Objective . The purpose of this study was to explore the association of nine types of Traditional Chinese Medicine (TCM) constitution with the five chronic diseases: hypertension, hyperlipidemia, diabetes mellitus, heart disease, and obesity. Methods . Chi‐squared test was performed to investigate the distribution characteristics of TCM constitutions in the participants with the five chronic diseases in questionnaire. Correspondence analysis was used to explore the correlation between them. Results . A total of 2,660 participants (1,400 males; 1,260 females) were included in this study. The mean age was 52.54 ± 13.92. Of them, 600 were of gentleness type accounting for 22.56%. Proportions of gentleness type in the chronic diseases (16.00%~23.70%) were less than that in general population (32.14%). The gentleness type and yin‐deficiency type were significantly correlated with hypertension and diabetes mellitus, qi‐deficiency type was correlated with heart disease, phlegm‐dampness type was associated with obesity, and dampness‐heat type was correlated with hyperlipidemia. Conclusions . The correlations between TCM constitution types and the five chronic diseases were different. This may have a significant implication for TCM practice, and even the people with gentleness type should not be ignored in health management.
Abstract Background We aimed to compare unstimulated saliva flow using 3‐minute modified Schirmer test (MST) following bilateral vs unilateral radiotherapy (RT) in oropharyngeal carcinoma (OPC). Methods We reviewed OPC patients treated with definitive intensity‐modulated radiation therapy (IMRT) between 2011 and 2017. MST was measured at baseline, 1‐/6‐/12‐/24‐month post‐RT. MST values were compared between bilateral‐RT vs unilateral‐RT groups. Multivariable logistic regression analysis (MVA) identified predictors of hyposalivation (MST < 25 mm). Results Total 498 bilateral‐RT and 36 unilateral‐RT patients were eligible. The MST values at 1‐/6‐/12‐/24‐month post‐RT were all significantly reduced from baseline for the entire cohort. Baseline unilateral‐RT and bilateral‐RT MST values (in mm) were similar ( P = .2), but much higher for unilateral‐RT 1‐month (mean: 19.1 vs 13.0, P = .03), 6‐month (20.5 vs 9.3, P < .001), 12‐month (20.1 vs 11.9, P < .01), and 24‐month post‐RT (22.2 vs 13.9, P = .04). MVA confirmed that unilateral RT reduced the likelihood of hyposalivation vs bilateral RT (OR 2.36, P = .006). Conclusion Unilateral RT reduces unstimulated salivary flow in OPC patients.
Background: The high incidence of venous thromboembolism (VTE) has been perceived in post thoracic surgery patients.However, the significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for VTE predicting is not clear.To investigate that, we conducted a prospective single center study.Methods: A total of 111 patients undergoing lung surgery were enrolled in this study, included 52 primary lung cancer patients and 59 benign lung disease patients from July 2016 to March 2017.Preoperative and postoperative days 1, 3, and 5 coagulation and fibrinolysis related parameters were tested, including antithrombin (AT), fibrinogen degradation product (FDP), prothrombin time (PT), prothrombin time activity (PA), prothrombin time ratio (PR), international normalized ratio (INR), activated partial thromboplastin time (APTT), plasma fibrinogen (FBG), thrombin time (TT) and D-Dimer.The Doppler ultrasonography was performed before and after surgery for deep venous thrombosis (DVT) confirmation.Patients with new postoperative DVT, unexplained dyspnea, hemoptysis, chest pain, or high Caprini score (≥9) were received further computer tomography pulmonary angiography (CTPA) for pulmonary embolism (PE).We used the area under receiver-operating-characteristic (ROC) curve to discriminate patients between those who developed VTE and those who did not.Single factor analysis was utilized to define risk factors associated with VTE. Results:The overall incidence of VTE was 16.2% (18/111).The incidence of VTE in primary lung cancer patients was 23.1% (12/52), much higher than that in benign lung diseases 10.2% (6/59), but did not reach statistical significance (P=0.066).Among 18 VTE patients, 83.3% was DVT, 16.7% was DVT + PE and 72.2% was muscular veins of the calf thrombosis.D-Dimer was much higher in VTE group than that in non-VTE group preoperatively and at postoperative days 1, 3 (0.64±0.24 vs. 0.33±0.06,P=0.007; 3.14±0.75vs. 1.51±0.09,P=0.005, and 1.88±0.53vs. 0.76±0.05,P=0.001, respectively).And the ROC curve areas of preoperative and postoperative days 1, 3 of D-Dimer were 0.70, 0.71 and 0.74, respectively.And FDP was much higher in VTE group than that in non-VTE group at postoperative day 3 (6.78±1.43 vs. 3.79±0.15,P=0.004).But AT, PT, PA, PR, INR, APTT, FBG and TT there were no significantly difference. Conclusions:The overall incidence of VTE after lung surgery was 16.2%.The patients with preoperative high D-Dimer should receive VTE prophylaxis.
Abstract Background The purpose of this study was to compare the clinicoradiologic characteristics of human papillomavirus (HPV)‐related (HPV‐positive) and HPV‐unrelated (HPV‐negative) oropharyngeal carcinoma (OPC). Methods Primary tumor and lymph node features of HPV‐positive and HPV‐negative OPCs from 2008 to 2013 were compared on pretreatment CT/MRI. Intrarater/interrater concordance was assessed. Multivariable analyses identified factors associated with HPV‐positivity to be used in nomogram construction. Results Compared to HPV‐negative (n = 194), HPV‐positive (n = 488) tumors were more exophytic (73% vs 63%; p = .02) with well‐defined border (58% vs 47%; p = .033) and smaller axial dimensions; lymph node involvement predominated (89% vs 69%; p < .001) with cystic appearance (45% vs 32%; p = .009) but similar topography. Intrarater/interrater concordance varied (fair to excellent). Nomograms combining clinical (age, sex, smoking pack‐years, subsite, T/N classification) and/or radiologic (nonnecrotic tumor and cystic lymph node) features were used to weigh the likelihood of HPV‐driven tumors (area under the curve [AUC] = 0.84). Conclusion HPV‐positive OPC has different radiologic tumor (exophytic/well‐defined border/smaller axial dimension) and lymph node (cystic) features but similar lymph node topography.
Abstract Background The causes for delays during the COVID19 pandemic and their impact on head and neck cancer (HNC) diagnosis and staging are not well described. Methods Two cohorts were defined a priori for review and analysis—a Pre‐Pandemic cohort (June 1 to December 31, 2019) and a Pandemic cohort (June 1 to December 31, 2020). Delays were categorized as COVID‐19 related or not, and as clinician, patient, or policy related. Results A total of 638 HNC patients were identified including 327 in the Pre‐Pandemic Cohort and 311 in the Pandemic Cohort. Patients in the Pandemic cohort had more N2‐N3 category (41% vs. 33%, p = 0.03), T3‐T4 category (63% vs. 50%, p = 0.002), and stage III‐IV (71% vs. 58%, p < 0.001) disease. Several intervals in the diagnosis to treatment pathway were significantly longer in the pandemic cohort as compared to the Pre‐Pandemic cohort. Among the pandemic cohort, 146 (47%) experienced a delay, with 112 related to the COVID‐19 pandemic; 80 (71%) were clinician related, 15 (13%) were patient related, and 17 (15%) were policy related. Conclusions Patients in the Pandemic cohort had higher stage disease at diagnosis and longer intervals along the diagnostic pathway, with COVID‐19 related clinician factors being the most common cause of delay.
Objective To evaluate the application value of dual-source CT coronary angiography in low tube voltage setting and the influence of heart rate on image quality and radiation doses.Methods 323 patients suspected of coronary artery disease received retrospective ECG-gating coronary angiography with dual-source CT scanner,who were divided into low tube voltage group (100 kVp,n =201) and conventional voltage group (120 kVp,E group,n =122).No beta-blockers were taken before CT scan.All patients in low tube voltage group were divided into four groups according to the heart rate (HR):group A,HR≤59 beats per minute (bpm),n =50; group B,60≤HR ＜69 bpm,n =64; group C,70≤HR ＜91bpm,n =62;group D,HR ≥ 91 bpm,n =25.All images were transferred to a workstation for further processing.The best R-R interval reconstruction images of all groups were evaluated.The value of pitch,CT volume dosage index(CTDIvol),dose length product(DLP) and effective dose(E)were recorded.The pitch,the score of imaging quality of coronary artery segments and the radiation dose were compared with One-Way ANOVA.The influence of heart rate on image quality and radiation doses of coronary artery was analyzed.Results The value of pitch in groups A-D was 0.24 ± 0.03,0.29 ± 0.04,0.33 ± 0.05,0.38 ± 0.06,respectively,with statistical difference (F =62.57,P ＜ 0.05).The value of CTDIvol in groups A-E was (21.59±7.97),(20.24±6.03),(18.23±7.55),(18.14 ±5.75),(38.62±16.21)mGy,respectively,with statistical difference (F =85.16,P ＜ 0.05).The value of E in group A-E was (5.31 ±2.18),(4.85 ±1.70),(4.49 ± 1.86),(4.37 ±1.50),(8.75 ± 4.07) mSv,respectively,with statistical difference(F =44.83,P ＜ 0.05).The image score was (4.65 ±0.46),(4.55 ± 0.53),(4.55 ±0.53),(4.47 ±0.72),(4.66 ± 0.44) (F =1.89,P ＞ 0.05).Conclusions No beta-blockers was taken before CT scan,and a high quality image could be acquired by using dual-source CT coronary angiography in low tube voltage setting(100 kVp).When the auto ECG-gating is selected,medium and low HR have little influences on radiation dose,while the radiation dose could be decreased significantly at higher HR,but the possibility to obtain the high quality image decreased.
Key words:
Heart rate; Coronary artery; Tomography; Radiation dosage
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