bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSESSMENT OF SOMATOTYPE IN INDIVIDUALS INVOLVED IN SOCCER PLAYING AT DIFFERENT POSITIONS
Authors:   Human Performance Analytics and Facilitation Unit University of Calcutta 92 Acharya Prafulla Chandra Road, Kolkata 700 009, Chatterjee Ayan ,   India,   School of Health Care Rishihood University Sonipat, Haryana
Published: December 2021

Total tribal population in India is 10.43 crore, consisting 8.6% of the total population. Santhals are one of the largest tribal communities inhabiting states of West Bengal., Bihar. Jharkhand. On the other hand, physical activity has been considered as the basic need for every work and particularly in team sports. Keeping this in view the present study has been undertaken in 43 Santhal males, of age range 18-26 years, involved in regular soccer playing, to compute the somatotyping characteristics and to find out whether there is any variation in such scoring among individuals playing at different positions. Anthropometric measurements included body weight, stature, skinfold thickness, breadths, girths. Somatotyping scores also calculated. Results of the study concluded that defenders and midfielders had high mesomorphic component whereas individuals, playing at forward position, possessed the highest ectomorphic component
Design and fabrication of wheel removing machine
Authors:   Associate Professor, Department of Mechanical Engineering, Kongu Engineering College, Erode, Tamil Nadu., Sivakumar A , Sathia Morthi P ,   Professor, Department of Mechanical Engineering, Kongu Engineering College, Erode, Tamil Nadu., Peer Mohamed Essac A ,   UG Students, Department of Mechanical Engineering, Kongu Engineering College, Erode, Tamil Nadu., Mohana Prasath S ,   UG Students, Department of Mechanical Engineering, Kongu Engineering College, Erode, Tamil Nadu., Mukundhan M ,   UG Students, Department of Mechanical Engineering, Kongu Engineering College, Erode, Tamil Nadu.
Published: December 2021

The proposed system's basic premise is to reduce personnel during nut fitting and removing wheels from autos. The motor is at the heart of the project and its implementation. Motor, Nut fitting arrangement (multi nut remover), and spur gear arrangement are the components employed here for the efficient operation of separate blocks. The model's main goal is to remove all of a wheel's nuts at once, rather than one by one. The model's premise is to use a spur gear to transfer relative motion to other gears. The primary spur gear is connected to the motor shaft in the model, which rotates due to the motor. The primary gear is the driver, while the secondary gears are the driven. The major gear is located in the model's center. The secondary gears and the primary gear are in sync. To ensure precise meshing and tool spacing, the secondary gears are set at predetermined distances. The drive axle is equipped with primary gear. The cover has several auxiliary axles that extend through it. Each secondary axle has a first end that is positioned inside the housing and a second end that extends outwardly from the cover. One of the first ends is attached to each of several secondary gears. Each of the secondary gears is in contact with the primary gear. One of the secondary axles is connected to each of the couplers. The project and implementation must provide the motor with both positive and negative potential. If we press the corresponding switch for forwarding rotation, the nut will be fixed; if we press the corresponding switch for reverse rotation, the polarity will be reversed, and the nut will be removed. The motor can be controlled according to the needs of the operator. To tighten or remove the nut, the operator should lift the model and place it in the proper location.
A STUDY ON THE LIVELIHOOD SECURITY OF MIGRANT CHILDREN YADGIR DISTRICT, KARNATAKA STATE
Authors:   PhD Research Scholar,  Centre for Rural Development, Annamalai University, Annamalai Nagar-608002., Dasa Anandamaya , Murugesan P ,   Assistant Professor,  Centre for Rural Development, Annamalai University, Annamalai Nagar-608002.
Published: December 2021

Migration shapes children and the world. It is accomplished by boosting individuals who may be more acceptant of transformation and variation and who are less observant and much more exposed and recognizing of the others, and those who have the most hurdles to overcome, like learning a foreign language, adapting to changing culture, and establishing more global connections. Based upon the origin and the social assistance provided by a host nation, children from migrant families had diverse experiences in life and possibilities. The academic achievement of migrant children and their psychological condition, social inclusion, and family responsibilities are all boosted by parental participation and action. Furthermore, it is essential for the migrant children parents should motivate their children to accept the current culture and acquire a new language, thereby maintaining their practices and culture at family. While migrant children go over the migration process, they confront various problems. The biggest issue affecting their well-being is changing surroundings, which has also become a barrier to intellectual growth and childhood happy memories. This study aims to explore the survival strategies and livelihood of migrant children. Also, it illustrates and evaluates the forces that drive children’s migration and their experiences and feelings as they try to adjust to their new surroundings. This study examines migrant workers’ household capital status and risk and the impact on their children. The conceptual framework is presented to understand migrant children’s livelihood security. Keywords: Capital, Household risks, Migrant Chil
Role of Platelet Mass Index in the Differential Diagnosis of Patients with Elevated Prostate-Specific Antigen Levels
Authors: ÖNCEL Halil Ferat , SALAR Remzi , ÖZBAY Engin , TARİNİ Emine Zeynep
Published: December 2021

Aim: To evaluate the role of platelet mass index (PMI) calculated using hemogram parameters obtained from a routine blood test in the differentiation of prostate cancer in patients with prostate-specific antigen (PSA) values of 2.5-10 ng/dl.Material and Method: Seventy-five patients with prostate cancer and 48 with prostatitis were included in the study and grouped according to their pathology results. The white blood cell (WBC), hemoglobin (HGB), thrombocyte (PLT), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV) and PMI values were compared between the two groups. Results: The PMI and PLT levels of the prostate cancer group were statistically significantly lower than those of the prostatitis group (p<0.05). In predicting prostate cancer, the cut-off value for the PMI level was determined as 1.480, at which the likelihood ratio was calculated as 1.08. Conclusion: We consider that PMI calculated using hemogram parameters in patients with a PSA value below 10 ng/dl will guide the clinician in differentiating prostate cancer from other prostate pathologies without performing an unnecessary biopsy.
Information, Attitudes and Behaviors of the Hospitalized Patients About Organ Donation
Authors: AYDIN Aydanur , KARADENİZ Havva
Published: December 2021

Aim: The research was carried out to determine the knowledge, attitudes and behaviors of the patients who were hospitalized due to their chronic disease. Material and Method: The descriptive study was completed with 47 patients hospitalized. The data were collected with a questionnaire and chi-square test was used.Results: It was found that one fifth of the patients donated organs by applying to a health institution and four of them thought to donate organs. Three-fifths of patients who do not want to donate organs are determined to be contrary to their religious beliefs, half of them do not want to donate organs to a person whose religious belief is not the same. It was observed that married patients wanted to donate organs higher than singles. Conclusion: It is thought that information about media support is needed in this regard, and information on family, aid and survival can be effective in changing the attitude towards organ donation.
Reflections of COVID-19 Pandemic on Dermatology Outpatient Clinics
Authors: ERTUĞRUL Gökşen
Published: December 2021

Aim: We aimed to investigate the effects of stress on dermatological diseases that come into our lives with this new infection, which can have vital effects and limitations in social life during the covid 19 pandemic process.Material and Method: In this retrospective study, patients who were examined in the dermatology outpatient clinic during the COVID-19 pandemic (April - May 2020) and the same period last year (April - May 2019) were evaluated. The number of patients who applied, application dates, age and sex of patients, and ICD-10 (International Classification of Diseases-10th Revision) diagnosis codes were recorded by scanning the electronic database of the hospital. Results: The rate of referral to the dermatology outpatient clinic decreased by 6.3 times compared to the previous year. The average age of the patients who applied to the dermatology outpatient clinic during the COVID-19 pandemic period was significantly higher compared to that of the patients who applied during the same period in the previous year. It was observed that during the pandemic period, men applied to the dermatology outpatient clinic significantly more than in the previous year. COVID-19 infection was not detected in patients who applied to the Dermatology outpatient clinic during the early period of the pandemic.Conclusion: While there was a decrease in outpatient consultations for cosmetic reasons, a significant increase in consultations for stress-induced dermatoses was found. Stria rubra development in the young population for reasons such as a sedentary life and possible nutritional disorders as a result of the restrictions experienced during the pandemic period was one of the interesting findings of this period. We think that patients with the coronavirus infection and associated skin findings apply to other clinics instead of the dermatology clinic due to the presence of other accompanying systemic symptoms.
U lympho tế bào T dạng viêm mỡ dưới da ở trẻ em
Authors: Tran Thi Thuy
Published: December 2021

TÓM TẮT

U lympho tế bào T dạng viêm mỡ dưới da (Subcutaneous panniculitis - like T - cell lymphoma - SPTCL) là một u lympho hiếm gặp với tổn thương chủ yếu ở bề mặt da và tổ chức mỡ dưới da. SPTCL có thể xảy ra ở cả người lớn và trẻ nhỏ, độ tuổi trung bình được chẩn đoán là 30 tuổi, nữ nhiều hơn nam. Trong SPTCL, bệnh nhân có nhiều nốt tổn thương ở mô mỡ dưới da và có thể gây loét bề mặt da. Tổn thương này được biết đến như viêm mỡ dưới da. Cơ chế bệnh sinh chưa rõ ràng nhưng có sự tham gia của yếu tố di truyền. Chẩn đoán SPTCL vẫn còn là thách thức, chủ yếu dựa vào sinh thiết da với sự bộc lộ của các dấu ấn hóa mô miễn dịch (HMMD). Điều trị SPTCL chưa thống nhất, phụ thuộc vào triệu chứng nhưng thường sử dụng steroid hoặc các thuốc ức chế miễn dịch (ƯCMD). Một số bệnh nhân với SPTCL tiến triển cần điều trị hóa chất. Về tiên lượng, SPTCL thường tiến triển chậm, tuy nhiên khoảng 20% bệnh nhân có hội chứng thực bào máu (Hemophagocytic lymphohistiocytosis - HLH), những bệnh nhân này kém đáp ứng với điều trị và có tiên lượng xấu hơn. Chúng tôi báo cáo một bé trai 13 tháng tuổi vào viện vì sốt và nhiều khối tổn thương dưới da. Bệnh nhân được chẩn đoán viêm mô tế bào và điều trị kháng sinh 2 tuần nhưng bệnh không thuyên giảm. Sau đó, bệnh nhân được sinh thiết tổn thương dưới da, dựa trên kết quả nhuộm HMMD, chúng tôi kết luận phù hợp với SPTCL.

ABSTRACT

SUBCUTANEOUS PANNICULITIS - LIKE T - CELL LYMPHOMA IN A CHILD

Subcutaneous panniculitis - like T - cell lymphoma (SPTCL) is a rare type of lymphoma that mainly affects the skin and subcutaneous fat tissue. SPTCL can occur in both adults and children. The average age at diagnosis is 30 years old, with more women than men. In SPTCL, the patient has multiple nodules in the fat layer under the skin, and these can cause swelling. This is known as panniculitis. The pathogenesis is unknown, but genetic factors may be involved. Diagnosis of SPTCL is challenging, mainly based on skin biopsies with staining of immunohistochemical markers. Treatment of SPTCL is inconsistent, depending on symptoms but usually using steroids or immunosuppressive drugs (ACEIs). Some patients with advanced SPTCL require chemotherapy. In terms of patients who have hemophagocytic lymphohistiocytosis (HLH), which is less responsive to treatment and has a worse prognosis. We report a 13 - month - old boy admitted to the hospital with fever and multiple subcutaneous lesions. The patient was diagnosed with cellulitis and treated with antibiotics for 2 weeks, but the disease did not improve. Then, the patient had a skin lesion biopsy. Based on the results of immunohistochemical staining, we concluded that it was suitable for SPTCL.

Keywords: Subcutaneous panniculitis - like T - cell lymphoma, Immunohistochemical, Hemophagocytic lymphohistiocytosis.
Nhiều ung thư nguyên phát trên một bệnh nhân
Authors: Tran Hoa
Published: December 2021

TÓM TẮT

Đặt vấn đề: Bệnh cảnh một bệnh nhân mắc nhiều ung thư nguyên phát đã được coi là hiếm gặp, tuy nhiên trong thời gian gần đây cho thấy tần suất mắc bệnh nhiều ung thư nguyên phát (MPMN) trên một bệnh nhân ngày có xu hướng gia tăng. Qua 17 trường hợp được thông báo nhằm mục đích rút kinh nghiệm chẩn đoán để có hướng xử lý kịp thời và tốt hơn trong điều trị và tiên lượng; tạo điều kiện triển khai các nghiên cứu có giá trị hơn trong tương lai

Báo cáo các trường hợp: Trong 17 trường hợp: 10 nữ và 7 nam: 4/17 (23,5%) MPMN cùng lúc, 13/17 (76,5%) MPMN phát triển sau đó. Hầu hết bệnh nhân trên 60 tuổi,các ung thư nguyên phát thứ 1 thường thấy ở các vị trí đường tiêu hóa: GIST 4/17 (23,5%) đại trực tràng 2/17 (11,8%), vú 6/17 (35,3%), phổi 2/117 (11,8 %) và ung thư thứ 2 và thứ 3 thường thấy ở đường tiêu hóa 6/17 (35,3 %), phụ khoa 5/17 (29,4%) vú 2/17 (11,8%) và phổi 3/17 (17,6%), 15/17 (88,2%) trường hợp mắc ung thư ở 2 vị trí và 2/17 (11,8 %) trường hơp mắc bệnh ở 3 vị trí.

Kết luận: Bệnh cảnh mắc nhiều ung thư trên một bệnh nhân không còn là hiếm gặp. Việc chẩn đoán bệnh cần phải được lưu ý trong thời gian theo dõi bệnh.

ABSTRACT

A CASE SERIES OF MULTIPLE PRIMARY MALIGNANT NEOPLASMS

Background: The development of improved diagnostic techniques, increased incidence of long term survival and life expectancy of cancer patients lead to the higher frequency of multiple primary malignant neoplasms (MPMN). This article aims to report series of cases our observed trend of increasing, in prevalence of both synchronously and metachronously second and third primary malignancy. Among the patients have been diagnosed with a cancer and reviewed in the relevant literature.

Case series: Among 17 cases of MPMN that have been reported, 4/17 were synchronous (23.5%) and 13/17 were metachronous (76.5%), out of 17 patients, 10 were femals and 7 were males. The majority of the cases were over 60 years of age. In this report, the most common types of cancer were GIST (Stomach, Small intestine): 4/17 (23.5%); Breast: 6/17 (35.3%), Adenocarcinome of lung and colorectal: 2/17 (11.8%) as the first primary and Adenocarcinoma of gastrointestinal tract: 6/17 (35.3%), lung: 2/17 (11.8%), gynecologic tumors: 5/17 (29.4%), Breast: 2/17 (11.8%), lung: 3/17 (17,6%) as the second or the third primary cancer.Among 17 such patients, 15 and 2 primary malignant lessions occured at 2 sites and 3 sites respectively.

Conclusion: The incidence of MPMN has not been rare at all. The diagnosis of MPMN should not be overlooked during follow - up. The doctor - patient relationship remains a critical factor in management. The clinicians should be aware of cases that cancer patients have metastasis in unusual sites and inconsistent clinical progression.

Keywords: Multiple malignant neoplasms, primary.
Ứng dụng nội soi dải ánh sáng hẹp kết hợp nội soi vi phẫu bằng laser CO2 trong chẩn đoán và điều trị ung thư hạ họng, thanh quản giai đoạn sớm
Authors: Tran Phuong Nam
Published: December 2021

TÓM TẮT

Mục tiêu: Đánh giá kết quả ứng dụng nội soi dải ánh sáng hẹp kết hợp nội soi vi phẫu bằng Laser CO2 trong chẩn đoán và điều trị ung thư hạ họng và ung thư thanh quản giai đoạn sớm.

Phương pháp nghiên cứu: Nghiên cứu tiến cứu, có can thiệp lâm sàng trên 18 bệnh nhân ung thư hạ họng, ung thư thanh quản ở giai đoạn sớm, được phát hiện tổn thương ác tính bằng nội soi dải ánh sáng hẹp, điều trị phẫu thuật nội soi vi phẫu bằng Laser CO2.

Kết quả: Tuổi trung bình mắc bệnh là 63,8 ± 12,6; bệnh nhân có hút thuốc lá chiếm 61,1%; triệu chứng khàn tiếng chiếm 72%, ung thư giai đoạn T1a có tỷ lệ 72,2%; IPCL type V-1 là 72,2%; khả năng kiểm soát bờ rìa là 83,3%, không có tai biến trong phẫu thuật 17/18 trường hợp và di chứng sau phẫu thuật tháng thứ 1 là tăng sinh mô hạt (77,8%), tháng thứ 3 là dính mép trước dây thanh (27,8%).

Kết luận: Nội soi dải ánh sáng hẹp có giá trị phát hiện sớm ung thư hạ họng, ung thư thanh quản. Phẫu thuật nội soi vi phẫu bằng Laser CO2 ung thư hạ họng, ung thư thanh quản ở giai đoạn sớm mang lại kết quả tốt, tỷ lệ tai biến và biến chứng sau phẫu thuật thấp, bảo tồn được tối đa chức năng phát âm, hô hấp và nuốt.

ABSTRACT

UTILITY OF NARROW - BAND IMAGING ENDOSCOPY COMBINED WITH CO2 LASER ENDOSCOPIC MICROSURGERY IN DIAGNOSIS AND TREATMENT OF EARLYSTAGE HYPOPHARYNGEAL AND LARYNGEAL CARCINOMA

Objective: To evaluate the results of applying narrow band imaging endoscopy combined with CO2 laser endoscopic microsurgery to diagnose and treat early stage hypopharyngeal and laryngeal carcinoma.

Methods: A prospective study was conducted on 18 patients with early stage hypopharyngeal and laryngeal carcinoma.

Results: The mean age was 63.8 ± 12.6; smoker was 61.1%, the rate of hoarseness was 72%, T1a tumor stage was 72.2%, IPCL type V-1 was 72,2%, marginal tumor control was 83.3%. There were of 17/18 case with no complication during operation. The rate of extensive granuloma was 77.8% in the first month, and of anterior commissure adhesion was 27.8% in the third month post - surgery.

Conclusion: Narrow band imaging endoscopy was a valuable tool in screening for early stage hypopharyngeal and laryngeal carcinoma. CO2 laser endoscopic microsurgery was an effective method. The rate of complication during and after surgery was low. This method restores the maximum function of speech, breathing and swallowing.

Keywords: Early - stage pharyngeal cancer, early - stage laryngeal cancer, narrow - band imaging endoscopy, CO2 laser endoscopic microsurgery.
Phẫu thuật ung thư khoang miệng có tạo hình khuyết hổng bằng vạt dưới cằm
Authors: Nguyen Xuan Hung
Published: December 2021

TÓM TẮT

Đặt vấn đề: Ung thư khoang miệng chiếm tỷ lệ 30% ung thư đầu cổ và 2.0% trong ung thư nói chung. Phẫu thuật phải đảm bảo cắt rộng u với diện cắt an toàn để hạn chế tái phát, nhưng thường để lại khuyết hổng khá lớn. Vạt dưới cằm được sử dụng rộng rãi trong tạo hình khuyết hổng vùng khoang miệng, có đặc điểm: tỷ lệ sống cao, linh hoạt. Nghiên cứu này nhằm đánh giá hiệu quả của vạt dưới cằm trong tạo hình khuyết hổng sau cắt ung thư khoang miệng tại khoa Phẫu Thuật - Trung tâm Ung Bướu - Bệnh viện Trung Ương Huế từ tháng 4/2020 - 8/2021.

Đối tượng và phương pháp nghiên cứu: Đây là nghiên cứu tiến cứu can thiệp lâm sàng không nhóm chứng trên 8 trường hợp sử dụng vạt dưới cằm trong tạo hình khuyết hổng sau cắt ung thư khoang miêng.

Kết quả: Kích thước vạt trung bình là 28 cm2 (4 x 7 cm), tái tao khuyết hổng vùng lưỡi 3 trường hợp, lưỡi sàn miệng 4 trường hợp, niêm mạc má và góc hậu hàm 1 trường hợp. Bệnh nhân được ăn qua đường miệng sau 8 ngày, xuất viện sau 12 ngày. Biến chứng: Rò miệng - cổ 2 trường hợp, hoại tử 1 phần vạt: 1 trường hợp. Sau 1 tháng, các vạt lành tốt, chức năng khoang miệng ảnh hưởng ít (chức năng nhai nuốt và phát âm ảnh hưởng ít). Sau 6 tháng, ghi nhận 7/8 trường hợp không tái phát tại chỗ, các vạt lành tốt, chức năng khoang miệng bình thường, 1 trường hợp tái phát tại chỗ.

Kết luận: Vạt dưới cằm có tỷ lệ sống cao hỗ trợ lấp khuyết hổng vùng khoang miệng.

ABSTRACT

ORAL CANCER SURGERY WITH RECONSTRUCTION DEFECTS BY SUBMENTAL FLAP

Introduction: Globally, oral cancer accounts for 30% of head and neck cancers and 2.0% of all cancer. The surgery must remove the tumor with safe marginal resection to limit recurrence; however, it causes large defects. The submental flap is gaining popularity as a technique for reconstructing oral defects, with advantages: high survival rate and flexibility. This study aimsto evaluate the efficacy of the submental flap in reconstructive defects after oral cancer surgery at the Department of Oncology Surgery - Oncology Center of Hue Central Hospital from April 2020 to August 2021.

Methods: A prospective study was conducted on 8 patients who had defects reconstructed by a submental flap after oral cancer surgery. Results: The average dimension of the submental flap was 28 cm2 (4 x 7 cm). The reconstructed sites included: tongue (3 cases), floor of mouth (4 cases), buccal mucosa (1 case). Patients had oral feeds after 8 days, discharged after 12 days. Complications: Oro - cutaneous fistula (2 cases), partial necrosis (1 case). After one month, the flaps were survival, and the oral cavity function had reduced (swallowing and speech function were quite limited). After six months, 7/8 cases had no locoregional recurrence; the flap was good, and the oral cavity function was normal. One case had local recurrence.

Conclusions: Submental flap is a valid option for reconstructing intra - oral soft tissue with a high survival rate.

Keywords: Oral cancer, submental flap.
Phẫu thuật nội soi 3D cắt bán phần xa dạ dày trong điều trị ung thư dạ dày
Authors: Phan Hai Thanh
Published: December 2021

TÓM TẮT

Đặt vấn đề: Những nghiên cứu gần đây cho thấy phẫu thuật nội soi với kỹ thuật 3D (three - dimensional) đã mang lại nhiều thuận lợi trong điều trị ung thư dạ dày khi so sánh với màn hình 2D truyền thống. Vì vậy chúng tôi thực hiện nghiên cứu này với mục đích đánh giá tính an toàn, kết quả ngắn hạn và kết quả ung thư học của phẫu thuật nội soi 3D trong điều trị ung thư phần xa dạ dày.

Phương pháp nghiên cứu: Thực hiện nghiên cứu tiến cứu trên 37 bệnh nhân cắt phần xa dạ dày kèm nạo vét hạch điều trị ung thư dạ dày bằng phẫu thuật nội soi kỹ thuật 3D tại Khoa Ngoại nhi - cấp cứu bụng, Bệnh viện Trung Ương Huế từ 03/2018 đến 09/2021.

Kết quả: Phẫu thuật nội soi 3D được thực hiện ở tất cả 37 bệnh nhân, không có trường hợp nào chuyển mổ mở. Thời gian phẫu thuật trung bình là 69,86 ± 20,46 phút, lượng máu mất trong mổ trung bình là 171,22 ± 15,47 ml, số hạch vét được trung bình là 20,49 ± 4,11 hạch và thời gian nằm viện sau phẫu thuật trung bình là 10 ngày (6 - 26 ngày). Tỷ lệ biến chứng là 8,1 % với 1 trường hợp (2,7%) dò mỏm tá tràng, không có trường hợp nào tử vong sớm sau mổ. Tỉ lệ sống còn sau 1 năm là 87,27% và sau 3 năm là 83,31%.

Kết luận: Áp dụng phẫu thuật nội soi 3D trong cắt phần xa dạ dày có thể thực hiện an toàn và khả thi. Giúp giảm đáng kể thời gian mổ, lượng máu mất trong mổ và đảm bảo được nguyên tắc an toàn về ung thư học.

ABSTRACT

EFFICACY USING THREE - DIMENSIONAL LAPAROSCOPY IN THE TREATMENT OF DISTAL GASTRIC CANCER

Background: Recent studies have supported that three - dimensional (3D) laparoscopy has advantages in treating gastric cancer compared with conventional two - dimensional (2D) screens. This study investigated the safety, short - term efficacy, and oncological outcome of three - dimensional (3D) laparoscopic distal gastric cancer surgery.

Materials and Methods: We prospectively analyzed the clinical data from 37 patients treated with 3D laparoscopic systemic lymphadenectomy for distal gastric cancer at the Hue Central Hospital from March 2018 to September 2021. The effects on operative time, intraoperative blood loss, the number of lymph nodes removed, postoperative recovery time, complications, and oncologic outcome were analyzed.

Results: Three - dimensional (3D) laparoscopic distal gastrectomy was successfully carried out in 37 patients. The mean operative time was 69,86 ± 20,46 minutes, mean intraoperative blood loss was 171,22 ± 15,47 ml, the number of harvested lymph nodes was 20,49 ± 4,11, and the mean postoperative hospital stay was 10 (6 - 26 days). The incidence of postoperative complications was 8,1%, with 1 case of duodenal stump fistula. The one - year overall survival rate was 87,27%, and the three - year overall survival rate was 83,31%.

Conclusions: 3D laparoscopy distal gastrectomy could be performed safely and feasibly. They reducethe operative time and intraoperative blood loss in distal gastrectomy with a good oncologic outcome.

Keywords: Laparoscopic gastrectomy, D2 lymphadenectomy, 3D laparoscopy
Ảnh hưởng của một số đặc điểm lâm sàng, cận lâm sàng lên sống còn toàn bộ bệnh nhân ung thư dạ dày giai đoạn tiến xa
Authors: Nguyen-Thi Hong Chuyen
Published: December 2021

TÓM TẮT

Mục tiêu: Khảo sát ảnh hưởng của một số đặc điểm lâm sàng và cận lâm sàng lên sống còn toàn bộ của bệnh nhân ung thư dạ dày giai đoạn tiến xa.

Phương pháp: Nghiên cứu mô tả loạt ca, hồi cứu trên 167 bệnh nhân ung thư dạ dày giai đoạn tiến xa được chẩn đoán và điều trị triệu chứng tại khoa Ung Bướu bệnh viện Trường Đại học Y Dược Huế và Trung tâm Ung Bướu Bệnh viện Trung Ương Huế từ tháng 01/2015 đến tháng 12/2020. Phân tích thời gian sống còn bằng mô hình Kaplan Meier và so sánh sự khác biệt về thời gian sống giữa các nhóm bệnh nhân theo đặc điểm lâm sàng, cận lâm sàng bằng Log rank test.

Kết quả: Tuổi trung bình là 58,2; tỷ lệ nam/nữ là 2.5/1. Tại thời điểm chẩn đoán, đa số bệnh nhân có BMI là dưới 18,5 kg/m2 (64,1%) và KPS = 90% (50,3%). Triệu chứng lâm sàng phổ biến nhất là đau thượng vị (73,7%). Albumin máu < 35g/L chiếm 86,2%. Hầu hết bệnh nhân có tình trạng di căn xa (89,8%); 2,4% bệnh nhân có tình trạng huyết khối tĩnh mạch. Trung vị sống còn toàn bộ là 11 tháng. Phân tích đơn biến cho thấy các yếu tố ảnh hưởng đến sống còn toàn bộ là tuổi, chỉ số trạng thái hoạt động cơ thể Karnofsky (KPS), vị trí tổn thương, di căn hạch vùng, huyết khối tĩnh mạch, Albumin huyết thanh.

Kết luận: Nghiên cứu cho thấy bệnh nhân ung thư dạ dày giai đoạn tiến xa có tiên lượng xấu với sống còn toàn bộ là 11 tháng. Các yếu tố lâm sàng gồm tuổi, chỉ số KPS, vị trí tổn thương, di căn hạch vùng, huyết khối tĩnh mạch ảnh hưởng đến sống còn toàn bộ bệnh nhân.

ABSTRACT

THE EFFECT OF SOME CLINICAL AND LABORATORY CHARACTERISTICS ON OVERALL SURVIVAL OF ADVANCED - STAGE GASTRIC CANCER PATIENTS

Purposes: To investigate the influence of some clinical and laboratory characteristics on the overall survival of advanced - stage gastric cancer patients.

Methods: A retrospective case series study with 167 early - stageadvanced - stage gastric cancer patients recruited from at oncology department, the Hospital of Hue University of Medicine and Pharmacy and Oncology Center of Hue Central HospitalfromJanuary 2015 to December 2020. The Kaplan - Meier method was used to estimate survival, the log - rank test analyzed the relevant factors.

Results: Median age was 58.2; male/female was 2.5/1; the most common clinical symptom was epigastric pain (78.7%); at the time of diagnosis, almost all patients had KPS 90% (50.3%); BMI index below 18.5 (64.1%). Serum albumin < 35g/l accounting for 86.2% of patients. 89.8% of patients had distant metastasis disease. The median survival was 11 months. Univariate analysis indicated that age, KPS, primary tumor location, regional nodal metastasis, venous thrombosis, serum albumin level affecting on overall survival.

Conclusions: Advanced - stage gastric cancer patients had poor survival with a median of 11 months. Age, KPS, tumor location, regional nodal metastasis, venous thrombosis, serum albumin level influence overall survival.

Keywords: Outcomes, advanced - stage, gastric cancer.
Cắt gan trung tâm ở trẻ 6 tháng tuổi bị u nguyên bào đã điều trị hóa chất
Authors: Ho Huu Thien
Published: December 2021

TÓM TẮT

Bệnh nhi 6 tháng tuổi được chẩn đoán u nguyên bào gan, ban đầu được xem là không thể cắt bỏ được vì khối u có kích thước lớn và lan tỏa. Bệnh nhân được điều trị 4 đợt hóa chất cisplatin với thời gian cách nhau 2 tuần. Kết quả chụp cắt lớp vi tính sau 4 đợt hóa trị cho thấy khối u đã thu nhỏ lại và có thể cắt bỏ. Khối u đã được cắt bỏ bằng phương pháp phẫu thuật cắt gan trung tâm. Bệnh nhân đã có thể ăn uống trở lại vào ngày thứ tư và xuất viện vào ngày thứ bảy sau mổ. Bác sĩ chuyên khoa nhi ung bướu đã theo dõi bệnh nhân bằng siêu âm gan, alpha - fetoprotein và tiếp tục điềutrị thêm 2 chu kỳ cisplatin.

ABSTRACT

CENTRAL HEPATECTOMY IN A 6 - MONTH - OLD CHILD WITH HEPATOBLASTOMA FOLLOWING CHEMOTHERAPY

A hepatoblastoma in a 6 - month - old child was initially considered unresectable because of diffuse liver involvement. The patient received 4 courses of cisplatin with an interval time of 2 weeks. A computed tomography scan after 4 courses of chemotherapy showed shrinking of the tumor, which made it resectable, and the tumor was removed by central hepatectomy. The patient was able to eat a regular diet on the fourth day and was sent discharge on the seventh day, after the operation. The pediatric oncologist followed the patient with liver ultrasonography and alpha - fetoprotein and administered 2 more cycles of cisplatin.

Keywords: Central Hepatectomy, Hepatoblastoma, children.
Đánh giá đáp ứng điều trị ung thư biểu mô tế bào gan sau nút mạch hóa chất (TACE) theo mRECIST
Authors: Le Trong Binh
Published: December 2021

TÓM TẮT

Mục tiêu: Đánh giá đáp ứng điều trị ung thư biểu mô tế bào gan (UTBMTBG) sau nút mạch hoá chất (TACE) theo tiêu chuẩn mRECIST.

Phương pháp: Nghiên cứu tiến cứu.Chẩn đoán UTBMTBG theo EASL 2018. Đánh giá đáp ứng sau TACE theo thang điểm mRECIST tại các thời điểm < 3 tháng, 3 - 6 tháng, 6 - 12 tháng, > 12 tháng.

Kết quả: 46 bệnh nhân (nam/nữ: 39/7), tuổi trung bình 61,5 ± 11,2 tuổi thỏa mãn tiêu chuẩn chọn bệnh. Thời gian theo dõi trung bình: 223 ngày (42 - 723 ngày). Đường kính lớn nhất trung bình của u: 62 mm (10 - 153 mm). 23,9% bệnh nhân có huyết khối tĩnh mạch cửa (HKTMC). Tỉ lệ đáp ứng hoàn toàn đối với tổn thương đích tại các thời điểm < 3 tháng, 3 - 6 tháng, 6 - 12 tháng, > 12 tháng lần lượt là 33,3%; 33,3%; 35,3% và 33,3%. Có 16,7% u tiến triển sau lần TACE thứ nhất. U thâm nhiễm, kích thước > 10cm, ở cả 2 thùy và có HKTMC là những yếu tố dự báo tái phát sau TACE.

Kết luận: TACE có hiệu quả kiểm soát u ngắn hạn khi đánh giá bằng mRECIST.

ABSTRACT EVALUATION OF TREATMENT RESPONSE OF HEPATOCELLULAR CARCINOMA AFTER TRANSARTERIAL CHEMOEMBOLIZATION USING mRECIST CRITERIA Nguyen Thi Thuy Linh1, Hoang Anh Dung1, Huyen Ton Nu Hong Hanh2, Ngo Dac Hong An1, Le Minh Tuan1, Dang Quang Hung2, Le Hoang Huy2, Le Trong Binh1* Purpose: To evaluate the treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) using mRECIST. Methods: Diagnosis of HCC was based on EASL 2018, and an indication of TACE was based on SIR practice guideline. Treatment responses were evaluated at < 3 - month, 3 - 6 - month, 6 - 12 - month and > 12 - month intervals. Results: Forty - sixpatients (male/female 39/7) with the mean age 61.5 ± 11.2 years were enrolled in the present study. The mean follow - up duration was 223 days (range, 42 - 723 days). The mean of maximal HCC diameter was 62mm (range, 10 - 153mm). 23.9% of patients had portal vein thrombosis (PVT). The rates of complete response of the target lesions at the < 3 - month, 3 - 6 - month, 6 - 12 - month and > 12 - month were 33.3%; 33.3%; 35.3% and 33.3%, respectively. Progression disease was seen in 16.7%. Infiltrative type, diameter > 10cm, bilobar HCC, and portal vein thrombosis were predictors for recurrence. Conclusion: TACE offered short - term therapeutic control of HCC when using mRECIST. Keywords: Hepatocellular carcinoma, transarterial chemoembolization, mRECIST.
Đánh giá thời gian sống thêm không tiến triển ung thư cổ tử cung tái phát - di căn điều trị phác đồ có platinum tại Bệnh viện K
Authors: Nguyen Thi Thanh Loan
Published: December 2021

TÓM TẮT

Mục tiêu: Đánh giá thời gian sống thêm không tiến triển và một số yếu tố liên quan của bệnh nhân ung thư cổ tử cung tái phát di căn được điều trị phác đồ phác đồ hóa chất có Platinum.

Phương pháp: Mô tả hồi cứu kết hợp tiến cứu, đối tượng nghiên cứu là 89 bệnh nhân được chẩn đoán ung thư cổ tử cung tái phát, tiến triển, di căn được điều trị phác đồ hóa chất Paclitaxel - Cisplatin hoặc Paclitaxel - Carboplatin tại bệnh viện K từ tháng 1/2019 - 4/2021.

Kết quả: Thời gian sống thêm không bệnh tiến triển trung vị là 5,2 ± 1,7 tháng. Số vị trí di căn và đáp ứng với điều trị ảnh hưởng đến thời gian sống thêm không tiến triển.

Kết luận: Phác đồ cho kết quả tốt và tương đối an toàn.

ABSTRACT

ASSESSMENT OF PROGRESSION - FREE SURVIVALIN METASTATIC RECURRENT CERVICAL CANCERTREATED BY PLATINUM - BASED CHEMOTHERAPY AT K HOSPITAL

Objectives: To evaluate the progression - free survival and explore some related factors of patients with metastatic recurrent cervical cancer treated with platinum - based chemotherapy.

Methods: A combined prospective and retrospective descriptive study was carried out in eighty - nine patients with recurrent, progressive, metastatic cervical cancer treated with Paclitaxel - Cisplatin or Paclitaxel - Carboplatin at the K hospital from 1/2019 - 4/2021.

Results: The median progression - free survival time was 5.2 ± 1.7 months. The number of metastatic sitesand response to treatment affect progression - free survival.

Conclusions: The regimen is effective and relatively safe.

Keywords: Recurrent metastatic cervical cancer, platinum.
Oral Anaerobic Microflora and Pregnancy Complication
Authors: Andonova Irena , Iliev Vasil
Published: December 2021

Bacterial vaginosis and periodontal diseases share very similar pathogenesis. Each of these diseases occurs when healthy microbiome changes to predominately anaerobic bacterial flora. Bacterial vaginosis is proven factor for adverse pregnancy outcomes. In recent years it has been hypothesized that infection from distant sites of the fetoplacental unit may also elicit an inflammatory response in utero. Aim: The study is designed to determine whether the presence of specific oral anaerobic bacteria in subgingival sulcus of mother increase the risk of adverse obstetric outcomes. Material and Methods: Case-control study.  Control group: 50 patients who gave birth to neonate whit normal birth weight at term. Group cases: I group - 40 pregnant women who were hospitalized with signs of preterm labor. II - 20 pregnant women, who have an ultrasound diagnosis of fetal growth retardation. Sub-gingival microbiological paper-point swab was taken in all patients. Results: The total number of isolated oral anaerobic bacteria was statistically significantly higher in the cases group compared to control group p <0.01. In our study, pregnant women who tested positive for Porphyrmonas gingivalis for 6.65 times were more likely to have preterm labor compare with pregnant women with negative oral swabs (95.0% CI: 1.38-32.11 / p <0.05), and for 2,79 times more likely to have fetus with intrauterine growth restriction (95.0% CI: 1.10-7.91 / p <0.05 Conclusions: The study confirmed the hypothesis of a statistically significant association between oral anaerobic infection and adverse pregnancy outcomes. In the future, more studies are needed to investigate the role of the microbial load, maternal immune response, pathophysiological pathway that leads to negative pregnancy outcome.
What Is Preparedness and Capacity of Intensive Care Service in Indonesia to Response to COVID-19? A Mixed-method Study
Authors: Helmi Mochamat , Sari Djayanti , Meliala Andreasta , Trisnantoro Laksono
Published: December 2021

BACKGROUND: Pandemics can increase disease spread, as well as unpredictable and highly in patient demand, which can have a negative impact on hospital capacity and the overall functioning of the health-care system. The preparedness and capacity of intensive care services to respond to COVID-19 in Indonesia are remain unknown.

AIM: This study aimed to investigate the preparedness and capacity of intensive care services in Indonesia to respond to the initial stage of the COVID-19 pandemic.

METHODS: A mixed-method research design was used in this study using in-depth interviews and an online survey. An in-depth interview was conducted with the medical team (intensive care consultant and an anesthesiologist) who is actively involved in the provision of COVID-19 services in 15 national referral hospitals. The online survey was conducted to all medical teams that provide direct care to the COVID-19 patients. A total of 459 (response rate was 95.2%) agreed to join the survey. The content analysis technique was used to analyze qualitative data and a descriptive analysis was used to describe issues encountered in providing health services to COVID-19 patients.

RESULTS: The analysis preparedness and capacity of intensive care service in Indonesia to respond to the initial stage of the COVID-19 pandemic resulting in 4 themes with 12 sub-themes. The four themes were limited quality and quantity of standardized intensive care unit (ICU) isolation room (inadequate zoning systems, adequacy of the standardized ICU isolation room, the readiness of the hospital infrastructure, and telemedicine facilities are not yet widely used, including in the COVID-19 isolation room), limited medical service support (lack of personal protective equipment (personal protective equipment [PPE], re-used PPE, lack of availability of medical devices), limitations in the medical team’s quality and quantity management (lack of number and distribution of expert doctors and medical team screening for ICU), and command systems (task shifting, effective communication, and leadership).

CONCLUSION: Medical team encounters several difficulties, particularly related to the quality of facilities, staff preparedness, and systems for the provision of services to COVID-19 patients with critical conditions. There is a critical need for well-defined pathways, legal protection, and occupational health for medical teams providing services in the aftermath of a pandemic.
Proximate, Mineral and Vitamin Analysis of Rebon Shrimp Diversification Products as an Indonesian Local Product: Supplementary Food for Malnourished Children
Authors: Anton Sri Sulistyawati , Bukhari Agussalim , Baso Aidah Juliaty A. , Erika Kadek Ayu , Syarif Isymiarni
Published: December 2021

Background: Rebon shrimp (Acetes sp.) is a local food in the coastal areas of Southeast Asia that has good nutritional potential. It is a nutrient-rich food, high in protein, and beneficial to human health, but the utilization of rebon shrimp is still very low. Aims: This study aims to measure the proximate and mineral analysis of various rebon shrimp products that can be used as supplementary food, expected to be popularly used and consumed by the Indonesian people, particularly those of low economic income. Methods: The diversified products in this study are meatballs, floss, nuggets, fish sticks, and fish cakes made from Rebon Shrimp (Acetes sp.). The proximate levels were analyzed referring to the AOAC method, The mineral content Fe and Zn were analyzed using the AAS method. The Vitamins A and Vitamin C were determined by spectrophotometric methods and titrimetry methods. Results: This study revealed that rebon shrimp could be used in making children's healthy snacks. Snacks with rebon shrimp contributed to moisture (8.79 – 72.58 %), ash (5.06 – 10.29%), crude protein (20.41 – 27.93 %), crude fat (3.09 – 47.16%), and crude fiber (0.35 – 3.36 %). In addition, these foods also contained several important minerals and vitamins for the body, such as iron (9.47– 56.13 ppm), zinc (4.05– 40.02 ppm), Vitamin A (0.016 – 0.045%), and vitamin C (0.11 – 0.19%). Conclusion: Thus, rebon shrimp is potentially used as an alternative to local ingredients to improve the nutritional quality of children's food.
Salat Dhuha Improves Haemodynamic: A Randomized Controlled Study
Authors: Boy Elman , Lelo Aznan , Tarigan Amira Permatasari , Machrina Yetty , Yusni Yusni , Harahap Juliandi , Sembiring Rosita Juwita , Syafril Santi , Rusip Gusbakti , Freeman Cindy Azzahra
Published: December 2021

BACKGROUND: The prevalence of hypertension increases with age, more than 1 in every two elderly have hypertension, dominated by women. The primary prevention of hypertension is a worldwide public health concern. Salat Dhuha is a moderate-intensity physical activity. Salat with a two-movement cycle (rakaat) demonstrated improved hemodynamic in adults.

AIM: Our study purpose was to asses the effects of 2 and 8 rakaats of Salat Dhuha in improving systolic and diastolic blood pressure and heart rate in healthy elderly women.

METHODS: Elderly women in the Senior Care Residence (aged 60–74 years) participated in a 6-week controlled study. We completed a formal physical, clinical, and blood assessments before admission. Participants with a history of hypertension were excluded from the study. The participants were randomized into 2 groups, i.e., “8 rakaats group” (n = 13) and “2 rakaats group” (n = 13) of Salat Dhuha. Two participants dropped out from the present study. At baseline and at the end of 6 weeks study period, blood pressure and heart rate were recorded. All data obtained were statistically analyzed.

RESULTS: Both groups demonstrated the benefits of Salat Dhuha in improving hemodynamic parameters (systolic and diastolic blood pressure and heart rate). However, the reduction of systolic blood pressure in the “2 rakaats group” (2.16 mmHg) was less than in the “8 rakaats group” (5.50 mmHg), the reduction of diastolic blood pressure in the “2 rakaats group” (0.75 mmHg) was less than the “8 rakaats group” (2.41 mmHg) and the reduction of heart rate in “2 rakaats group” (2.08 bpm) was less than the “8 rakaats group” (6.08 bpm). All differences were statistically significant (p < 0.05).

CONCLUSION: This study demonstrated that the Salat Dhuha has a significant potential in improving hemodynamic parameters for elderly women which the more frequent rakaat will give more benefit than less frequent rakaat.
Platelet Index in Patients with Confirmed Coronavirus Disease 2019 Cases
Authors: Harun Haerani , Nayoan Christin Rony , White Ipfi , Syamsi Nur , Tanra Andi Alfia Mutmainnah , Sarifuddin Sarifuddin
Published: December 2021

BACKGROUND: Changes found on hematological examination are a helpful modality for assessing coronavirus disease 2019 (COVID-19). In addition, platelet index is a parameter that can help in assessing the COVID-19 disease prognosis.

AIM: Objective of the study is to determine the difference in platelet index in nucleid acid amplification test (NAAT) confirmed COVID-19 patients, suspected COVID-19 with negative NAAT results, and non-COVID-19 controls.

METHODS: This is an analytical observational study with 96 subjects; 48 subjects with confirmed COVID-19, 23 subjects suspected COVID-19 with negative NAAT results, and 24 non-COVID-19 control subjects. First, NAAT examination was carried out using the GeneXpert tool with the target genes of the E and N2 genes. Then, the platelet index was compared between the three groups by the Kruskal-Wallis test.

RESULTS: There was no significant difference in the number of platelet (PLT), mean PLT volume (MPV), and PLT crit (PCT) between the three groups with p = 0.732, 0.741 and 0.483, respectively. In general, the number of PLT, MPV, and PCT in the three groups was within the normal reference value.

CONCLUSIONS: There were no significant differences observed in the number of PLT, MPV, and PCT between COVID-19 patients with positive NAAT, COVID-19 suspects with negative NAAT, and non-COVID-19 controls. Therefore, detecting the severe acute respiratory syndrome coronavirus 2 virus by NAAT examination in COVID-19 patients has not altered the PLT index changes.
Effect of Anatomical and Physiological Factors on Ultrasonic Breast Imaging Reporting and Data System Score in Iraqi Women Presenting with Breast Lumps
Authors: Hameed Ahmed Fakhir , Akkila Sameh S. , Noel Khalida I. , Alshahwani Saad
Published: December 2021

BACKGROUND: Breast lumps are a common presentation that can be assess non-invasively using the ultrasonic examination. AIM: The study aimed to assess the effect of different anatomical and physiological factors on the outcome of ultrasonic scoring of breast lumps. METHODS: A total of 60 females presented with a breast lump on ultrasound assessment were randomly selected after their consent at the Clinic for Early Detection of Breast Cancer in Baghdad. The results were expressed according to the ultrasound breast imaging reporting and data system (BI-RADS) scoring. RESULTS: There was a statistically significant positive correlation between the BI-RADS score with breast size, age, postmenopausal state, and personal or familial history of breast disease. Most cases (46.7%) scored BI-RADS II, followed by scores of III (21.6%), 4 (16.7%), and V (15%). The upper lateral quadrant of the breast was the most commonly affected sites. Marital status, parity, and breastfeeding didn’t have statistically significant influence on the sores. CONCLUSION: Ultrasonic BI-RADS scoring of breast lumps provides an initial reliable tool for the management of breast disease. Higher scores are associated with increasing breast size, age, postmenopausal state, and personal or familial history of breast disease. Several anatomical, physiological, hereditary, and environmental aspects influence such factors.
Thomas J. Kiernan and Irish diplomatic responses to cold-war anticommunism in Australia, 1946-1951
Authors: Madden Gerard
Published: December 2021

Despite being a peripheral actor in the Cold War, Ireland in the immediate post-war period was attentive to cold war developments internationally, and the influence of the Catholic Church over state and society predominantly shaped the state's response to the conflict. Irish diplomats
internationally sent home repo rts on communist activity in the countries in which they served. This article will discuss Thomas J. Kiernan, Ireland's Minister Plenipotentiary in Australia between 1946 and 1955, and his responses, views and perceptions of Australian anti-communism from his
1946 appointment to the 1951 plebiscite on banning the Communist Party of Australia, which ultimately failed. Through analysis of his reports in the National Archives of Ireland – including accounts of his interactions with politicians and clergy, the Australian press, parliamentary
debates and other sources – it argues that his views were moulded by the dominant Irish conception of the Cold War, which was fundamentally shaped by Catholicism, and his overreliance on Catholic and print sources led him to sometimes exaggerate the communist threat. Nonetheless, his
reports home to Dublin served to reinforce the Irish state's perception that communism was a worldwide malaise which the Catholic Church and Catholics internationally were at the forefront of combatting.
Year of refusal: crisis and ideology in the Communist Party of Canada, 1956-7
Authors: Penner Mack
Published: December 2021

Just as they did for other communist parties around the world, events in 1956 brought a crisis to the Communist Party of Canada (CPC). Khrushchev's Secret Speech and the Soviet invasion of Hungary produced a reckoning with what exactly it meant to be a communist and a marxist-leninist.
In Canada, this reckoning would lead to a mass exit of party members and to a precipitous decline in the general fortunes of the party after 1956. In existing histories, this crisis has been presented as though it played out in quite strictly bipolar fashion as a conflict between a growing
minority of independent marxists on the one hand and, on the other, a larger group of party leaders and their supporters who remained committed to a Soviet-aligned marxist-leninist politics in Canada. In fact, the ideology of the crisis was more complex. Ideological reactions to 1956 could
range, at least, across stalinist, liberal, marxist-leninist, or independent-marxist iterations. Taking 1956 to constitute a year of refusal in the CPC, this essay follows the trajectories of these ideologically distinct 'modes of refusal' and suggests an alternative history.