Summary of best evidence for exercise rehabilitation for stroke / 中国实用护理杂志

Objective:To summarize the relevant evidence of motor rehabilitation of stroke at home and abroad, so as to provide reference for medical staff to carry out motor rehabilitation.Methods:The related evidence on exercise management for patients with stroke in BMJ Best practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, National Guideline, American Heart Association/American Stroke Association, European Stroke Organization, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Canadian Medical Association, American Association of Critical Care Nurses, National Stroke Foundation, Chinese Stroke Association, Medlive, Cochrane library, PubMed, Web of Science, Embase, OVID, Medline, China National Knowledge Infrastructure, Wanfang, VIP, SinoMed were searched by computer. The retrieval time limit was from 2012 to June 30, 2022. Two to four investigators independently assessed the quality of the included article, and extracted and summarized the evidence that met the quality standards.Results:A total of 22 articles were included, including 5 guidelines, 2 summary of evidence, 2 expert consensus, and 13 systematic evaluations. A total of 42 pieces of evidence related to exercise rehabilitation were extracted and integrated, including 11 aspects such as multidisciplinary teams, exercise goals, exercise timing, exercise evaluation, exercise venue, exercise style, exercise intensity, exercise time and frequency, safety monitoring, exercise behavior maintenance, and health education.Conclusions:The best evidence summarized in this study can provide a reference for clinical medical staff to implement exercise rehabilitation, but in clinical practice, it is necessary to select and apply evidence in a targeted manner in combination with specific circumstances, so as to improve the safety and effect of exercise rehabilitation.

CTCs Detection and Whole-exome Sequencing Might Be Used to Differentiate Benign and Malignant Pulmonary Nodules / 中国肺癌杂志

BACKGROUND@#Low-density computed tomography (LDCT) improved early lung cancer diagnosis but introduces an excess of false-positive pulmonary nodules data. Hence, accurate diagnosis of early-stage lung cancer remains challenging. The purpose of the study was to assess the feasibility of using circulating tumour cells (CTCs) to differentiate malignant from benign pulmonary nodules.@*METHODS@#122 patients with suspected malignant pulmonary nodules detected on chest CT in preparation for surgery were prospectively recruited. Peripheral blood samples were collected before surgery, and CTCs were identified upon isolation by size of epithelial tumour cells and morphological analysis. Laser capture microdissection, MALBAC amplification, and whole-exome sequencing were performed on 8 samples. The diagnostic efficacy of CTCs counting, and the genomic variation profile of benign and malignant CTCs samples were analysed.@*RESULTS@#Using 2.5 cells/5 mL as the cut-off value, the area under the receiver operating characteristic curve was of 0.651 (95% confidence interval: 0.538-0.764), with a sensitivity and specificity of 0.526 and 0.800, respectively, and positive and negative predictive values of 91.1% and 30.3%, respectively. Distinct sequence variations differences in DNA damage repair-related and driver genes were observed in benign and malignant samples. TP53 mutations were identified in CTCs of four malignant cases; in particular, g.7578115T>C, g.7578645C>T, and g.7579472G>C were exclusively detected in all four malignant samples.@*CONCLUSIONS@#CTCs play an ancillary role in the diagnosis of pulmonary nodules. TP53 mutations in CTCs might be used to identify benign and malignant pulmonary nodules.

Expression of MAD2L1 in Lung Adenocarcinoma and Its Effect on Immune Microenvironment / 肿瘤防治研究

Objective To investigate the expression of MAD2L1 in lung adenocarcinoma and its effect on the prognosis and immune microenvironment of patients. Methods The difference of MAD2L1 expression in lung adenocarcinoma tissue and normal lung tissue was analyzed by TCGA and GEO database. Survival analysis was carried out to evaluate the prognostic significance of MAD2L1 gene expression in lung adenocarcinoma patients. StarBase database was used to construct miRNA-MAD2L1 regulatory network of lung adenocarcinoma. The relation between the expression of MAD2L1 and immune cell infiltration in lung adenocarcinoma was analyzed by TIMER database. Results The expression of MAD2L1 was up-regulated in lung adenocarcinoma, and the high expression of MAD2L1 was significantly correlated with pathological stage and lymph node metastasis of lung adenocarcinoma. The patients with high expression of MAD2L1 had a poor prognosis. miR-101-3p/MAD2L1 axis was identified as the most potential upstream regulation pathway of MAD2L1 in lung adenocarcinoma. The expression level of MAD2L1 was significantly correlated with tumor immune cell infiltration and immune checkpoint expression. Conclusions MAD2L1 is highly expressed in lung adenocarcinoma, which is related to poor prognosis and tumor immune infiltration. MAD2L1 can be used as a potential target for the treatment of lung adenocarcinoma.

Exploration and practice of constructing a risk-based quality management model for clinical trials / 中华医学科研管理杂志

Objective:To conduct a quantitative and qualitative analysis of the issues found in quality management, establish a risk-based whole-process quality management model, and improve the quality of clinical trials.Methods:Based on the risk-based quality management theory, the issues found in the quality control of drug clinical trials in Beijing Cancer Hospital in 2020 were structured and classified by severity (mild to moderate to severe) and 10 categories, and the risk matrix was graded by a semi-quantitative method. Targeted quality control strategies for different levels of risk were carried out according to visual analysis of the informative quality analysis platform. Chi-square tests of the severity of quality control issues in our hospital in 2020 and 2021 and non-parametric tests of the number of issues per capita in each category were used to evaluate the effectiveness of the management model.Results:A risk matrix was established according to the severity and frequency of the issues found in the quality control in 2020. The issues with severe risks were categorized as protocol compliance and serious adverse events, and categories with moderate risks included informed consent, biological sample related, original records, and investigator folders. After using visual analysis and adopting the risk-based quality control strategy, the proportion of severe issues found in quality control in our hospital in 2021 was 0.92%, lower than that of 1.39% in 2020, and the difference was statistically significant. The average number of issues detected per capita in each category for each trial in 2021 was lower than that in 2020 with a statistical difference, indicating that the management model was effective.Conclusions:Using information technology to adopt risk-based quality management is helpful to improve the quality of hospital clinical trials.

Drug target inference by mining transcriptional data using a novel graph convolutional network framework

A fundamental challenge that arises in biomedicine is the need to characterize compounds in a relevant cellular context in order to reveal potential on-target or off-target effects. Recently, the fast accumulation of gene transcriptional profiling data provides us an unprecedented opportunity to explore the protein targets of chemical compounds from the perspective of cell transcriptomics and RNA biology. Here, we propose a novel Siamese spectral-based graph convolutional network (SSGCN) model for inferring the protein targets of chemical compounds from gene transcriptional profiles. Although the gene signature of a compound perturbation only provides indirect clues of the interacting targets, and the biological networks under different experiment conditions further complicate the situation, the SSGCN model was successfully trained to learn from known compound-target pairs by uncovering the hidden correlations between compound perturbation profiles and gene knockdown profiles. On a benchmark set and a large time-split validation dataset, the model achieved higher target inference accuracy as compared to previous methods such as Connectivity Map. Further experimental validations of prediction results highlight the practical usefulness of SSGCN in either inferring the interacting targets of compound, or reversely, in finding novel inhibitors of a given target of interest.

Chronic inflammatory response syndrome in the elderly / 中华老年医学杂志

Chronic inflammatory response syndrome(CIRS)is a chronic, low-grade, systemic inflammatory response, resulting from sustained long-term stimulation of the innate immune system.CIRS is not only associated with certain chronic diseases, but also associated with aging, the development and progression of a variety of diseases in the elderly, and functional decline.Additionally, it is closely related to adverse clinical outcomes and is not uncommon in the elderly.Here we review the characteristics of CIRS and their clinical implications and consider whether CIRS can be classified as a geriatric syndrome, in order to identify new targets for the prevention and treatment of diseases and functional decline in the elderly.

Research progress of mTOR in digestive system neoplasms / 中国医师杂志

Mammalian target of rapamycin (mTOR) is involved in a variety of cellular signaling pathways, which is related to cell growth, proliferation, autophagy, apoptosis and cell cycle progression.mTOR signaling pathway is usually activated in tumors and is closely related to the occurrence, progression and metabolism of tumors.Therefore, mTOR signaling pathway is a hot spot in anti-tumor therapy research.In recent years, with the research of the mechanism of mTOR signaling pathway in digestive system tumors and the exploration of inhibitors, new ideas have been provided for clinical diagnosis and treatment, prognosis assessment and targeted drug development.

A survey and an intervention study on Chinese medical students' willingness to pursue a career in geriatrics / 中华老年医学杂志

Objective:To explore the attitudes of Chinese medical students toward the elderly and their willingness to practice in geriatrics, and to investigate the influence of geriatrics education on their attitudes.Methods:Medical students studying diagnostics in four medical universities were enrolled in a cross-sectional survey and, for the intervention study, graduate trainees from non-geriatrics specialties taking a geriatrics course were interviewed before and after the course.An electronic questionnaire was used to collect general information, the experience of interacting with the elderly, attitudes towards the elderly and the willingness to develop careers in geriatric medicine.Changes in attitudes towards the elderly and their willingness to practice in geriatrics before and after the 40-hour geriatric medicine course were compared.Results:A total of 648 medical students completed the cross-sectional survey, with the highest score in compassion for the elderly(3.54±0.54)and the lowest score for medical services for elderly patients(3.36±0.78). Only 2.2%(14/648)of the students showed strong interest in geriatric medicine.The results of the intervention from 42 graduate trainees showed that the average scores of revised Geriatric Attitude Scale(r-GAS)were 3.80±0.43 and 3.92±0.40 before and after the course, respectively, and the difference was statistically significant( t=2.148, P=0.038). At the end of the course, 7 trainees(16.7%, 7/42)showed great interest in geriatrics, significantly different from 2 trainees(4.8%, 2/42)before the course( χ2=8.211, P=0.025). Conclusions:Chinese medical students show a serious lack of interest in geriatrics, and geriatrics education can improve their attitudes towards the elderly and their willingness to work in geriatrics.With the rapid population aging in China, it is urgent to strengthen the education of geriatric medicine.

Research progress of exercise rehabilitation in women with perimenopausal syndrom / 中国实用护理杂志

Perimenopausal syndrome is a common uncomfortable symptom in women during the perimenopausal period, with a high incidence, a long duration, and adverse effects on physical and psychological, patients bear a heavy burden of symptoms, and increase the risk of adverse events in the elderly stage, increase the social medical burden. With the development of sports rehabilitation research, more and more attention has been paid to the effect of exercise on human health. This paper reviews the studies on exercise rehabilitation in women with perimenopausal syndrome, including exercise forms, exercise intensity, exercise time and exercise effect, in order to provide basis for the relevant research and practice.

Study on the contamination level and dietary exposure of 9,10-anthraquinone in different types of teas in Wuhan / 公共卫生与预防医学

Objective To investigate the pollution level of 9,10-anthraquinone in teas sold in Wuhan, and to assess the dietary exposure of 9,10-anthraquinone ingested through tea. Methods The content of 9,10-anthraquinone in teas collected from local tea markets in Wuhan was analyzed by GC-MS/MS. Results 9,10-anthraquinone was detected in all 36 tea samples with a concentration ranging from 0.0080 mg/kg to 0.137 mg/kg. The standard limit for 9,10-anthraquinone has not yet been set in China. Referring to EU standards, the total over-standard rate was 86.11% (31/36). Generally, the concentration of residual 9,10-anthraquinone was higher in highly fermented teas. The highest average concentration of residual 9,10-anthraquinone was found in fully/post-fermented tea (0.0762 mg/kg), and the over-standard rate was 100%. The second highest was in semi-fermented tea (0.0452 mg/kg), and the over-standard rate was 86.7%. The concentration of 9,10-anthraquinone in non-fermented tea was 0.0262 mg/kg, and the over-standard rate was 42.9%. According to people’s tea-drinking habits, tea samples were brewed with boiling water（1:50）for 5 minutes, and the concentration of 9,10-anthraquinone in tea soup was 0.0004 mg/kg～0.01 mg/kg, with an average leaching rate of 7.2%. The average daily intake exposure of tea for an adult was 0.0551μg/kg bw/day. Conclusion There was a certain degree of 9,10-anthraquinone pollution in the teas sold in Wuhan, and the rate exceeding the standard was high. Since the acceptable daily intake (ADI) for 9,10-anthraquinone has not been established, it is impossible to assess the health risks of 9,10-anthraquinone ingested through tea.

Discussion on the management mode of real-time reimbursement of testing expense in clinical trials / 中华医学科研管理杂志

Objective:To explore the management mode of the real-time reimbursement of testing expenses in clinical trials, dealing with the possible disadvantages of manual reimbursement and improving work efficiency.Methods:Based on hospital information system, the GCP center integrates the clinical trial information system, optimizes the trial reimbursement process, and explores a unique " clinic-GCP-finance" streamlined clinical trial real-time settlement management model.Results:This management mode of real-time reimbursement of testing expenses has been adopted for 3 years. This management model enables human subjects to complete the reduction or exemption of clinical trial-related medical testing expenses before making the payments, which is also highly praised by both investigators and subjects.It complied with informatization and technology development in the era of big data, realized full process dynamic supervision over clinical trial lab testing expenses and avoided management delay. It also had advantages in simplifying reimbursement process, reducing work load and mistakes, complying with inspection and improving trial quality.Conclusions:Clinical trial real-time reimbursement management mode of testing expenses works better in compliance with GCP, safeguards the rights and interest of human subject, and can provide a certain reference for other GCP centers.

On the current situation of the knowledge-attitude-practice of clinical scientific research ability of pediatric residents in standardized residency training / 中华医学教育探索杂志

Objective:To understand the clinical research knowledge, attitude and practice of pediatrics residents in standardized residency training, and to provide scientific basis for improving their capability of clinical medical scientific research.Methods:A self-complied questionnaire survey including demographic information, knowledge and attitudes toward capability of medical scientific research as well as personal interview was conducted in 22 pediatric residents during the standardized residency training from April to July, 2017. Data were analyzed by (mean±standard deviation) and percentage for description, and qualitative data were analyzed by classification and induction. SPSS 18.0 was used to analyze the data.Results:Firstly, the total score of basic knowledge in clinical scientific research was (54.14±23.06), with the scores between 31 and 60 being the most. Secondly, all these residents believed that capability of clinical medical scientific research was very important for them and clinical research training was necessary for them during the standardized residency training. Thirdly, the residents had the scientific research practices but no article published during the standardized residency training. Fourthly, the residents hoped to improve their capability of clinical scientific research by various means during the training.Conclusion:It is indicated that basic knowledge on capability of clinical medical research is still insufficient in standardized residency training of pediatrics residents, so relevant measures should be taken to cultivate their capability of clinical scientific research.

Clinical features and prognostic analysis of extranodal nasal type NK/T cell lymphoma / 白血病·淋巴瘤

Objective:To investigate the clinical features, treatment methods and prognostic factors of extranodal nasal type NK/T lymphoma (ENKTL).Methods:The clinical data of 45 patients treated in Renmin Hospital of Wuhan University from January 2013 to June 2019 were retrospectively analyzed. Short-term efficacy was compared among low-risk, medium-risk and high-risk three groups according to PINK score. According to the treatment methods, the patients of stage Ⅰ-Ⅲ were divided into radiotherapy group and radiotherapy+ chemotherapy group. Chi-square test was used to compare the treatment outcomes. The effects of diagnosis time, clinical staging, symptom B, erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), Ki-67, prognostic index of NK lymphoma (PINK) and treatment methods on overall survival (OS) and progression-free survival (PFS) were analyzed by using Kaplan-Meier method, log-rank test was used for univariate analysis, and Cox proportional hazard model was used for multivariate prognostic analysis.Results:The median age of 45 patients was 51 years old. There were 39 cases (86.7%) of stage Ⅰ-Ⅱ, 4 cases (8.9%) of stage Ⅲ, 2 cases(4.4%) of stage Ⅳ. The median time from first onset to diagnosis was 3.0 months (1.0-36.0 months), and serum EBV-DNA positive rate was 95.6% (43/45). The complete remission (CR) rate and progression of the disease (PD) rate were statistically different of different risk groups ( χ2 = 10.952, P < 0.01; χ2 = 12.217, P = 0.002). Among 43 patients of stage Ⅰ-Ⅲ, there were 11 patients in the radiotherapy alone group, including 4 cases (36.3%) of CR, 3 cases (27.3%) of partial remission (PR), 4 cases (36.4%) of PD; and 32 patients in the chemotherapy combined with radiotherapy group, including 23 cases (71.9%) of CR, 4 cases (12.5%) of PR, 5 cases (15.6%) of PD. The difference in CR rate of both groups was statistically significant ( χ2 = 4.418, P = 0.036). Univariate analysis suggested that PINK score and B symptom were related to OS ( χ2 = 8.140, P = 0.017; χ2 = 5.545, P = 0.019). PINK score and clinical staging were associated with PFS ( χ2 = 12.517, P = 0.002; χ2 = 10.016, P = 0.002); Cox multivariate analysis indicated that clinical staging was an independent influencing factor of PFS ( HR = 4.104, 95% CI 1.571-10.725, P = 0.004). Conclusions:ENKTL with specific location has longer clinical diagnosis time, and the positive rate of EBV-DNA is high. The patients with B symptom and high PINK score have poor OS, and patients with late clinical staging and high PINK score have short PFS. Clinical staging is considered as an independent factor affecting PFS. The PINK score risk stratification has a guiding significance in the short-term efficacy evaluation, and the chemotherapy combined with radiotherapy can increase CR rate for patients less than stage Ⅳ.

Expressions of transforming growth factor β 1 and dimethylarginine dimethylaminohydrolase 2 in early-stage lung adenocarcinoma and their clinical significances / 肿瘤研究与临床

Objective:To investigate the expressions and significances of transforming growth factor β 1 (TGF-β 1) and dimethylarginine dimethylaminohydrolase 2 (DDAH2) in different stages of early-stage lung adenocarcinoma, and to provide basis for accurate pathological diagnosis of lung adenocarcinoma. Methods:Sixty-two surgical specimens from patients with early-stage lung adenocarcinoma in Shanxi Bethune Hospital from January 2012 to June 2019 were selected. Most of the specimens contained more than one pathological type. According to the pathological types, they were divided into three groups: 18 cases of atypical adenomatous hyperplasia (AAH), 60 cases of adenocarcinoma in situ (AIS), and 55 cases of invasive carcinoma (CA) component in minimally invasive adenocarcinoma (MIA) and lepidic predominant adenocarcinoma (LPA), and the wall attached growth patterns were selected as control group. Immunohistochemistry was used to detect the expressions of TGF-β 1 and DDAH2 proteins in different pathological types of lesions and control tissues, and the correlation among them was analyzed. Results:TGF-β 1 and DDAH2 proteins were expressed in normal lung tissue epithelial cells, and the positive rates were high [46.8% (29/62) and 98.4% (61/62)]. The positive rates of TGF-β 1 and DDAH2 proteins in epithelial cells of AAH, AIS and CA increased gradually, the positive rate of TGF-β 1 protein was 16.7% (3/18), 31.7% (19/60) and 70.9% (39/55), the positive rate of DDAH2 protein was 66.6% (12/18), 81.7% (49/60) and 90.1% (49/55), and the differences of positive rates among different pathological types were statistically significant (all P < 0.01). The positive rates of TGF-β 1 and DDAH2 protein in interstitial fibroblasts of normal lung tissue, AAH, AIS and CA increased gradually, the positive rate of TGF-β 1 protein was 11.3% (7/62), 61.1% (11/18), 72.3% (44/60), and 83.6% (46/55), the positive rate of DDAH2 protein was 0 (0/62), 22.2% (4/18), 65.0% (39/60), and 98.2% (54/55), and the differences of positive rates among different pathological types were statistically significant (all P < 0.01). In lung adenocarcinoma tissues, there was a positive correlation between the expression of TGF-β 1 in epithelial cells and the expression of DDAH2 in interstitial fibroblasts ( r = 0.221, P = 0.011). Conclusions:The expression trend of TGF-β 1 and DDAH2 proteins in different pathological types of early-stage lung adenocarcinoma lesions may relate to the degree of lesions. The combined detection of TGF-β 1 and DDAH2 proteins is expected to be a biomarker for the auxiliary diagnosis of early-stage lung adenocarcinoma with different pathological types.

Analysis of the Rules of Pulmonary Nodule Prescriptions Based on TCMISS / 中国药房

OBJECTIVE：To provide reference for improving TCM treatment of pulmonary nodule. METHODS ：The experience of famous TCM doctors in the TCM treatment of pulmonary nodule was searched by computer ，the formulations of the cases were sorted out ，and the data were recorded into the TCMISS V 2.5 for data analysis ，and the medicine frequency was counted. Apriori algorithm and association rules were used for statistical analysis of core combination of formulations （support degree was 16，confidence degree was 0.65）. Inner core combination and new combination were extracted according to the entropy clustering method of complex system （correlation was 6，penalty was 2）. RESULTS ：A total of 25 literatures were input ，including 64 formulations in total ，166 medicinal materials. For the prescriptions of pulmonary nodule ，the frequency of single ingredient from high to low was Bolbostemma paniculatum ，Glycyrrhiza uralensis ，Astragalus membranaceus ，Prunella vulgaris ，Ostrea gigas，Angelica sinensis ，Pinellia ternate ，Ligusticum chuanxiong ，Mori Corlex ，etc. The main compatibility of the drug model is to invigorate Qi ，dissipate phlegm ，invigorate Qi and activate blood circulation ，and promote Qi and softness ，such as “G. uralensis，B. paniculatum ”“A. membranaceus ，B. paniculatum ”“A. membranaceus ，G. uralensis ”，etc；10 core combinations of the drug were found out ， such as Begonia fimbristipula-Rhodiola rosea-Bupleurum Chinense ， Cervus elaphus Clematis chinensis-Buffalo Horn，etc. There were 5 new prescriptions ，i.e. B. fimbristipula-R. rosea-B. chinense-Setaria italic ，C. elaphus-C. chinensis-Buffalo Horn-French chalk ，A. sinensis-L. chuanxiong-Morus alba- Mori Corlex -P. vulgaris-Ganoderma lucidum ，Hedyotis diffusa-Prunus persica-Trichosanthes kirilowii-Achyranthes bidentata-Eupolyphaga sinensis- Cinnamomi Ramulus ，A. bidentata-E. sinensis-Ephedra sinica-Curcuma aromatica-Curcuma longa-Concretio silicea . CONCLUSIONS ：Most modern doctors believe that the interaction of phlegm and blood stasis is the main pathogenesis of pulmonary nodule ，and the treatment is mainly based on the treatment of lung ，spleen，liver and kidney ，focus on the elimination of symptoms and phlegm ，the elimination of blood stasis and the soft and hard treatment ，pay attention to the weak body of the patient. TCM treatment of pulmonary nodule has a good prospect.

Incidence and risk factors of the corrected QT prolongation in breast cancer patients induced by anthracyclines / 中华全科医师杂志

Objective:To study the incidence and risk factors of the corrected QT (QTc) prolongation in breast cancer patients treated with anthracyclines.Methods:From July 2017 to January 2019, 279 female breast cancer patients who underwent 4 cycles of anthracycline treatment in Department of Breast Surgery of the People′s Hospital of Shanxi Medical University were enrolled in the study. The ECG of all patients before treatment showed sinus rhythm and QTc<440 ms. The most common electrocardiographic abnormalities after treatment were the changes of QTc. There were 78 cases with prolonged QTc (≥440 ms, QTc prolongation group) and 201 cases with normal QTc (<440 ms, non-prolongation group). The risk factors of QTc prolongation were analyzed by univariate and multivariate logistic regression. Cardiac toxicity was evaluated according to clinical symptoms and ECG results during treatment.Results:The common ECG abnormalities after treatment were 78 cases of QTc prolongation (28.0%), 22 cases of ST-T changes (7.9%), and 18 cases of sinus bradycardia (6.5%). Univariate analysis showed that there were significant differences in administration of anthracyclines(contained epirubicin in 48 and 73 cases, pirubicin in 10 and 33 cases, doxorubicin in 4 and 12 cases, liposomal doxorubincin in 16 and 83 cases,χ 2=15.54, P<0.01), dexrazoxane use (χ 2=5.43, P=0.02), coronary heart disease (χ 2=4.56, P=0.03), obesity or overweight (χ 2=4.51, P=0.03) between two groups. Multivariate logistic regression analysis showed that the use of different types of anthracyclines ( OR=1.42, 95 %CI: 1.37-1.48, P=0.02) and overweight/obesity ( OR=1.23, 95 %CI: 1.16-1.30, P=0.04) were independent risk facors of QTc prolongation. The liposomal doxorubicin in anthracyclines resulted in a minimum incidence of the QTc prolongation (16.2%, 16/99), while that of epirubicin was up to 39.7% (48/121). Preventive use of dexrazoxane reduced the incidence of the QTc prolongation to 11.4% (4/35). The incidence of the QTc prolongation in breast cancer with coronary heart disease or overweight/obesity was relatively high, which was 4/6 and 34.4%(42/122), respectively. No cardiotoxic symptoms such as chest pain, palpitation and shortness of breath occurred during the treatment, and no fatal arrhythmia such as ventricular tachycardia and ventricular fibrillation was observed in electrocardiogram. Conclusion:Although the incidence of the QTc prolongation in breast cancer patients treated with anthracyclines is high, there is no serious cardiotoxicity such as fatal arrhythmia. Breast cancer patients with coronary heart disease or overweight/obesity are more likely to have the QTc prolongation. Preventive use of dextrazoxan or the selection of liposomal doxorubicin can reduce the incidence of the QTc prolongation.

Relationship between urinary 8-oxo-Gsn and physical function in the elderly / 中华老年医学杂志

Objective:To investigate the correlation between urinary 8-oxo-7, 8-dihydroguanosine(8-oxo-Gsn)and physical function in community-dwelling elderly people.Methods:A total of 210 community-dwelling elderly people aged 75 years and over were enrolled in this cross-sectional analysis.According to the scores of short physical performance battery(SPPB), subjects were divided into three groups: the high performance group(summary score 10-12), the intermediate performance group(summary score 7-9)and the low performance group(summary score 0-6). All participants received a comprehensive geriatric assessment.Urinary 8-oxo-dGsn, serum high-sensitivity C-reactive protein(hs-CRP)and white blood cell count were measured.The correlation between urinary 8-oxo-Gsn and physical function was analyzed by using Pearson correlation analysis and the ordered Logistic regression model.Results:The scores of activities of daily living(ADL), instrumental activities of daily living(IADL), grip strength and gait speed were lower in the low performance group than in the other two groups( H=47.002, 110.902, F=11.962, 235.952, all P<0.001). Levels of urinary 8-oxo-Gsn and serum hs-CRP were higher in the low performance group than in the other two groups( F=23.780 and 13.259, both P<0.001). There was no significant difference in levels of urinary 8-oxo-dGsn or white blood cell count between the three groups(both P>0.05). Urinary 8-oxo-Gsn was negatively correlated with gait speed, grip strength and SPPB score( r=-0.559, -0.302 and-0.450, all P<0.001)and was positively correlated with the time of five-times-sit-to-stand test( r=0.290, P<0.001). Adjusting for age, gender and Charlson comorbidity index, the ordered Logistic regression analysis showed that elevated levels of urinary 8-oxo-Gsn( OR=1.38, 95% CI: 1.06-1.77, P<0.05)and hs-CRP( OR=1.23, 95% CI: 1.04-1.48, P<0.05)decreased physical function. Conclusions:Urinary 8-oxo-Gsn is independently associated with the decline of physical function in community-dwelling elderly adults, suggesting that the oxidative stress level is increased in the elderly with poor physical function.

Application of molecular tracing technique in one analysis of AIDS infection source / 中华实验和临床病毒学杂志

Objective@#To determine the HIV infection of a 13-year-old leukemia patient Wei using molecular tracing technique.@*Methods@#Three blood samples were collected from the persons who were associated with HIV positive blood donation member Lang. The viral load was tested and pol gene was sequenced and analyzed. At the same time using HyPhy2.2.4 and Cytoscape 3.6.1 to establish the molecular network with these 3 samples sequences and other HIV subtypes sequences obtained from Luzhou.@*Results@#The HIV-1 viral load test result of the three patients were: Lang 933 CPS /ml (treated, blood donor), Wei (blood recipitent) 89 813 CPS /ml, Deng (blood recipitent) 85 158 CPS /ml. The subtype of HIV-1 of these three samples were all recombinant HIV CRF01_AE, and the pol gene similarity was 98.8% (Lang and Wei), 99.7% (Lang and Deng), and 99.1% (Wei and Deng), respectively. The gene sequences of the three samples were linked into clusters (the gene distance was less than 0.004).@*Conclusions@#The patient Wei with leukemia was infected with HIV-1 due to blood transfusion during the seroconversion period, and the three patients were more likely to be infected with the same HIV-1 strain. It is necessary to popularize the use of high-sensitivity nucleic acid detection method in blood collection and supply institutions, which can effectively improve the safety of blood use.

Related factors of sarcopenia in hospitalized elderly patients with coronary heart disease / 中华心血管病杂志

Objective@#To explore the incidence and clinical characteristics of sarcopenia in hospitalized elderly patients with coronary heart disease and search for the related factors.@*Methods@#This study was a single-center observational study. According to the inclusion criteria, elderly patients hospitalized with coronary heart disease from Peking Union Medical College Hospital between December 2017 and December 2018 were enrolled. The patients were divided into sarcopenic group and non-sarcopenic group according to the diagnostic criteria of the Asian Working Group for Sarcopenia. Activities of daily living of the patients were assessed (including ADL and IADL) . Comorbidity of the patients was evaluated by the Charlson comorbidity index (CCI). Long-term medication use of the patients was recorded to assesse whether there was polypharmacy. The nutritional status of the patients was examined by the mini nutritional assessment-short form (MNA-SF). The full tandem stance time of the patients was evaluated. The history of falls over the previous year, urinary incontinence, and living conditions of the patients were also recorded. Multivariate logistic regression was used to analyze the related factors for sarcopenia of elderly patients with coronary heart disease.@*Results@#A total of 364 patients were enrolled in the study. The patients were aged 65-96 (74.6±6.5) years and there were 218 (59.9%) male patients. There were 264 cases of stable coronary heart disease and 100 cases of acute coronary syndrome. The median number of long-term used medication was 7. One hundred and fifty-two (41.8%) patients were complicated with type 2 diabetes, 38 (10.4%) patients were complicated with anxiety/depression, and 98 (26.9%) patients had the history of falls over the previous year. Eighty-two (22.5%) patients were complicated with urinary incontinence, 12 patients (3.3%) were complicated with malnutrition and 33 patients (9.2%) were living alone. There were 81 (22.3%) sarcopenic patients and 283 (77.7%) non-sarcopenic patients among all the hospitalized elderly patients with coronary heart disease. The sarcopenic patients were more older, with lower body mass index(BMI)(both P<0.001), higher CCI and more long-term used medication (both P<0.05), higher proportions of malnutrition, urinary incontinence, history of falls, and living alone (all P<0.05) compared to non-sarcopenic patients. ADL and IADL scores of sarcopenic patients were significantly lower than those of non-sarcopenic patients (both P<0.001). There was also a higher proportion of unable to accomplish full tandem stance among sarcopenic patients compared to non-sarcopenic patients (P<0.001). Moreover, higher hs-CRP level (P=0.047) , lower albumin level (P=0.004) and significantly lower prealbumin level (P<0.001) were observed in sarcopenic patients compared to non-sarcopenic patients. Stepwise multivariate binomial logistic regression analysis revealed that male (OR=5.036, 95%CI 1.782-14.230, P=0.002), low BMI (OR=0.883, 95%CI 0.796-0.980, P=0.019), as well as low prealbumin level (OR=0.990, 95%CI 0.980-1.000, P=0.045) were related factors for sarcopenia among elderly patients with coronary heart disease.@*Conclusions@#Sarcopenia is a geriatric condition commonly seen in hospitalized elderly patients with coronary heart disease. Male, low BMI, and low prealbumin level were the factors related to sarcopenia for older adults with coronary heart disease.

Observation on the efficacy of consolidation chemotherapy combined with allogeneic natural killer cell infusion in the treatment of low and moderate risk acute myeloid leukemia / 中华血液学杂志

Objective@#To evaluate the efficacy of consolidation chemotherapy combined with allogeneic natural killer (NK) cell infusion in the treatment of low or intermediate-risk (LIR) acute myeloid leukemia (AML) .@*Methods@#A cohort of 23 LIR AML patients at hematologic complete remission (CR) received NK cell transfusion combined with consolidation chemotherapy after 3 consolidation courses from January 2014 to June 2019 were reviewed. Control group cases were concurrent patients from Department of Hematology, and their gender, age, diagnosis, risk stratification of prognosis, CR and the number of courses of consolidate chemotherapy before NK cell transfusion were matched with LIR AML patients.@*Results@#A total of 45 times of NK cells were injected into 23 LIR AML patients during 4 to 7 courses of chemotherapy. The median NK cell infusion quantity was 7.5 (6.6-8.6) ×109/L, and the median survival rate of NK cells was 95.4% (93.9%-96.9%) . Among them, the median CD3-CD56+ cell number was 5.0 (1.4-6.4) ×109/L, accounting for 76.8% (30.8%-82.9%) ; The number of CD3+ CD56+ cells was 0.55 (0.24-1.74) ×109/L, accounting for 8.8% (4.9%-20.9%) . Before NK cell infusion, the number of patients with positive MRD in the treatment and control groups were 9/23 (39.1%) and 19/46 (41.3%) (χ2=0.030, P=0.862) respectively. After NK infusion, There was no significant difference in terms of MRD that went from negative to positive between the treatment and the control groups (14.3% vs 22.2%, χ2=0.037, P=0.847) . In the treatment group, 66.7% (6/9) of the MRD were converted from positive to negative, which was significantly higher than that in the control group (10.5%, 2/19) (χ2=6.811, P=0.009) . Morphological recurrence occurred in 1 case of MRD negative in the treatment group and 2 cases of MRD positive in the control group. By the end of follow-up, the median follow-up was 35 (10-59) months, the number of patients with morphological recurrence in the treatment group was 30.4% (7/23) , which was significantly lower than that in the control group (50.2%, 24/46) (χ2=2.929, P=0.087) , although there was no statistically significant difference between the two groups. There was no significant difference on MRD-negative between the treatment and the control groups (43.5% vs 43.5%, χ2=1.045, P=0.307) . The 3-year leukemia-free survival was better in the treatment group [ (65.1±11.1) %] than that in the control group [ (50.0±7.4) %] (P=0.047) . The 3-year overall survival in the treatment and control groups were (78.1±10.2) % and (65.8±8.0) % (P=0.212) , respectively.@*Conclusion@#The consolidation of chemotherapy combined with allogeneic NK cell infusion contributed to the further remission of patients with LMR AML and the reduction of long-term recurrence.