Comparative efficacy of secukinumab against adalimumab and infliximab in patients with moderate-to-severe plaque psoriasis / 中华医学杂志(英文版)

BACKGROUND@#Psoriasis is a common, chronic, immune-mediated inflammatory skin disease with increased epidermal proliferation. The objective of this review was to systematically identify the evidence and perform a network meta-analysis (NMA) to estimate the relative efficacy of secukinumab (SEC) against adalimumab (ADA) and infliximab (INF) for the treatment of moderate-to-severe plaque psoriasis.@*METHODS@#A systematic literature review (SLR) was conducted according to a pre-specified protocol to identify relevant studies. Initially, the databases were searched from database inception till June 2013, and the SLR was updated in April 2020. The eligibility criteria included adult patients (≥18 years old) with moderate-to-severe plaque psoriasis, and the SLR included randomized controlled trials (RCTs). The comparators of interest were SEC, ADA, INF, and placebo (PLA), while outcomes of interest were Psoriasis Area and Severity Index (PASI) (50, 75, and 90) at weeks 12, 16, and 24. A Bayesian NMA for PASI was utilized with a framework that evaluated the probability of PASI responses in different categories of PASI thresholds within a single model.@*RESULTS@#A total of 23 RCTs that assessed the efficacy of SEC, ADA, and INF in patients with moderate-to-severe plaque psoriasis were identified. At 12 weeks, SEC was associated with a significantly better response compared with PLA and ADA for PASI 75 and 90, while response results were comparable against INF. At 12 weeks, risk ratio (95% confidence interval) derived from NMA for SEC vs. ADA and INF for PASI 75 was 1.35 (1.19, 1.57) and 1.01 (0.90, 1.18), respectively. At the 16-week and 24-week time interval, SEC was significantly better than PLA, ADA, and INF for PASI 75 and 90.@*CONCLUSION@#Efficacy of SEC in the treatment of patient populations with moderate-to-severe plaque psoriasis is well demonstrated through NMA.

Chinese electronic medical record named entity recognition based on sentence-level lattice-long short-term memory neural network / 第二军医大学学报

Objective To propose a conditional random field (CRF) model based on the new word segmentation method Re-entity, and to compare with bi-directional long short-term memory neural network (BiLSTM)-CRF and Lattice-long short-term memory neural network (LSTM). Methods After analyzing the existing entity recognition methods, we proposed CRF method based on Re-entity, BiLSTM-CRF and Lattice-LSTM for the China Conference on Knowledge Graph and Semantic Computing in 2018 (CCKS2018) task one: Chinese clinical named entity recognition, and trained character vector sets at different parameter levels based on different corpora. The comparative experiments on model performance were carried out in the different neural network models for each methods. Finally, the comparative study was carried out based on different input lengths such as the sentence level and the text level. Results Re-entity method can improve the performance of CRF model. Lattice-LSTM model based on sentence level achieved a strict F1-measure of 89.75% on this task, which was higher than the highest F1-measure (89.25%) on the task one of CCKS2018. Conclusion The CRF model based on Re-entity can effectively improve the recognition rate of traditional Chinese medicines in electronic medical records by using normalized Chinese clinical drug. Re-entity method can improve the error accumulation caused by word segmentation in data preprocessing. Lattice structure can better combine the latent semantic information of characters and word sequences. At the same time, sentence-level input can effectively improve the recognition accuracy of neural network models.

Prognostic Value of Corrected Levels of Serum Calcium and Serum Lactate Dehydrogenase for Newly Diagnosed Multiple Myeloma Patients / 中国实验血液学杂志

OBJECTIVE@#To investigate the prognostic value of the serum calcium level corrected by serum albumin (cCA) and corrected serum lactate dehydrogenase (LDH) level for the risk stratification for newly diagnosed multiple myeloma (MM) patients.@*METHODS@#The clinical data and survival of 186 newly diagnosed MM patients admitted to our hospital from June 1, 2015 to November 1, 2017 were collected. The patients's survival time was obtained by telephone and follow-up visits to patients and their families. The value of the prognostic system consisting of cCA levels and LDH levels in the survival time of MM patients was retrospectively analyzed. Moreover, the post-corrected hypercalcemia and high LDH as 2 factors were used for risk stratification, then according to these 2 factors, the MM patients were divided into 3 groups: group 1 (no risk factor), group 2 (1 risk factor) and group 3 (2 risk factors), and the effect of risk factors on the prognosis of MM patients was analyzed.@*RESULTS@#The median follow-up time was 16 months. The cumulative OS rate of the post-corrected hypercalcemia group was lower than that of the non-hypercalcemia group. The 1-year cumulative OS rate in the 2 groups was 79.0%±6.7% and 88.6%±3.0%, the 3-year cumulative OS rate was 53.0%±10.5% and 74.6%±6.6% (P=0.016), respectively. The cumulative OS rate of the high LDH group [LDH ＞upper limit of normal (ULN), ULN=250 U/L] was lower than that in the normal LDH group. The 1-year cumulative OS rate in the 2 groups was 71.6%±8.6% and 90.0%±2.8%, the 2-year cumulative OS rate was 44.9%±12.1% and 83.1%±4.0%, respectively, and the median OS time was 19 months (95%CI: 15.32-23.34) and not reached (P=0.001). The risk stratification analysis showed that the median OS time of the 3 group was not reached (n=103, 57%), not reached (n=70, 39%) and 17 months (n=7, 4%, 95%CI: 5.19-28.41, P＜0.001). Patients with two risk factors had a prognosis worse than patients with 0-1 risk factor.@*CONCLUSION@#The prognostic combination of corrected serum calcium and LDH levels may provide a basis for risk stratification and prognosis in MM patients in clinical practice.

The SWI/SNF chromatin-remodeling factors BAF60a, b, and c in nutrient signaling and metabolic control

Metabolic syndrome has become a global epidemic that adversely affects human health. Both genetic and environmental factors contribute to the pathogenesis of metabolic disorders; however, the mechanisms that integrate these cues to regulate metabolic physiology and the development of metabolic disorders remain incompletely defined. Emerging evidence suggests that SWI/SNF chromatin-remodeling complexes are critical for directing metabolic reprogramming and adaptation in response to nutritional and other physiological signals. The ATP-dependent SWI/SNF chromatin-remodeling complexes comprise up to 11 subunits, among which the BAF60 subunit serves as a key link between the core complexes and specific transcriptional factors. The BAF60 subunit has three members, BAF60a, b, and c. The distinct tissue distribution patterns and regulatory mechanisms of BAF60 proteins confer each isoform with specialized functions in different metabolic cell types. In this review, we summarize the emerging roles and mechanisms of BAF60 proteins in the regulation of nutrient sensing and energy metabolism under physiological and disease conditions.

Traditional Chinese medicine health management guidance to the community of puerperal women’s breast-feeding / 国际中医中药杂志

Objective By combining the traditional Chinese medicine(TCM) health care service and the current community puerperal women's health management, to explore the feasibility of TCM health management in the grass-roots community on puerperal women’s breast-feeding. Methods 440 patients meeting the inclusion criteria of puerperal women according to the neighborhood of residence were recruited into a non TCM intervention group of 225 people, and a TCM intervention group of 215 people. The non TCM intervention group was given health guidance on puerperal women. On such basis, the TCM intervention group was further cooperated with appropriate technical guidance of TCM. Puerperal women breastfeeding before and after the intervention was studied. Results After the intervention, the milk shortage of puerperal women breastfeeding rate of TCM intervention group was higher than the non TCM intervention group, 76.9% (60/78) vs. 56.9% (41/72), and mixed feeding rate was lower 21.8% (17/78) vs. 40.3%(29/72), the difference was statistically significant (χ2=5.916, 5.178; P < 0.05). The rate of breast feeding and mixed feeding rate were also statistically different between the TCM intervention group and the non TCM intervention group 78.1%(168/215) and 17.2% (37/215) vs. 62.7% (141/225) and 33.3% (75/225), (χ2=11.860, 14.226; P<0.01). Conclusion TCM health management guidance on puerperal women in the community can effectively improve the hypogalactia puerperal women's breastfeeding rate.