Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.
Female ; Humans ; Male ; Aged ; Middle Aged ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy* ; Prognosis ; Lymphoma, B-Cell ; Immunohistochemistry ; Immunoglobulin Heavy Chains/therapeutic use*

Objective To analyze the characteristics of the bilateral external ears of Uygur adults by directly observing the morphological characteristics of the external ears of Uygur adults and classifying each feature. The frequency distribution of the characteristics was calculated to provide reference for forensic identification. Methods The 210 cases （75 males and 135 females） of bilateral external ear photos of Uygur adults in Xinjiang that met the inclusion criteria were collected. The frequencies of the features of the external ear were recorded and distinguished between the two sexes and the different sides. The data were statistically analyzed by SPSS 21.0 statistical software. Results The shapes of the external ears of males and females were commonly oblique or rectangular （34.67% of the left external ear of males and 41.33% of the right were oblique; 30.37% of the left and right external ear of females were rectangular）, while triangular ears were the rare variants and the least common. Sex and bilateral differences were observed as regards the form of the helix in the subjects. Normally rolled helix was the most common （58.67% males and 61.48% females for the left ear; 60.00% males and 72.59% females for the right ear）. Wide covering scapha helix was the most rare for the male left ear and flat helix was the most rare for the female right ear. Square and free earlobes were the most common （49.33% males and 62.96% females for the left ear; 40.00% males and 54.81% females for the right ear）, whereas triangular earlobes were rarely seen. Single knob tragus （40.00% males and 37.78% females for the left ear; 37.33% males and 33.33% females for the right ear） and projection type of Darwin's tubercle （50.67% males and 40.00% females for the left ear; 48.00% males and 39.26% females for the right ear） were found to be common. Conclusion The characteristics of the bilateral external ears of male and female Uygur adults have differences, which can be used for forensic identification.
Adult ; Ear, External ; Ethnicity ; Female ; Humans ; Male ; Sex Characteristics

Bite marks are increasingly common in violent cases such as child abuse and sex crimes. Bite marks are often the result of a suspect's attack or a victim's self-defense. Because human teeth vary in size, shape and arrangement, bite marks on objects such as skin and food are characteristic. By using this principle, forensic odontology can identify or exclude suspects by comparing actual bite marks with the teeth marks in the mouth. In this paper, the practical application of bite mark evidence, the research status and problems of bite mark analysis are briefly reviewed, and the prospect of bite mark analysis is also discussed.
Bites, Human ; Child ; Child Abuse ; Face ; Forensic Dentistry ; Humans ; Tooth

Objective:To investigate the clinical effect of the medial perforator flap of the first plantar artery for repairing the soft tissue defect near the first metatarsophalangeal joint.Methods:From January 2016 to April 2018, 10 patients of soft tissue defect near the first metatarsophalangeal joint were treated in the Department of Orthopedics, Shandong Police General Hospital, including 6 males and 4 females, aged 22-61 years old, with an average age of 40 years. The defects of the feet were recovered by the medial perforator flap of the first plantar artery, and the flap donor defects were covered by split-thickness skin grafts.Results:All flaps and skin grafts of the patients were survived.All patients were followed up for 12-22 months postoperationly/after operation. The flaps were not swollen or ruptured, and the patients walked normally with full weight-bearing.Conclusions:The perforator artery of this flap is consistant, the harvesting of the flap is simple, and the texture of skin is similarwith surrounding tissue, there is no deficit to the flood supply of the foot after harvesting the flap. So, it is an ideal choice for repairing the defect of the soft tissue near the first metatarsophalangeal joint.

Objective:To investigate the clinical effect of the medial perforator flap of the first plantar artery for repairing the soft tissue defect near the first metatarsophalangeal joint.Methods:From January 2016 to April 2018, 10 patients of soft tissue defect near the first metatarsophalangeal joint were treated in the Department of Orthopedics, Shandong Police General Hospital, including 6 males and 4 females, aged 22-61 years old, with an average age of 40 years. The defects of the feet were recovered by the medial perforator flap of the first plantar artery, and the flap donor defects were covered by split-thickness skin grafts.Results:All flaps and skin grafts of the patients were survived.All patients were followed up for 12-22 months postoperationly/after operation. The flaps were not swollen or ruptured, and the patients walked normally with full weight-bearing.Conclusions:The perforator artery of this flap is consistant, the harvesting of the flap is simple, and the texture of skin is similarwith surrounding tissue, there is no deficit to the flood supply of the foot after harvesting the flap. So, it is an ideal choice for repairing the defect of the soft tissue near the first metatarsophalangeal joint.

Objective: To investigate the current practice of extracorporeal cardiopulmonary resuscitation (ECPR) for Chinese cardiac arrest patients after the publication of 2015 American Heart Association guidelines for cardiopulmonary resuscitation. Methods: A questionnaire was distributed to healthcare providers of emergency departments (EDs) and/or Intensive Care Units (ICUs) across 52 hospitals in China from August to November 2016. Data collection ended in February 2017. The questionnaire included three parts: (1) characteristics of the departments and the respondents; (2) knowledge about ECPR; (3) practice of ECPR in cardiac arrest patients (case volume, inclusion/exclusion criteria, ECPR procedure). The characteristics of the departments/hospitals were only answered by the head of the department. Results: A total of 1 952 (86.8%) respondents fulfilled the survey. Only 2.5% of the respondents from 3 of 52 hospitals performed ECPR. Among the three hospitals, the case number of ECPR were ≤5 per year and none of them had written ECPR procedures. Only one hospital had formal inclusion/exclusion criteria. The inclusion criteria included age between 18 to 60 years, suspected cardiogenic cardiac arrest, beginning of cardiopulmonary resuscitation <5 min after cardiac arrest and duration of cardiopulmonary resuscitation >10 min. The top three reasons for the nonuse of ECPR were unknown fields (31.2%), potential ECMO-related side effects (26.9%) and cost (18.7%). Conclusions: ECPR for cardiac arrest patients are not well understood by healthcare providers in the emergency department or ICUs and its application is still in the early stage in China. Educational training and other interventions are needed to promote the clinical practice.

Objective: To assess the association between lupus nephritis disease activity and anti-C1q antibodies. Methods: The study analyzed the medical records of 98 patients with lupus nephritis (LN), 35 patients without lupus nephritis. LN disease activity was measured by the systemic lupus international collaborating clinics (SLICC) renal activity score of 2008. All biopsied tissues were scored based on the International society of nephrology/Renal pathology society (ISN/RPS) 2003 LN pathological typing standards, acute and chronic index scores were used to evaluate the activities of lupus. All patients were test for the levels of anti-dsDNA and anti-C1q antibodies using the enzyme-linked immuno sorbent assay (ELISA), C3, C4, 24-hour urinary protein performed in parallel. For normally distributed quantitative parameters, the differences between groups were assessed by t test. Mann-Whitney U test was performed for non-normally distributed data. The cut-off values were evaluated by using receiver operating characteristic (ROC). The Spearman methods were used to test correlations. Results: Patients with LN had a higher levels of anti-C1q antibodies than patients without lupus nephritis [3.94 (10.2, 91.3) AU/ml与6.9 (2.0, 15.4) AU/ml; Z=-4.299, P<0.01]. Patients with inactive lupus nephritis had higher levels of C1q, C3, C4 than active LN (t=2.393, 3.777, 2.557; P<0.05). Patients with active lupus nephritis had higher levels of anti-C1q antibodies than inactive LN (Z=-4.632, P<0.01). Anti-C1q antibody levels were positively correlated with levels of 24-hour urinary protein, AI score (r=0.327, P<0.01) and SLICC score (r=0.493, P<0.01), and were negatively correlated with serum C1q (r=-0.373, P<0.01), C3 (r=-0.532, P<0.01) and C4 (r=-0.463, P<0.01). The optimal cutoff value of Anti-C1q for a diagnosis of active LN was 48.9 RU/ml, and the sensitivity and specificity were 62.5% and 80%, respectively. The area under the curve (AUC) was 0.771. Conclusion Anti-C1q antibodies are more closely correlated with renal disease activity, and anti-C1q antibody is an important serum marker for monitoring LN activity, but its pathological mechanism in the pathogenesis of LN still needs to be further explored.

OBJECTIVETo investigate the distribution of abnormal hilit syndromes in traditional Uighur medicine (TUM) among human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) patients, and to find out the clinical characteristics of abnormal savda syndrome type HIV/AIDS patients.

METHODSBetween June and July in 2012, 307 eligible HIV/AIDS patients from in-patient department and out-patient clinics of Xinjiang Uighur Autonomous Region the Sixth People's Hospital in Urumqi were investigated. TUM syndrome differentiation was performed by a senior TUM physician. Each participant completed a Sign and Symptom Check-List for Persons Living with HIV/AIDS (SSC-HIV) questionnaire. Depression was evaluated by using Hamilton Rating Scale for Depression Questionnaire. Blood specimen was collected from each participant to test the levels of blood chemicals.

RESULTSOf 307 HIV/AIDS patients, 189 (61.6%) were abnormal savda syndrome type, 118 (38.4%) were non-abnormal-savda syndrome type. Mean CD4 counts of abnormal savda syndrome type patients was (227.61±192.93) cells/µL, and the prevalence of anemia, thrombocytopenia, and elevated cystatin C were 49.7%, 28.6%, and 44.7%, which were significantly higher than those in the non-abnormal-savda syndrome type patients (26.3%, 16.0% and 25.0%,P<0.05). In addition, depression (79.9%) and HIV/AIDS-related symptoms such as fatigue (42.3%), back aches (40.7%), lack of appetite (33.9%), night sweats (31.7%) were more common among abnormal savda syndrome patients (P<0.05).

CONCLUSIONAbnormal savda syndrome is the dominant syndrome among HIV/AIDS patients, and they present a more sever clinical manifestation.

Acquired Immunodeficiency Syndrome ; diagnosis ; Adult ; CD4 Lymphocyte Count ; China ; ethnology ; Cross-Sectional Studies ; Female ; HIV Infections ; diagnosis ; Humans ; Male ; Medicine, Traditional ; Middle Aged ; Surveys and Questionnaires

OBJECTIVETo investigate the association between the polymorphism of CYP17 gene and risk of prostate cancer in Chinese Vigurs men.

METHODSA case-control study including 31 patients with prostate cancer and 104 aged-matched controls was conducted. The polymorphism was investigated by PCR using DNA from peripheral blood lymphocytes. The transition (T-->C) in the risk allele (A2) produced a new recognition site for the restriction enzyme MSPAI I. Three genotypes of CYP17 gene (A1/A1, A1/A2, A2/A2) were determined and confirmed by sequencing.

RESULTSCompared with male A1/A1 genotype, the odds ratios were 1.49 and 2.87 for the A1/A2 and A2/A2 genotypes (P =0.321, 0. 052, respectively). Comparison among 3 subgroups (division by genetypes) of prostate cancer patients, the PSA levels were not significantly different. But in the controls, PSA levels in A1/A2 group were higher but not significant than those in A1/A1 group (P = 0.062). Then, PSA levels in A2/A2 group were significantly higher than those A1/ A1 group (P = 0.018).

CONCLUSIONMore frequency of A2/A2 genotype in prostate cancer than in the control may be associated with the morbidity of prostate cancer in Vigurs male population. Meanwhile, the significant high PSA levels in A2/A2 group also support the view.

Aged ; Aged, 80 and over ; Case-Control Studies ; China ; ethnology ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Prostatic Neoplasms ; ethnology ; genetics ; Steroid 17-alpha-Hydroxylase ; genetics

Animals ; Blood Coagulation Tests ; Liver ; blood supply ; metabolism ; Male ; NF-kappa B ; biosynthesis ; genetics ; Peroxidase ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Rats ; Rats, Wistar ; Reperfusion Injury ; metabolism ; Thromboplastin ; biosynthesis ; genetics