Objective:To analyze the relationship between early-life famine exposure and the risk of metabolic syndrome in Chinese population.Methods:Relevant literature on the relationship between early-life famine exposure and the risk of metabolic syndrome in the Chinese population was retrieved from databases such as CNKI, Wanfang, VIP, CBM, Web of Science, and PubMed. The search was conducted from the inception of the databases up to October 2022. Two researchers independently extracted and systematically evaluated the data from the literature, and meta-analysis was performed using Stata 16.0 software. Results:A total of 12 publications met the inclusion criteria, including 71 470 study subjects. Meta-analysis results showed that early-life famine exposure increased the risk of metabolic syndrome in the Chinese population( OR=1.28, 95% CI 1.16-1.40). Subgroup analysis showed that both fetal famine exposure( OR=1.25, 95% CI 1.03-1.52) and childhood famine exposure( OR=1.29, 95% CI 1.15-1.45) increased the risk of developing metabolic syndrome compared to the non-exposed group, and this significant association was only found in the female population. Conclusion:Early-life exposure to famine may increase the risk of developing metabolic syndrome in adulthood in the Chinese population, particularly among females.

Objective: To explore the effect of standardized grading transport scheme in intrahospital transport of emergency critical patients. Methods: Selected a total of 1 425 critically ill patients from the emergency department in July 2017 - August 2018 as the research object, whom were transported by hospital for completing CT examination, transferring into Angiography Room or specialist ward, December 7, 586 cases of 2017 as control group, in August 1, 839 of 2018 as the observation group. Patients in the control group were transported by conventional transport, while patients in the observation group were transported by standardized graded transport scheme. The hospital transport time and adverse event incidence rates of patients in the two groups were compared. Results: In the observation group, the time taken to complete CT examination, complete CT examination and transfer into angiography room, transfer into specialized wards, transfer into angiography room was respectively (25.70±2.94, 31.05±3.27, 20.04±2.54, 16.29±1.82) points, which was significantly different from (33.65±4.31, 37.12±4.16, 25.46±2.24, 20.20±2.17) points in the control group (t=16.665-26.709, P<0.01). Observation group of patients with nosocomial transhipment adverse events (a decrease in blood pressure, blood oxygen desaturation, accidental extubation, unobstructed intravenous drip, insufficient supply of oxygen, power insufficiency, the insufficient number of drugs and drug kinds) rates were 6.9% (58/839), 8.6% (72/839), 0.2% (2/839), 15.0% (126/839), 4.5% (38/839), 0.9% (8/839), 0.7% (6/839), 0, Significantly lower than the control group of 19.5% (114/586), 22.7% (133/586), 1.5% (9/586), 34.9% (205/586), 26.6% (156/586), 11.9% (70/586), 5.9% (35/586), 3.9% (23/586), the difference was statistically significant (χ²=31.950-106.173, P<0.01). Conclusion The standardized and graded transport scheme can fully warn patients of various risks in the course of intrahospital transportation, take effective preventive and control measures to ensure the safety of intrahospital transportation of emergency critical patients, and should be popularized.

Autism spectrum disorders (ASD) is a neurodevelopmental condition characterized by altered social communication,alongside restricted and stereotyped behaviors and interests,bringing a heavy burden to the family and society.International experts develop the International Classification of Functioning,Disability and Health (ICF) core sets for individuals with ASD.The ICF core sets for ASD will be a tool to describe individual functioning comprehensively.

Objective The recurrence rate is alarmingly high in patients with positive lymph node metastasis (pN+) esophageal squamous cell carcinoma (ESCC) after two-field surgery.This study aims to retrospectively evaluate the value of pN+ region in predicting postoperative recurrence in patients with pN+ thoracic ESCC after two-field radical esophagectomy.Methods A total of 329 patients with pN+ thoracic ESCC after two-field R0 esophagectomy were enrolled in this study.After surgery,pN+ region was located at the upper abdomen in 116 patients,mediastinum in 119 and upper abdomen plus mediastinum in 94,respectively.The enumeration data were analyzed by chi-square test.Logistic multivariate regression analysis was performed to evaluate the risk factors of postoperative recurrence.Cumulative recurrence rate was statistically analyzed by using Kaplan-Meier method,Log-rank test and Cox model multivariate analysis.Results The overall recurrence rate was 72.4％ (239/329).The overall locoregional recurrence (LR) rate was 58.1％(139/329) including 14.6％ in the neck,42.9％ in the mediastinum and 10.0％ in the upper abdomen.Multivariate logistic and Cox regression analyses demonstrated that pN + region was the only independent factor affecting the overall recurrence and LR rates (both P＜0.05).The overall recurrence and LR rates were 57.8％ and 44.0％ for patients with pN+ region in the upper abdomen,77.3％ and 62.3％ for those with pN+ region in the mediastinum and 85.1％ and 72.3％ for their counterparts with pN+ region in the upper abdomen and mediastinum,respectively.Additionally pN+ region was also the independent factor of the recurrence in the mediastinum or upper abdomen (both P＜0.05) rather than the neck (P＞0.05).The recurrence rates in the mediastimun and upper abomen were 27.6％ and 12.9％ for patients with pN+ region in upper abdomen,47.1％ and 4.2％ for those with pN+ region in the mediastinum,and 56.4％ and 13.8％ for patients with pN+ region in the upper-abdomen plus mediastinum,respectively.Conclusions LR is the main cause of failure in patients with pN + thoracic ESCC after two-field R0 surgery.pN + region can be utilized to predict the overall recurrence and LR rates,especially for patients with postoperative recurrence in the the mediastinum and upper abdomen.The findings in this investigation contribute to the design of the target volume of postoperative adjuvant radiotherapy.

Objective The purpose of this study was to assess the value of prenatal ultrasound diagnosis for fetal ear auricle malformations.Methods The coronal and sagittal planes of fetuses ears were obtained prospectively in 6239 singleton fetuses in the First Affiliated Hospital of Shantou University Medical College for the period from 2012 February to 2015 December,the ultrasound images and pregnancy outcomes were analyzed in 11 cases of fetuses ear auricle malformations diagnosed prenatally.Results Eleven Cases of fetuses ear auricle malformations include with 7 cases of microtia,3 cases of low-set ears and 1 case of anotia.Eleven cases were combined with other structural malformations were as followings,3cases with craniocerebral congenital malformation,5 cases with dentofacial deformity,5 cases with malformation of heart,3 cases with limb deformity.Cordocentesis was performed in 7 cases among which 6 with abnormal karyotype,including 2 cases of trisomy 21,2 cases of trisomy 13,2 cases of trisomy 18,1 case of 22ql 1 abnormalities.Compared with the postpartum facial examination,prenatal ultrasound correctly diagnosed 10 cases of fetal ear auricle malformations,missed diagnosis 1 case of microtia.Conlusions Fetus with ear auricle abnormalities have characteristic prenatal ultrasound imaging;prenatal ultrasonography can provide reliable information in the diagnosis of this disease.This study suggests that antenatal ear auricle length measurements might be a promising sonographic screening method for the detection of abnormal karyotype in pregnancy.

Objective To observe the effect of human adipose mesenchymal stem cells (hADMSCs) on pancreatic tissue repair and inflammatory reaction of acute necrotic pancreatitis (ANP) in rat, and explore the possible mechanism.Methods Isolation and purification of hADMSCs and flow cytometry to detect the the surface markers including CD90, CD29, CD34 and CD45 were performed.Eighty SD male rats with the body weight of 170~210 g were randomly divided into 4 groups.There were 8 rats in the control group, 24 rats in other group.Control group underwent no treatment;sham operation group underwent intestinal wall stirring and then abdominal closure;ANP model group was established by open abdominal retrograde injection of sodium taurocholate into bile duct;and in hADMSCs group, DAPI labeled hADMSCs were injected by tail vein into the rat at 12 h after sodium taurocholate injection.The survival of the rats, and gross morphological and pathological changes of the pancreas was observed at 12, 24, and 48 h, and the serum TNF-α, IL-6, IL-10 and amylase were detected.The distribution of hADMSCs in the pancreas, liver and lung was examined in hADMSCs group.Results Rats in control group and sham operation group were all alive.In ANP group, 5 and 11 rats were dead at 24 and 48 h, respectively, and in hADMSCs group 12 rats were dead at 48 h.Compared with ANP group, the difference was not statistically significant (P>0.05).The pathological changes of the pancreas were significantly less severe in hADMSCs group than in ANP group.In hADMSCs group, the amylase at 12, 24 and 48 h was(999±110 )、(1 831±110)、(3 991±130 )U/L;TNF-α level was (62.40±2.35), (80.51±4.51) and (93.46±6.60)ng /L;IL-6 was (60.46±7.34), (80.61±8.40) and(100.58±9.49)ng /L;and these were all significantly lower than those in ANP model group [amylase (2 402±146), (3 292±137) and (5 632±112)U/L;TNF-α(87.13±3.39), (105.41±10.06), (114.57±3.06)ng/L;IL-6 (70.67±10.90)、(107.61±10.53)、(145.34±10.48)U/L], and the differences were all statistically significant (all P<0.05).IL-10 in hADMSCs group was (56.63±6.35), (81.32±5.96), (100.26±6.51)ng/L, which were increased compared with those in ANP model group [(45.26±8.04), (68.25±8.42), (80.38±5.71)ng/L], and the difference was statistically significant (all P<0.05).hADMSCs can migrate to the pancreas, liver, lungs and other damaged tissue, with most in pancreatic tissue, less in lung tissue, and least in liver tissue.Conclusions The mechanism of hADMSCs in repairing pancreatic tissue injury was associated with inhibiting TNF-α and IL-6 secreting and increasing IL-10, thus reducing inflammatory reaction.

Objective: To investigate the postoperative prognosis and the related factors of patients with stage pT2N0-1M0 of thoracic esophageal carcinoma(EC). Methods: From 2008 to 2011, clinical data of 275 cases with stage pT2N0-1M0 of thoracic EC treated by esophagectomy were enrolled. These cases includ 180 male and 95 female. Among them, 32 cases were upper thoracic EC, 186 cases were middle thoracic EC and 57 cases were lower thoracic EC. Alternatively, 205 cases were stage pN0, 70 cases were stage pN1. 155 cases received esophagectomy alone and 120 cases received esophagectomy and postoperative adjuvant therapy. Results: The end of follow-up time was on September 30th, 2014. The 1-, 3-, 5-year overall survival (OS) rates were 91.6%, 70.2% and 63.7%, respectively. The 1- 3-, 5-year progression-free survival (PFS) rates were 83.9%, 64.0% and 60.0%, respectively. The result of univariate analysis showed that the depth of tumor invasion, pathological type, pN stage and number of metastatic lymph nodes were significantly associated with OS (all of P<0.05). Moreover, the gender, the depth of tumor invasion, pathological type, pN stage and number of metastatic lymph nodes were significantly associated with PFS (all of P<0.05). Cox multivariate analysis showed that the location of primary tumor and pN stage were the independent factors of OS (both P<0.05). The gender, pN stage and postoperative adjuvant therapy were the independent factors of PFS (all of P<0.05). Conclusion Among the patients with pT2N0~1M0 stage of thoracic EC, patients with upper thoracic EC or pN1 stage have poorer postoperative prognosis compared with others, and postoperative adjuvant treatment is recommended for these patients.

Objective To retrospectively analyze the value of postoperative adjuvant therapy in the treatment of stageⅢthoracic esophageal squamous cell carcinoma ( ESCC) . Methods From 2008 to 2011, a total of 395 patients with stageⅢthoracic ESCC undergoing radical resection were enrolled as subjects. In those patients.97 received surgery alone (S).212 postoperative adjuvant chemotherapy (POCT),and 86 postoperative radiotherapy (PORT).Comparison of categorical data was made by chi?square test. The survival rates were calculated by the Kaplan?Meier method. The log?rank test was used for between?group comparison and univariate analysis. Results All patients were followed up for at least 3 years.125 cases were followed up for at least 5 years. The 5?year overall survival ( OS) rates in patients treated with S,POCT and PORT were 17. 1%,29. 2% and 36. 4%,respectively (P=0. 000).POCT and PORT could mainly increased OS in patients of males.upper?and middle?segment,severe ahhesion at surgery.well?or middle?differentiation,stageⅢa andⅢb(P=0. 000?0. 049);whenever ages.tumor lesion,two?/three field esophagectomy.and the number of removal lymph nodes. PORT could improved OS also (P=0. 001?0. 047).POCT could also improve OS in patients of ages≤60, tumor lesion<6 cm and removal lymph nodes<10 ( P=0. 002?0. 049 ) . The 5?year progression?free survival (PFS) were 19. 0% with S,28. 8% with POCT,36. 4% with PORT,respectively (P=0. 012).PORT could improve PFS (P=0. 012);especially for patients of males,ages ≤60,upper?and middle segment ESCC,tumor lesion ≥6 cm,severe ahhesion at surgery,removal lymph node<10 and ≥10,well or middle differentiation,stageⅢa andⅢb(P=0. 001?0. 042).But POCT could not increased PFS (P=0. 119) . Conclusions In the treatment of patients with stage Ⅲ thoracic ESCC undergoing radical resection,both POCT and PORT can improve the OS rate, particularly in patients with stage Ⅲa or Ⅲb middle and upper thoracic ESCC, severe adhesion formation during surgery. and moderately or well differentiated squamous cell carcinoma. The DFS rate is improved in patients treated with PORT,but not in those treated with POCT.

Objective: To evaluate the patterns of recurrence and their value on target delineation for postoperative radiotherapy (RT) in patients with stage Ⅲ thoracic esophageal squamous cell carcinoma (ESCC) after esophagectomy. Methods: 395 patients (302 male and 93 female) of stage Ⅲ thoracic ESCC after radical resection were enrolled in this study. Among them, 375 patients were treated with two-field and other 20 with three-field esopahgectomy. 97 patients were treated with surgery alone, 212 with adjuvant postoperative chemotherapy (CT), 56 with radiotherapy (RT) and 30 with CT plus RT. Diagnosis of recurrence was primarily based on CT images, some of which were biopsy confirmed. The location and patterns of tumor recurrence were analyzed. Results: The overall failure rates was 75.7% (299/395). Locoregional recurrence (LR) was found in 48.4% of the patients, distant metastasis (DM) in 16.2%, and LR plus DM in 4.3%. There were 208 patients occurred with LR, 26.9% (56) recurred in supraclavicular/neck (51 in supraclavicular), 69.7% (145) in mediastinum (88.7% in upper-mediastinum), and 19.7% (41) in upper abdomen (38 in para-aortic lymph node). Chi-square test and logistic multivariate regression analysis showed that TNM stage and adjuvant therapy were significantly associated with LR (P<0.05). Postoperative RT reduced LR (mainly LR in mediastinum), but postoperative CT did not decrease LR. Conclusions The recurrence rate is very high in stage Ⅲ thoracic ESCC patients, LR is the main pattern of failure. TNM stage is one of the most important factors for LR. Postoperative radiotherapy can reduce LR but postoperative chemotherapy does not decrease LR. Upper-mediastinum is the most common site of recurrence, followed by supraclavicular and para-aortic regions; these areas should be considered as the key target of postoperative radiotherapy.

Objective To assess the therapeutic efficacy and prognostic factors in elderly patients with stage Ⅲ non-small cell lung cancer (NSCLC) after three-dimensional conformal radiotherapy (3DCRT).Methods A retrospective analysis of 124 stage Ⅲ NSCLC patients aged 70 or over who had received treatment with 3DCRT was conducted retrospectively in this study.There were 99 male and 25 female patients,with a median age of 74 years(range:70-84).The median dose was 60 Gy(range 50-72 Gy).Eighty-three patients were treated with radiotherapy alone,27 with sequential and 14 with concurrent radiochemotherapy.Results The end date of follow-up was August 30,2013.After 3DCRT,the 1-,3-and 5-year overall survival (OS) were 61.1％,23.8％ and13.2 ％,respectively,and the median survival time was 18 months.Univariate analysis revealed that gender,obstructive pneumonia,dosage,method of therapy and immediate effect were related to OS(x2 =3.957,6.398,7.147,12.307 and 11.035,respectively;P=0.047,0.011,0.008,0.002 and 0.001,respectively).Multi-variable analysis indicated that age,gender,obstructive pneumonia,dosage and method of therapy were independent prognostic factors for OS.The OS time was longer inpatients who were female,aged over 75,with no obstructive pneumonia or dosage≥ 60 Gy.Compared with radiotherapy alone,sequential radiochemotherapy increased OS while concurrent radiochemotherapy decreased OS.Conclusions Sex,age,obstructive pneumonia and dosage affect the survival of elderly stage Ⅲ NSCLC patients treated with three-dimensional conformal radiotherapy.Concurrent radiochemotherapy should be considered with caution