ABSTRACT
Objective:To ulteriorly explore the differences of psychotic symptoms and neurocognitive between patients with first-episode deficit subtype of schizophrenia (FDS) and patients with first-episode nondeficit subtype of schizophrenia (FNDS).Methods:From January 2021 to September 2021, a total of 88 first-episode treatment-naive schizophrenia were recruited from the Mental Health Center of West China Hospital and divided into FDS group( n=44) and FNDS group( n=44) according to the schedule for the deficit syndrome (SDS), and 44 healthy subjects were included as healthy control group (HC group, n=44). Positive and negative syndrome scale (PANSS) was used to assess psychotic symptoms of patients and Wechsler adult intelligence scale, trail making test and logic memory test were used to evaluate intelligence quotient and neurocognitive function of all subjects.SPSS 22.0 was used for statistical analysis, and independent samples t-test and one-way analysis of variance (ANOVA) were used to compare variables that met normal distribution, while the Mann-Whitney U test and Kruskal-Wallis H test were used to compare variables that did not meet normal distribution. Results:(1) There were significant differences in psychotic symptoms between the FDS group and the FNDS group.Compared with the FNDS group, the FDS group had higher total score of PANSS ((95.95±16.82) vs (88.39±16.29)), negative symptoms ((27.57±7.52) vs (16.57±5.76)) and anergastic reaction ((13.43±3.82) vs (7.00(5.00, 9.00)), and lower positive symptoms scores ((21.95±6.88) vs (25.41±6.07)), activation ((8.00(5.00, 9.00) vs (9.27±3.47)), depression ((5.50(4.00, 9.00) vs (8.00(6.00, 12.00)) and supplementary item ((13.60±4.17) vs (17.30±5.39))(all P<0.05). (2) There were differences in neurocognitive functions between FDS group and FNDS group, and which in FDS and FNDS group were worse than that in HC group.Spatial memory (block design test: (23.70±11.05) vs (31.72±11.49)) and information processing speed (digit symbol test: (38.38±15.85) vs (47.97±14.99)) of FDS group were significantly lower than those of FNDS group(both P<0.05). Intelligence quotient, information processing speed and spatial memory of FDS group and FNDS group were lower than those of HC group(all P<0.05). Conclusion:FDS patients has more severe negative symptoms and anergastic reaction, and exit worse information processing speed and spatial memory dysfunction than FNDS patients.This unique pattern of impairment suggests that information processing speed and spatial memory may be important classification indicators for differentiating the deficit subtype of schizophrenia in the early stage.
ABSTRACT
Objective:To summarize the clinical data and imaging characteristics of patients with PHACES syndrome treated with oral Propranolol.Methods:The clinical data of 4 cases of PHACES syndrome treated with oral Propranolol in Children′s Hospital, Capital Institute of Pediatrics from October 2018 to October 2022 were retrospectively analyzed.Relevant studies reporting the treatment of PHACES with Propranolol were retrieved in PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang Data.Results:Three cases of the 4 patients with PHACES syndrome treated with Propranolol obtained relieved symptoms of facial hemangioma, and 1 case died due to late treatment, complication of severe cardiovascular malformation, and treatment abandonment by parents.A total of 7 clinical studies on the use of Propranolol in the treatment of PHACES were retrieved, including 6 retrospective studies and 1 observational study.Most studies have shown that Propranolol is well tolerated in the treatment of PHACES syndrome, and most of cases have relieved facial hemangioma.The main factors affecting the prognosis are the degree of damage to middle and small arteries such at brain, aorta, chest and neck.Propranolol treatment can improve the prognosis.Conclusions:Oral Propranolol is currently the first-line treatment for PHACES syndrome, and most patients tolerate oral Propranolol well.
ABSTRACT
Objective: To assess the prevalence, risk factors and treatment of anemia in patients with chronic kidney disease (CKD). Methods: A descriptive method was used to analyze the prevalence and treatment of anemia in CKD patients based on regional health data in Yinzhou District of Ningbo during 2012-2018. The multivariate logistic regression analysis was used to identify independent influence factors of anemia in the CKD patients. Results: In 52 619 CKD patients, 15 639 suffered from by anemia (29.72%), in whom 5 461 were men (26.41%) and 10 178 were women (31.87%), and anemia prevalence was higher in women than in men, the difference was significant (P<0.001). The prevalence of anemia increased with stage of CKD (24.77% in stage 1 vs. 69.42% in stage 5, trend χ2 test P<0.001). Multivariate logistic regression analysis revealed that being women (aOR=1.57, 95%CI: 1.50-1.63), CKD stage (stage 2: aOR=1.10, 95%CI: 1.04-1.16;stage 3: aOR=2.28,95%CI: 2.12-2.44;stage 4: aOR=4.49,95%CI :3.79-5.32;stage 5: aOR=6.31,95%CI: 4.74-8.39), age (18-30 years old: aOR=2.40,95%CI: 2.24-2.57, 61-75 years old: aOR=1.35,95%CI:1.28-1.42, ≥76 years old: aOR=2.37,95%CI:2.20-2.55), BMI (<18.5 kg/m2:aOR=1.29,95%CI: 1.18-1.41;23.0-24.9 kg/m2:aOR=0.79,95%CI: 0.75-0.83;≥25.0 kg/m2:aOR=0.70,95%CI: 0.66-0.74), abdominal obesity (aOR=0.91, 95%CI: 0.86-0.96), chronic obstructive pulmonary disease (aOR=1.15, 95%CI: 1.09-1.22), cancer (aOR=3.03, 95%CI: 2.84-3.23), heart failure (aOR=1.44, 95%CI: 1.35-1.54) and myocardial infarction (aOR=1.54, 95%CI:1.16-2.04) were independent risk factors of anemia in CKD patients. Among stage 3-5 CKD patients with anemia, 12.03% received iron therapy, and 4.78% received treatment with erythropoiesis-stimulating agent (ESA) within 12 months after anemia was diagnosed. Conclusions: The prevalence of anemia in CKD patients was high in Yinzhou. However, the treatment rate of iron therapy and ESA were low. More attention should be paid to the anemia management and treatment in CKD patients.
ABSTRACT
Abstract Fibrolipomatous hamartoma (FLH) of the nerve, also known as lipomatosis of the nerve, neurofibrillary lipomatous lesion, or intraneural lipoma, is a rare benign soft tissue tumor which mainly occurs in the nerves of the upper limb, especially in the median nerve. In April 2021, a 30-year-old male patient was secondly admitted to our hospital and underwent his third surgery, due to the recurrence of a mass and pain in the right palm, noticeable swelling and numbness of the right index and ring fingers, and limited flexion and extension activities of the right ring finger. He first visited our hospital in December 2017 due to a mass and pain in the right palm and swelling and numbness of the right index and ring fingers. When the clinician asked for the patient medical history, his parents stated that his right middle finger was swollen after birth. When the patient was ten years old; he was diagnosed with "macrodactyly" at the local county hospital, not in our hospital, and subsequently, the middle finger was amputated at the metacarpophalangeal joint level at the local county hospital. The postoperative pathological examination was not performed at that time, which was the first surgery the patient received. FLH is clinically rare, and its exact epidemiology and etiology are poorly understood. FLH is highly suspected in cases where a painless mass is present in the wrist, combined with macrodactyly. Magnetic resonance imaging and pathological examination are helpful in clarifying the diagnosis. Although FLH is a benign tumor, an individual treatment plan is the best choice according to the severity of the patient's symptoms. Therefore, further exploration and understanding of this disease by clinicians radiologists, and pathologists is necessary.
Resumen El hamartoma fibrolipomatoso (FLH) del nervio, también conocido como lipomatosis del nervio, lesión neurofibrilar lipomatosa, o lipointraneural, es un tumor benigno de tejido blando poco frecuente, que se presenta principalmente en los nervios del miembro superior, especialmente en el nervio mediano. En abril de 2021, un paciente masculino de 30 años fue ingresado por segunda vez en nuestro hospital y sometido a su tercera cirugía debido a la recurrencia de una masa y dolor en la palma derecha, evidente hinchazón y entumecimiento de los dedos índice y anular derecho y limitadas actividades de flexión y extensión del dedo anular derecho. En diciembre de 2017, visitó por primera vez nuestro hospital debido a una masa y dolor en la palma derecha, y a la hinchazón y entumecimiento de los dedos índice y anular derecho. Cuando el clínico preguntó la historia clínica del paciente, sus padres declararon que su dedo medio derecho estaba hinchado después del nacimiento, y cuando el paciente tenía 10 años, fue diagnosticado con "macrodactilia" en el hospital local del condado, no en nuestro hospital Posteriormente, el dedo medio fue amputado a nivel de la articulación metacarpofalángica en el hospital comarcal local, pero no se realizó la patología postoperatoria en ese momento, siendo ésta la primera cirugía a la cual se sometió el paciente. La FLH es clínicamente rara, y su epidemiología y etiología exactas no se entienden bien. En los casos que presentan una masa indolora en la muñeca, combinada con macrodactilia, se sospecha de FLH. La resonancia magnética y la patología son útiles para aclarar el diagnóstico. Aunque la FLH es un tumor benigno, el plan de tratamiento individual es la mejor opción de acuerdo con la gravedad de los síntomas del paciente. Por lo tanto, es necesaria una mayor exploración y comprensión de esta enfermedad por parte de médicos, radiólogos y patólogos.
ABSTRACT
The liver is the main place for metabolism in human body, and when severe liver injury is induced by various factors, there will be disorders in the functions of synthesis, metabolism, and biological conversion. This article summarizes the features of the metabolism of nutrients such as glucose, amino acids, and lipids in the presence of liver failure, as well as the assessment of malnutrition and clinical interventions. For patients with liver failure, it is of great importance to identify and correct malnutrition in a timely manner, so as to improve energy metabolism and inflammation and increase survival rate.
ABSTRACT
Through literature research and standard retrieval, Corydalis-derived medicinal materials, the origins, and related standards were summarized. Finally, 27 medicinal materials were screened out, involving 71 species(varieties). Among them, only 11 are recorded in Chinese Pharmacopoeia(2020), National Standard for Chinese Patent Drugs·Tibetan Medicine, Tibetan Medicine Standards, and other local standards, including Corydalis Bungeanae Herba and Corydalis Herba. The names and original plants of the medicinal materials are different in different standards, and the phenomena of "same medicinal material with different names" and "same name for different medicinal materials" are prominent. Most standards only include the traits, microscopic identification, and physico-chemical property identification, with unsound quality criteria. Thus, efforts should be made to strengthen the sorting of Corydalis medicinal plants, herbal textual research, and investigation of the resources and utilization. Moreover, via modern techniques, the chemical components and medicinal material basis of different original plants should be explored and sound quality standards should be established to improve the safety and quality of Corydalis-derived medicinal materials. Summarizing Corydalis medicinal plants, Corydalis-derived medicinal materials, and related standards, this study is expected to provide a reference for the standard formulation, quality evaluation, expansion of drug sources, and rational development and utilization of Corydalis resources.
Subject(s)
Corydalis , Drugs, Chinese Herbal/chemistry , Medicine, Chinese Traditional , Medicine, Tibetan Traditional , Plants, Medicinal/chemistry , Reference StandardsABSTRACT
Objective:To analyze distribution characteristics of facial port-wine stains and brain imaging features in children with Sturge-Weber syndrome (SWS) .Methods:Clinical and imaging data were collected from 22 children with confirmed SWS at Department of Dermatology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from July 2017 to August 2020, and retrospectively analyzed. The distribution characteristics of port-wine stains along the facial trigeminal nerve and brain imaging features were investigated in these children with SWS.Results:Among the 22 children, 10 were males and 12 were females. Their age ranged from 0.08 to 9.92 years, and the median age was 1.67 years. There were 13 cases of SWS type Ⅰ and 9 cases of SWS type Ⅱ. In terms of the port-wine stain type, 4 children aged from 0.50 to 2.17 years were diagnosed with pink port-wine stains; 14 children aged from 0.08 to 8.83 years were diagnosed with purple port-wine stains; 4 children aged from 4.92 to 9.92 years were diagnosed with thickened port-wine stains. Port-wine stains were distributed in the ophthalmic (V1) division of the trigeminal nerve in 22 patients, in the maxillary (V2) division in 20 patients, and in the mandibular (V3) division in 8 patients. There were 17 children with ocular abnormalities, aged from 0.08 to 9.92 years, including 11 with glaucoma, 5 with elevated intraocular pressure and 2 with visual impairment. Among the children with glaucoma, 7 developed glaucoma within 2 years of age, 8 suffered from unilateral glaucoma, and 3 from bilateral glaucoma, and glaucoma occurred on the same side as port-wine stains. Brain imaging abnormalities were observed in 12 children, and mainly included vascular malformations in the cerebral cortex involving the frontal, parietal, temporal and occipital lobes, as well as cerebral atrophy, punctate hemorrhage, calcification, sulcal widening, midline deviation and increased intraventricular choroid plexus vessels. Eleven children had symptoms of epilepsy and other neurological manifestations, including developmental delay, mental retardation and physical impairment.Conclusion:Port-wine stains distributed in the V1 and V2 divisions of the facial trigeminal nerve may indicate a higher risk of SWS, and ophthalmic and brain imaging screening as well as long-term follow-up should be performed.
ABSTRACT
Objective:To analyze the clinical and pathological features of asymptomatic primary hyperparathyroidism (PHPT) .Methods:A retrospective analysis was carried out in terms of the clinical characteristics and pathological data in 30 patients with asymptomatic PHPT and 86 patients with typical PHPT hospitalized in the Department of Endocrinology and General Surgery of Beijing Jishuitan Hospital from Jan. 2013 to Dec. 2018. There were 7 males (23.3%) and 23 females (76.7%) , with a male to female ratio of 1:3.3. The average age was 56.9±13.3 years. In typical PHPT group, there were 32 males (37.2%) and 54 females (62.8%) , with the average age of 46.4±17.0 years. Bone metabolism indicators included bone density and bone biochemical markers (parathyroid hormone, 25-hydroxyvitamin D and alkaline phosphatase) . The t test was used to compare normally distributed variables, the Mann-Whitney rank sum test was used to compare skewed distributed variables, and the χ 2 test was used to compare enumeration data. Results:The median serum parathyroid hormone and alkaline phosphatase were 144.2 (108.1, 207.0) pg/ml and 80.0 (53.7, 105.5) IU/L respectively, the average serum concentration of calcium was 2.80±0.20 mmol/L, which were significantly lower than those of the classic group ( P<0.05) . The median serum 25-hydroxyvitamin D was 12.14 (7.87, 14.38) ng/ml, which was higher than that of the classic group ( P<0.001) . Ten patients (33.3%) developed osteoporosis, and the incidence was lower than that of the classic group ( P< 0.001) . The median tumor weight was 0.80 (0.25, 1.98) g, significantly smaller than that in the classical group ( P=0.003) . There were 26 cases (86.7%, including 2 atypical parathyroid adenomas) of parathyroid adenomas and 4 cases (13.3%) of hyperplasia. Conclusions:The asymptomatic PHPT has the same sex ratio as the classic type, mainly female, but the average age is significantly higher than that in the classic type. Although asymptomatic PHPT in this study are all benign lesions, abnormal bone biochemical indicators, especially vitamin D deficiency, are common, which also lead to osteoporosis.
ABSTRACT
Objective:To assess the efficacy and safety of the combination therapy of camrelizumab, apatinib, nab-paclitaxel, and S-1 for patients with locally unresectable advanced gastric cancer.Methods:From September 1, 2019 to August 1, 2021, in Beijing Friendship Hospital Affiliated to Capital Medical University, 17 patients with advanced gastric cancer were enrolled in this prospective, single-arm study. All the enrolled patients received camrelizumab, nab-paclitaxel, apatinib and S-1 combination therapy (in each 21 days cycle, camrelizumab 200 mg intravenously, D1; nab-paclitaxel 240 mg/m 2 intravenously, D2; apatinib 500 mg orally, once a day, D1-D21; S-1 40-60 mg twice a day, D1-D14). Patients who have been evaluated by multidisciplinary team to be eligible for radical surgery should stop treatment for at least 2 weeks. Patients were discontinued from the study when disease progression or unbearable toxicity, or withdrew consent. We analyzed the conversion rate, objective response rate (ORR), disease control rate (DCR), overall survival (OS) and safety.Statistical data were show by numbers and persentages(%), and comparisons between subgroups were assessed by Fisher′s exact probability method. Patients survival was analyzed using Kaplan-Meier curves and compared between groups using Log-rank. Results:At the data of cutoff (December 15, 2021), the median follow-up duration was 19.6 months. Eight of 17 patients underwent gastrectomy, and all of them were R0 resection (47.1%, 95% CI: 0.262-0.690). ORR was 47.1%, DCR was 82.4%, the median overall survival was 23.63 months. Grade 3 and 4 adverse events occurred in 3 patients (17.6%), including neutropenia, thrombocytopenia, anemia and upper gastrointestinal hemorrhage. There were no serious treatment-related adverse events or treatment-related deaths. Conclusion:In this trial, the combination of camrelizumab, apatinib, nab-paclitaxel and S-1 as the conversion therapy showed significant anti-tumor activity and manageable adverse events, providing a new option for locally unresectable advanced gastric cancer.
ABSTRACT
OBJECTIVE@#To explore the amino acid metabolomics characteristics of myeloid-derived suppressor cells (MDSCs) in mice with sepsis induced by the cecal ligation and puncture (CLP).@*METHODS@#The sepsis mouse model was prepared by CLP, and the mice were randomly divided into a sham operation group (sham group, n = 10) and a CLP model group (n = 10). On the 7th day after the operation, 5 mice were randomly selected from the surviving mice in each group, and the bone marrow MDSCs of the mice were isolated. Bone marrow MDSCs were separated to measure the oxygen consumption rate (OCR) by using Agilent Seahorse XF technology and to detect the contents of intracellular amino acids and oligopeptides through ultra-performance liquid chromatography/tandem mass spectrometry (UPLC-MS/MS) technology. Different metabolites and potential biomarkers were analyzed by univariate statistical analysis and multivariate statistical analysis. The major metabolic pathways were enriched using the small molecular pathway database (SMPDB).@*RESULTS@#The proportion of MDSCs in the bone marrow of CLP group mice (75.53% ± 6.02%) was significantly greater than that of the sham group (43.15%± 7.42%, t = 7.582, P < 0.001), and the basal respiratory rate [(50.03±1.20) pmol/min], maximum respiration rate [(78.07±2.57) pmol/min] and adenosine triphosphate (ATP) production [(25.30±1.21) pmol/min] of MDSCs in the bone marrow of CLP group mice were significantly greater than the basal respiration rate [(34.53±0.96) pmol/min, (t = 17.41, P < 0.001)], maximum respiration rate [(42.57±1.87) pmol/min, (t = 19.33, P < 0.001)], and ATP production [(12.63±0.96) pmol/min, (t = 14.18, P < 0.001)] of sham group. Leucine, threonine, glycine, etc. were potential biomarkers of septic MDSCs (all P < 0.05). The increased amino acids were mainly enriched in metabolic pathways, such as malate-aspartate shuttle, ammonia recovery, alanine metabolism, glutathione metabolism, phenylalanine and tyrosine metabolism, urea cycle, glycine and serine metabolism, β-alanine metabolism, glutamate metabolism, arginine and proline metabolism.@*CONCLUSION@#The enhanced mitochondrial oxidative phosphorylation, malate-aspartate shuttle and alanine metabolism in MDSCs of CLP mice may provide raw materials for mitochondrial aerobic respiration, thereby promoting the immunosuppressive function of MDSCs. Blocking the above metabolic pathways may reduce the risk of secondary infection in sepsis and improve the prognosis.
Subject(s)
Animals , Mice , Adenosine Triphosphate/metabolism , Alanine/metabolism , Aspartic Acid/metabolism , Biomarkers/metabolism , Chromatography, Liquid , Glycine/metabolism , Malates/metabolism , Myeloid-Derived Suppressor Cells/metabolism , Sepsis/complications , Tandem Mass SpectrometryABSTRACT
Objective:To evaluate the effect of preventive application of PEG-rhG-CSF on the prevention of neutropenia during concurrent chemoradiotherapy in patients with lung cancer.Methods:A total of 149 patients with lung cancer who received concurrent chemoradiotherapy at Peking University Cancer Hospital from April 2020 to April 2021 were retrospectively analyzed. There were 79 cases in the prevention group, including 48 cases of primary prevention group (preventive application of PEG-rhG-CSF in all concurrent chemoradiotherapy cycles) and 31 cases of secondary prevention group (preventive application of PEG-rhG-CSF in the concurrent chemoradiotherapy cycles after neutropenia occurred). There were 70 cases in non-prevention group. The incidence of grade 3-4 neutropenia, the completion rate of concurrent chemoradiotherapy, the rate of chemoradiotherapy dose reduction and treatment delay, and the rate of hematological toxicities related hospitalization were compared between the prevention group and the non-prevention group.Results:The incidence of grade 3-4 neutropenia in the whole group was 32.2% (48/149), including 6.3% (3/48) in the primary prevention group, 9.7% (3/31) in the secondary prevention group, and 35.7% (25/70) in the non-prevention group. The difference was statistically significant ( χ2=17.81, P<0.001) in the incidence of grade 3-4 neutropenia. The incidence of febrile neutropenia was 3.4% (5/149) in the whole group, but none of them occurred in the primary prevention group. The full completion rate of concurrent chemotherapy was 96.2% (76/79) in the prevention group, which was significantly higher than 82.9% (58/70) in the non-prevention group ( χ2=7.30, P=0.007). The incidence of treatment delayed and dose reduction of chemoradiotherapy was 19.0% (15/79) in the prevention group and 40.0% (28/70) in the non-prevention group, and the difference was statistically significant ( χ2=7.98, P=0.005). Conclusions:The preventive application of PEG-rhG-CSF can effectively reduce the incidence of neutropenia and better ensure the concurrent chemoradiotherapy in lung cancer patients on schedule.
ABSTRACT
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.
ABSTRACT
Objective To investigate the role of dual-layer detector energy spectral CT in resting myocardial perfusion imaging for patients with normal coronary artery. Methods One hundred and fifty-six patients with suspected coronary heart disease underwent dual-layer detector energy spectral CT coronary angiography,and resting myocardial perfusion imaging was performed for 28 patients with normal coronary artery.According to American Heart Association's 17-segmentmodel,the iodine density and effective atomic number(Z
Subject(s)
Humans , Computed Tomography Angiography , Coronary Angiography , Coronary Vessels/diagnostic imaging , Myocardial Perfusion Imaging , Tomography, X-Ray ComputedABSTRACT
Objective:To investigate the clinical efficacy of external fixators combined with anterolateral thigh musculocutaneous flap for treatment of Gustilo type IIIB/C open tibiofibular fractures.Methods:A retrospective case series study was conducted to analyze clinical data of 15 patients with Gustilo type IIIB/C open tibiofibular fractures admitted to Ruihua Hospital of Soochow University from March 2016 to June 2019. There were 11 males and 4 females, with the age of (48.5±12.6)years (range, 22-67 years). All patients underwent emergency debridement in stage I, the major blood vessels, nerves and tendons were inspected and repaired, and the fracture ends were fixed by external fixator. There were different degrees of wounds necrosis, infection and bone defect after operation. After debridement in stage II, the soft tissue defects with the dimension of 10.0 cm×5.0 cm to 30.0 cm×8.0 cm were repaired with anterolateral thigh musculocutaneous flaps whose areas ranged from 10.5 cm×5.5 cm to 30.5 cm×8.5 cm. All donor areas of the musculocutaneous flaps were sutured directly in stage I. The healing of the donor areas and musculocutaneous flaps were observed within 2 weeks after operation. At the last follow-up, the shape and sensory recovery of the flap, healing of fractures and related complications were observed. The lower extremity functional scale (LEFS) was used to evaluate the injured limb function.Results:All patients were followed-up for 12-32 months [(22.0±5.8)months]. All donor areas were healed by first intention, leaving only linear scars. The musculocutaneous flaps survived completely in all patients. Partial necrosis of large area of musculocutaneous flap occurred in 2 patients, and healed after debridement and skin grafting. Another patient had vascular crisis after musculocutaneous flap operation and survived after the embolized vein repaired by contralateral great saphenous. At the last follow-up, the shape of flap recovered well, and the feeling partially recovered with the two-point discrimination of 18-26 mm. All fractures healed well, and there were no serious infection-related complications such as osteomyelitis. The LEFS score was 47-69 points [(59.0±9.5)points].Conclusion:Theexternal fixator combined with anterolateral thigh musculocutaneous flaps for treatment of Gustilo type IIIB/Copen tibiofibular fractures can better restore the appearance of soft tissue defect of the lower leg, and can effectively reduce the occurrence of severe infection-related complications.
ABSTRACT
Biliary tract cancer (BTC) is a series of rare malignancies with poor overall prognosis. Radical surgery the preferred treatment option, but most patients have lost the opportunity of surgery at the time of diagnosis. At present, there are limited systematical treatment options for biliary tract cancers, and such treatments have poor efficacy and short duration of responses. In the past few years, immune checkpoint inhibitor therapy has been established as an effective systemic therapy option for many solid tumors and hematological tumors. The research for biliary tract cancer treated by of immune checkpoint inhibitors has been continuously carried out and demonstrated the anti-tumor efficacy and safety. However, in view of the low incidence and high heterogeneity of BTC more large number of clinical trials and practices need to be carried out, and the effective combination regimens and predictive biomarkers are urgent to be explored. This article reviews the recent clinical studies on immune checkpoint inhibitors for biliary tract cancer, and summarizes the ongoing clinical studies. At the same time, the predictive biomarkers of immune checkpoint inhibitors proposed by domestic and foreign researches in recent years are summarized.
ABSTRACT
Objective:To explore the application value of modified Shiquan Dabutang in the treatment of elderly patients with osteoporotic intertrochanteric fractures （OIFs） due to Qi and blood deficiency by observing its impacts on inflammatory and bone metabolism indexes. Method:Ninety-eight elderly patients admitted to our hospital for OIFs of Qi and blood deficiency syndrome from April 2018 to April 2020 were randomized into an observation group （<italic>n</italic>=49） and a control group （<italic>n</italic>=49）. Following the proximal femoral nail antirotation （PFNA） fixation， patients in the control group were treated with Guipiwan， while those in the observation group received the modified Shiquan Dabutang. The clinical efficacy， inflammatory and bone metabolism indexes， and complications were compared between the two groups after four weeks of treatment. Result:The levels of such serum indexes as fibroblast growth factor-2 （FGF-2）， osteoprotegerin （OPG）， transforming growth factor-<italic>β</italic><sub>1</sub> （TGF-<italic>β</italic><sub>1</sub>）， <italic>β</italic>-endorphin （<italic>β</italic>-EP）， bone-specific alkaline phosphatase （BALP）， and osteocalcin （BGP） in the observation group after treatment were significantly elevated as compared with those in the control group （<italic>P</italic><0.05）， whereas the serum tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） and <italic>D</italic>-dimer （<italic>D</italic>-D） declined （<italic>P</italic><0.05）. The TCM symptom score in the observation group after treatment was obviously lower than that in the control group， while the Harris Hip Score （HHS） was higher （<italic>P</italic><0.05）. The overall response rate of the observation group was 93.88% （46/49）， higher than 75.51% （37/49） of the control group （<italic>χ<sup>2</sup></italic>=6.376， <italic>P</italic><0.05）. The total incidence of incision infection， deep vein thrombosis of lower limbs， and pulmonary infection in the control group was 24.49% （12/49）， significantly higher than 6.12% （3/49） in the observation group （<italic>χ<sup>2</sup></italic>=6.607， <italic>P</italic><0.05）. Conclusion:The modified Shiquan Dabutang is able to alleviate inflammation， regulate bone metabolism， promote bone repair， and reduce the incidence of complications in elderly patients with OIFs due to Qi and blood deficiency.
ABSTRACT
Codonopsis Radix， one of the bulk commodities， has been commonly used for tonification in clinical practice. Apart from the medicinal purpose， it can also be utilized as food. Among the multiple local varieties， the ones called "Luduiduoji" in Tibetan medicine cannot be neglected， which have frequently been adopted for diminishing inflammation and swelling， invigorating spleen and stomach， and tonifying Qi， etc. Considering its complex origins and frequent substitution by or confusion with other medicinal materials， this paper reviewed the Si Bu Yi Dian， Jingzhu Bencao， ministerial and local standards， modern literature on Tibetan medicine， and the results of field investigation in major Tibetan medicine hospitals and medicinal material markets of Sichuan， Qinghai and Tibet to figure out the name， original plants， medicinal parts， effects， and local varieties of Codonopsis Radix in Tibetan medicine. The results showed that the names of local varieties were diverse， many of which were transliterated into Tibetan， with "Luduiduoji" being most well-known. It was derived from 14 species in genus Codonopsis and one in Adenophora of family Campanulaceae， with Codonopsis foetens subsp. nervosa， C. thalictrifolia var. mollis， C. canescens， C. alpina， and C. pilosula being the main species. According to literature records， the roots， aerial parts， and whole plants could all be employed as medicine， but there were certain differences in their clinical applications. At present， in order to protect the medicinal resources， Tibetan medical workers mostly collect the aerial parts， which are applicable to patients with yellow water， rheumatism， Gamba disease， and leprosy. This literature review of local varieties for Codonopsis Radix and textual research on their original plants are of great significance for elevating the standard， accelerating the pharmacodynamic research， expanding the sources and promoting the rational use of Codonopsis Radix.
ABSTRACT
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.
ABSTRACT
OBJECTIVE@#To observe the expression of plasma microRNA (miR)-146a and miR-223 in children with acute lymphoblastic leukemia (ALL), so as to analyze the relationship between the two factors and the prognosis of children with ALL.@*METHODS@#100 children with ALL treated in the hospital from January 2015 to December 2017 were selected, according to the standard of Chinese Children's Leukemia Group (CCLG)-ALL-2008 program, the children were performed standardized treatment in our hospital according to different risk degree, the follow-up results were obtained, the follow-up time was ≥36 months, and the follow-up time was till to March 2021, the recurrence and mortality of the children were used as prognostic indicators; the baseline data of the children at admission were inquired and recorded, the plasma miR-146a and miR-223 levels were analyzed at admission, and their correlation with the prognosis of children with ALL was analyzed.@*RESULTS@#During the follow-up period, 4 cases of children died while 18 cases recurred, which means 22(22.00%) children showed the poor prognosis; the plasma miR-146a level of the children in poor prognosis group at admission was higher than those in good prognosis group, while the plasma miR-223 level was lower than those in good prognosis group, the differences showed statistically significantly (P0.80); the results of correlation test showed that there was a negative correlation of plasma miR-146a with miR-223 levels at admission (r=-0.239, P=0.016).@*CONCLUSION@#Plasma miR-146a is overexpressed and miR-223 is low-expressed in children with ALL, the abnormal expression of the two factors is related to the prognosis of children with ALL.
Subject(s)
Child , Humans , MicroRNAs , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Prognosis , ROC CurveABSTRACT
Objective:To analyze the cardiopulmonary function of stable patients with pulmonary arterial hypertension (PAH), and to explore effects of the cardiopulmonary exercise testing (CPET)-based individualized moderate-intensity exercise prescription on cardiopulmonary functional reserve and exercise capacity in patients with PAH. Methods:From April, 2018 to July, 2019, 31 stable patients with PAH (PAH group) and 32 healthy counterparts (normal group) were enrolled. All subjects underwent CPET. PAH group was assessed with 6-Minute Walking Test (6MWT), and then was divided into exercise group (n = 16) and control group (n = 15). Both groups were treated with ordinary targeted drugs, while the exercise group was additionally provided with an individualized moderate-intensity exercise prescription of △50% power treadmill training, five days a week for eight weeks. CPET and 6MWT were conducted again after intervention. Results:Before intervention, body mass, body mass index (BMI), force vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum voluntary ventilation (MVV), anaerobic threshold (AT), peak heart rate (HRpeak), peak systolic blood pressure (SBPpeak), peak load power (WRpeak), peak oxygen uptake (VO2peak), peak oxygen pulse (VO2/HRpeak), peak cardiac output (COpeak), peak minute ventilation (VEpeak), peak end-tidal carbon dioxide (PETCO2peak), peak pulse oxygen saturation (SpO2peak) and oxygen uptake efficiency plateau (OUEP) were significantly lower (t > 2.419, P < 0.05), and the rest heart rate (HRrest), peak dead space to tidal volume ratio (VD/VTpeak), minimum ventilatory equivalent for carbon dioxide (Lowest VE/VCO2) and slope of ventilatory equivalent for carbon dioxide (VE/VCO2 slope) were higher (|t| > 2.615, P < 0.05) in PAH group than in the normal group. After intervention, FEV1, MVV, VO2peak (ml/min/kg) and VO2/HRpeak decreased in the control group (t > 2.272, P < 0.05); FVC, FEV1, MVV, AT, SBPpeak, WRpeak, VO2peak, VO2/HRpeak, COpeak, VEpeak, PETCO2peak, SpO2peak and 6-Minute Walking Distance (6MWD) increased (|t| > 2.167, P < 0.05), while the average Lowest VE/VCO2 and VE/VCO2 slope decreased (t > 2.264, P < 0.05) in the exercise group. Compared with the control group, the FEV1/FVC, AT, WRpeak, VO2peak, VO2/HRpeak, COpeak and 6MWD increased in the exercise group (|t| > 2.168, P < 0.05). Conclusion:The holistic cardiopulmonary function of stable patients with PAH decreases. CPET-based individualized moderate-intensity exercise could enhance the cardiopulmonary functional reserve and exercise capacity of patients with PAH.