We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies

The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.

Objective: To study the correlation between meteorological factors and the incidence of hand, foot and mouth disease (HFMD) in Xinjiang Uygur Autonomous Region (Xinjiang) so as to provide scientific evidence for the early warning, prediction, prevention and control of HFMD. Methods: Data on HFMD surveillance and related population was collected from the China Information System for Disease Control and Prevention from 2011 to 2018. Meteorological data was obtained from http://www.tianqihoubao.com. Correlation analysis on meteorological factors and the incidence of HFMD in Xinjiang was conducted, using the Excel 2007, SPSS 17.0, and Spatial Distribution Map by ArcGIS 10.2 software. Results: HFMD usually occurred between April and July. Numbers of patients reached the top in May and June. Temperature was positively correlated with the incidence of HFMD (r=0.370, P<0.01) while precipitation was positively correlated with the incidence of HFMD (r=0.747, P<0.01). The temperature threshold appeared as 5 ℃-35 ℃ for the incidence of HFMD. Interval period was one month between the peak of both the incidence of HFMD and the precipitation. A power function relationship (y=0.009 4x^{2.332 9}, R²=0.898 9) was noticed between the precipitation and the incidence of HFMD. Conclusions The incidence of HFMD was closely related to the meteorological factors including temperature and precipitation in Xinjiang during 2011-2018. Our findings have provided evidence for the development of early warning system on HFMD in Xinjiang.

PURPOSE: This study aims to investigate the feasibility of contouring target volume according to residual tumor and decreasing the dose to the tumor regression field after induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: From August 2009 to August 2013, patients with stage III–IVB NPC were treated with IC and concurrent chemoradiotherapy. Gross tumor volume of nasopharynx (GTVnx)–residual and gross tumor volume of cervical lymph node (GTVnd)–residual were contoured according to post-IC residual primary tumor and any N+ disease, respectively. The tumor regression field was included in CTVnx1/CTVnd1 and prescribed a dose of 60 Gy. Outcomes and toxicities of all patients were evaluated. RESULTS: A total of 57 patients were enrolled. At a median follow-up of 68 months, three cases displayed locoregional recurrence and one case showed both distant metastasis and locoregional recurrence. All locoregional recurrences were in the GTVnx-residual/GTVnd-residual and in-field. The 5-year overall, locoregional relapse-free, distant metastasis-free, and progression-free survival rates were 82.2%, 87.7%, 85.8% and 80.3%, respectively. CONCLUSION: After IC, contouring of GTVnx-residual/GTVnd-residual as residual tumor volume and distribution 60 Gy ofradiation dose to the tumorregression field may be feasible and need further investigation.
Chemoradiotherapy ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Induction Chemotherapy ; Lymph Nodes ; Nasopharynx ; Neoplasm Metastasis ; Neoplasm, Residual ; Radiotherapy, Intensity-Modulated ; Recurrence ; Tumor Burden

The technical operation criteria and clinical application guidelines for pediatric nuclear medicine include information related to the preparations,precautions,responsibilities of nuclear personnel,dosage of radiopharmaceutical,history-taking,imaging protocol,as well as indication and safety,focusing primarily on the usual pediatric nuclear medicine examinations.The purpose of the criteria and guidelines is to offer nuclear medicine physicians a framework that could prove practical and helpful in daily clinical practice.

OBJECTIVETo observe the long-term therapeutic efficacy of standardized specific subcutaneous immunotherapy on persistent allergic rhinitis in children. METHODSFrom Jan. 2007 to Aug. 2009, 236 children with persistent allergic rhinitis were divided into two groups, which 120 cases underwent standardized house dust mite allergen subcutaneous specific immunotherapy (SCIT), another 116 cases accepted a serious of steroids nasal spray and oral antihistamine (control group). The efficacy of the patients was evaluated by using the visual analog scale (VAS) and Rhino conjunctivitis quality of life questionnaire (RQLQ).RESULTSAfter patients underwent 3-years SCIT, the VAS score was 2.3±0.7, 2.4±0.6, 1.6±0.4, 1.9±0.5, and the RQLQ score was 7.7±1.6, 7.4±1.1, 4.3±0.7, 4.1±0.9, respectively, at the follow-up period of 3 month, 1 year, 3 years and 5 years, and both scores were significantly lower than the score of pre-treatment (P<0.001). Compared the single dust mite allergen positive patients with multiple allergens positive patients, both VAS and RQLQ scores were not significantly changed at each follow-up period after SCIT (P>0.05). No serious adverse events occurred in all treatments.CONCLUSIONThe standardized specific immunotherapy has the long-term efficacy for dust mite positive children with persistent allergic rhinitis. It demonstrated a similar effect in both single dust mite positive patients and multiple allergens positive patients.

Objective To observe the effects of early rehabilitation training on endothelial progenitor cells (EPCs),stromal cell-derived factor alpha 1 (SDF-lα) and motor function recovery in hemiplegic patients with acute cerebral infarction.Methods Fifty hemiplegic patients after a first acute cerebral infarction were randomly divided into a control group (n =25) and an experimental group (n =25).Both groups of patients were given routine drug therapy,while the experimental group also received early rehabilitation (within 48 hours of onset).EPCs and SDF-1α levels in peripheral blood were measured before and after one week of treatment,and Fugl-Meyer assessments and modified Barthel index scoring were conducted at admission and after three months of treatment.Results There was no difference between the 2 groups before the treatment.After a week of treatment,however,the EPC and SDF-1α values of both groups had increased,with those of the experimental group increasing significantly more than in the control group.Spearman rank correlation analysis showed that the increase in EPCs was positively correlated with the SDF-1α increment in the first week.After 3 months of treatment,the average FMA and MBI results of the experimental group were significantly better than those of the control group.Conclusion Early rehabilitation training can help to further improve the recovery of motor function for hemiplegic patients after acute cerebral infarction.This may be related to its effect in upregulating the expression of SDF-1α,thus contributing to the mobilization of EPCs in the bone marrow.

Objective To study chemical ingredients and angiogenesis effects for different compatibility proportions ofDanggui Buxue Decoction.Methods For chemical components, HPLC was performed to study the ingredients (Ferulic Acid, Calycosin-7-glusosido, Calycosin, Formononetin) inDanggui Buxue Decoction. For angiogenesis effects, transgenosis zebrafish model was incubated with different proportions ofDanggui Buxue Decoction.Results With the raise of Astragali Radix content, the synthetic scores of four ingredients in different compatibility proportions increased. When the Astragali Radix content to Angelicae Sinensis Radix content was 8 to 2 and 5 to 1, the scores were the highest. For zebrafish vascular injury model, vessel recoveries in top three were 5:1, 6:1 and 2:1 (Astragali Radix: Angelicae Sinensis Radix).Conclusion From comprehensive analysis of chemical composition and angiogenesis, the best compatibility ratio of Astragali Radix to Angelicae Sinensis Radix is 5:1.

Using Dachengqi Tang (DCQT) as a model, high performance liquid chromatography (HPLC) fingerprints were applied to optimize machine extracting process with the Box–Behnken experimental design. HPLC fingerprints were carried out to investigate the chemical ingredients of DCQT; synthetic weighing method based on analytic hierarchy process (AHP) and criteria importance through intercriteria correlation (CRITIC) was performed to calculate synthetic scores of fingerprints; using the mark ingredients contents and synthetic scores as indicators, the Box–Behnken design was carried out to optimize the process parameters of machine decocting process under high pressure for DCQT. Results of optimal process showed that the herb materials were soaked for 45 min and extracted with 9 folds volume of water in the decocting machine under the temperature of 140 1C till the pressure arrived at 0.25 MPa;then hot decoction was excreted to soak Dahuang and Mangxiao for 5 min. Finally, obtained solutions were mixed, filtrated and packed. It concluded that HPLC fingerprints combined with the Box–Behnken experimental design could be used to optimize extracting process of traditional Chinese medicine (TCM).

OBJECTIVE:To evaluate the quality of TCM decoction pieces in our hospital preliminarily and explore the solu-tions for the problem of the quality of decoction pieces purchased by the hospital. METHODS:In Jun. 2012,a system was estab-lished by our hospital,where the quality inspector was designated to daily inspect new batches of TCM decoction pieces such as ap-pearance provided by suppliers. The batches of TCM decoction piece samples inspected and those of unqualified products from Jun. 2012 to May 2014 were calculated. The reasons of unqualified products were analyzed and corresponding solutions were made. RE-SULTS&CONCLUSIONS:Over two years,a total of 94 671 batches of TCM decoction piece samples were inspected by our hos-pital,among which 737 were unqualified products predominantly because of mildew,damage by worms,greasing,containing for-eign substances and others. The solutions to such problems included interviewing the suppliers,returning or discontinuing the use of crude drugs and special focus on particular seasons and on the demand for key varieties. The unqualified products rate in the quality inspection reduced from 0.56%in Jun. 2012 to 0.34%in May 2014. Therefore,setting the post of drug quality inspector in the hos-pital can ensure the quality of TCM decoction piece purchased,however,it need to improve the inspection and acceptance of quali-ty inspection by sampling,scoring and using the new technology.