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Objective:To explore the clinical characteristics and influencing factors of myocarditis induced by immune checkpoint inhibitors (ICIs).Methods:Using programmed death receptor-1 (PD-1), nivolumab, pembrolizumab, programmed cell death receptor ligand-1 (PD-L1), atezolizumab, durvalumab, avelumab, cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), ipilimumab, tremelimumab as keywords respectively, we combined these words with myocarditis or the corresponding Chinese to search.Results:A total of 49 articles were reported, including 64 patients. Nivolumab was the most reported, followed by pembrolizumab and ipilimumab. The average age was (65.47±13.24)years, mainly elderly patients; 37 cases (57.81%) were male; the overall mortality rate was 31.25%(20/64). The clinical symptoms were diverse and nonspecific, with dyspnea being the most common (39/64, 60.94%). Heart biomarkers were elevated in 94.64%(53/56) of the patients. 35 patients (54.69%, 35/64) developed myocarditis after 1-2 doses and 17 patients died. 60 patients received steroids as initial treatment, and immunosuppressive therapies such as infliximab, intravenous immunoglobulin, antithymic globulin, and/or plasmapheresis were used in 25 patients, symptoms improved in 17 cases (68.00%).Conclusions:ICIs can cause myocarditis, with high mortality, and should be closely monitored and timely treatment. Steroids can be used as initial first-line therapy and immunosuppressants and/or plasmapheresis may improve clinical symptoms and survival rate.
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Objective To observe the efficacy of modified Tianma?Sanqi Decoction on hypertension patients with anxiety. Methods Totally 64 hypertension patients with anxiety patients were randomly divid?ed into control group (32 cases) and treatment group (32 cases).The control group with standard medica?tions for hypertension and treatment group with addition of Tianma?Sanqi Decoction, and both groups were continuously treated for 8 weeks. The changes of 24 hours ambulatory blood pressure and SAS scores were compared.Results ( 1) After treatment in the control group and treatment group of 24 h mean systolic blood pressure (24 hSBP) ((130.13±3.81)mmHg,(123.56±4.37)mmHg) (1 mmHg=0.133 kPa) were lower than before treatment((145.36±7.17) mmHg,(145.16±6.77) mmHg) and the difference was statisti?cally significant( P<0.01).(2) After treatment in the control group and treatment group 24 h systolic pres?sure standard deviation,diurnal systolic pressure standard deviation and nocturnal systolic pressure standard deviation((12.19±3.21) mmHg,(11.16±2.26) mmHg,(10.49±3.76) mmHg and (10.95±2.35) mmHg, (10.08±2.67) mmHg,(10.12±3.78)mmHg) were lower than before treatment ((14.53±3.65) mmHg, (13.81±4.04) mmHg,(12.47±4.23) mmHg and (16.73±7.90)mmHg,(16.06±4.14)mmHg,(13.65± 4.92)mmHg),and the difference was statistically significant( P<0.01 or P<0.05).After treatment in the treatment group, 24 h systolic pressure standard deviation, nocturnal systolic pressure standard deviation ((10.95±2.35) mmHg,(10.08±2.67) mmHg) were lower than control group((12.19±3.21) mmHg, (11.16±2.26) mmHg) and the difference was statistically significant.( P<0.01).(3) After treatment in the treatment group,SAS scores (36.68±3.88) points were lower than before treatment (58.66±3.13) points and the difference was statistically significant(P<0.01).After treatment the SAS score ((36.68±3.88) points) in the treatment group was lower than control group((51.86+2.62) points).Conclusion The hypertension patients with anxiety treated with Tianma?Sanqi Decoction and benazapril can improve blood pressure variability and the symp?toms of anxiety.
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Objective To assess the relationship between ambulatory pulse pressure (PP),pulse pressure indices (PPI) and the severity of cognitive function.Methods Sixty patients with severe,moderate,mild vascular cognitive impairment(VCI) as the research object,and forty healthy people as control group.All of the patients of ambulatory blood pressure were monitored.Results Severe VCI group of PP and PPI was significantly higher than moderate,mild VCI group and the control group (PP (mmHg):(59.10 ± 11.82,54.94 ± 10.86,50.28 ±8.33,45.54±9.22,P＜0.05),PPI:(0.61±0.08,0.53±0.06,0.44±0.05,0.37±0.03,P＜0.05),and the MMSE score was significantly lower than moderate,mild,and the control group(15.56±2.64,19.32±3.32,22.62±3.11,26.45±2.94,P＜0.05).Moderate VCI group of PP and PPI was significantly higher than the control group(P＜0.05).MMSE score was significantly lower than mild VCI and the control group(P＜0.05).Linear correlation analysis showed that PP and PPI was significantly negative related to MMSE score.Conclusion The increase of dynamic pulse pressure,pulse pressure index is associated with the damage of cognitive function.
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Objective The purpose of the study is to analyse the counseling contents in psychological hot line during four years and the characteristics in different groups of the people. Methods Inputting all the completed recorders in hot line from January, 1995 to December, 1999, and using the Statistic Analysis System to analyse the data. Results The main age groups of the counseling people are 20～years and 30～years (77.39%), and 87.43 percent of the people has good education. The main counseling contents are related to mental disorders (23.61%), emotional difficulty (19.74%), love (17.07%), social intercourse (9.69%), marriage (9.15%), consulting for other persons (7.67%), sexual problems counseling (6.36%), and others. Conclusions The main groups of people in hot line are young and good educated people. The counseling contents have touched upon many areas, but mental disorder is the most numerous problems. The main problems in different groups of people are marked difference.