Multimorbidity Pattern and Risk for Mortality Among Patients With Dementia: A Nationwide Cohort Study Using Latent Class Analysis

Objective@#Individuals with dementia are at a substantially elevated risk for mortality; however, few studies have examined multimorbidity patterns and determined the inter-relationship between these comorbidities in predicting mortality risk. @*Methods@#This is a prospective cohort study. Data from 6,556 patients who were diagnosed with dementia between 1997 and 2012 using the Taiwan National Health Insurance Research Database were analyzed. Latent class analysis was performed using 16 common chronic conditions to identify mortality risk among potentially different latent classes. Logistic regression was performed to determine the adjusted association of the determined latent classes with the 5-year mortality rate. @*Results@#With adjustment for age, a three-class model was identified, with 42.7% of participants classified as “low comorbidity class (cluster 1)”, 44.2% as “cardiometabolic multimorbidity class (cluster 2)”, and 13.1% as “FRINGED class (cluster 3, characterized by FRacture, Infection, NasoGastric feeding, and bleEDing over upper gastrointestinal tract).” The incidence of 5-year mortality was 17.6% in cluster 1, 26.7% in cluster 2, and 59.6% in cluster 3. Compared with cluster 1, the odds ratio for mortality was 9.828 (95% confidence interval [CI]=6.708–14.401; p<0.001) in cluster 2 and 1.582 (95% CI=1.281–1.953; p<0.001) in cluster 3. @*Conclusion@#Among patients with dementia, the risk for 5-year mortality was highest in the subpopulation characterized by fracture, urinary and pulmonary infection, upper gastrointestinal bleeding, and nasogastric intubation, rather than cancer or cardiometabolic comorbidities. These findings may improve decision-making and advance care planning for patients with dementia.

Ginsenoside Rg1 injection combined with inosine tablets and vitamin B1 for the treatment of primary retinitis pigmentosa / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effects of ginsenoside Rg1 injection combined with inosine tablets and vitamin B1 on serum brain-derived neurotrophic factor(BDNF), pituitary adenylate cyclase activating polypeptide(PACAP)and clinical efficacy in primary retinitis pigmentosa.METHODS: A total of 50 patients(100 eyes)with primary retinitis pigmentosa who admitted to the Department of Ophthalmology, the Second Affiliated Hospital of Hebei North University from August 2019 to March 2022 were selected as the research object. They were divided into the study group and the control group according to random number table, with 50 eyes in each group. Patients in the control group were treated with inosine tablets and vitamin B1, while patients in the study group were treated with ginsenoside Rg1 injection on the basis of the control group. The expression of BDNF and PACAP in serum, electroretinogram and spectral-domain optical coherence tomography(SD-OCT)were compared before and after treatment, and the retinal thickness(RT), mean deviation(MD), clinical efficacy and safety indexes were compared between the two groups.RESULTS: There were no differences in the MD of the two groups before treatment(t=1.670, P=0.098), while the MD of the study group was significantly lower than that of the control group after treatment(t=3.628, P&#x003C;0.01). Before treatment, RT with a diameter of 1mm at the circle of macular fovea was compared between the two groups(t=0.108, P=0.914), it was significantly higher than that in the control group after treatment(t=6.125, P&#x003C;0.01). Before treatment, there was no significant difference in the results of dark adaptation of electroretinogram between the two groups(all P&#x003E;0.05). After treatment, the results of dark adaptation in the study group were significantly better than those in the control group(all P&#x003C;0.01). Before treatment, there was no significant difference in the results of electroretinogram adaptation between the two groups(all P&#x003E;0.05). After treatment, the results of electroretinogram adaptation in the study group were significantly better than those in the control group(all P&#x003C;0.01). There was no significant difference in BDNF and PACAP between the two groups before treatment(all P&#x003E;0.05). BDNF and PACAP in the study group were higher than those of the control group after treatment(all P&#x003C;0.01). After treatment, no adverse reactions were observed in both groups.CONCLUSION: The treatment of patients with primary retinitis pigmentosa with ginsenoside will improve the retinal function and promote the prognosis of the disease by regulating the expression of BDNF and PACAP, and it is highly safe.

Protective effect of salvianolic acid B on retina and its influence on angiogenesis in retinal vein occlusion injured rat model / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the protective effect of salvianolic acid B on retina and its influence on angiogenesis in retinal vein occlusion(RVO)injured rats.METHODS: SD rats were randomly divided into control group, model group and salvianolic acid B group, with 10 rats in each group. In addition to the control group, rats in model group and salvianolic acid B group were induced RVO by Bengal red combined with laser photodynamic method. The rats in salvianolic acid B group were intraperitoneally injected with salvianolic acid B 50 mg/(kg·d), while the rats in control group and model group were only given the same amount of normal saline for 21 consecutive days. Fundus fluorescein angiography(FFA)was used to observe the retinal vein structure before and after administration. HE staining was used to observe the pathological changes of rat retina. The retinal function of rats was evaluated by electroretinogram(ERG). The fluorescence expression of vascular endothelial growth factor A(VEGFA)in retina of rats in each group was detected by immunofluorescence staining. The relative expression of HIF-1α, STAT3, p-STAT3 and VEGFA proteins in retinal tissue were detected by Western blotting.RESULTS: Compared with the control group, the blood flow at the retinal obstruction in the model group was recanalized, and the effective collateral circulation was abundant, but the shape was irregular, and there was fluorescence leakage. In salvianolic acid B group, the retinal vein circulation recovered, the shape became regular gradually, and the collateral vessels decreased. The retina of the model group and salvianolic acid B group showed different degrees of pathological damage. At the same time, the amplitude of ERG a wave and b wave, the thickness of retinal total layer(RTL), inner nuclear layer(INL)and outer nuclear layer(ONL)decreased, the fluorescence intensity of VEGFA enhanced, and the relative expression of HIF-1α, p-STAT3 and VEGFA protein increased(P&#x0026;#x003C;0.05). Compared with the model group, the retinal histopathological damage of salvianolic acid B rats was alleviated, the amplitude of ERG a-wave and b-wave, the thickness of RTL, INL and ONL were increased, the fluorescence intensity of VEGFA was weakened, and the relative expression of HIF-1α, p-STAT3 and VEGFA proteins was decreased(P&#x0026;#x003C;0.05).CONCLUSION: Salvianolic acid B can alleviate the retinal histopathological injury and improve retinal function in RVO rats, which may be related to inhibiting the activation of HIF-1α/STAT3/VEGFA pathway and reducing angiogenesis.

Practice of pediatric pharmacists providing internet medication consultation services based on the platform of “Our Pharmacists” / 中国药房

OBJECTIVE To analyze the effect of pharmaceutical practice of pediatric pharmacists providing internet medication consultation services. METHODS A total of 8 356 children’s medication cases through the “Our Pharmacists” online medication consultation platform （hereinafter referred to as “Our Pharmacists”） were collected from July 2020 to June 2022. The general information， disease type and irrational drug use were analyzed statistically. RESULTS Among 8 356 cases， 4 234 were male and 4 122 were female； the age of children was mainly from 12 months to 3 years old； the consulting diseases were mainly respiratory diseases （46.56%）， followed by digestive system diseases （18.41%） and skin system diseases （12.71%）. Among respiratory diseases， the proportion of irrational drug use was 92.30%， mainly including the use of antibiotics without indication （83.59%）， inappropriate selection of Chinese patent medicines （61.14%） and compound cold medicines （49.77%）， etc. Among digestive system diseases， the proportion of irrational drug use was 71.15%， mainly including not using oral rehydration salts （48.85%）， inappropriate use of probiotics （31.19%）， the use of antibiotics without indication （26.89%）， etc. A total of 4 273 evaluations of pharmacist services were received from child guardians， with a five-star rating of 99.88%. CONCLUSIONS Pharmacists provide pediatric medication consultation services through “Our Pharmacists”， providing individualized evidence-based medication suggestions， increasing the safety of drug use and satisfaction with pharmaceutical care， and ensuring the safety of children medication.

Efficacy of Danshen injection iontophoresis in the treatment of retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the efficacy of Danshen injection iontophoresis in the treatment of retinal vein occlusion(RVO).METHODS: The clinical data of 90 patients(90 eyes)with RVO treated in our hospital from January 2020 to December 2021 were analyzed retrospectively, and they were divided into control group and observation group according to treatment methods. A total of 38 patients(38 eyes)in the control group were treated with intravenous Xueshuantong+oral compound Xueshuantong capsule+enteric-coated aspirin, and 52 patients(52 eyes)in the observation group were treated with Danshen injection iontophoresis on this basis. The treatment time of the two groups was 3mo. The clinical efficacy, best corrected visual acuity, retinal condition and hemorheological indexes(whole blood low shear viscosity, fibrinogen)were compared between the two groups before and after treatment.RESULTS: The total effective rate of the observation group was significantly higher than that in the control group(87% vs 58%,P&#x003C;0.05)at 3mo after treatment. The best corrected visual acuity in both groups was better than that before treatment, and the observation group was better than the control group(all P&#x003C;0.05).The circulation time of retinal vein, the relative diameter of retinal vein and the relative area of retinal hemorrhage in the observation group were lower than those before treatment,and the observation group was lower than the control group(all P&#x003C;0.05). The whole blood low shear viscosity and fibrinogen levels in the two groups were lower than those before treatment, and the observation group was lower than those in the control group(all P&#x003C;0.05).CONCLUSION: Danshen injection iontophoresis is effective in the treatment of patients with RVO, which can effectively improve the visual acuity, treat fundus lesions and improve the abnormal blood flow.

The role of renal tubular Injury in the transition from acute kidney injury to chronic kidney disease / 医学研究生学报

Acute kidney injury (AKI) is an acute and critical kidney disease that seriously threatens human health and even life. It can lead to the chronic kidney disease (CKD) and end-stage kidney disease (ESRD), causing global public health problems. At present, the transition mechanism from AKI to CKD has not been fully elucidated, and renal tubular injury may play an important role in it. This paper reviews the role of renal tubular injury in the transition from AKI to CKD including cell dedifferentiation, inflammatory cell infiltration, hypoxia and vascular density decline, mitochondrial dysfunction and oxidative stress, G2/M cell cycle arrest, autophagy, TGFβ signaling pathway and Wnt signaling pathway.

Predictive Biomarkers of Immune-related Adverse Events Induced by Checkpoint Inhibitors in Malignancies / 中国医学科学院学报

While immune checkpoint inhibitors(ICIs)are effective and promising treatments for a variety of malignancies,they also have safety concerns,especially the immune-related adverse events(irAEs).Unlike the side effects of traditional chemotherapy and targeted therapy,irAEs are adverse events caused by immune activation after ICIs treatment and thus may involve almost every system of the body.Therefore,biomarkers for predicting irAEs after ICIs treatment are urgently needed.Here we review the currently available predictive biomarkers of irAEs.

Case series study on efficacy and safety of Omalizumab in the treatment of moderate-to-severe allergic asthma in children / 中华实用儿科临床杂志

Objective:To explore the clinical efficacy and safety of the new targeted anti-immunoglobulin E (IgE) drug Omalizumab in the treatment of children with moderate and severe allergic bronchial asthma in China.Methods:The clinical data of children with moderate and severe allergic asthma who were treated in the Department of Pediatrics of Peking University First Hospital from July 2018 to January 2020 and treated with Omalizumab were retrospectively analyzed.A comparison was performed on the changes of questionnaires, including childhood asthma control test (C-ACT), pediatric asthma quality of life questionnaire (PAQLQ), mini-asthma quality of life questionnaire (Mini-AQLQ) and global evaluation of asthma treatment effectiveness (GETE), pulmonary function test, including forced expiratory volume in the first second (FEV 1), percentage to predicted value (FEV 1% pred) and small airway function, fractional concentration of exhaled nitric oxide (FeNO) and so on, before and after treating with Omalizumab. Results:A total of 15 pediatric patients completed 16 weeks of treatment follow-up.After 16 weeks of Omazumab treatment, the score of C-ACT increased from (16.001.66) scores to (25.38±0.64) scores ( F=11.969, P<0.001), PAQLQ increased from (118.08 ± 23.78) scores to (141.00 ± 11.91) scores ( F=9.289, P=0.001), Mini-AQLQ increased from (78.93±7.43) scores to (97.92±3.12) scores ( F=4.145, P=0.042), and GETE decreased from (2.47±0.27) scores to (1.60±0.19) scores ( t=2.982, P=0.010). The actual value of FEV 1, FEV 1% pred, the maximum expiratory flow percentage of the predicted value (PEF% pred), forced expiratory flow at 25% (MEF 75), forced expiratory flow at 50% (MEF 50) and maximum midexpiratory flow (MMEF 75/25), increased from (1.96±0.12) L to (2.17±0.21) L ( F=0.425, P=0.789), (81.46±2.85)% to (82.64±1.55)% ( F=0.926, P=0.465), (82.05±3.58)% to (91.10±4.67)% ( F=1.909, P=0.128), (60.36±7.43)% to (76.94±4.65)% ( F=2.120, P=0.096), (52.72±3.75)% to (73.80±8.34)% ( F=3.140, P=0.047) and (60.05±8.47)% to (74.86±10.85)% ( F=7.860, P=0.010), respectively.FeNO decreased from 25.0 (14.5, 35.5) μg/L to 20.0 (18.5, 30.0) μg/L ( Z=-0.206, P=0.840). Transient headache was observed in 1 case and evanescent eruption in 2 cases during the treatment, respectively. Conclusions:Omalizumab can significantly improve the clinical manifestations, lung function indicators and quality of life of children with moderate and severe allergic asthma, and has good safety.Thus, it is expected to play an important role in the treatment of children with moderate-to-severe allergic asthma.

Application of Single-cell RNA Sequencing in Research on Tumor Immune Microenvironment / 中国医学科学院学报

Tumors are highly complex systems. Understanding the compositions and functions of the tumor immune microenvironment is a prerequisite for effective tumor immunotherapy. Single-cell RNA sequencing can detect the transcriptome of a cell at the resolution of single-cell level,describe its functional status,and thus deepen the understanding of the composition and function of different cell clusters in tumor immune microenvironment. This article reviews the application of single-cell RNA sequencing in research on tumor immune microenvironment.

Thermosensitive liposomal doxorubicin plus radiofrequency ablation increased tumor destruction and improved survival in patients with medium and large hepatocellular carcinoma: A randomized, double-blinded, dummy-controlled clinical trial in a single center

Background: Lyso-thermosensitive liposomal doxorubicin (LTLD, ThermoDox) consists of doxorubicin encapsulated contained within a heat-sensitive liposome. Aims and Objectives: We sought to evaluate whether the use of combined radiofrequency ablation (RFA) and LTLD would result in larger coagulation volume and longer overall survival (OS) compared with the use of RFA alone in patients with 3–7 cm unresectable hepatocellular carcinoma (HCC). Materials and Methods: Between 2010 and 2012, 22 HCC patients were randomly assigned to one of two treatments in our center: (1) ultrasound-guided percutaneous RFA plus intravenous (IV) infusion of LTLD (combination, n = 11) or (2) RFA plus IV dummy (RFA, n = 11). Four patients withdrew from the study, and the remaining 18 patients entered the final analysis. There were 14 male and 4 female patients with an average age of 61.1 ± 9.3 years (range: 40–73 years). The average tumor size was 4.2 ± 1.0 cm (range: 3.1–6.1 cm). One-month enhanced computed tomography was used to evaluate the ablation efficacy and coagulation volume after RFA. Regular follow-up after RFA was performed to assess toxicity, local response rates, and OS rates. Results: A major complication (empyema) occurred in one case in the combination group. Combination treatment region did not induce any additional toxicity beyond doxorubicin. The primary ablation success rate was 93.3% (14/15 tumors) in the combination group and 77.8% (7/9 tumors) in the RFA group (P = 0.308). The difference in coagulation volume between pre- and post-RFA in the combination group was significantly larger than that of the RFA group (105.7 ± 73.8 cm 3 vs. 37.3 ± 8.5 cm 3, P = 0.013). The follow-up period ranged from 11 to 80 months (average: 49.1 ± 24.8 months). The local progression rate was 6.7% (1/15 tumors) in the combination group and 22.2% (2/9 tumors) in the RFA group. The mean OS for the combination group was 68.5 ± 7.2 months, which was significantly greater compared with the RFA group (46.0 ± 10.6 months, P = 0.045). Conclusions: RFA with heat target delivery chemotherapy facilitated better tumor coagulation necrosis without additional toxicity. This combined treatment may improve the clinical efficacy of RFA or free doxorubicin and prolong survival in patients with medium to large HCC

Gut Microbiome Differences between Gastrointestinal Cancer Patients and Healthy People / 中国医学科学院学报

Objective To compare the differences in fecal flora among patients with esophageal cancer,gastric cancer,or colorectal cancer and between patients with gastrointestinal tumors and healthy people.Methods The 16S rRNA method was used to analyze the differences in fecal flora among 13 patients with esophageal squamous cell carcinoma,23 patients with gastric cancer,6 patients with colorectal cancer,and 49 healthy persons.Results Bifidobacterium,,and were less abundant in the fecal flora of cancer patients than in those of healthy controls(all <0.05).Some species of and were significantly reduced in the feces of patients with esophageal cancer or gastric cancer than in healthy people(<0.05),whereas others showed consistency with the intestinal cancer group.Anti-tumor treatment,antibiotics,and lactic acid could affect the fecal flora of cancer patients.Conclusion The gut microbiota compositions(mainly and )and some specific bacteria species in the feces of patients with esophageal cancer and gastric cancer are similar to those in the feces of patients with intestinal cancer,suggesting these bacteria may be involved in the development of upper gastrointestinal tumors.

A New High-throughput Real-time PCR Assay for the Screening of Multiple Antimicrobial Resistance Genes in Broiler Fecal Samples from China / 生物医学与环境科学（英文）

OBJECTIVE@#Antimicrobial resistance (AMR) has become a global concern and is especially severe in China. To effectively and reliably provide AMR data, we developed a new high-throughput real-time PCR assay based on microfluidic dynamic technology, and screened multiple AMR genes in broiler fecal samples.@*METHODS@#A high-throughput real-time PCR system with an new designed integrated fluidic circuit assay were performed AMR gene detection. A total of 273 broiler fecal samples collected from two geographically separated farms were screened AMR genes.@*RESULTS@#The new assay with limits of detection ranging from 40.9 to 8,000 copies/reaction. The sensitivity rate, specificity rate, positive predictive value, negative predictive value and correct indices were 99.30%, 98.08%, 95.31%, 99.79%, and 0.9755, respectively. Utilizing this assay, we demonstrate that AMR genes are widely spread, with positive detection rates ranging from 0 to 97.07% in 273 broiler fecal samples. blaCTX-M, blaTEM, mcr-1, fexA, cfr, optrA, and intI1 showed over 80% prevalence. The dissemination of AMR genes was distinct between the two farms.@*CONCLUSION@#We successfully established a new high-throughput real-time PCR assay applicable to AMR gene surveillance from fecal samples. The widespread existence of AMR genes detected in broiler farms highlights the current and severe problem of AMR.

Effectiveness of Auricular Acupressure for Acute Postoperative Pain after Surgery: A Systematic Review and Meta-Analysis / 中国结合医学杂志

OBJECTIVE@#To identify the effectiveness of auricular acupressure (AA) in patients with acute postoperative pain after surgery by systematic review.@*METHODS@#A search of randomized controlled trials was conducted in 5 English medical electronic databases and 4 Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis.@*RESULTS@#A total of 26 studies with 1,682 participants were included. Results showed that compared with conventional therapy, AA significantly improved the total effective rate [risk ratio=1.25, 95% confidence interval (CI), 1.13 to 1.37, Plt;0.0001; heterogeneity: Plt;0.0001, I=85%]. In the subgroup analysis, the results changed in different follow-up time and surgery categories. The pain relief in the AA group might be the most significant at 72 h after surgery (mean difference=-0.85, 95% CI,-1.20 to-0.50, Plt;0.0001) and in abdominal surgery (mean difference=-1.15, 95% CI,-1.41 to-0.90, Plt;0.0001). Sensitivity analysis demonstrated that the results of this meta-analysis were stable. No serious adverse effects were recorded.@*CONCLUSION@#It was recommended to provide AA to patients with acute postoperative pain. However, a more accurate estimate of the effect requires further rigorously designed large-scale and high-quality RCTs for improving acute postoperative pain after surgery.

Expression of α-smooth Muscle Actin in Advanced Colorectal Cancer Tissue and Its Significance in Chemotherapy Response Prediction and Prognosis / 中国医学科学院学报

Objective To investigate the expression of α-smooth muscle actin(α-SMA)in advanced colorectal cancer tissue and its association with chemotherapy response and prognosis.Methods The expression of α-SMA was detected by immunohistochemistry in tissues from 52 advanced colorectal cancer patients who received oxaliplatin plus 5-fluorouracil regimen as first-line chemotherapy. Its relationship with clinical characteristics,chemotherapy response,and survival were analyzed.Results Of these 52 patients,29(55.8%)were α-SMA overexpression,and the expression of α-SMA protein was not significantly associated with the age(χ =0.113,P=0.730),gender(χ =0.515,P=0.332),tumor location(χ =3.675,P=0.159),and tissue differentiation(χ =1.852,P=0.604). The chemotherapy resistance rate was 65.5%(19/29)in patients with high α-SMA expression,which was significantly higher than that (13.0%,3/23)in patients with low α-SMA expression(χ =14.470,P=0.000). Patients with high α-SMA expression exhibited a significantly shorter progression-free survival(PFS)compared with those with low α-SMA expression [(6.4±1.0)months vs.(16.0±3.5)months; χ=5.985,P=0.018]. Conclusion High α-SMA expression is associated with resistance to first-line chemotherapy and poor prognosis in advanced colorectal cancer patients.

A preliminary study on the content reformation of medical ultrasound course of undergraduates of BME based on the perspective of clinical engineering / 中国医学装备

Objective: To preliminarily explore the teaching content reformation of medical ultrasound course of undergraduates of biomedical engineering(BME)based on the perspective of clinical engineering(CE)so as to enhance competitive capability of graduate of BME in applying jobs.Methods: Self-designed questionnaire was adopted to investigate graduation plan,knowledge degree of medical ultrasound equipment and learning interests of senior undergraduates of BME.Results: The survey results showed that 22.85％(7 in 31 valid questionnaire)students hope to find a job in a hospital after they graduated.Before course starts,77.42％(24 in 31 valid questionnaire)respondents said they know nothing about the quality control(QC)of ultrasound diagnostic equipments,which is one of the most important tasks in CE.Comparing with other technical knowledge about medical ultrasound,the knowledge degree of QC is the lowest level.Meanwhile,in the rank of learning interest,students have very high learning interesting at relative QC and management.Conclusion: According to students' employment intension and learning interesting,the relative teaching contents of CE can meet the demand of position of BME students,and it is benefit to improve the job competitiveness of the graduates.Therefore,it is necessary to reform teaching content of medical ultrasound course of BME according to the point of CE.

Incidence of Cerebral Apoplexy in the Elderly Population in Longevity Areas in China and Its Correlation with Hypertension, Diabetes and Heart Disease / 现代检验医学杂志

Objective To study the incidence of stroke among elderly people in China's longevity area and its association with diseases such as hypertension,diabetes and heart disease.The differences in the following common hematological indicators in subjects with stroke and non-hypertension,diabetes,heart disease and stroke were studied:superoxide dismutase (SOD),malondialdehyde (MDA),hypersensitive c-reactive protein (hsCRP),albumin (propagated) glucose (GLU),cholesterol (CHO),triglyceride (TG),high-density lipoprotein cholesterol (HDLC),glycosylated serum protein (GSP) urea nitrogen (BUN),creatinine (CREA) and uric acid (UA).Methods Residents who participated in the project of biomedical research of aging population conducted in 2014 were selected from 8 longevity Areas in China.2 315 people aged 40 and over attended the study,including 22 aged 40 and over,238 aged 60 and over,490 aged 70 and over,629 aged 80 and over,518 aged 90 and over,418 aged 100 and over.Using the self-designed questionnaire to collect information about the characteristics of social demographics,the clinical doctors used the unified inspection tool to examine the subjects.The fasting blood samples were collected by vacuum tube at early morning.The contents of plasma SOD,MDA,hsCRP,ALB,GLU,CHO,TG,HDLC,GSP,BUN,CREA and UA were detected and compared among these elderly who were classified into different genders and different age groups and different healthy groups.Results The prevalence of high blood pressure,diabetes,heart disease and stroke increased with age,reaching a peak and then slowly decreasing.The age of peak was 90 ～ 99,60 ～ 69,70～ 79 and 80～ 89.The prevalence of hypertension was 71.62 ％ and 60.54 ％ respectively for stroke subjects and non-cerebral apoplexy subjects,and the difference was statistically significant.The prevalence of diabetes was 18.92％ and 11.35％ respectively,and the difference was statistically significant.The prevalence of heart disease was 20.98％ and 5.26％,respectively,and the difference was statistically significant.The rates of non-hypertension,non diabetic and non-heart disease were 4.73％ and 33.41％ respectively,and the difference was statistically significant.In the groups of Stroke subjects and Non-high blood pressure,nomdiabetic,non-heart disease subjects the following indicators were Compared,values of SOD were 55.76±8.27 and 57.16±8.00 U/ml respectively,the difference between groups were not statistically significant (t=0.341,P=0.053),values of MDA were 5.81 ± 3.82 and 5.67± 3.16 μmol/L respectively,the difference between groups were not statistically significant (t=0.329,P =0.661),values of hsCRP were 4.15 ± 12.33 and 2.94 ± 6.25 mg/L,respectively,the difference between groups were not statistically significant (t=0.026,P=0.080),values of ALB were 41.60±4.51 and 42.08±3.94 g/L respectively,the difference between groups were not statistically significant (t=0.032,P=0.194),values of ALB were 41.60 ± 4.51 and 42.08± 3.94 g/L respectively,the difference between groups were not statistically significant (t =0.032,P=0.194),values of ALB were 41.60 ± 4.51 and 42.08 ± 3.94 g/L respectively,the difference between groups were not statistically significant (t =0.032,P=0.194),values of GLU were 5.89 ± 2.67 and 4.90 ± 0.90 mmol/L respectively,the difference between groups showed statistically significant (t=0.000,P=0.000)),values of CHO were 4.81 ± 1.00 and 4.71±1.02 mmol/L respectively,the difference between groups were not statistically significant (t =0.670,P=0.318),values of TG were1.33±0.69 and 1.14±0.57 mmol/L respectively,the difference between groups showed statistically significant (t=0.012,P=0.000),values of HDLC were 1.29±0.35 and 1.41±0.40 mmol/L respectively,the difference between groups showed statistically significant (t=0.004,P=0.001),values of GSP were 259.10±60.90 and 246.75±24.52 μmol/L respectively,the difference between groups showed statistically significant (t =0.000,P =0.000),values of BUN were 6.84±± 3.53 and 6.62 ± 2.20 mmol/L respectively,the difference between groups were not statistically significant (t=0.110,P=0.338),values of CREA were 84.92 ± 33.00 and 80.14 ± 24.64 μmol/L respectively,the difference between groups showed statistically significant (t=0.013,P=0.044),values of UA were 296.73±91.34 and 288.12±80.47 μmol/L respectively,the difference between groups were not statistically significant (t=0.123,P=0.247).Conclusion Diabetes,hypertension,and heart disease are risk factors for stroke.Abnormal blood glucose and lipid metabolism:the increase of GLU,TG and the decrease of HDLC are important common biochemical index of stroke.Patients with cerebral apoplexy have certain renal impairment.

Clinical Analysis of 25 Cases of Malignant Peritoneal Mesothelioma / 中国医学科学院学报

Objective To investigate the clinicopathological features,treatment,and prognosis of patients with malignant peritoneal mesothelioma(MPM). Methods Clinical data of 25 MPM patients admitted to Peking Union Medical College Hospital from 1993 to 2017 were retrospectively analyzed.Results The mean age of these 25 patients with pathologically confirmed MPM(epithelioid subtype) was 50 years.The tumors were diffuse in 24 patients(96%) and localized in 1 patient(4%).Cytoreductive surgery was performed in 6 patients(24%),intraperitoneal chemotherapy in 12 patients(48%),and systemic chemotherapy in 24 patients(96%).The median overall survival was 26 months,with 1-year survival rate of 74.2% and 5-year survival rate of 16.7%.Cytoreductive surgery or intraperitoneal chemotherapy combined with systemic chemotherapy showed a significant survival advantage over intraperitoneal or intravenous chemotherapy alone(P=0.046,P=0.005).Cytoreductive surgery(P=0.018) showed statistical significance by multivariate analysis as a predictive factor in survival(hazard rate=6.889;95%CI=1.386-34.247).Conclusions MPM has its diverse clinical manifestations.Patients after cytoreductive surgery have longer survival time.Chemotherapy drugs(except for pemetrexed) and targeted therapy may be promising treatments.Cytoreductive surgery is an independent prognostic factor.

Efficacy and Prognostic Factors of Cetuximab Therapy in Treating KRAS or All RAS Wild-type Metastatic Colorectal Cancer / 中国医学科学院学报

Objective To explore the efficacy and prognostic factors of cetuximab therapy for KRAS or all RAS wild-type(WT)metastatic colorectal cancer(mCRC).Methods We screened mCRC patients receiving at least two cycles of cetuximb and chemotherapy from those with KRAS WT(before November 2013)or all-RAS-WT(after November 2013)in the Department of Medical Oncology,Peking Union Medical College Hospital from November 2007 to December 2016. The relationship between the clinicopathological characteristics and the efficacy was retrospectively analyzed.Results A total of 60 patients were included. For the 34 patients receiving cetuximab as first-line treatment,the objective response rate(ORR)was 55.9%,and the progression-free survival and overall survival(OS)was 10 and 24 months,respectively. All-RAS-WT mCRC had significantly lower risk of progression than those with KRAS-only-WT(P=0.012),and left-sided colorectal cancer had higher ORR than right-sided colon cancer(62.1% vs. 0,P=0.033)during the first-line treatment. The median OS of the eight patients continuing cetuximab beyond first-line progression was 35.0(95%CI:23.6-46.4)months.Conclusions The efficacy of cetuximab for left-sided colorectal cancer was better than for right-sided colon cancer,and patients with all-RAS-WT have lower risk of progression than those with KRAS-only-WT. Patients benefiting from first-line cetuximab and continuing cetuximab beyond progression survive longer.

Efficacy of Gemcitabine and S-1 for Patients with Advanced Pancreatic Cancer / 中国医学科学院学报

Objective To explore the efficacy and toxicities of gemcitabine combined with S-1 in treating locally advanced and metastatic pancreatic ductal adenocarcinoma and prognostic factors. Methods We retrospectively analyzed the clinical data of patients with locally advanced and metastatic pancreatic cancer receiving gemcitabine and S-1 as first-line therapy in the Department of Medical Oncology,Peking Union Medical College Hospital from January 2014 to January 2017.Gemcitabine was administered at a dose of 1000 mg/mover 30 min-utes on days 1 and 8,and oral S-1 at a dose of 40-60 mg twice daily from days 1 to 14,repeated every 3 weeks.All patients received at least two cycles of chemotherapy. Results A total of 60 patients were included,13(22%) achieved partial remission,37(61%) had stable disease,and 10(17%) experienced progressive disease.The median progression-free survival was 7 months(95% CI=6-10 months) and the median overall survival was 12 months(95% CI=9-20 months).Both univariate and multivariate analyses of prognostic factors showed primary resection was significant in predicting shorter progression-free survival and lung metastasis was significant for shorter overall survival.The most common grade 3-4 toxicities were neutropenia(27%) and leukopenia(18%). Conclusion Gemcitabine combined with S-1 is an effective regimen with manageable toxicities in the treatment of advanced pancreatic cancer and can be used as first-line therapy.

Single Nucleotide Polymorphisms of Paclitaxel-induced Peripheral Sensory Neuropathy in Chinese Han Population / 中国医学科学院学报

Objective To study the single nucleotide polymorphisms (SNPs)that predict a patient's risk of grade 2-3 paclitaxel-induced peripheral sensory neuropathy (PSN) in Chinese Han populations.Methods Totally 216 patients received paclitaxel in Peking Union Medical College Hospital from May 2014 to December 2016 were enrolled.DNA was isolated from peripheral blood.Genotyping for eight candidate SNPs was performed on Sequenom-MassARRARYiPLEX platform.Patients were followed up and PSN was assessed by trained physicians according to National Cancer Institute-Common Terminology Criteria for Adverse Events v4.03.Results A total of 209 patients entered the final analysis.Among the candidate SNPs,only rs4141404:A>C(LIMK2) was significantly associated with grade 2/3 PSN (OR:4.32,95%CI:2.37-7.89,P<0.0001).In multivariate logistic regression analysis,both rs4141404:A>C(LIMK2) and history of receiving platinum compound (OR:2.70,95%CI:1.32-5.51,P=0.007) were associated with grade 2/3 PSN.Conclusion rs4141404:A>C(LIMK2) may be the markers of risk of grade 2/3 PSN.