Different clinical features between patients with ROS1-positive and ALK-positive advanced non-small cell lung cancer

ObjectiveTo compare the baseline clinical characteristics between patients with ROS1-positive and ALK-positive advanced non-small cell lung cancer (NSCLC), and the correlations of these subtypes with the distribution of metastases.MethodsWe compared the clinical characteristics and imaging features of patients with ROS1-positive and ALK-positive NSCLC using statistical methods.ResultsData for 232 patients were analyzed. Compared with ALK-positive NSCLC, ROS1-positive NSCLC was more likely to occur in women (71% vs 53%), and primary lesions ≤3 cm were more common in patients with ROS1-positive compared with ALK-positive NSCLC (58% vs 37%). There was no significant difference in the distribution of metastases between the two groups. Subgroup analysis within the ROS1-positive group showed that, compared with primary lesions >3 cm, primary lesions ≤3 cm were more likely to present as peripheral tumors (72% vs 43%) and more likely to exhibit non-solid density (44% vs 4%).ConclusionsAlthough ROS1-positive and ALK-positive NSCLCs show similar clinical features, the differences may help clinicians to identify patients requiring further genotyping at initial diagnosis.     

2016—2021年灌云县手足口病流行病学特征分析

目的 分析灌云县2016—2021年手足口病流行特征,为手足口病的防控提供参考依据。方法 采用描述性统计方法,分析灌云县手足口病的流行特征以及病原学变化等。结果 2016 —2021年灌云县手足口病 4 205例,呈现出“隔年高发”特征,年平均发病率为67.50/10万;4 —6月和10 —12月为高发期;男性占比明显高于女性;0～4岁散居儿童居多;伊山镇、侍庄街道和东王集镇发病率位居前三。2016 —2017年确诊患儿病原以EV71为主,2018—2021年以Cox A6为主。8例重症病例集中在1～5岁,确诊的重症患者以EV71感染为主。结论 灌云县手足口病疫情具有“隔年高发”和季节性“双峰流行”特征,以0～4岁散居儿童为高发人群和灌云县县城及周边镇(街)为高发区域。EV71灭活疫苗接种能有效预防EV71病毒引发的手足口病。     

舌三针为主治疗脑卒中后吞咽功能障碍的临床研究

目的观察舌三针为主治疗脑卒中后吞咽功能障碍的临床疗效及其对脑神经机制的影响。方法将130例脑卒中后吞咽功能障碍患者随机分为治疗组和对照组,每组65例。对照组采用康复训练配合低频脉冲电刺激治疗,治疗组在对照组基础上采用舌三针治疗。观察两组治疗前后吞咽功能(洼田饮水试验评分)、精神状态[汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分]及表面肌电图各项指标[平均振幅值(AEMG)、持续时间(t)]的变化情况。结果两组治疗后洼田饮水试验评分、HAMA评分及HAMD评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后洼田饮水试验评分、HAMA评分及HAMD评分与对照组比较,差异均具有统计学意义(P<0.05)。两组治疗后空吞咽时及吞咽5 mL水时sEMG各项指标(颏下肌群及舌骨下肌群的AEMG和t)与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后空吞咽时及吞咽5 mL水时sEMG各项指标与对照组比较,差异均具有统计学意义(P<0.05)。治疗组治疗后误吸及肺部感染的发生率分别为16.1%和17.7%,对照组分别为36.2%和32.8%,两组比较差异均具有统计学意义(P<0.05)。结论舌三针配合康复训练及低频脉冲电刺激能有效改善脑卒中患者的吞咽功能。     

溃疡性结肠炎薄白苔和黄腻苔患者的肠道菌群特征分析

  目的：通过分析溃疡性结肠炎(UC)薄白苔、黄腻苔患者的肠道菌群特征,探讨UC患者舌苔与肠道菌群之间的关系。  方法：选取UC薄白苔患者、UC黄腻苔患者、健康对照者各35例,分别设为UC薄白苔组、UC黄腻苔组、健康对照组。收集粪便标本,采用16S rDNA基因测序分析技术和生物信息学方法分析比较各组肠道菌群的多样性和丰度。  结果：①与健康对照组比较,UC薄白苔、黄腻苔组患者肠道菌群物种的丰富度和多样性降低(P＜0.001),肠道菌群物种数量减少；与UC薄白苔组比较,UC黄腻苔组患者肠道菌群丰富度差异无统计学意义(P＞0.05),但肠道菌群物种数量减少。②门水平差异分析:与健康对照组比较,UC薄白苔、黄腻苔组患者肠道菌群中厚壁菌门(Firmicutes)减少(P＜0.05)；与UC薄白苔组比较,UC黄腻苔组患者肠道菌群中蓝细菌门(Cyanobacteria)增多(P＜0.05)。③属水平差异分析:与健康对照组比较,UC薄白苔组患者肠道菌群中埃希氏-志贺氏菌属(Escherichia-Shigella)、链球菌属(Streptococcus)等增多(P＜0.05),罕见小球菌属(Subdoligranulum)、多尔氏菌属(Dorea)、瘤胃球菌属(Ruminococcus)、罗氏菌属(Roseburia)等减少(P＜0.05)；UC黄腻苔组患者肠道菌群中埃希氏-志贺氏菌属(Escherichia-Shigella)、乳杆菌属(Lactobacillus)等增多(P＜0.05),多尔氏菌属(Dorea)、罕见小球菌属(Subdoligranulum)、瘤胃球菌属(Ruminococcus)、考拉杆菌属(Phascolarctobacterium)、罗氏菌属(Roseburia)等减少(P＜0.05)。与UC薄白苔组比较,UC黄腻苔组患者肠道菌群链球菌(Streptococcus)增多(P＜0.05),巨球型菌属(Megasphaera)、拟普氏菌属(Alloprevotella)、普氏菌属(Prevotella)、奈瑟氏菌属(Neisseria)等减少(P＜0.05)。④LDA判定(纲、目、科水平):UC薄白苔组患者肠道菌群中普氏菌科(f_Prevotellaceae)、奈瑟氏球菌目(o_Neisseriales)、奈瑟氏球菌科(f_Neisseriaceae)丰度显著多于UC黄腻苔组(LDA＞2.0),UC黄腻苔组患者肠道菌群中杆菌纲(c_Bacilli)、乳杆菌目(o_Lactobacillales)、链球菌科(f_Streptococcaceae)、消化链球菌科(f_Peptostreptococcaceae)丰度显著高于UC薄白苔组(LDA＞2.0)。  结论：UC薄白苔、黄腻苔患者肠道菌群丰富度和多样性均较健康者明显下降；UC薄白苔患者和UC黄腻苔患者在肠道菌群组成和细菌丰度上均存在差异,黄腻苔患者肠道致病性细菌增多而具有潜在保护作用的细菌减少；肠道菌群检测可以为舌诊现代化提供一定的信息。     

H型高血压患者舌面诊图像颜色特征参数分析＊

目的 分析H型高血压患者的舌面诊图像颜色参数特征，探讨H型高血压患者的舌诊、面诊变化规律。方法 运用上海中医药大学自行研制的Smart TCM-1型中医舌面一体仪，采集高血压患者舌面诊图像，提取特征参数，分析健康对照组、H型高血压组与非H型高血压组患者舌面颜色参数特征。结果 ①在舌色各项参数中，H型高血压组舌尖部R值、B值、V值均显著小于健康对照组（P < 0.01）；非H型高血压组舌尖部B值显著小于健康对照组（P < 0.01），S值较健康对照组显著增大（P < 0.05）；H型高血压组舌尖部R、V值均明显小于非H型高血压组（P < 0.05）。在舌苔各项参数中，H型高血压组舌中H值、V值均明显小于健康对照组（P < 0.05）；非H型高血压组舌中V值、舌右V值均显著小于健康对照组（P < 0.01）；H型高血压组舌中H值明显小于非H型高血压组（P < 0.05），右侧舌苔S值明显大于非H型高血压组（P < 0.05）。②H型高血压组面色参数鼻G值、下颌G值、口唇R值、口唇V值均明显小于健康对照组（P < 0.05）；非H型高血压组前额H值、目眶H值、脸颊H值、鼻H值、下颌H值、整体H值均明显大于健康对照组（P < 0.05）；H型高血压组前额H值、目眶G值、目眶H值、脸颊H值、鼻G值、鼻H值、下颌R值、下颌G值、下颌H值、下颌V值、口唇R值、口唇G值、口唇V值、整体R值、整体G值、整体H值、整体V值均明显小于非H型高血压组（P < 0.05）。结论 H型高血压患者苔色偏黄，以舌中部为主，且舌右侧黄苔积聚较明显；H型高血压患者面色为黄中带红，口唇、下颌部更为晦暗。H型高血压患者的舌、面诊特征参数的变化，与高血压病阳亢湿盛病机相符。     

不同性别系统性红斑狼疮患儿的临床特征及随访比较

目的 对不同性别系统性红斑狼疮（SLE）患儿的临床特征及随访情况进行比较。方法 回顾性分析2008~2018年确诊为SLE的≤14岁患儿79例（男18例，女61例）的临床资料，对男女儿童首发及主要临床症状、器官/系统损害情况、相关实验室指标、随访情况等进行对比研究。结果 首发症状及非首发症状中，男童组以发热发生率最高，女童组以面部红斑发生率最高。男童更易出现肾脏和血液系统的损害（P < 0.05），其中蛋白尿发生率较女童明显升高（P < 0.05）。女童更易出现关节痛（P < 0.05）。两组抗核抗体、抗双链DNA抗体、补体C3、红细胞沉降率的异常率均很高（>80%，P > 0.05）。男童组的疾病活动度在首次就诊及随访至第9年时高于女童组（P < 0.05）。随访结果显示（随访时间1个月至10年），在男童组中，3例失访，1例死亡，7例病情控制良好，但均需口服较大剂量激素或免疫抑制控制病情，2例发展为慢性肾功能衰竭，1例出现狼疮脑病。女童组中，3例失访，5例死亡，34例病情控制良好，其中口服醋酸泼尼松10 mg以下维持的有5例，停药1年的1例，停药2年的2例；4例出现狼疮脑病；1例在患病后第7年出现抑郁焦虑状态并有自杀倾向；2例出现视力下降、视物模糊、绿视；1例在服用激素第3年出现双侧股骨头缺血坏死。结论 不同性别SLE患儿的临床特征、部分实验室指标及预后存在差异。男性SLE患儿可能起病更重，更易发生肾脏及血液系统损害，且远期预后可能更差。女性SLE患儿可能更易累及关节。     

The influence of tongue strength on children's performance in computer games reliant on lingual force generation

Oral motor exercises, for recovering tongue strength, can be integrated with computer games to increase motivation, especially for treatments in children. The aim of this study was to investigate the influence of tongue strength on motor performance in computer games reliant on lingual force generation. An observational study was carried out at a speech-language pathology outpatient university clinic. Twenty participants (10 with normal tongue strength and 10 with reduced tongue strength) aged 8-13 years used an intra-oral joystick controlled by the tongue to play six computer games during which they had to reach targets that appeared on the screen. Motor performance was measured by the number of attempts to score and the time during which the target force was maintained. Tongue motor performance was compared between groups and across directions of tongue movement, resistance force levels, order of target appearance, continuous force application time on the target, age and sex. Children with normal tongue strength had a lower number of attempts to score (P = .014) and maintained the target force for longer periods (P = .002) than those with reduced tongue strength. The performance was better for both groups (a) in the downward direction compared with the performance in other directions, (b) in games with the lowest resistive force level (0.5 N) compared to those with other levels of resistive force and (c) in the second and third rounds compared with the first round. There were no gender-related differences in performance. Older participants performed better than younger participants. Tongue strength, direction of movement, force to reach the target, time of continuous force application, order of target appearance and age influenced tongue motor performance.     

A comparison of airway interventions and gastrostomy tube placement in infants with Robin sequence

The purpose of this study was to evaluate feeding impairment following non-operative or operative management of airway obstruction in a large series of infants with Robin sequence (RS) by rate of G-tube placement. A retrospective study was conducted at Boston Children’s Hospital including 225 patients (47.1% female) with RS treated between 1976 and 2018. Subjects were grouped by intervention required for successful management of airway obstruction: non-operative only (n = 120), tongue–lip adhesion (TLA, n = 75), mandibular distraction osteogenesis (MDO, n = 21), or tracheostomy (n = 9). The operative group had a higher rate of G-tube placement (58.1%) than the non-operative group (28.3%, P < 0.0001). Subjects in the TLA and tracheostomy groups had higher odds of G-tube placement than subjects in the MDO group: odds ratio (OR) 5.5 (95% confidence interval (CI) 1.8–17.3, P = 0.004) and OR 27.0 (95% CI 3.2–293.4, P = 0.007), respectively. Syndromic patients and those with gastrointestinal anomalies also had higher odds of G-tube placement: OR 3.5 (95% CI 1.7–7.2, P = 0.001) and OR 5.9 (95% CI 1.6–21.0, P = 0.007), respectively. Infants with RS who require an airway operation and those with a syndromic diagnosis or gastrointestinal anomalies are more likely to require placement of a G-tube. Of the operative groups, MDO was associated with the lowest G-tube rate, compared to TLA and tracheostomy.