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Epigenetic therapies that cause genome-wide epigenetic alterations, could trigger local interplay between different histone marks, leading to a switch of transcriptional outcome and therapeutic responses of epigenetic treatment. However, in human cancers with diverse oncogenic activation, how oncogenic pathways cooperate with epigenetic modifiers to regulate the histone mark interplay is poorly understood. We herein discover that the hedgehog (Hh) pathway reprograms the histone methylation landscape in breast cancer, especially in triple-negative breast cancer (TNBC). This facilitates the histone acetylation caused by histone deacetylase (HDAC) inhibitors and gives rise to new therapeutic vulnerability of combination therapies. Specifically, overexpression of zinc finger protein of the cerebellum 1 (ZIC1) in breast cancer promotes Hh activation, facilitating the switch of H3K27 methylation (H3K27me) to acetylation (H3K27ac). The mutually exclusive relationship of H3K27me and H3K27ac allows their functional interplay at oncogenic gene locus and switches therapeutic outcomes. Using multiple in vivo breast cancer models including patient-derived TNBC xenograft, we show that Hh signaling-orchestrated H3K27me and H3K27ac interplay tailors combination epigenetic drugs in treating breast cancer. Together, this study reveals the new role of Hh signaling-regulated histone modifications interplay in responding to HDAC inhibitors and suggests new epigenetically-targeted therapeutic solutions for treating TNBC.
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AIM: To investigate the influencing factors of disequilibrium refractive development in children aged 6-12 years old.METHODS: A total of 607 children with a mean age of 8.2±1.8 years old from two primary schools in Binhai New Area of Tianjin in December 2019 were selected by cluster sampling for optical biometry measurement(axial length and equivalent corneal power), cycloplegia refractive examination and questionnaire survey.RESULTS: The childrens'spherical equivalent was -0.11±1.63D, binocular spherical equivalent difference was -0.08±0.64D and absolute value of spherical equivalent difference was 0.41±0.49D. There were 56 children with anisometropia and 551 children without anisometropia. There was no difference in the absolute value of binocular corneal power difference between anisometropia and non-anisometropia group(0.30±0.34D vs 0.27±0.24D, P=0.430). But the absolute value of axial difference was significantly different(0.67±0.39mm vs 0.13±0.13mm, P=0.005). Multivariate linear regression analysis showed that weekly usage time of phones/computers, weekly close work hours, weekly visual fatigue times and habitual reading distance were the influencing factors of refractive imbalance development(the absolute value of binocular spherical equivalent difference). Habitual reading distance and handedness in writing are the influencing factors of the developmental bias of refractive imbalance(binocular spherical equivalent difference).CONCLUSION: Children aged 6-12 years old who spend more time on phones/computers, and have prolonged close work, more times of visual fatigue and close habitual reading distance may increase the degree of refractive imbalance. Children with right-handed handwriting and severe left or right head deviation have a deeper degree of myopia in the right eye than in the left eye.
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Objective:To study relationship between sense of coherence and anxiety-depression in elderly patients with gestational diabetes mellitus (GDM).Methods:A total of 360 gestational pregnant women who were admitted to the hospital from November 2018 to January 2019 were enrolled by simple random sampling. The Sense of Coherence Scale (SOC-13), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were applied to survey them. The scores of SOC-13, SAS and SDS of them were observed. The correlation between sense of coherence and anxiety-depression was analyzed.Results:Among 360 gestational pregnant women, there were 98 cases with age-appropriate GDM (less than 35 years old, age-appropriate GDM group), 159 cases with advanced GDM (not less than 35 years old, advanced GDM group), and 103 advanced non-GDM pregnant women (advanced non-GDM group). Arranging SOC-13 scores from low to high, the corresponding order was advanced GDM group, age-appropriate GDM group and advanced non-GDM group (with scores of 52.25±10.57, 60.18±9.31, 63.24±8.57) ( F value was 45.109, P<0.01). SAS score was the highest in advanced GDM group, followed by age-appropriate GDM group and advanced non-GDM group (50.33±5.85, 45.62±6.77, 42.26±5.34) ( F value was 59.598, P<0.01). SDS score was the highest in advanced GDM group, followed by age-appropriate GDM group and advanced non-GDM group (52.59±5.62, 47.64±4.83, 45.48±4.72) ( F value was 65.419, P<0.01). SOC-13 of 160 advanced GDM patients was negatively correlated with SAS ( runderstanding sense=-0.532, rcontrol sense=-0.653, rsignificance sense=-0.631, rtotal score=-0.735, all P<0.01). And SOC-13 was negatively correlated with SDS ( runderstanding sense=-0.438, rcontrol sense=-0.562, rsignificance sense=-0.581, rtotal score=-0.685, all P<0.01). Conclusions:Sense of coherence in elderly GDM patients is negatively correlated with anxiety and depression. Nursing staff can improve their anxiety and depression by intervening in sense of coherence.
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OBJECTIVE: To analyze the reproductive health status of female employees in an automobile manufacturing industry and its influencing factors. METHODS: By a method of convenient sampling, 989 female employees of an automobile manufacturer were selected as the study subjects. The Female Employees′ Reproductive Health Status Questionnaire was used to investigate and analyze the influencing factors. RESULTS: The prevalence of abnormal menstruation was 23.7%(234/989). The abnormal menstruation was mainly the menstrual cycle disorder, with the prevalence of 15.4%(152/989). The prevalence of reproductive tract infection was 39.1%(387/989), and the top 2 types of infection were cervicitis(12.7%) and vaginitis(12.1%). The results of multivariate logistic regression analysis showed that the risk of abnormal menstruation in night shift workers was higher than that in day shift workers(P<0.05). The risk of abnormal menstruation increased in female workers with the increase of work intensity(P<0.05). Female workers with a history of abortion had higher risk of abnormal menstruation and reproductive tract infection than those without a history of abortion(all P<0.05). Female workers with abnormal menstruation had a higher risk of reproductive tract infection than those with normal menstruation(P<0.01). Married employees had a higher risk of reproductive tract infection than unmarried ones(P<0.01). CONCLUSION: The reproductive health of female workers in the automobile manufacturing industry is related to their marital status, work shift, work intensity and history of abortion.
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Objective To understand the condition of tick carrying CRT(Candidatus rickettsia tarasevichiae) and compound infection with SFTSV(Sever fever thrombocytopenia syndrome virus) in Yanbian area of Jilin province. Methods Free ticks were collected from 6 counties including Yanji, Wangqing, Hunchun, Dunhua, Antu and Helong in the Korean Autonomous Prefecture of Jilin Province(Yanbian Prefecture) by using the flagging, and they were classified morphologically. The CRT and SFTSV in ticks were detected by Nest PCR(Nested polymerase chain reaction) and Real Time RT-PCR(Real-time Quantitative polymerase chain reaction) methods. Target DNA sequencing was performed for CRT positive products, and the homology of gene sequence and phylogenetic relationship were analyzed. Results A total of 1032 ticks were collected in this study, including ixodes persulcatus (35.56%) and dermacenter silvarum (20.64%). haemaphysalis japonica (20.45%), haemaphysalis longicornis (10.47%), haemaphysalis concinna (8.33%),others( 4.55%). The CRT was detected from the Ixodes persulcatus, Haemaphysalis longicornis, Haemaphysalis japonica Dermacentor silvarum. The MIR(Minimum infection rate per 100 ticks) of CRT was 10.47%.The SFTSV was detected from the Haemaphysalis-concinna, Haemaphysalis-japonica,Ixodes-persulcatus,Haemaphysalis-longicornis,Dermacentor-silvarum. The MIR of SFTSV was 2.52 %. Three species of ticks, including Ixodes persulcatus(2.45%), Haemaphysalis japonica(1.42%), and dermacentor silvarum(0.47%), had CRT and SFTSV compound infections, and the MIR of two pathogens compound infections was 1.26 %. In this study, the gene sequence of CRT positive PCR products ompA and 17kDa with nucleotide sequence of Xinyang plant of HeNan XinYang strain (KX365196.1),had homology of 100%. Phylogenetic analysis showed that CRT ompA and the HeNan XinYang strain (KX365196.1) gene sequences formed a cluster in Yanbian, while the 17 kDa gene formed an independent branch. Conclusions For the first time, CRT was detected from free ticks in Yanbian area of Jilin Province, and it was found that Ixodes persulcatus may be the main medium of transmission of the pathogen. At the same time, it was found that CRT and SFTSV have compound infection in ticks of Yanbian area. Therefore, it can be clearly identified that Yanbian area in Jilin Province is the natural source of CRT, and there are two pathogenic compound infections in the local ticks.
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Objective To investigate the adults smoking status of Hui and Han in Ningxia. Methods Among 6 monitoring sites in Ningxia from 2013 to 2014, multi-stage stratified cluster random sampling method was used, information about risk factors of chronic diseases by were collected questionnaire investigation, a total of 3 527 subjects were effective sample for smoking analysis among 3 540 adults aged 18 and over. After the complex weighting, the smoking status of different nationalities, sexes and age was analyzed. Results The current smoking rate was 29.42% (95% CI:27.91%-30.92%), the current smoking rate of male(56.73%, 95％ CI:54.25%-59.20%) was higher than female (0.92%, 95％ CI:0.50％-1.34％) (P<0.001); The current smoking rate of Han (32.04%, 95% CI:30.24%-33.85%) was higher than Hui (23.09%, 95% CI:20.41%-25.76%). The daily smoking rate of Han (27.98%, 95% CI: 26.25%-29.72%) was higher than that of Hui nationality (19.83%, 95% CI:17.30%-22.36%) (P=0.001), and that of male (49.41%, 95% CI: 46.92%-51.91%) was higher than that of female (0.73%, 95% CI: 0.36%-1.11%) (P<0.001). The average daily smoking of male (20) was higher than that of female (8) (Z=-4.448, P<0.001). Smokers quit smoking rate was 12.54% (95% CI:10.50%-14.57%). Adult secondhand smoke exposure rate was 54.44% (95% CI:52.53%-56.36%). Conclusions The smoking rate of adult residents is high in Ningxia province, but the quit smoking rate is low, male smoking rate is higher than female, Han smoking rates higher than the Hui. The sample population was highly exposed to secondhand smoke. Tobacco control interventions should be taken against high-risk groups.
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PURPOSE: We aim to examine nasopharyngeal carcinoma (NPC) characteristics and survival outcomes in patients aged 70 years and older in the intensity-modulated radiotherapy (IMRT) era. MATERIALS AND METHODS: From 2006 to 2013, 126 non-metastatic NPC patients aged ≥ 70 years who were treated with IMRT +/‒ chemotherapy were included. Adult Comorbidity Evaluation 27 (ACE-27) was used to measure patient comorbidities. The overall survival (OS) and cancer-specific survival (CSS)were calculatedwith the Kaplan-Meier method, and differenceswere compared using the log-rank test. The Cox proportional hazards model was used to carry out multivariate analyses. RESULTS: For the entire group, only two patients (1.6%) presented stage I disease, and up to 84.1% patients had stage III-IVB disease. All patients had a comorbidity score of 0 in 24 (19.0%), 1 in 45 (35.7%), 2 in 42 (33.3%), and 3 in 15 (11.9%) patients. The main acute grade during radiotherapy was 3-4 adverse events consisting of mucositis (25.4%), bone marrow suppression (16.7%), and dermatitis (8.7%). After treatment, four patients (3.2%) developed temporal lobe injury. Five-year CSS and OS rates were 67.3% (95% confidence interval [CI], 58.6% to 77.4%) and 54.0% (95% CI, 45.6% to 63.9%), respectively. Five-year OS was significantly higher for ACE-27 score 0-1 than ACE-27 score 2-3 (72.9% and 39.9%, respectively; p 0.05). CONCLUSION: Our findings suggest IMRT +/– chemotherapy has a manageable toxicity and provides an acceptable survival in patients aged ≥ 70 years with NPC. ACE-27 score was significantly associated with survival outcomes in this group population.
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Adult , Humans , Bone Marrow , Comorbidity , Dermatitis , Drug Therapy , Methods , Mucositis , Multivariate Analysis , Proportional Hazards Models , Radiotherapy , Radiotherapy, Intensity-Modulated , Temporal LobeABSTRACT
Objective@#To analyze the incidence of pneumoconiosis among workers in the coal industry in the past 13 years in Chongqing, understand the different epidemiological characteristics of new pneumoconiosis among workers in the coal industry in the city, provide basic evidence for the prevention and treatment of pneumoconiosis.@*Methods@#Collecting new cases of pneumoconiosis diagnosed in the coal industry in Chongqing in January 2006-May 2018, and analyze its epidemiological characteristics.@*Results@#In January 2006-May 2018, 25329 cases of pneumoconiosis were added to workers in the coal industry in Chongqing, and 23, 328 cases were present, all male. Among the existing cases: coal workers' pneumoconiosis accounted for 89.30%, silicosis accounted for 10.70%; age distribution was 50-59 years old. The main, accounting for 45.19%, the average age of onset was 52.21±7.45 years; the actual dusting age was mainly 10-19 years, the average actual working age was 17.52±8.47 years; the distribution of the work was mainly by the main coal mining (53.20%) ; There are more new cases in enterprises, accounting for 88.86%; distributed in 36 districts and counties.@*Conclusion@#There was a large number of new pneumoconiosis diseases in the coal industry in Chongqing. Different measures should be taken according to the characteristics of different enterprises, and relevant enterprises should be urged to take the initiative to carry out occupational health surveillance, effectively protect the health of workers, improve the coordination mechanism, improve medical security, and gradually realize government assistance and Social care is combined.
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Objective@#To investigate the living conditions, insurance coverage, and assistance of pneumoconiosis patients diagnosed in Chongqing from May 2006 to May 2018.@*Methods@#A cross-sectional survey was conducted in July 2018, and 40 890 pneumoconiosis patients from occupational diseases report management agency were obtained. 34 625 cases meeting the inclusion criteria were investigated, and descriptive statistical analysis was performed on the data.@*Results@#There were 34 625 cases of pneumoconiosis patients alive in Chongqing, and 22730 (65.6%) had participated in work-related injury insurance, 6 308 (18.2%) had participated in basic medical insurance for urban employees which were still effective. 27 056 (78.1%) had participated in cooperative insurance for urban and rural residents which were still effective. 4 393 (12.7%) received assistance for the residents in need in urban and rural areas. 5827 (16.8%) benefited the policy of "Xiangyu Railway". There were 7 961 cases (2.4%) whose work-related injury insurance had expired did not get one-off compensation, and did not receive any assistance.@*Conclusion@#Most of the patients with pneumoconiosis in Chongqing obtained protection in terms of work-related injury insurance, medical insurance, civil assistance and poverty alleviation to a certain extent, but the strength of the guarantee is not enough. Patients with pneumoconiosis might suffer from poverty caused by illness. It is recommended to improve the system of work-related injury insurance benefits, establish special funds for pneumoconiosis patients, strengthen health education and health promotion for pneumoconiosis patients, and strengthen the management of pneumoconiosis patients.
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Objective: To observe the clinical efficacy of grain-sized moxibustion in treating chemotherapy-induced myelosuppression for non-small cell lung cancer (NSCLC) and its effect on quality of life (QOL). Methods: Eighty NSCLC patients admitted to the Inpatient Department of Zhejiang Cancer Hospital between September 2016 and March 2018 were recruited and divided into an observation group and a control group by random number method, with 40 cases in each group. The two groups both received chemotherapy with paclitaxel plus cisplatin (TP regimen). The control group received oral administration of leucogen tablets starting from the first day of chemotherapy, 20 mg each time, three times a day, for consecutive 14 d; the observation group was additionally given grain-sized moxibustion, once a day, five days per week at a two-day interval, until the fourteenth day. The myelosuppression severity was observed and compared between the two groups prior to chemotherapy, at the 3rd, 7th and 14th days of chemotherapy; the QOL in the two groups was evaluated before chemotherapy, at the 14th and 21st days of chemotherapy. Results: Regarding myelosuppression, the peripheral blood indicators increased significantly at the 3rd day of chemotherapy in both groups (P<0.05 or P<0.01); at the 7th and 14th days of chemotherapy, the peripheral blood indicators presented a decreasing tendency in the two groups, but the level in the observation group was still significantly higher than that before chemotherapy (P<0.01); at the 3rd, 7th and 14th days of chemotherapy, the peripheral blood indicators in the observation group were higher than those in the control group (P<0.05 or P<0.01); the occurrence rate of myelosuppression in the observation group was significantly lower than that in the control group (P<0.01). The QOL score in the observation group was markedly higher than that in the control group at the 14th and 21st days of chemotherapy (both P<0.05). Conclusion: Grain-sized moxibustion can effectively improve myelosuppression after chemotherapy for NSCLC, reducing its occurrence and enhancing the patient's QOL.
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Objective To investigate the detection situation of prehypertension among the permanent residents aged more than 15 years old in partial districts and counties of Chongqing City,and to analyze its influencing factors.Methods The stratified 4-stage random sampling method was used to conduct the questionnaire survey and physical examination on the permanent residents aged ≥15 years old in the districts of Qianjiang and Yongchuan and counties of Liangping and Bishan.Results The detection rate of prehypertension in these districts and counties was 42.72 ％,the detection rate of rural area was higher than that in city (47.85 ％vs.37.53 ％,P＜0.01),and male was higher than female (48.30 ％ vs.37.31％).The prehypertension detection rate in male and female was decreased after the age of 55 years old (x2=27.14,20.29,P＜0.01).The multivariate unconditional Logistic regression results suggested that the risk factors of prehypertension included the rural area,age (＞ 25 years old),male,overweight/obesity and alcohol consumption.The prehypertension protective factors were Tujia nationality(OR=0.83,P＜0.01).Conclusion The detection rate of prehypertension is relatively high among the residents aged ≥ 15 years old in partial districts and counties of Chongqing City.Therefore the intervention on the living style and behaviors among the population in prehypertension should be strengthened.
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Objective To explore the distribution ofchoroidal thickness and its influence factors in university students.Methods A cross-sectional study.A total of 896 eyes of 896 college students were included in the study.Among them,there were 350 males (350 eyes) and 546 females (546 eyes).All the eyes were right eyes.The average age was 19.18 ± 1.36 years old.According to the spherical equivalent refraction (SER),the eyes were divided into non-myopia group,low myopia group,moderate myopia group and high myopia group,which were 59,251,356 and 230 eyes,respectively.The subfoveal ChT (SFCT) was measured using a swept-frequency source optical coherence tomography scanner.According to the ETDRS,the choroid within 6 mm of the fovea was divided into three concentric circles centered on the fovea of the macula,which were the central area with a diameter of 1 mm,the inner ring area of 1-3 mm and the outer ring area of 3-6 mm.The outer ring area of 3-6 mm has a total of 9 zones.The inner ring and outer ring 4 regions were superior,inferior,nasal and temporal,respectively.The distribution characteristics of ChT in different regions,genders and diopter groups were observed.Bivariate correlation analysis were used to analyze the correlation of ChT and SER,axial length (AL).Results The average SFCT of 896 eyes was 221.28± 67.35 μm.The mean SFCT of males and females were 227.20 ± 69.38 and 217.50± 65.80 μm,respectively.The difference of SFCT between different genders was statistically significant (t=2.075,P=0.038).Compared with the central region ChT,there was no significant difference in ChT between the outer ring and the outer region (t=0.086,P=0.932).The difference of ChT in other regions was statistically significant (t=-21.973,-5.818,36.328,-3.065,-18.017,-10.595,57.007;P＜0.001,＜0.001,＜0.001,＜0.002,＜0.001,＜0.001,＜0.001).In the horizontal direction,ChT gradually thickens from nasal to temporal (F=2 251.558,P＜0.001);in the vertical direction,ChT gradually decreases from superior to the central,but have a little increased from central to inner inferior,then decreased to outer inferior again (F=45.425,P＜0.05).Correlation analysis showed that SFCT was negatively correlated with AL (r=0.478,P＜0.01) and a negative correlation with axial length (r=-0.395,P＜0.01),and positively correlated with SER (r=0.478,P＜0.01).SFCT decreased by 12.29 μm for every in myopic refractive error of 1 D,or by 20.14 μm for every increase in AL of 1 mm.Conclusions ChT is changed by different location.The horizontal direction is gradually thickened from nasal to temporal.The vertical direction is thicker than the center.The inferior inner ring area is thicker than the outer ring area.Gender,SER and AL are the influencing factors of SFCT.
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OBJECTIVE: To explore the protective effect of Radix Rhapontici water extract (RRWE) on the damage of vascular endothelial cells induced by tert-butyl hydroperoxide (TBHP) in vitro. METHODS: The cellular model was established by treating human umbilical vein endothelial cells with TBHP, and randomly assigned to 4 groups:the control, TBHP, low and high-dose RRWE groups. Cell viability was tested by MTT assay, the levels of reduced glutathione (GSH), malondialdehyde (MDA), and superoxide dismutase (SOD) were measured by colorimetric method, the reactive oxygen species (ROS), apoptosis, and mitochondrial membrane potentials were observed by fluorescent staining, and the protein expressions of NF-κB, JNK, Bax, Bcl-2 and caspase-3 were determined with Western blotting method. RESULTS: Pretreatment with RRWE significantly increased the cell viabilities, reduced ROS levels, decreased MDA formation, increased the GSH contents and SOD activities, elevated the mitochondrial membrane potentials, down-regulated the p-JNK and p-NF-κB levels, reduced Bax/Bcl-2 ratios, suppressed caspase-3 activation, and inhibited cell apoptosis of vascular endothelial cells. CONCLUSION: RRWE has a protective effect on the damage of vascular endothelial cells induced by TBHP in vitro, and suppresses the cell apoptosis maybe through inhibiting JNK and NF-κB activation.
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Rheumatoid arthritis (RA) has the characteristics of long course of disease and difficulty in treatment. The conventional therapy may easily induce adverse drug reactions or events (ADR/ADE) due to the long-time medication. Thus, it should be given special attentions to treatment benefit and medication risk of RA patients. Aconitum, a kind of toxic traditional Chinese herbs, is an important complement therapy for RA, with some controversy in clinical application. Coming straight to the practical problem of combined use of traditional Chinese medicines (TCM) and Western medicines (WM), this study conducted quantitative assessment on the benefits and risks of Aconitum using combined with WM or not, which was carried out by the method of multi-criteria decision analysis model. RevMan 5.2 software was used to separately analyze the results of every index of 21 random clinical trials (RCTs) of Aconitum exclusive use in the treatment of RA, and 49 RCTs of Aconitum combined use with WM. The merged results indicated that as compared with the conventional therapy of WM, no matter the exclusive use or the combined use of Aconitum could improve the efficacy and decrease the incidence of ADR/ADEs. Based on the benefit-risk assessment decision tree of RA treatment, Hiview 3 software and Crystal Ball Monte Carlo simulation were used to calculate the benefit value, risk value and benefit-risk value of Aconitum exclusive use and the combined use of Aconitum with WM. The results showed that the combination therapy had significantly better benefits than Aconitum exclusive using, difference value was 15, (95%CI[9.72, 20.25]), but the risk of combined use was higher difference value=23, （95%CI[15.57, 30.55]）. In comprehensive consideration of the benefit and risk, the total benefit-risk value of using Aconitum alone was 58, while that of the combination therapy was 55, and the probability of the former superior to the latter was 81.07%. The study showed that Aconitum was the important therapy to supply RA treatment. In clinical application, the patient's acceptability of benefit and risk need to be considered; if patients cannot bear the risk, the combination use of Aconitum and WM is not recommended.
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Humans , Aconitum , Chemistry , Arthritis, Rheumatoid , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Medicine, Chinese Traditional , Randomized Controlled Trials as Topic , Risk AssessmentABSTRACT
The incidence of idiopathic membranous nephropathy (IMN) is increasing year by year, and the clinical research on Chinese medicine treatment of INM is also growing. This study aims to evaluate the efficiency and safety of Yiqi Huoxue method for IMN. Data sources used were from PubMed, EMbase, the Cochrane Library, CBM, CNKI, Wanfang and VIP database. Two researchers independently screened the literature and extracted data. RevMan 5.3 software was used for Meta analysis, and the evidences were graded for the outcomes according to GRADE system by using GRADEprofiler 3.6. Eventually, eleven trials (725 participants) were included in the Meta-analyses. There was statistically significant difference between Yiqi Huoxue method and controls when combining all trials in 24 h UTP [RR=-1.23, 95%CI=(-1.94,-0.53), P=0.000 6] or when combining all trials in ALB [RR=3.56, 95%CI=(1.64, 5.47), P=0.000 3]. Meanwhile, there was statistically significant difference between Yiqi Huoxue method and controls when combining all trials in TC [RR=-0.39, 95%CI=(-0.57, -0.20), P<0.000 1] or when combining all trials in TG [RR=-0.49, 95%CI=(-0.82, -0.15), P=0.004]. However, there was no statistically significant difference between Yiqi Huoxue method and controls when combining all trials in Scr [RR=-3.25, 95%CI=(-9.35, 2.84), P=0.30] or when combining all trials in BUN [RR=-0.81,95%CI=(-2.29, 0.66), P=0.28]. In the statistics, the most frequently used Chinese medicines in clinical application were Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma, Codonopsis Radix, Atractylodis Macrocephalae Rhizome and Salvia Miltiorrhiza. The present evidences suggested that Yiqi Huoxue method should be thought highly of in the treatment of IMN, and at the same time, the rational use of traditional Chinese medicine, such as Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma also should be paid attention to. However, due to the GRADE evidence grading of the primary outcome measure of 24 h UTP had very low quality, this review can not provide high-quality evidence to prove the clinical efficacy of this method. More well-designed and large-scale multi-center randomized controlled trials should be conducted in the future for verification.
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Objective To explore the potential influence of gender on screening value of aldosterone-renin ratio (ARR) for primary aldosteronism (PA).Methods The biochemical parameters were collected of 451 PA patients and 300 essential hypertension (EH) patients who were diagnosed in the General Hospital of PLA from 1992 to 2014. Each group was then divided into two groups by gender. The clinical characteristics were compared and then the receiver operating characteristic curve (ROC) was conducted to evaluate the best cut-off value.Results The plasma aldosterone concentration (PAC), serum sodium and ARR were much higher, but the plasma rennin activity (PRA), serum potassium and BMI were much lower in PA patients than in EH patients (P0.05). The best cut-off value of ARR in male PA patients was 19.11, the relevant area under the curve (AUC) was 0.968, the sensitivity and specicantcity was 92.44% and 93.08%, and the Youden index (YI) was 0.86. The best cut-off value of ARR in female PA patients was 27.26, with AUC 0.956, sensitivity 92.07%, specicantcity 90.00% and YI 0.82, respectively. If the cut-off value was set at 27.26 in males, the specicantcity would rise a little, but the sensitivity and YI would sharply decrease. Similarly, the sensitivity would increase a little but the specicantcity and YI would fall substantially if the cut-off value in females was set at 19.11. The best cut-off value of ARR in men was smaller than the ocantcial value recommended by guidelines.Conclusion Gender is an important factor should be considered while ARR is used in PA screening, and the cut-off value of ARR in screening female PA patients should be setting higher.
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Objective To summarize and analyze the clinical features and etiologies in hospitalized patients with syndrome of inappropriate antidiuretics (SIAD) during the past 25 years.Methods All data of 128 patients with SIAD admitted to Chinese PLA General Hospital since January 1991 to January 2016 were collected.SIAD was diagnosed based on the 1957 criterion.Results (1) The most frequent causes of increased inappropriate secretion of vasopressin were malignant tumors , lung diseases ( e.g.pneumonia ) , and central nervous system diseases , in which malignant tumors accounted for 38.28% of the SIAD.(2) During the past 25 years, the proportion of malignant diseases declined from 4/7 to 35.29%, while, the proportion of pulmonary infection increased from 1/7 to 35.29% ( P<0.05 ) .( 3 ) The patients with malignant tumors had the lowest serum sodium and serum osmolality among all SIAD patients .(4) CT scan had a high diagnostic value for chest and brain detection .( 5 ) Among three SIAD subjects with unknown reasons at onset , two were diagnosed with small cell lung cancer and one with gastric cancer during follow -up.Conclusion The etiology of SIAD is complex and it could be attributed to multifarious etiological factors.Malignant tumors account for the largest proportion of all patients , and pulmonary infection was ranked in second place .Cautions on tumors have to be taken when serum sodium of a SIAD patient is below 118.1 mmol/L.
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This study conservatively estimates that the Chinese government invests about 267millions USD per year on health facilities aid,almost reaching the amount of Germany,and ranked fifth globally.Health facilities built by China mostly are general hospitals and health care centers located in Arica with unified model and standards,and are the "Turn Key" projects.These facilities have helped to alleviate the scarcity of medical and health resources and accessibility of residents to health services to some extent,as well as promoting the employment and the living standards of local people.However,due to the lack of guidance and coordination of the overall strategic planning and harmonization of health aid efforts,and the knowledge of partner countries' health systems,emphasis on demand driven and feasibility of infrastructure construction while ignoring the needs assessment and feasibility of functional fulfillment,it's hard to achieve the targeted assistance in China's health facilities aid projects.It was found that it's necessary to make three changes in the future:from "infrastructure assistance" to "functional assistance";from "'project assistance" to "program assistance";from a single government official assistance to a combination of official assistance and investment.
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Health Human Resource Development Cooperation(HHRDC) is a critical component in Chinese foreign aid,which had cultivated thousands of health workers for Asian and Arican developing countries by on-job training,degree education,short-term exchange activities for more than 60 years.This paper systematically reviewed the management mechanism,mode and features of HHRDC via literature review,stakeholders interviews and field investigations,and it is found that the main mode of HHRDC is short-term on-job training,but its effect for capacity building is limited;although degree education account for a small proportion of HHRDC,it plays an important role for elite cultivation;the impact for medical team teaching and technical cooperation have become more obvious;the "going out" training have less invest,short period,but bigger social impact.The main challenges of HHRDC includes the deficiency of specific strategies and action plans;the lack of understanding on recipient countries' health human resource situation,characteristics and needs;the alignment with other aid programs;the lack of timely evalu ation towards current cooperation projects.According to the need analysis of undeveloped countries,it is suggested that a cooperation plan for HHDRC is required;the implementation of HHRDC should integrate into other aid programs;the follow-up mechanism and evaluation system need improved;the Chinese degree certification and qualification in local institutions need promoted;the aid to medical educational institutions should added,thereby strengthening developing countries' capacity and realizing common development.
ABSTRACT
This study conservatively estimates that the Chinese government invests about 267millions USD per year on health facilities aid,almost reaching the amount of Germany,and ranked fifth globally.Health facilities built by China mostly are general hospitals and health care centers located in Arica with unified model and standards,and are the "Turn Key" projects.These facilities have helped to alleviate the scarcity of medical and health resources and accessibility of residents to health services to some extent,as well as promoting the employment and the living standards of local people.However,due to the lack of guidance and coordination of the overall strategic planning and harmonization of health aid efforts,and the knowledge of partner countries' health systems,emphasis on demand driven and feasibility of infrastructure construction while ignoring the needs assessment and feasibility of functional fulfillment,it's hard to achieve the targeted assistance in China's health facilities aid projects.It was found that it's necessary to make three changes in the future:from "infrastructure assistance" to "functional assistance";from "'project assistance" to "program assistance";from a single government official assistance to a combination of official assistance and investment.