NATIONAL FIELD TRIAL OF THE CHINESE CLASSIFICATION AND DIAGNOSTIC CRITERIA OF MENTAL DISORDERS: COMPREHENSIBILITY, ACCEPTABILITY AND APPLICABILITY

The Chinese Neurology and Psychiatry Association conducted a national field trial of its Chinese Classification and Diagnostic Criteria of Mental Disorders (CCMD-2) involov-ing 26 provinces and municipalities, 80 psychiatric institutes, and 224 professionals. The results were as follows: (1)95.2% of researchers considered the comprehensibility of the CCMD-2 diagnstic criteria good. Within the ten major categories, comprehensibility ranged from 85.7% to 100%. (2) Of those surveyed concerning the acceptibility of the CCCMD-2 diagnostic criteria, 85.9% considered them acceptable. In individual classifications, the rate ranged from 74.1% to 95.2%. (3) 1498 cases were tested. The overall applicability rate which indicated the consistency between the CCMD-2 result and the actual clinical diagnoses was found to be 87.6%, (averaging Kappa = 0.82,P<0.01), better than those obtained from non-Chinese systems of diagnosis.

Surgery for pancreatic tumors in the midst of COVID-19 pandemic

The spread of the new coronavirus(COVID-19)infection in 2020 has had a significant impact on the treatment of cancer worldwide.During the COVID-19 pandemic,the biggest challenge for pancreatic surgeons is the difficulty in providing oncological care.In this review article,from the standpoint of surgeons,we explain the concept of triaging of patients with pancreatic tumors under the COVID-19 pandemic,and the actual impact of COVID-19 on the treatment of patients with pancreatic tumors.The most vital points in selecting the best therapeutic approach for patients with pancreatic tumors during this pandemic are(1)Oncologists need to tailor the treatment plan based on the COVID-19 phase,tumor malignant potential,and patients’comorbidities;and(2)Optimal treatment for pancreatic cancer should be planned according to the condition of each patient and tumor resectability based on national comprehensive cancer network resectability criteria.To choose the best therapeutic approach for patients with pancreatic tumors during this pandemic,we need to tailor the treatment plan based on elective surgery acuity scale(ESAS).Newly established ESAS for pancreatic tumor and flowchart indicating the treatment strategy of pancreatic cancer,are feasible to overcome this situation.

Health related quality of life among patients with chronic graft-versus-host disease in China

Background Chronic graft-versus-host disease （GVHD）,the commonest long-term complication after allogeneic hematopoietic stem cell transplantation （HSCT）,has a negative impact on patients＇ health related quality of life （HRQoL）.This study was designed to investigate the HRQoL in patients with chronic GVHD in China.Methods Two hundred and sixty-four patients with chronic GVHD who were ＞24 months post-HSCT and had been in continuous complete remission since HSCT were enrolled in this retrospective study.HRQoL was evaluated using an SF-36 questionnaire.Multivariate analysis was used to identify the factors that affect HRQoL in patients with chronic GVHD.Results HRQoL in patients categorized as having mild and moderate chronic GVHD was significantly better than in those in the severe category.In the moderate chronic GVHD category,markedly poorer HRQoL was observed in patients with both multiple organ involvement and more severe organ impairment than in those without these factors.According to multivariate analysis,chronic GVHD severity had the greatest significant negative impact on patients＇ HRQoL; whereas being female was associated with a negative impact on psychological health.Conclusion Chronic GVHD severity strongly correlates with negative impacts on patients＇ HRQoL.

Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical hematopoietic stem cell transplantation in acute myeloid leukemia

Chronic graft-versus-host disease(cGVHD)is a major complication following unmanipulated haploidentical hematopoietic stem cell transplantation(haplo-HSCT).We aimed to identify the risk factors for cGVHD in patients who underwent anti-thymocyte globulin-based haplo-HSCT for acute myeloid leukemia(n=280).The diagnosis of cGVHD was in accordance with the National Institutes of Health consensus criteria.A total of 169 patients suffered from cGVHD.The patients who had 3 loci mismatched had a higher 8-year incidence of cGVHD(total,66.0%vs.53.7%,P=0.031;moderate to severe,42.4%vs.30.1%,P=0.036)than the patients who had 1 to 2 loci mismatched.The patients who had maternal donors had a higher 8-year incidence of moderate to severe cGVHD(49.2%vs.32.9%,P=0.024)compared with the patients who had other donors.The patients who had grades III to IV acute GVHD(aGVHD)had higher 8-year incidence of cGVHD(total,88.0%vs.50.4%,P<0.001;moderate to severe,68.0%vs.27.0%,P<0.001)compared with the patients without aGVHD.In multivariate analysis,grades III to IV aGVHD was the only independent risk factor for cGVHD.Thus,further interventions should be considered in patients with severe aGVHD to prevent cGVHD.