Along with the popularity of low-dose computed tomography lung cancer screening, an increasing number of lung ground-glass opacity (GGO) lesions are detected. The pathology of GGO could be benign, but persistent GGO indicates early-stage lung cancer. Distinct from traditional lung cancer, GGO-featured lung cancer is more common in the young, nonsmokers and females. GGO-featured lung cancer represents an indolent type of malignancy with a long time to intervene. However, there is still no consensus on the screening, pathology, surgical procedure, and postoperative surveillance of GGO-featured lung cancer. Therefore, we proposed a personalized treatment strategy for GGO-featured lung cancer. The screening for GGO-featured lung cancer should be conducted at young age and low frequency. Adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic, and non-lepidic growth patterns could present as GGO. The following issues should be taken into consideration while determining the treatment of GGO-featured lung cancer: avoiding treating benign disease as malignancies, avoiding treating early-stage disease as advanced-stage disease, avoiding treating indolent malignancy as aggressive malignancy, and choosing appropriate timing to receive surgery without affecting life tracks and career developments. Bronchoscope and bone scan are not necessary for preoperative examinations of GGO-featured lung adenocarcinoma. For selected patients, sublobar resection without mediastinal lymph node dissection might be sufficient. Intraoperative frozen section is an effective method to guide resection strategy. Given the excellent survival of GGO-featured lung cancer, a less intensive postoperative surveillance strategy may be sufficient.
ObjectiveTo evaluate the reporting quality of systematic reviews (SRs)/meta-analyses on acupuncture focusing on literature screening results and explore the influencing factors of the complete reporting.MethodsPubMed, EMbase, CNKI, WanFang Data, and VIP databases were searched to collect SRs/meta-analyses on acupuncture from inception to December 31st, 2019. Two reviewers independently screened literature, extracted data and evaluated the reporting quality of literature screening results of SRs/meta-analyses on acupuncture based on PRISMA statement. Logistic regression model analysis was applied to explore the influencing factors of the complete reporting rate of literature screening results. Statistical analysis was performed by using Excel 2016 and SPSS 16.0 software.ResultsA total of 1 227 SRs/meta-analyses were included. Only 62.3% SRs fully reported the four parts of literature screening results. The parts with a low reporting rate included the number of studies assessed for eligibility (73.2%) and the reasons for exclusions at each stage (67.0%). And the reporting rate of the literature screening flowchart was also low (63.6%). The reporting rate of literature screening results in Chinese SRs was lower than that in English SRs, and there was significantly statistical difference (P<0.001). Multivariate logistic regression analysis showed that the type of published journal, publication year, pages of article and the number of searched databases were correlated with the complete reporting rate of literature screening results (P<0.001).ConclusionsThe complete reporting rate of the literature screening results of SRs on acupuncture is low, especially in Chinese SRs. The complete reporting rate of literature screening results is significantly higher for SRs published after PRISMA statement, in SCI journals, with longer length and more searched databases.
Objective To study the prevalence of combined pulmonary fibrosis and emphysema (CPFE) in a community-based lung cancer screening program in Shanghai. Methods From June 2018 to July 2019, eligible participants who were assessed through a high-risk lung cancer questionnaire in Xuhui, Shanghai underwent low-dose computed tomography of the lungs. The suspected CPFE patients were invited to provide medical history and blood for analysis, and received high-resolution CT (HRCT) scanning for confirmation. Results Of the 15 cases of suspected CPFE from a total of 4478 participants in which 1704 males and 2774 females, 4 declined further examination and 11 received further examine. Eight subjects were confirmed as CPFE, and all were male, of whom two were ex-smokers and six were active smokers. These CPFE patients had cough, chest tightness and dyspnea. There were 3 cases of centrilobular emphysema, 2 cases of paraseptal emphysema, 1 case of panlobular emphysema and 2 cases of mixed emphysema. There were 2 cases of usual interstitial pneumonia, 3 cases of non-specific interstitial pneumonia, 2 cases of airspace enlargement with fibrosis and 1 case of unclassifiable smoking-related interstitial fibrosis. The KBILD scores were 61.7±7.5 and mMRC scores were 1.5±0.8. Serum Krebs von den Lungen-6 concentration was (380.75±212.05)U/mL. Lung function test showed normal or mild restrictive ventilatory function, and mild-moderate impairment in diffusion capacity. Conclusions The prevalence of CPFE is 1.79‰ in a community-based lung cancer screening population, and is 4.69‰ in male lung cancer screening population.
Objective To investigate whether the peri pheral administration of amitri ptyl ine and bupivacaine produces anti-hyperalgesic effect and to screen the neurotoxicological effect on sciatic nerve blockade in a rat model of neuropathic pain. Methods Twenty-four adult male SD rats [weighing (200 ± 20) g] were made the models of chronic constriction injury (CCI) and randomly divided into 3 groups (n=8) 5 days after operation: group A (amitriptyl ine), group B (bupivacaine) and group C (normal sal ine). 0.5 mL 0.5% amitriptyl ine, 0.5% bupivacaine or normal sal ine were given in group A, group B, and group C, respectively through implanted cannulas after 5, 7 and 9 days of CCI once a day for successive 3 days. The motor function was measured before administration and 1, 2, 4, 8, 12 and 24 hours after every administration. Mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured before administration and 1, 3, 5 and 7 days after the third administration. The operated sciatic nerve samples were obtained for neuropathological examination under l ight microscope. Results Twenty-four CCI rats were all survival without infection, palsy and catheter fall ing off. Compared with group C, the rats of group A and group B both produced significant ambulation deficits after every administration (P lt; 0.05). The ambulation deficits lasted 2 hours (group B) and 8 hours (group A) respectively. But the ambulation deficits of CCI rats were all reversible. The MWT and TWL of group A 1 and 3 days after the third administration increased when compared with those before administration and 5 and 7 days after the third administration, and when compared with group B and group C (P lt; 0.05). There was no significant difference (P gt; 0.05) in l ight microscopic neuropathological examination among three groups. Epineurial tissue and endoneurium tissue integrity, tidy arrangement of fibers, less inflammatory cell and no marked degeneration of myel inated fibers were observed. Conclusion Repeated sciatic nerve blockade with 0.5% amitriptyl ine has peripheral anti-hyperalgesic effects on neuropathic pain of rats. No morphological evidence of neurotoxicity in the sciatic nerve of rats is observed in 0.5% amitriptyl ine.
ObjectiveTo understand the prevalence of anorectal diseases in the elderly in the community, and to evaluate the role of electronic rectosigmoidoscope in the screening of anorectal diseases.MethodThe resident population aged 60–74 in the Xichang’an Street Area of Xicheng District of Beijing were collected to complete the initial screening by filling in the risk factor assessment questionnaire, and who were classified as the high-risk with positive initial screening were admitted to the diagnostic re-screening by electronic rectosigmoidoscope.ResultsThere were 4 782 screening subjects, while 4 347 people actually participated in the initial screening, and 2 997 people were positive (positive rate was 68.9%). Among them, 2 312 participated in the electronic rectosigmoidoscope screening, and the compliance rate was 77.1%. A total of 2 275 patients with various anorectal diseases were detected by electronic rectosigmoidoscope, 1 311 (56.7%) of whom were hemorrhoids, 458 (19.8%) were rectal polyps, 154 (6.7%) were anal papillary hypertrophy, 147 (6.4%) were proctitis, 103 (4.4%) were anal fissure, 52 (2.2%) were anal fistula , 33 (1.4%) were rectal melanoma , and 17 (0.7%) were suspected rectal cancer. The detection rates of rectal polyps, proctitis, and anal fistula in the men were higher than those in the women (P<0.05), while the detection rates of hemorrhoids, anal papilla hypertrophy, anal fissure, and rectal melanosis in the women were higher than those in the men (P<0.05).ConclusionsAs a screening tool, electronic rectosigmoidoscope has the characteristics of simple operation, good compliance of the subject, and high compliance rate for re-screening. It is suitable for large-scale screening of anorectal diseases for elderly residents in the community.
Objective To observe the fundus characteristics and associated factors of retinal hemorrhage (RH) in newborns. Methods A total of 293 healthy newborns (586 eyes) were enrolled in this study. A digital wide-angle retinal imaging device (RetCam Ⅲ) was used to examine the subjects at about 2 days after birth (2.7plusmn;0.9) days. The images of posterior pole, temporal quadrant, superior quadrant, nasal quadrant and inferior quadrant of the fundus of each eye were taken sequentially. Every newborn completed the examination and the mean duration of the procedure was (2.62plusmn;0.55) minutes. Newborns with RH were reexamined after one month. RH was classified according to the location and size of the hemorrhages based on guidelines in the literature. The location and degree of RH was determined in each newborn. The incidence of RH by gender, parity, birth weight, maternal age and delivery method was compared and analyzed. Results RH was present in 87 eyes (14.8%) of 58 newborns (19.8%) and of the 58 newborns with RH, half (29 eyes) had hemorrhages in both eyes, and half (29 eyes) had hemorrhages in only one eye. The site of the hemorrhage was all on the superficial retina. Of the 87 eyes with RH, 72 eyes (82.8%) had hemorrhage in zone Ⅰ, 86 eyes (98.9%) had hemorrhage in zone Ⅱ, and 36 eyes (41.4%) had hemorrhage in zone Ⅲ. Thirty-eight eyes (43.7%) had hemorrhage in zone Ⅰand Ⅱ. Three eyes (3.4%) had hemorrhage in zone Ⅱ and Ⅲ. Thirtythree eyes (37.9%) had hemorrhage in zone Ⅰ, Ⅱ and Ⅲ. One eye (0.4%) had hemorrhage in zoneⅠonly. Twelve eyes (13.8%) had hemorrhage in zone Ⅱ only. None had hemorrhage in zone Ⅲ only. The severity of RH was grade Ⅰ in 13 of 87 eyes (14.9%), grade Ⅱ in 33 of 87eyes (37.9%), and grade Ⅲ in 41 of 87 eyes (47.1%). Fourteen of 58 newborns with RH (24.1%) were lost to follow-up. Forty-four of 58 newborns with RH (75.9%) were reexamined one month after birth and all the RH disappeared entirely. There were no statistically significant differences among the incidences of RH of the different gender (chi;2=0.018,P=0.893), parity（chi;2=0.772,P=0.380）, birth weight（chi;2=1.611,P=0.447）and maternal age (chi;2=0.915,P=0.339). The incidence of RH was higher for vaginal delivery than that for cesarean section delivery (chi;2=3.073,P＜0.05). Conclusions The RH in newborn is located in the superficial retina, mostly located in zone Ⅰor zone Ⅱ, and resolves itself within one month after birth. The RH in newborns is related to the mode of delivery, but not related to gender, parity, birth weight or maternal age.
ObjectiveTo measure and analyze the tortuosity of retinal veins in neonatal and premature infants quantitatively. MethodsA retrospective clinical study. The fundus images of the left eyes were selected from 30 healthy neonates and 30 premature infants without retinopathy of prematurity underwent RetCam screening. There were 16 premature infants with a history of oxygen inspiration. The tortuosity of superior temporal veins, inferior temporal veins, superior nasal veins, inferior nasal veins was measured separately using a self-developed computer program. Pearson correlation analysis was used to analyze the relationship between tortuosity of retinal veins and birth weight, gestational age and correct gestational age. ResultsIn full-term neonatal infants, the vascular tortuosity of the nasal veins was significantly higher than the temporal veins (t=5.73, P < 0.01), while the superior veins and inferior veins showed no significant difference (t=0.39, P > 0.05). There was no correlation between vascular tortuosity of temporal (r=0.179, -0.175) or nasal veins (r=0.055, 0.345) with birth weight or gestational age (P > 0.05). In premature infants, the vascular tortuosity of the nasal veins was also significantly higher than the temporal veins (t=5.00, P < 0.01), no significant difference was found between the superior veins and inferior veins (t=0.39, P > 0.05). The vascular tortuosity of temporal veins of premature infants was negatively correlated with birth weight (r=-0.375, P < 0.05); however, no significant correlation was found with gestational age (r=-0.296, P > 0.05). The vascular tortuosity of the temporal retinal veins of premature infants with a history of oxygen inspiration was significantly higher than premature infants without a history of oxygen inspiration (t=2.517, P < 0.05), though no significant difference was found between the nasal veins (t=-0.261, P > 0.05). The vascular tortuosity of the temporal and nasal retinal veins of premature infants was both higher than neonate, but was not statistically significant (t=0.88, 1.50; P > 0.05). ConclusionsThe vascular tortuosity of the temporal veins was greater than the nasal veins in both full-term and premature infants, though no significant difference was found between superior and inferior veins. The vascular tortuosity of temporal veins of premature infants increased as birth weight decreased. The vascular tortuosity of the temporal retinal veins of premature infants with a history of oxygen inspiration was higher than premature infants without a history of oxygen inspiration.
Lung cancer is the leading cause of death among the tumors in the whole world. Although new diagnostic techniques have been developed for nearly 20 years, the mortality is still high. Until now, no randomized controlled trial of chest x-ray and sputum cytology showed the improvement of the survival rate of lung cancer. Low-dose CT can screen more patients in early stage, however, overdiagnosis, cost and the quality of studies should be considered. Further studies of RCTs should be done to clarify these questions.
Objective To investigate the incidence and risk factors associated with the development of retinopathy of prematurity (ROP) in Hubei province. MethodsFrom July 2009 to May 2011, 313 premature infants (626 eyes) with gestational age less than 37 weeks were examined by indirect ophthalmoscopy and RetCamⅡ as part of ROP screening.Two hundred infants were male and 113 were female. Their birth weight was from 890 to 3500 grams, with a mean of (1977.37±497.03) grams. Their gestational age was from 26 to 37 weeks, with a mean of (33.13±2.44) week. The infants were divided into ROP group and non-ROP group according to the results of screening. All infants were followed up until retinopathy was stable or received laser therapy as the requirements of prevention and control guidelines of ROP. The sex, gestational age, birth weight, delivery mode, IVF baby, multiple pregnancy, oxygen therapy, intrauterine hypoxia, eclampsia, threatened abortion, oxygen history of infants, respiratory distress syndrome, hypoxicischemic encephalopathy, jaundice, and blueray radiation therapy in two groups were statistically analyzed. ResultsIn 313 infants (626 eyes), ROP developed in 52 infants (16.61%) and 87 eyes (13.90%), which including 2 eyes suffering from AP-ROP, 38 eyes from stage 1, 36 eyes from stage 2, 11 eyes from stage 3. There were 261 infants (83.39%) and 539 eyes (8610%) in nonROP group. Eleven infants (20 eyes) received laser therapy. The results of statistical analysis showed that gestation age(t=-4.348), birth weight (t=-3.966), oxygen therapy (χ2=9.05;OR=3.403, 95%CI=1.475 - 7.854) were significantly related to ROP (P＜0.05).ConclusionThe incidence of ROP in Hubei province is 16.61%. The gestation age, birth weight and oxygen therapy are closely related to the occurrence of ROP.
Sleep apnea causes cardiac arrest, sleep rhythm disorders, nocturnal hypoxia and abnormal blood pressure fluctuations in patients, which eventually lead to nocturnal target organ damage in hypertensive patients. The incidence of obstructive sleep apnea hypopnea syndrome (OSAHS) is extremely high, which seriously affects the physical and mental health of patients. This study attempts to extract features associated with OSAHS from 24-hour ambulatory blood pressure data and identify OSAHS by machine learning models for the differential diagnosis of this disease. The study data were obtained from ambulatory blood pressure examination data of 339 patients collected in outpatient clinics of the Chinese PLA General Hospital from December 2018 to December 2019, including 115 patients with OSAHS diagnosed by polysomnography (PSG) and 224 patients with non-OSAHS. Based on the characteristics of clinical changes of blood pressure in OSAHS patients, feature extraction rules were defined and algorithms were developed to extract features, while logistic regression and lightGBM models were then used to classify and predict the disease. The results showed that the identification accuracy of the lightGBM model trained in this study was 80.0%, precision was 82.9%, recall was 72.5%, and the area under the working characteristic curve (AUC) of the subjects was 0.906. The defined ambulatory blood pressure features could be effectively used for identifying OSAHS. This study provides a new idea and method for OSAHS screening.