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OBJECTIVE@#To assess the efficacy and safety of Guanxin Danshen Dripping Pills (GXDS) in the treatment of depression or anxiety in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).@*METHODS@#From September 2017 to June 2019, 200 CHD patients after PCI with depression and anxiety were included and randomly divided into GXDS (100 cases) and placebo control groups (100 cases) by block randomization and a random number table. Patients in the GXDS and control groups were given GXDS and placebo, respectively, 0.4 g each time, 3 times daily for 12 weeks. The primary outcomes were scores of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Scale (GAD-7) and the Seattle Angina Pectoris Scale (SAQ). The secondary outcomes included 12 Health Survey Summary Form (SF-12) scores and the first onset time and incidence of major adverse cardiovascular events (MACEs). Other indices including blood pressure, blood lipids, microcirculation and inflammatory-related indices, etc. were monitored at baseline, week 4, and week 12.@*RESULTS@#In the full analysis set (200 cases), after treatment, the PHQ-9 and GAD-7 scores in the GXDS group were considerably lower than those in the control group (P<0.05). Compared with the baseline, the total PHQ-9 scores of the experimental and control groups decreased by 3.97 and 1.18, respectively. The corrected mean difference between the two groups was -2.78 (95% CI: -3.47, -2.10; P<0.001). The total GAD-7 score in the GXDS group decreased by 3.48% compared with the baseline level, while that of the placebo group decreased by 1.13%. The corrected mean difference between the two groups was -2.35 (95% CI: -2.95, -1.76; P<0.001). The degree of improvement in SAQ score, SF-12 score, endothelin and high-sensitive C-reactive protein levels in the GXDS group were substantially superior than those in the placebo group, and the differences between the two groups were statistically significant (P<0.05). Similar results were obtained in the per protocol population analysis of 177 patients. Three cases of MACES were reported in this study (1 in the GXDS group and 2 in the placebo group), and no serious adverse events occurred.@*CONCLUSIONS@#GXDS can significantly alleviate depression and anxiety, relieve symptoms of angina, and improve quality of life in patients with CHD after PCI. (Registration No. ChiCTR1800014291).
Subject(s)
Humans , Percutaneous Coronary Intervention/adverse effects , Quality of Life , Depression , Coronary Disease/drug therapy , Drugs, Chinese Herbal/therapeutic use , Angina Pectoris/drug therapy , Prognosis , Anxiety , Treatment Outcome , Double-Blind MethodABSTRACT
【Objective】 To investigate the expressions of P53 and Ki-67 in prostate cancer (PCa)and to explore their correlation with the clinicopathological characteristics. 【Methods】 The expressions of P53 and Ki-67 in 90 PCa patients were detected with immunohistochemistry. Patients’ age, preoperative prostate-specific antigen (PSA) level, postoperative Gleason score, pathological stage, and invasion of neurovascular cancer embolus of all patients were recorded. The relationship of P53 expression with the above indexes was evaluated. 【Results】 The positive rates of P53 and Ki-67 were 27.8% (25/90) and 46.7% (42/90), respectively. The positive rate of P53 in pT2 and pT3-T4 stage groups were 19.7% (13/66) and 50.0% (12/24) (P=0.005), and the positive rate of Ki-67 were 36.4% (24/66) and 75.0% (18/24) (P=0.001), respectively. The positive rate of Ki-67 in Gleason score ≤6, ≤7 and ≥8 groups were 30.4%, 53.8% and 66.7%, respectively, with statistical difference. Positive expression of P53 was related to Ki-67 expression, but not to patients’ age, preoperative PSA level, postoperative Gleason score and nerve and invasion of neurovascular cancer embolus. 【Conclusion】 P53 expression is related to tumor stage and Ki-67, while Ki-67 expression is associated with tumor stage ang grade.
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【Objective】 To reduce the misdiagnosis rate by analyzing the clinical data of patients with primary upper tract urothelial carcinoma (UTUC) complicated with calculi. 【Methods】 Clinical data of 7 UTUC with calculi patients treated during Sep.2018 and Apr.2022 were retrospectively analyzed, including general data, time from visit to diagnosis, imaging data, urine exudation cytological results, surgical methods, pathological stages and follow-up data. 【Results】 The ratio of male to female was 3∶4, and the mean age was 66.4 (55-72) years. The initiate imaging examination results only showed calculi, but did not indicate suspicious tumor (including 1 case with missing data). The median time from the first visit to diagnosis was 12 months (5-36 months). Of all 7 cases, 2 (2/4) were clinically diagnosed by enhanced CT, 3 (3/4) by MRI, and 2 (2/7) by positive urine exudation cytology. All patients received surgical treatment. Postoperative pathology showed 85.71% (6/7) were high-grade UTUC. Postoperative staging was T1N0M0 in 4 cases, T3N0M0 in 2 cases, and T4N2M0 in 1 case. Adjuvant chemotherapy was conducted in 2 cases. During the median follow-up of 12 months (6-41), 1 case developed multiple systemic metastases in month 9, while the other cases had no recurrence or metastasis. 【Conclusion】 For UTUC patients without obvious filling defect on imaging, especially when ipsilateral calculi were complicated, misdiagnosis should be alerted for timely treatment and better prognosis.
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Objective:To compare the complications associated with various urinary flow diversion methods and identify the factors that contribute to the decline in renal function after radical total cystectomy for myoinfiltrating urothelial carcinoma.Methods:This study conducted a retrospective analysis on the clinical data of 46 patients with pathologically confirmed muscle-invasive bladder cancer.The patients underwent laparoscopic radical cystectomy with either ileal conduit diversion(n=21)or ureterocutaneous diversion(n=25)between January 2017 and December 2021.Perioperative data, postoperative pathology, postoperative complications, and follow-up results were compared between the two groups.Results:The study found significant differences between the two groups in terms of age[(67±6)years vs.(73±8)years, t=3.132, P=0.003], Charlson comorbidity index adjusted for age[(3.80±1.15) vs.(4.52±1.03), t=2.223, P=0.031], prognostic nutritional index[(48.81±5.74) vs.(43.64±4.74), t=3.347, P=0.002], operation time[(449±108)minutes vs.(326±130)minutes, P=0.001]], hospital stay[(20.1±11.1)days vs.(13.3±5.2)days, t=2.762, P=0.008], proportion of Clavien grade 3 or higher complications within 3 months after surgery(4/21 vs 0/25, χ2=2.105, P<0.05), and proportion of stoma-free patients(18/21 vs.5/25, χ2=6.373, P<0.01). According to Logistic multivariate analysis, perioperative blood transfusion and urinary tract infection were identified as independent risk factors for renal function decline 12 months after surgery.Escherichia coli was found to be the most common bacteria cultured from urinary tract infections in both groups after surgery. Conclusions:Laparoscopic radical cystectomy with ureterocutaneous diversion offers benefits such as shorter hospital stays and fewer perioperative complications for older and frail patients.However, a higher proportion of patients may require ureteral stenting.It is important to note that perioperative blood transfusion and urinary tract infection are major risk factors for renal function decline following radical cystectomy.
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Objective:To investigate the clinical features, diagnosis, treatment and prognosis of primary urethral carcinoma.Methods:The clinical and follow-up data of 12 patients with primary urethral carcinoma admitted to Beijing Hospital from July 2016 to December 2020 were retrospectively analyzed.Results:There were four males and eight females, with an average age of 66.3(53~75)years.Nine patients underwent magnetic resonance examination before operation, and eight patients presented with abnormal urethral signals.The clinical stage of female patients was generally later than those of male patients, and all patients received surgical treatment.Four male patients did not receive post-operative adjuvant treatment, and all of them attained disease-free survival.Among the eight female patients, four patients received postoperative adjuvant radiotherapy or chemotherapy, five patients had recurrence or metastasis during follow-up, and two patients died.Conclusions:The clinical stage of female urethral cancer is later than that of male.MRI examination is beneficial to the determination of local invasion of urethral cancer.For female proximal urethral cancer and male posterior urethral cancer, radical resection has a good therapeutic effect.
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Objective: To investigate the clinical features and long-term prognosis of primary biliary cholangitis (PBC) in patients with past hepatitis B virus (HBV) infection. Methods: 353 cases with PBC who visited the Liver Disease Center of Beijing Friendship Hospital Affiliated to Capital Medical University between January 2000 and January 2018 were retrospectively analyzed and were divided into the past HBV infection group (156 cases) and the no HBV infection group (197 cases). The two groups' baseline clinical features were compared. Ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, and long-term liver transplantation-free survival rate were compared through outpatient and telephone follow-up. Results: PBC with past HBV infection had a significantly reduced female proportion compared to the no HBV infection group (91.9% vs. 79.5%, P = 0.001). However, there were no statistically significant differences in age, biochemical indices, immunological indicators, platelet count, cirrhosis proportion, and others. Ursodeoxycholic acid biochemical response rate was reduced in patients with past HBV infection at the end of one year of treatment, but the difference was not statistically significant (65.8% vs. 78.2%, P = 0.068). In addition, there were no statistically significant differences between the GLOBE score (0.57 vs. 0.59, P = 0.26) and UK-PBC 5-year (2.87% vs. 2.87%, P = 0.38), 10-year (9.29% vs. 8.2%, P = 0.39) and 15-year liver transplantation rates (16.6% vs. 14.73%, P = 0.39). Lastly, the overall 5-year liver transplantation-free survival rate had no statistically significant difference between the two groups of patients (86.4% vs. 87.5%, P = 0.796). Conclusion: Primary biliary cholangitis had no discernible effect in terms of age at onset, biochemical indices, immunological indicators, cirrhosis proportion, ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, or overall liver transplantation-free survival rate in patients with past hepatitis B virus infections.
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Objective To investigate the dietary intake of preschool children in Northwest China, and provide scientific basis for studying the dietary patterns and characteristics of preschool children and formulating targeted dietary interventions. Methods Using the self-designed “Semi-quantitative Food Frequency Questionnaire for Preschool Children in Northwest China“, a convenient sampling method was used to investigate the dietary intake of children aged 3 to 7 years in Northwest China. The factor analysis combined with the cluster method was used to extract the dietary pattern. Results Through factor analysis of the average daily food intake of preschool children, the results show that the KMO test value was 0.82, Bartlett’s test value was 4 528.97, and the associated probability was <0.001, so factor analysis can be performed. In order to obtain more typical factor components so that the results were easier to explain, under the guidance of nutrition experts, the first 4 common factors were finally retained for analysis, and the cumulative variance contribution rate was 62.17%. On this basis, the number of clusters was 4, and the K-means cluster analysis method was used to cluster the factor scores of various foods for preschool children. According to the proportions of various foods and the characteristics of the foods, The dietary patterns of preschool children can be divided into staple food-based dietary patterns, high-protein dietary patterns, healthy dietary patterns, and high-sugar dietary patterns. Conclusion Using factor analysis method, the scores of each food factor of preschool children were continuous variables, and the results were highly repeatable, and subsequent analysis can be carried out. The factor analysis combined with cluster analysis method extracting the dietary pattern of preschool children that had certain degree of science. According to the characteristics of the four dietary patterns extracted in this study, children's dietary interventions can be targeted to promote children's physical and mental health.
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Objective@#The current study aims to explore precipitating and social risk factors for internet addiction (IA) in university undergraduate students, and to provide evidence for interventions and the early prevention of IA in different genders. @*Methods@#Four thousand eight hundred and fifty-eight college sophomores completed an online survey on their internet use-related behaviours and social risk factors. @*Results@#We found that more male (8.3%) than female students (5.4%) had moderate and severe IA. The main online activity in the moderate and severe IA groups was online gaming in males and online streaming in females. Roommates engaging in similar internetbased entertainment was a risk factor of IA only for males, while not being in a romantic relationship was a risk factor of IA for females only. Infatuation with the internet before college and adjustment problems for college life were shared risk factors for both genders in the mild and moderate IA groups. @*Conclusion@#IA was a common phenomenon in college students with shared and unique precipitating and social risk factors in males and females. The gender-sensitive risk factors for IA warranted earlier and individualized intervention and prevention strategies for IA in this population.
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Objective:To assess the performance of liver and spleen stiffness measured by MR elastography (MRE) and their combined model in diagnosing liver fibrosis.Methods:From November 2018 to November 2019, 104 patients with chronic liver disease were prospectively enrolled in Beijing Friendship Hospital, all patients underwent MRE scans. Liver and spleen stiffness were measured from MRE elastograms. Liver biopsy was used to identify fibrosis stage (F0—F4). The differences among different fibrosis stages were analyzed by one-way ANOVA or independent samples t test. The Spearman rank correlation analysis was used to evaluate the correlation with fibrosis stages. Liver and spleen stiffness combined model was established by logistic regression. The ROC curve was used to evaluate the performance of the liver, spleen stiffness and combined model in staging fibrosis (≥F1), significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4).The area under the ROC curve(AUC) was compared using Delong test. Results:The liver and spleen stiffness both showed significant differences among the 5 fibrosis stages ( F=64.058, 32.890, both P<0.001). The liver and spleen stiffness were positively associated with fibrosis stage ( r s=0.89, 0.69, both P<0.001). The AUC of liver stiffness in staging ≥F1, ≥F2, ≥F3 were 0. 91, 0.97, 0.93, respectively. The corresponding AUCs of the spleen stiffness were 0.81, 0.82, 0.85, respectively, which were statistically lower than those of liver stiffness ( Z=2.283, 4.085, 2.314, P=0.022,<0.001, 0.021). In diagnosing F4, the AUCs of liver and spleen stiffness were both 0.95. The AUCs of the liver and spleen combined model were 0.92, 0.97, 0.93, 0.96 in diagnosing ≥F1, ≥F2, ≥F3 and F4, with no significantly differences from liver stiffness (all P>0.05). Conclusions:The liver stiffness measured with MRE have better diagnostic performance than spleen stiffness in staging fibrosis. Parameters combined model slightly improves diagnostic value but without significant difference with liver stiffness in staging early fibrosis. Spleen stiffness evaluation is feasible in detecting cirrhosis.
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Objective:To investigate the effects of anesthesia depth control on cognitive function and high mobility group protein B1 (HMGB-1) level in older adult patients with breast cancer.Methods:Eighty-six female older adult patients with breast cancer who received mastectomy between June 2019 and June 2020 in the First Hospital of China Medical University, China were included in this study. They were randomly assigned to undergo anesthesia with sodium phenobarbital and atropine at deep (bispectral index 30-45, deep anesthesia group, n = 43) or superficial level (bispectral index 45-60, superficial anesthesia group, n = 43). The mean arterial pressure, heart rate, HMGB-1 level, Mini-Mental State Examination (MMSE) score were assessed in each group. Results:There were no significant differences in mean arterial pressure and heart rate recorded during each time period between the deep anesthesia and superficial anesthesia groups (all P > 0.05). No significant difference in HMGB-1 level was found between the two groups before anesthesia induction and at the end of surgery (both P > 0.05). At 1 and 2 days after surgery, HMGB-1 level in the deep anesthesia group was (75.46 ± 3.33) pg/mL and (93.98 ± 4.32) pg/mL, respectively, which was significantly lower than that in the superficial anesthesia group [(87.89 ± 5.13) pg/mL and (121.01 ± 4.36) pg/mL, t = 13.327, 28.878, both P < 0.05)]. At 1 day before surgery, there was no significant difference in MMSE score between the two groups ( P > 0.05). In the deep anesthesia group, MMSE score was (26.73 ± 1.11) points, (28.16 ± 0.72) points, and (28.97 ± 0.88) points at 1, 3 and 6 days after surgery respectively, which was significantly higher than that in the superficial anesthesia group [(21.03 ± 1.46) points, (22.39 ± 1.24) points, and (24.69 ± 0.57) points, t = 20.380, 26.388, 26.768, all P < 0.05]. Conclusion:Deep anesthesia for mastectomy in older adult patients can reduce cognitive impairment and decrease HMGB-1 level after surgery, and plays a positive role in postoperative recovery.
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Liver cirrhosis is the leading cause of liver-related death globally, and the most common causes of liver cirrhosis are chronic hepatitis B and C, alcoholic liver disease, and nonalcoholic fatty liver disease. Recent studies have shown that despite an increase in the number of deaths due to liver cirrhosis around the world, there is a reduction in age-standardized death. In China, there are increases in number of patients with liver cirrhosis, prevalence rate of liver cirrhosis, number of deaths due to liver cirrhosis, and mortality rate of liver cirrhosis, while there are reductions in age-standardized prevalence rate and mortality rate; chronic hepatitis B remains the main cause of liver cirrhosis, with a gradual increase in the proportion of liver cirrhosis cases caused by alcoholic and nonalcoholic fatty liver diseases.
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ObjectiveTo investigate the diagnostic efficiency of FibroTouch, FibroScan, and acoustic radiation force impulse (ARFI) for liver fibrosis in patients with primary biliary cholangitis (PBC). MethodsA retrospective analysis was performed for the patients who underwent liver biopsy and were then diagnosed with PBC in Beijing Friendship Hospital, Capital Medical University, from September 2014 to October 2018, and the METAVIR scoring system was used to evaluate the degree of liver fibrosis and inflammation. Within 1 week after liver biopsy, FibroTouch, FibroScan, and ARFI were used to measure liver stiffness (LS); with pathological results as the gold standard, the area under the ROC curve (AUC) was used to compare the value of FibroTouch, FibroScan, and ARFI in the diagnosis of liver fibrosis in PBC patients, and related influencing factors were analyzed; Youden index was used to calculate the cut-off values of LS for different degrees of liver fibrosis. The Kruskal-Wallis H test was used for comparison between multiple groups, and P value corrected by the Bonferroni method was used for further comparison between two groups. A Spearman correlation analysis was performed, and a multiple linear regression model was used for multivariate analysis. ResultsA total of 68 patients with PBC were enrolled in the study, among whom 13 had F0 liver fibrosis, 15 had F1 liver fibrosis, 18 had F2 liver fibrosis, 12 had F3 liver fibrosis, and 10 had F4 liver fibrosis. LS obtained by FibroTouch (FT-LS), LS obtained by FibroScan (FS-LS), and LS obtained by ARFI (ARFI-LS) were strongly positively correlated with the degree of liver fibrosis (r=0.798, 0.782, and 0.742, all P＜0.001). FT-LS had AUCs of 0.922, 0.881, and 0.926, respectively, in the diagnosis of F≥2, F≥3, and F=4 liver fibrosis, and the corresponding cut-off values were 10.5 kPa, 15.8 kPa, and 17.5 kPa, respectively; FS-LS had AUCs of 0.918, 0.878, and 0.939, respectively, in the diagnosis of F≥2, F≥3, and F=4 liver fibrosis, and the corresponding cut-off values were 10.1 kPa, 12.9 kPa, and 18.2 kPa, respectively; ARFI-LS had AUCs of 0.904, 0.869, and 0.928, respectively, in the diagnosis of F≥2, F≥3, and F=4 liver fibrosis, and the corresponding cut-off values were 1.45 m/s, 1.83 m/s, and 2.08 m/s, respectively. There was no significant difference in diagnosing the same stage of liver fibrosis between FibroTouch, FibroScan, and ARFI (P＞0.05). The multivariate analysis showed that degree of liver fibrosis (β=0.399, P＜0.001), total bilirubin (β=0.466, P＜0.001), and prothrombin time activity (β=-0.195, P=0.020) were influencing factors for FT-LS; degree of liver fibrosis (β=0370, P＜0.001), aspartate aminotransferase (β=0.450, P＜0.001), prothrombin time activity (β=-0.303, P=0.001), and alkaline phosphatase (β=-0.187, P=0.042) were influencing factors for FS-LS; degree of liver fibrosis (β=0.489, P＜0.001), aspartate aminotransferase (β=0.467, P＜0.001), and platelet count (β=-0.188, P=0.028) were influencing factors for ARFI-LS. ConclusionFibroTouch has similar efficiency to FibroScan and ARFI in the diagnosis of liver fibrosis in PBC patients, with relatively high diagnostic efficiency for significant liver fibrosis (F≥2) and liver cirrhosis (F=4), and therefore, it can be used as a reliable method for the diagnosis of liver fibrosis in PBC patients.
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Objective:To survey the status of illness and consultation within two weeks among residents in a community in Chengdu.Methods:A multi-stage stratified random sampling was used to carry out a questionnaire survey among the residents in a community in Chengdu during March to April 2019. The disease status, disease severity and consultation within two weeks were surveyed, and influencing factors of two-week illness were analyzed with logistic regression.Results:Among 2 714 participants, 715 had illness (900 times) within two weeks, with a two-week prevalence rate of 26.3%. The main symptoms were dizziness (6.4%, 58/900), cough (6.2%, 56/900), lumbago and leg pain (4.9%, 44/900), palpitations (3.3%, 30/900) and headache (3.1%, 28/900). The three most common diseases were hypertension (38.3%, 345/900), diabetes (19.3%, 174/900) and common cold (6.4%, 58/900). In this survey, the rate of two-week in bed was 20.6‰(56/2 714), and the rate of two-week off work was 4.8‰(13/2 714). Age, gender, education level and work status were the influencing factors of the illness in two weeks ( P<0.05). The choice of medical institution was also different among residents. Conclusion:The survey suggest that primary care should focus on the key groups of residents in the community such as elderly, women, low education level, retirement and unemployed; and it is necessary to strengthen the primary care institutions and two-way referral system of health care.
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Objective:To evaluate the efficacy and safety of docetaxel+ prednisone in the treatment of castrated resistant prostate cancer in patients over 75 years old.Methods:In this study, 118 metastatic castration resistant prostate cancer (mCRPC) patients over 60 years old treated in Beijing Hospital from February 2013 to December 2019 were retrospectively analyzed. The median age of the patients was 72 (65, 77)years, ECOG scores ≤2. All 118 cases had bone metastasis, 5 cases had visceral metastasis. A total of 40 patients chose docetaxel as the first-line treatment of mCRPC, and the remaining 78 patients chose docetaxel as second-line or third-line treatment. The study included 53 patients >75 years old and 65 patients aged 60-75 years. The age of patients in the two groups were 67 (63, 71) years old and 78 (76, 83) years old, the difference was statistically significant ( P<0.05). Among them, there were 24 cases with Gleason score ≤7 and 41 cases with Gleason score >7 in 60-75 years old group, and 30 cases with Gleason score ≤7 and 23 cases with Gleason score >7 in the group of >75 years old, with significant difference between the two groups ( P = 0.034). Sixty-one patients received endocrine therapy and 4 received orchiectomy in the 60-75 years old group; 43 patients received endocrine therapy and 10 received orchiectomy in the group of >75 years old, the difference was statistically significant ( P=0.035). There were 37 cases with ECOG 0 score, 25 cases with 1 scores and 3 cases with 2 scores in the group of 60-75 years old; there were 5 cases with ECOG 0 score, 38 cases with 1 score and 10 cases with 2 score in the group of >75 years old, with significant difference between the two groups ( P<0.05). There was no significant difference in PSA level[ 90 (35.5, 258) ng/ml vs. 115 (60, 296) ng/ml], G8 scale score [(14.3±2.1 vs. 13.6±1.1)], Mini-Cog score[3(2, 3) vs. 3(1, 3)], and visceral metastasis [2 cases (3.1%) vs. 3 cases (5.7%)]( P>0.05). The efficacy and safety of docetaxel in the two groups were further observed. Results:The median follow-up time was 21.5 (6, 62) months. There was no significant difference in chemotherapy cycle [(6.1±1.3) vs. (6.8±1.7)] and chemotherapy dose [(70.3±4.3) mg/m 2 vs. (66.3±5.2) mg/m 2] between the 60-75 years old group and the >75 year old group ( P> 0.05). The PSA response rate [72.3%(47/65)vs.66.0%(35/53)], pain relief rate [45.0% (9/20) vs. 54.5% (6/11)], and median progression-free survival[6.1 (1.4, 11.2) months vs. 5.9 (2.0, 12.0) months] had no statistical significance ( P>0.05). There were no deaths in the two groups during chemotherapy. The median overall survival(OS) of patients aged 60-75 years and those >75 years old who received docetaxel as first-line treatment were 26.5 (16.1, 31.3) months and 24.8 (17.5, 28.4) months, respectively ( P=0.223). The median OS of the two groups were 17.3 (13.2, 20.5) months and 15.4 (12.3, 20.0) months with docetaxel treatment as second or third line treatment ( P=0.331). There were 3 cases (4.6%) and 5 cases (9.4%) of grade 3 adverse reactions in 60-75 years group and >75 years old group, respectively. Grade 3 leukopenia occurred in 1 case time (1.5%) and 2 cases (3.8%) respectively. Grade 3 neutropenia fever occurred in 1 case time in both groups. There was no significant difference in the incidence of above complications between the two groups ( P > 0.05). Conclusions:The efficacy and safety of docetaxel + prednisone chemotherapy for mCRPC patients >75 years old were similar to those of 60-75 years old. Age should not be the absolute contraindication of docetaxel for prostate cancer chemotherapy.
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Objective:To investigate the value of serum IL-23 in predicting the progression of prostate cancer at different stages of treatment.Methods:A total of 124 patients with metastatic prostate cancer diagnosed in Beijing Hospital from June 2018 to March 2019 were collected.Patients were TNM-staged according to the Prostate Cancer Guidelines of the European Association of Urology.Serum IL-23 levels were measured in patients with metastatic castration resistance prostate cancer(mCRPC), metastatic castration sensitive prostate cancer(mCSPC)and benign prostatic hyperplasia(BPH), respectively.Patients with mCRPC were subgrouped based on disease stability, and serum IL-23 levels were compared between the subgroups.Serum IL-23 levels in the groups were analyzed and compared with the Gleason score and the prostate-specific antigen(PSA)level.Results:The median value of serum IL-23 in the mCRPC group was 79.73(45.61, 95.63)μg/L, which was higher than that in the BPH group[30.88(15.01, 44.94)μg/L, Z=22.66, P=0.000]and the mCSPC group[46.10(35.27, 80.92)μg/L, Z=11.46, P=0.001]. Serum IL-23 levels were higher in the mCSPC group than in the BPH group( Z=7.17, P=0.007). Analysis for the subgroups showed that the median value of serum IL-23 was 110.25(88.47, 159.09)μg/L in mCRPC patients with unstable disease, which was higher than that in mCRPC patients with stable disease[46.52(44.97, 80.33)μg/L, Z=33.99, P=0.000]. There was no significant difference in serum IL-23 levels between mCRPC patients with stable disease and mCSPC patients[46.10(35.27, 80.92)μg/L]( Z=0.35, P=0.554). Conclusions:Serum IL-23 can be used as a potential biological indicator to predict the therapeutic effect of mCSPC and to predict tumor metastasis.
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Objective:To evaluate the clinical efficacy of intramedullary nailing for femoral shaft fracture in adolescents.Methods:From May 2017 to October 2019, 30 adolescent patients with femoral shaft fracture were treated at Department of Pediatric Orthopaedics, Foshan Hospital of Traditional Chinese Medicine. They were 20 males and 10 females, aged from 12 to 17 years (average, 14 years), with 13 left and 17 right sides affected. They were all fixated with intramedullary nailing; open reduction and internal fixation was performed in 12 cases and closed reduction and internal fixation in 18 cases. Recorded were operation time, intraoperative blood loss, and time for postoperative antibiotic use; compared were lower limb length, neck-shaft angle, femoral neck diameter (FND), articular trochanteric distance (ATD) and Harris scores between the healthy and affected sides at the final follow-up.Results:For the 18 patients undergoing closed reduction and 12 patients undergoing open reduction, respectively, the intraoperative blood loss averaged 153.2 mL and 238.0 mL, the operation time 70.5 min and 91.5 min, and the time for antibiotic use 1.5 d and 3.0 d. The 30 patients were followed up for 12 to 41 months (average, 20.3 months). Follow-up revealed no such complications as fracture nonunion, delayed union, malunion, heterotopic ossification of the hip, refracture of the femoral shaft, or developmental deformity of the proximal femur. The lower limb length, neck-shaft angle, FND, ATD and Harris scores at the final follow-up were, respectively, 133.4°±2.3°, (29.3±4.2) mm, (27.1±6.3) mm and 96.4±3.6 for the affected side, insignificantly different from those for the healthy side [132.4°±3.5°, (30.2±3.6) mm, (26.4±6.8) mm and 95.6±4.7] ( P>0.05). Conclusion:Intramedullary nailing is effective for femoral shaft fracture in adolescents, leading to positive efficacy and limited complications and impact on the development of proximal femur.
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Objective:To observe and investigate the effect and mechanism of intrathecal injecting miR-125b mimic on regulating microglial and its-mediated NOD-like receptor protein 3 (NLRP3) inflammasome activation after spinal cord ischemia reperfusion injury (SCIRI) in rats.Methods:120 Sprague-Dawley (SD) rats were randomly divided into four groups: sham group (sham group, intrathecal injection of normal saline), injury group (IR group, intrathecal injection of normal saline), mimic group (IR+ intrathecal injection of miR-125b mimic) and control group (IR+ intrathecal injection of miR-125b control). In sham group, the aortic arch was exposed without clamping. In other groups, the aortic arch was clamped for 14 minutes, and then the artery clamp was removed to prepare SCIRI model. Rats in each group were given intrathecal injection for 3 consecutive days before operation, once a day. Immunofluorescence was used to observe the morphology of microglia and count the number of activated cells 48 hours after injury; double immunofluorescence was used to observe the distribution of Iba-1 and NLRP3 in cells. The protein expression of Iba-1, NLRP3 and cleaved caspase-1 in spinal cord were determined by Western blot, and the inflammatory factor IL-1 β was determined by enzyme linked immunosorbent assay (ELISA).Results:The activated microglias exhibited the amoeba morphology and increased Iba-1 fluorescence signal in immunofluorescence. The microglias in spinal dorsal horn of Sham group were all branched-like morphology and absent of the increased Iba-1 signal at 48 h post-IR. And the microglias in IR and control groups was all amoeba-like morphology with obviously increased number and intensity of Iba-1 signal, whereas in mimic group, the microglias were mixed morphology with the less increased number and intensity of Iba-1 signal ( P<0.05). And NLRP3 signals were mainly distributed in microglias with increased Iba-1 signal. Meantime, compared with Sham group, the protein expression of Iba-1, NLRP3, cleaved caspase-1 and IL-1β were significantly increased in IR group ( P<0.05). Compared with IR group, the above-mentioned protein expression were decreased in mimic group ( P<0.05). There were no statistical differences between IR and control groups in the above-mentioned protein levels ( P>0.05). Conclusions:Intrathecal injection of miR-125b mimic inhibits the SCIRI-induced microglial activation and then reduces NLRP3 inflammasome expression in spinal cords, thereby exerting an effective anti-inflammatory effects.
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OBJECTIVE: To analyze the hazardous status of respiratory dust in coal mining enterprises. METHODS: A total of 20 coal mining enterprises in a mining group were selected as the research subjects using a cluster random sampling method. Respiratory dust in the workplace was detected, and the incidence of pneumoconiosis was investigated. RESULTS: The dust types in the workplace of these 20 coal mining enterprises were mainly coal dust and silica dust. The posts with serious coal dust hazard were coal mining and tunneling posts. The M(P_0-P_(100)) of the exposure concentration of time weighted average(C_(TWA)) were 2.38(0.19-14.21) and 2.73(0.49-9.57) mg/m~3. The over-standard rate was 49.2% and 50.0%, respectively, that was higher than the post of gangue selection(all P<0.05 or all P<0.017). The results of short time exposure concentration of short term(C_(STE)) and the over-standard rate were higher in the coal mining and tunneling posts than those of gangue selection and boiler room post(all P<0.05 or all P<0.008). The most serious post with silica dust hazard was the tunneling post, and the M(P_0-P_(100))of C_(TWA) was 1.30(0.38-8.50) mg/m~3, and the over-standard rate was 85.7%. The detection results and over-standard rate of C_(STEL) were higher in the coal mining and tunneling posts than that of boiler room post(all P<0.01). The coal dust over-standard rate of C_(TWA) in workplaces of coal mining enterprises increased from 2015 to 2018(P<0.05). However, there was no significant difference in the over-standard rate of silica dust C_(TWA) in different years(P>0.05). From 2015 to 2018, the incidence of pneumoconiosis was 0.3%, 0.3%, 0.2% and 0.3% respectively, and the patients were all from coal mining and tunneling posts. CONCLUSION: The supervision, management and treatment of respiratory dust hazard in coal mining and tunneling posts should be strengthened to protect the health of workers.
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Objective@#The current study aims to explore precipitating and social risk factors for internet addiction (IA) in university undergraduate students, and to provide evidence for interventions and the early prevention of IA in different genders. @*Methods@#Four thousand eight hundred and fifty-eight college sophomores completed an online survey on their internet use-related behaviours and social risk factors. @*Results@#We found that more male (8.3%) than female students (5.4%) had moderate and severe IA. The main online activity in the moderate and severe IA groups was online gaming in males and online streaming in females. Roommates engaging in similar internetbased entertainment was a risk factor of IA only for males, while not being in a romantic relationship was a risk factor of IA for females only. Infatuation with the internet before college and adjustment problems for college life were shared risk factors for both genders in the mild and moderate IA groups. @*Conclusion@#IA was a common phenomenon in college students with shared and unique precipitating and social risk factors in males and females. The gender-sensitive risk factors for IA warranted earlier and individualized intervention and prevention strategies for IA in this population.
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Nephrotic syndrome is a clinical syndrome characterized by massive proteinuria, serum hypoalbuminemia, edema, hyperlipidemia.Most children can get relief with hormone therapy, but 15%~20% of children with hormone resistance eventually reach to end-stage nephropathy.Genes associated with steroid resistant nephrotic syndrome(SRNS)include NPHS1, NPHS2, CD2AP, TRPC6 encoding the slit diaphragm of podocytes, ACTN4 and INF2 encoding podocyte cytoskeleton proteins, WT1 encoding the nucleus of podocytes, COQ2 and COQ6 encoding mitochondrial proteins of podocytes, LAMB2 encoding glomerular basement membrane proteins.Research have found that one mutation in one of these molecules is enough to cause SRNS, so SRNS is also known as podocyte molecular disease.