influenza H5N1 virus and a fusion protein neuraminidase (NA)/spike 1 (S1) that was generated by fusing IBV S1 protein to the cytoplasmic and transmembrane domains of NA protein of avian influenza H5N1 virus. The chimeric VLPs elicited significantly higher S1-specific antibody responses in intramuscularly immunized mice and chickens than inactivated IBV viruses. Furthermore, the chimeric VLPs induced significantly higher neutralization antibody levels than inactivated H120 virus in SPF chickens. Finally, the chimeric VLPs induced significantly higher IL-4 production in mice. These results demonstrate that chimeric VLPs have the potential for use in vaccines against IBV infection.
Animals ; Antibodies, Viral/blood ; *Chickens ; Chimera/genetics/immunology ; Coronavirus Infections/prevention & control/*veterinary/virology ; Female ; *Immunity, Innate ; Infectious bronchitis virus/genetics/*immunology ; Influenza A Virus, H5N1 Subtype/genetics/immunology ; Injections, Intramuscular/veterinary ; Mice ; Mice, Inbred BALB C ; Neuraminidase/genetics ; Poultry Diseases/*prevention & control/virology ; Recombinant Fusion Proteins/genetics/immunology ; Spike Glycoprotein, Coronavirus/genetics/*immunology ; Vaccines, Synthetic/administration & dosage/genetics/immunology ; Vaccines, Virus-Like Particle/administration & dosage/genetics/*immunology ; Viral Proteins/genetics

Objective To observe the value of detection of pulmonary arterial hypertension(PAH) with curvature ratio measured at cardiac MR.Methods We performed a retrospective study of 48 patients with cardiac MR,systemic systolic blood pressure and right heart catheterization(RHC) data.The parameter curvature ratio (Rc) was measured at cardiac MR and transseptal/transmural pressure ratio (RP) was calculated.By using the regression analysis between Rc and RP,the SPAP was calculated.Bland-Altman analysis was used to compare the SPAP calculated with SPAP obtained by RHC.The accuracy of the SPAP calculated in detecting PAH was analyzed by using receiver operating characteristic (ROC) curves (SPAP higher than 40 mmHg as cutoff).The normality of parameter is tested by K-S test.Bivariate correlation Pearson test was used to test the consistency of parameters obtained by different measurers.Linear regression analysis was performed to find the relationship between Rc and RP.Results Parameter RP =0.28 ± 0.37 (-0.50-0.83) and RC =0.31 ± 0.57 (-0.78-0.97).Linear relationship was found between Rc and RP (r =0.94,P ＜ 0.01) and regression equation:Rc =1.44 × RP-0.09.Bland-Altman analysis showed satisfactory limits of agreement with the SPAP calculated and obtained by RHC.ROC analysis of the diagnostic value in PAH revealed 94.4％ (34/36) of sensitivity and 100.0％ of specificity (12/12,area under ROC curve =0.942,P ＜ 0.01).Conclusions Our study suggests that with curvature ratio measured at cardiac MR,the SPAP estimated have considerable sensitivity and specificity for detecting PAH.It may be a useful non-invasive assessment in patients that suspected of PAH.

Objective To determine the effectiveness of endovascular embolization through pulmonary artery access in patients with refractory massive hemoptysis in whom systemic artery (SA)embolization is ineffective or contraindicated. Methods A total of 102 patients were treated with SA embolization for hemoptysis. Of the 102 patients, 6 patients had severe persistent hemoptysis despite complete SA embolization and 1 patient had severe hemoptysis following complete bronchial artery embolization and other SA embolization was contraindicated. The underlying diseases were chronic cavitary pulmonary tuberculosis (n = 3), chronic cavitary pulmonary tuberculosis complicated with aspergilloma (n=1), tuberculous bronchiectasis (n=1), severe necrotizing pneumonia (n=1) and bronchiectasis complicated with pneumatocele (n=1). The findings of SA angiography, main pulmonary angiography and selective pulmonary angiography were analyzed. Endovascular embolization was performed in patients with the detectable pathology in PA and the clinical results were observed. Results The findings of SA angiography showed bronchopulmonary shunting in all cases, and pseudoaneurysm of PA in 2 cases and hypertrophy of peripheral PA in 2 cases. The main PA angiography demonstrated pseudoaneurysm of PA in 1 case and hypoperfusion of the diseased PA in other case. The selective PA angiography demonstrated pseudoaneurysm of PA in 4 cases (1 case with extravasation of constrast medium) and hypertrophy ofperipheral PA in 2 cases. Coil embolizations of the pathologic PA were successfully performed and bleeding ceased in all patients. During follow-up, 1 patient had episodic bloody sputum after embolization, and 2 died day 6 and 15 of severe infection and respiratory failure and the remaining patients were all stable.Conclusions In patients with refractory massive hemoptysis after systemic embolization, the possibility of PA pathology, especially pseudoaneurysm of PA should be considered. Selective pulmonary angiography is necessary to demonstrate the pathology in PA. Endovascular management of the pathologic PA appears to be a safe and effective treatment.

A semantic modeling approach for medical image semantic retrieval based on hierarchical Bayesian networks was proposed, in allusion to characters of medical images. It used GMM (Gaussian mixture models) to map low-level image features into object semantics with probabilities, then it captured high-level semantics through fusing these object semantics using a Bayesian network, so that it built a multi-layer medical image semantic model, aiming to enable automatic image annotation and semantic retrieval by using various keywords at different semantic levels. As for the validity of this method, we have built a multi-level semantic model from a small set of astrocytoma MRI (magnetic resonance imaging) samples, in order to extract semantics of astrocytoma in malignant degree. Experiment results show that this is a superior approach.
Artificial Intelligence ; Astrocytoma ; diagnosis ; Bayes Theorem ; Brain Neoplasms ; diagnosis ; Diagnostic Imaging ; methods ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Image Processing, Computer-Assisted ; methods ; Magnetic Resonance Imaging ; Models, Theoretical ; Semantics

Objective To investigate the incidence and relation to primary diseases of the nonbronchial systemic arteries (NBSA) supply to the pulmonary lesions, and to evaluate the clinical value of transcatheter arterial embolization (TAE) of the responsible NBSA for hemoptysis. Methods The aortography and subclavian artery angiography were performed in 139 patients with hemoptysis, including pulmonary tuberculosis in 66 cases (2 cases with post-thoracoplasty, 1 case with post-lobectomy, and 1 case with ventricular septal defect), bronchiectnsis in 41 ( 1 ease with post-lobectomy and 1 case with post- ligation of patent ductus arteriosus), bronchiogenic carcinoma in 15, unknown hemoptysis in 7, silicosis in 3, broncholithiasis in 3, bronchial cysts in 1, empyema in 1, postoperative lung cancer in 1, and chronic pulmonary embolism in 1, respectively. TAE was performed in patients with the discoverable responsible NBSA. The frequency, distribution and relation to primary diseases of the responsible NBSA were evaluated and the clinical results and complications were observed. Follow-up time ranged from 6 months to 5 years. Results Seventy-three patients (52. 5% ) had nonbronchial systemic contributions, including 5 cases of post-thoracotomy with pulmonary lesions, 1 case complicating with ventricular septal defect, 1 ease with post-ligation of patent ductus arterinsns, and 1 case of chronic pulmonary embolism. The total number of NBSA were 181 including posterior intercostal arteries (n = 88), internal thoracic arteries (n = 27 ), inferior phrenic arteries ( n = 21 ), proper esophageal arteries ( n = 20 ), lateral thoracic arteries ( n = 9 ), subscapular arteries ( n = 7 ), eostocervical trunks ( n = 5 ) and thyrocervical trunks ( n = 4 ) . Main responsible NBSA were posterior intercostal arteries (n = 75 ) and branches of subclavian and axillary artery (n =44) in patients with pulmonary tuberculosis, and proper esophageal arteries (n = 16 ) and inferior phrenic arteries (n = 17 ) in bronchiectasis. The clinical result was satisfactory and the bleeding ceased immediately in 69 eases including 19 cases of failed or repeated bronchial artery embolization (the arteries had been obstructive) and 4 cases of the normal bronchial arteries. No severe complications occurred except ipsilateral cerebellar infarction after subclavian artery angiography in 1 case and respiratory failure after internal thoracic artery embolization in another case. Sixty patients were followed up for more than 6 months. The result demonstrated episodic bloody sputum in 16 patients, re-bleeding in 11 and non-bleeding in another after TAE. Eight patients had non-bleeding and 2 patients had episodic bloody sputum who were re- bleeding and underwent repeated TAE. Conclusions The stimulation of adjacent lesions and the cardiovascular diseases with weakened or defected pulmonary perfusion can lead to the responsible NBSA supply to the lung in hemoptysis. During TAE for hemoptysis, the integrity angiograpby and TAE can improve the curative effect.