Enthesitis in patients with psoriatic arthritis: A nationwide data from the Chinese Registry of Psoriatic Arthritis (CREPAR) / 中华医学杂志(英文版)

BACKGROUND@#The clinical features of enthesitis in patients with psoriatic arthritis (PsA) have been reported in some Western countries, but data in China are very limited. This study aimed to describe the characteristics of enthesitis in Chinese patients with PsA and compared them with those in other cohorts.@*METHODS@#Patients with PsA enrolled in the Chinese Registry of Psoriatic Arthritis (CREPAR) (December 2018 to June 2021) were included. Data including demographics, clinical characteristics, disease activity measures, and treatment were collected at enrollment. Enthesitis was assessed by the Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht ankylosing spondylitis enthesitis score (MASES), and Leeds enthesitis index (LEI) indices. A multivariable logistic model was used to identify factors related to enthesitis. We also compared our results with those of other cohorts.@*RESULTS@#In total, 1074 PsA patients were included, 308 (28.7%) of whom had enthesitis. The average number of enthesitis was 3.3 ± 2.8 (range: 1.0-18.0). More than half of the patients (165, 53.6%) had one or two tender entheseal sites. Patients with enthesitis had an earlier age of onset for both psoriasis and arthritis, reported a higher proportion of PsA duration over 5 years, and had a higher percentage of axial involvement and greater disease activity. Multivariable logistic regression showed that axial involvement (odds ratio [OR] 2.21, 95% confidence interval [CI], 1.59-3.08; P <0.001), psoriasis area and severity index (PASI) (OR: 1.03, 95% CI: 1.01-1.04; P = 0.002), and disease activity score 28-C reactive protein (DAS28-CRP) (OR: 1.25, 95% CI: 1.01-1.55; P = 0.037) were associated with enthesitis. Compared with the results of other studies, Chinese patients with enthesitis had a younger age, lower body mass index (BMI), a higher rate of positive human leukocyte antigen (HLA)-B27, more frequent dactylitis, and a higher proportion of conventional synthetic disease-modifying antirheumatic drugs' (csDMARDs) use.@*CONCLUSIONS@#Enthesitis is a common condition among Chinese patients with PsA. It is important to evaluate entheses in both peripheral and axial sites.

Association of skin lesion severity with clinical features of psoriatic arthritis / 中华内科杂志

Objective:To investigate the relationship between psoriasis severity and clinical features in psoriatic arthritis (PsA).Methods:Patients were recruited from the Chinese REgistry of Psoriatic ARthritis (CREPAR) between December 2018 and June 2021, and data were collected including the baseline demographic characteristics, various clinical manifestations (including arthritis, nail disease, comorbidities), laboratory tests[including erythrocyte sedimentation rate(ESR), C-reactive protein (CRP)], health assessment questionnaire (HAQ). Body surface area (BSA) and psoriasis area and severity index (PASI) were selected for the tools of assessment of cutaneous psoriasis. Patients were divided to two groups, including the severe psoriasis group (BSA>10%) and the non-severe psoriasis group (BSA≤10%). Disease assessment included ankylosing spondylitis disease activity score (ASDAS), disease activity score 28 (DAS28) and disease activity in psoriatic arthritis (DAPSA).Results:1 074 eligible patients with PsA were recruited, and 106 (9.9%) had severe psoriasis. Compared with non-severe psoriasis group, the severe psoriasis group had more peripheral joint involvement (including patients with ever or current peripheral arthritis, 94.3% vs. 85.6%), more polyarticular joint involvement (including patients with current peripheral arthritis, 74.0% vs. 58.2%), more axial joint involvement (51.4% vs. 39.9%), more nail disease (72.6% vs. 61.4%), more frequency of smoking (20.2% vs. 18.7%), and higher proportion of hypertension (23.4% vs. 14.4%). In addition, the severe psoriasis group had higher level of ESR [33(10, 70) mm/1h vs. 20(9, 38) mm/1h] and CRP [18.6(5.0, 60.8) mg/L vs. 7.0(2.4, 18.1) mg/L], higher values of DAS28-ESR (4.5±1.7 vs. 3.7±1.5), DAS28-CRP (4.2±1.5 vs. 3.4±1.4), ASDAS-ESR (3.5±1.4 vs. 2.6±1.2), and ASDAS-CRP(3.4±1.6 vs. 2.5±1.2), higher scores of HAQ [0.6(0.1, 1.0) vs. 0.3(0.0, 0.8)].Conclusion:Patients with PsA with severe psoriasis bore a heavier disease burden. Therefore, clinicians were supposed to pay more attention to them. In addition to skin lesions, they should also focus on examination of other clinical manifestations, such as joints and nails.

Current Situation and Prospect of Pharmacoeconomic Evaluation of Hemophilia in China / 罕见病研究

In 2018, hemophilia, one of the first ones, entered into the catalogue of Rare Disease in China. However, drug accessibility and affordability have been the challenges for hemophilia patients. Therefore, a comprehensive evaluation of the cost and efficacy of hemophilia drugs is essential to push forward the appropriate application of hemophilia drugs. In the article, we have teased out the existing process of the review and approval of hemophilia drugs; have examined the procedures for the drug entry into the medical insurance policy; have systematically searched the pharmacoeconomic evaluation studies of hemophilia in published literature in both China and overseas; and have comprehensively analyzed the quality, the content of evaluation, and challenges of pharmacoeconomic studies of hemophilia in China. At last, we discuss the prospect for the future based on the following three aspects: developing a special model of hemophilia, obtaining the health utility from various sources, and establishing the threshold of willingness to pay for rare diseases, hoping to provide reference and examples to the research into pharmacoeconomic evaluation of hemophilia in China.

Cost-utility analysis of tislelizumab in the second -line treatment of advanced or metastatic esophageal squamous cell carcinoma / 中国药房

OBJECTIVE To evaluate the cost -effectiveness of tislelizumab in the second -line treatment of advanced or metastatic esophageal squamous cell carcinoma （ESCC）in China .METHODS A three -state Markov model was constructed to assess the cost -effectiveness of tislelizumab versus chemotherapy in the second -line treatment of advanced or metastatic ESCC and programmed death receptor 1（PD-L1）positive patients . The cycle length of the model was 1 month，and the time horizon of the model was set as 10 years. The discount rate of cost and utility was 5%. One-way sensitivity analysis ，probability sensitivity analysis and scenario analysis were used to verify the robustness of the base -case analysis results . RESULTS The results of the base-case analysis showed that compared with chemotherapy ，the incremental cost -effectiveness ratio （ICER）of tislelizumab in the second-line treatment of advanced or metastatic ESCC and PD -L1-positive patients were 26 864.01 yuan/QALY and 37 510.07 yuan/QALY，respectively，which was much lower than 1 time per capita gross domestic product （GDP）in 2021（80 976 yuan）. Results of scenario analysis showed that the ICER was less than 1 times per capita GDP ，regardless of the chemotherapy regimens（paclitaxel，docetaxel or irinotecan ）used. With the extension of the simulation time limit ，the ICER of tirelizumab regimen gradually decreased ，and the reduction rate gradually E-mail：lishunping@sdu.edu.cn decreased，but they were all less than 1 time China ’s per capita GDP in 2021. The results of the one -way sensitivity analysis showed that the 3 parameters with the most significant impact on the ICER were progression -free survival of tislelizumab group ，price of tislelizumab ，and the proportion of patients receiving follow-up treatment in the tislelizumab group . The results of the probability sensitivity analysis showed that the probability of tislelizumab with cost -effectiveness in the treatment of advanced or metastatic ESCC patients and PD -L1-positive patients were 99.09% and 99.94%，respectively，when using 3 times per capita GDP as the willingness -to-pay threshold . CONCLUSIONS Tislelizumab has economic advantages over chemotherapy alone in the second -line treatment of advanced or metastatic ESCC patients.

Clinical Progress in Negative-Pressure Endometrial Sampler for Endometrial Cancer Screening / 中国医科大学学报

Endometrial cancer is a common malignancy of the female reproductive system. Despite improvement in living standards, the incidence of endometrial cancer is increasing due to the lack of effective screening. Early detection of endometrial cancer and precancerous lesions can significantly improve prognosis and survival. At present, China lacks a method for screening endometrial lesions comparable to that for cervical cancer screening. A recently introduced endometrial sampler has the advantages of simple operation, low cost, and minimal trauma, and is gradually being accepted for clinical screening of endometrial cancer and precancerous lesions in other countries.This study aims to explore current screening methods for endometrial cancer and precancerous lesions and the clinical application of an endometrial sampler for screening.

Effects of concentrated growth factors on the angiogenic properties of dental pulp cells and endothelial cells: an in vitro study

Abstract The aim was to investigate the angiogenic effects of concentrated growth factors on human dental pulp cells and human umbilical vein endothelial cells. Cells were treated with concentrated growth factor extracts. The CCK-8 assay and cell cycle assay were conducted to evaluate cell growth. Cell migration was evaluated by the Transwell migration assay. Angiogenesis-associated mRNA and protein expression levels were determined using quantitative real-time PCR and Western blotting, respectively. A tube formation assay was conducted to evaluate the angiogenic capacity in vitro. The data showed that compared with the control, concentrated growth factor extracts significantly promoted dental pulp cell proliferation and differentiation and endothelial cell proliferation and migration in a dose-dependent manner (p < 0.05). Concentrated growth factor extracts also promoted the tube-like structure formation of endothelial cells in vitro. The RT-PCR and Western blot results showed that concentrated growth factor extracts upregulated the expression of angiogenesis-related genes - chemokine receptor-4, platelet-derived growth factor, and vascular endothelial growth factor - in dental pulp cells. In conclusion, concentrated growth factors showed proangiogenic effects on dental pulp cells and endothelial cells and have good application potential for dental pulp revascularization.

An in vitro study of the angiogenic effects of concentrate growth factor on human umbilical vein endothelial cells / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aimed to explore the effects of concentrate growth factor extracts (CGFe) on human umbilical vein endothelial cells (HUVECs) in vitro.</p><p><b>METHODS</b>Concentrate growth factor (CGF) were prepared from the peripheral blood of healthy donors, followed by CGFe. Four groups were designed based on cell culture medium, as follows: 2%CGFe, 5%CGFe, 10%CGFe, and control. The proliferation activity of HUVECs was detected by cell cycle and CCK-8 assays. The migration of HUVECs was detected by scratch assay. The mRNA expression levels of vascular endothelial growth factor (VEGF), chemokine receptor 4 (CXCR4), and platelet derived growth factor (PDGF) were examined by quantitative real time polymerase chain reaction (qRT-PCR).</p><p><b>RESULTS</b>Results of CCK-8 and cell cycle assays showed that CGFe promoted the proliferation capability of HUVECs in a dose-dependent manner, and the data had statistical significance among four groups (P<
0.05). The cell migration assay indicated that CGF accelerated wound closure in a dose-dependent manner after 12 h of culture (P<0.05). The results of qRT-PCR showed that CGF upregulated the expression levels of VEGF, CXCR4, and PDGF in HUVECs.</p><p><b>CONCLUSIONS</b>CGFe can promote the proliferation, migration, and angiogenic differentiation of HUVECs. Thus, CGF might be an appropriate cure for dental pulp revascularization.</p>

Role of tumor-derived exosomes in tumor metastasis / 国际肿瘤学杂志

Tumor-derived exosomes (TEXs) are small membrane vesicles secreted by tumor cells.They contain various proteins and RNA which make they serve as functional mediators in cell interaction.TEXs can alter the components of extracellular matrix and induces epithelial-mesenchymal transition of tumor cells,which enhance the invasiveness of tumor cells.TEXs regulate immunity through multiple pathways,allowing circulating tumor cells to escape immune surveillance.TEXs promote pre-metastatic microenvironment in target organ before metastasis and induce angiogenesis after circulating tumor cells colonization.Understanding the role and mechanism of TEXs in this process can effectively block relevant signaling pathways which may provide new targeted therapies for clinic.

Investigation into a new professional English teaching system for postgraduate dental students / 中华医学教育探索杂志

In view of the weakness of the teachers' strength, students' lack of interest and the lack of unity of teaching materials in the foreign language teaching, Oral Medicine College of Chongqing Medical University carried out the reform to the professional foreign language courses in the postgraduate education period by strengthening the preparation of special teaching materials, reinforcing teaching staff construction, reforming teaching methods and creating a learning environment. The results of teaching assessment by students and peer-reviewers show that reform has achieved good results, and aiming at the problems in the teaching practice we also put forward such improvement measures as strengthening the student-centered teaching method, promoting new teaching methods and optimizing curriculum assessment programs.

Current Situation on Rehabilitation Personnel in Medical Institutions in Shanghai / 中国康复理论与实践

@#Objective To investigate the status of rehabilitation personnel in Shanghai. Methods Shanghai medical institutions were investigated through self-questionnaire including rehabilitation personnel quantity, basic characteristics of sociology and training from 2011 to 2013. Results There are 2262 rehabilitation personnel on duty in the medical institutions, with 321 rehabilitation doctors, 860 rehabilitation therapists and 666 rehabilitation nurses, 415 people without identity; female rehabilitation doctors, female rehabilitation therapists and female rehabilitation nurses account for 48.91%, 54.77%, 98.80% respectively; 25-34 years old group accounts for 44.24%, 38.84% and 39.79% respectively; working less than 5 years accounts for 30.84%, 65.00% and 60.81% respectively. Rehabilitation doctors with bachelor degree and clinical profession account for 56.70% and 75.07% respectively; rehabilitation therapists with college degree and rehabilitation profession account for 48.37% and 89.19% respectively; rehabilitation nurses with college degree and nursing profession account for 52.25% and 99.55% respectively; rehabilitation physicians, therapists and rehabilitation nurses who didn't accept the professional training of rehabilitation account for 4.36%, 4.07% and 28.68% respectively. Conclusion Shanghai rehabilitation personnel are deficient and some staff has not yet been identified, rehabilitation personnel structure and functional reeducation also need to be reinforced.

Investigation of Rehabilitation Medical Resources and Services in Shanghai / 中国康复理论与实践

@#Objective To investigate Shanghai rehabilitation resources and services, define the status and problems and provide suggestions for making Shanghai rehabilitation health care system planning. Methods Based on the "Structure-Process-Result" theoretical framework, the questionnaire survey and field investigation were conducted on medical institutions in term of the rehabilitation departments setting, manpower, beds, equipment, housing, income and expenditure, and referral services. Results There were 321 rehabilitation doctors, 860 rehabilitation therapists and 666 rehabilitation nurses, 2199 preparation beds and 2573 real beds in all kinds of rehabilitation medical institutions. The rates of carrying out rehabilitation services were 94.79% in general hospitals, 100.00% in rehabilitation hospitals, 75.56% in community health service centers, rehabilitation equipment rates were 50.79%, 71.15%, 17.77%, and 27.73 %, 30.00%, 13.21% of them provided outpatient rehabilitation services. Conclusion Shanghai tertiary rehabilitation medical services architecture has initially formed, however, there are still many problems in the rehabilitation function. The rehabilitation health care system planning should focus on rehabilitation services capacity, rehabilitation staff team, rehabilitation resources and services referrals.

Study of the community-based indexing system for prevention and control technologies of chronic non-communicable diseases / 中华医院管理杂志

An indexing system is constructed,based on the implementation of prevention and control technology for chronic non-communicable diseases in community health service institutions,using both literature review and Delphi method,and using the Analytic Hierarchy Process (AHP) to calculate the weight of the indexing system.The system comprises three level-1 indexes,8 level-2 indexes and 33 level-3 indexes.The research proposed a transition from emphasis of therapeutic means to prevention,and emphasis on prevention and control technologies to the high-risk population in the prevention and control technology of chronic non-communicable diseases,along with development of techniques and measures to encourage behavioral changes of the population with chronic diseases.

Research on root fracture resistance after root canal filling / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To compare the fracture resistance of roots filled with three different root canal filling techniques.</p><p><b>METHODS</b>Forty extracted single-rooted permanent teeth were instrumented and randomly divided into four groups. Three experimental groups were filled with lateral compaction technique, vertical compaction technique and single-cone technique, respectively. No filling was performed in control group. All specimens were subjected to a vertical load to cause vertical root fracture. The force required to fracture was measured and the fracture lines was classified.</p><p><b>RESULTS</b>Three experimental groups exhibited higher mean fracture load values than that of control group (179.93 N+/-34.03 N). There was no significant difference among the three experimental groups, and the mean fracture load values were (210.041+/-64.57), (232.55+/-50.74), (216.80+/-78.03) N, respectively. Eighty-five percent of root fracture lines were found in the bucco-lingual direction.</p><p><b>CONCLUSION</b>Root canal filling alone can't influence the root strength significantly. There is no difference in root strength after three canal filling techniques.</p>

Effects of Long-term Administration of Low-dose FTY720 on Survival of Murine Cardiac Allograft / 华中科技大学学报（医学）（英德文版）

This study examined the effect of long-term administration of low-dose FTY720 on survival of murine cardiac allograft and the possible mechanism.Murine models of abdominal heterotopic heart transplantation were established.Low-dose FTY720 (0.3 mg/kg) was administrated to the animals 4 days before the transplantation of cardiac allografis until the occurrence of rejection or the observation terminals.The animals without FTY720 treatment and those with syngencic cardiac grafts transplanted served as controls.The mean survival time (MST) of grafts,and T lymphocyte subsets in gratis,peripheral blood and lymphoid organs were measured by histopathological examination or flow cytometry,and compared among groups.The results showed that the MST of allografts in FTY720-treated mice was more than 40 days,significantly longer than that in the untreated group (MST=8 days,P＜0.01).After the long-term administration of FTY720,the proportion of CD4+ and CD8+ lymphocytes in peripheral blood was diminished significantly,but the proportion ofCD4+ lymphocytes was increased in mesenteric lymph nodes (MLNs) and spleen.lmmunofluorescence staining revealcd that the infiltration of CD4+ and CD8+ lymphocytes in allografts was significantly inhibited after long-term administration of low-dose FTY720.It was concluded that low-dose long-term administration of FTY720 could promote T lymphocytes in lymphatic organs and decrease their infiltration in allografts,resulting in the inhibition of rejection and the long-term survival of allografts.

Hydrodynamics-based transgene directively into rat regenerating liver in vivo / 解剖学报

Objective To study the conditions and methods of hydrodynamics-based transgene into rat regenerating liver in vivo. Methods The solution with concentration 30mg/L gene-containing plasmid was injected into rat tail veins at a speed of 2ml/s, then partial hepatectomy (PH) was performed at different times before/after injection, finally the rat (g) and regenerating liver (g) were weighed, and the liver coefficient (Lc) was calculated. Out of 15 groups which are Lc±Lc*0%, *5%, *10%, *15%, *20%, *25%, *30%, *35%, the most suitable group was chosen as correction coefficient to calculate the most appropriate volume of plasmid solution which was injected into the regenerating liver at different recovery times, and at the same time, right lobe of liver was gathered to make frozen section, then observe and quantify the positive green fluorescent protein (GFP) rate at 488 nm excitation wavelength. Results Injection of either physiological saline or empty plasmid has no significant difference compared with control (only PH performance). The appropriate time of hydrodynamics-based transgene is more than 12 hours before PH or anytime after PH. The solution volume of hydrodynamics-based transgene into liver regenerating rat after PH is rat weight (g) ×9%×1/3×corresponding correction coefficient (Trc). Both vector and target gene have effect on the time and abundance of gene expression. Conclusion Hydrodynamics-based transgene can effectively be applied to gene transfection in rat regenerating liver.