Study on timing of preoperative fasting and water deprivation in patients receiving fiberoptic bronchoscopy

Purpose:To compare the effects of different preoperative fasting intervals and water deprivation in patients receiving fiberoptic bronchoscopy(FB).Methods:In total,390 patients receiving FB were divided into two groups.The 200 patients in the experimental group had 100 mL semi-liquid food two hours before FB,and 190 patients in the control group had 250 g ordinary food four hours before FB.The incidence of nausea,vomiting,aspiration,dizziness,and palpitations and vital signs,oxygen saturation,and anxiety level before and after FB were recorded.Results:There was no significant difference in the incidence of nausea,vomiting,aspiration,or palpitations;and respiration rate,heart rate,and oxygen saturation were not different between the two groups(p>0.05).There were,however,significant differences in the incidence of dizziness,comfort level,anxiety,and blood pressure(p<0.05).Conclusion:Intake of 100 mL semi-liquid food two hours prior to FB is safe and feasible.

Available Evidence of Association between Zika Virus and Microcephaly

Objective：To clarify the possible association between the Zika virus （ZIKV） and microcephaly and understand where we are in terms of research and the debate on the causation between mild maternal clinical features and severe fetal microcephaly.Data Sources：We did a comprehensive literature review with the keywords ＂zika＂ and/or ＂microcephaly＂ from inception to May 27,2016,with PubMed.Study Selection：Studies were included and analyzed if they met all of the following criteria：＂probable or confirmed infant microcephaly＂ and ＂probable or confirmed ZIKV infection among mothers or infants＂.Results：We emphasize the diagnosis of ZIKV infection,including maternal clinical manifestations,maternal and fetal laboratory confirmation,and possible autopsy if need.Other confounders that may lead to microcephaly should be excluded from the study.We presented the results from clinical manifestations of ZIKV infection,testing methods evolving but the mechanism of microcephaly uncertain,flexible definition challenging the diagnosis ofmicrocephaly,and limited causal reference on pregnant women.We made analog comparison of severe acute respiratory syndrome and chikungunya virus in terms of DNA mutation and global movement to provide further research recommendation.The chance of catch-up growth may decrease the number of pervious ＂diagnosed＂ microcephaly.Conclusions：There are some evidence available through mice models and direct isolation of ZIKV in affected pregnancies on kindly causal relationship but not convincible enough.We analyzed and presented the weakness or limitation of published reports with the desire to shed light to further study directions.

Innovative analysis of predictors for overall survival from systemic non-Hodgkin T cell lymphoma using quantile regression analysis

Background:Non-Hodgkin T/NK cell lymphoma is a rare and widely variable type of lymphoma with the most dismal prognosis. This study aimed to investigate varied impact of the clinical indicators to the overall survival (OS).Methods:We conducted a retrospective study to identify the non-invasive clinical features of T cell lymphoma that can predict prognosis with an innovative analysis method using quantile regression. A total of 183 patients who visited a top-tier hospital in Beijing, China, were enrolled from January 2006 to December 2015. Demographic information and main clinical indicators were collected including age, erythrocyte sedimentation rate (ESR), survival status, and international prognostic index (IPI) score.Results:The median age of the patients at diagnosis was 45 years. Approximately 80% of patients were at an advanced stage, and the median survival time after diagnosis was 5.1 months. Multivariable analysis of the prognostic factors for inferior OS associated with advanced clinical staging [HR=3.16, 95%CI (1.39-7.2)], lower platelet count [HR=2.57, 95%CI (1.57-4.19), P<0.001] and higher IPI score [HR=1.29, 95%CI (1.01-1.66), P=0.043]. Meanwhile, T cell lymphoblastic lymphoma [HR=0.40, 95%CI (0.20-0.80), P=0.010], higher white blood cell counts [HR=0.57, 95%CI (0.34-0.96), P=0.033], higher serum albumin level [HR=0.6, 95%CI (0.37-0.97), P=0.039], and higher ESR [HR=0.53, 95%CI (0.33-0.87), P=0.011] were protective factors for OS when stratified by hemophagocytic lymphohistiocytosis (HLH). Multivariable quantile regression between the OS rate and each predictor at quartiles 0.25, 0.5, 0.75, and 0.95 showed that the coefficients of serum β2-microglobulin level and serum ESR were statistically significant in the middle of the coefficient curve (quartile 0.25-0.75). The coefficient of IPI was negatively associated with OS. The coefficients of hematopoietic stem cell transplantation (HSCT) and no clinical symptoms were higher at the middle of the quartile level curve but were not statistically significant.Conclusions:The IPI score is a comparatively robust indicator of prognosis at 3 quartiles, and serum ESR is stable at the middle 2 quartiles section when adjusted for HLH. Quantile regression can be used to observe detailed impacts of the predictors on OS.