A study on the Charlson comorbidity index and health-related quality of life in the middle-aged and elderly osteoporosis population / 中国骨伤

OBJECTIVE@#To explore the characteristics of comorbidities in patients with osteoporosis(OP) and factors associated health-related quality of life, so as to provide decision-making reference for improving the ability of disease co-prevention and co-treatment and the patient's life-cycle quality of life.@*METHODS@#From November 2017 to July 2018, clinical information and biological samples from residents in 10 communities in Chaoyang District and Fengtai Distric of Beijing were collected, and bone density testing was conducted. Based on the Charlson comorbidity index (CCI), the comorbidity of the population was quantified, and grouped according to factors such as gender, age, and the differences between the groups were explored. Combined with the clinical information of patients, the difference characteristics of comorbidity and non-comorbidity population were analyzed. Pearson/Spearman correlation analysis and binary Logistic regression analysis were used to explore the factors affecting the health-related quality of life in patients with OP.@*RESULTS@#Among the 521 OP patients, 121 patients had no comorbidities, and there were 153, 106, 65, and 30 patients with one, two, three, and four comorbidities, respectively, 46 patients with 5 or more kinds of comorbidites. Hypertension was the most common comorbidity in OP patients, accounting for 21.60%;followed by hyperlipidemia, accounting for 13.51%. The most common combination of the two diseases was hypertension plus hyperlipidemia (64 cases, 12.28%). Through the analysis of differences between age groups, it was found that the older patients, showed higher the CCI, and the difference between groups was statistically significant(Z=1.93, P=0.05). There were significant differences in the total EQ-5D score and the dimensions of anxiety and depression between patients with comorbidities (CCI≠0) and non-comorbidities (CCI=0) (Z=-2.67, P=0.01;Z=-2.44, P=0.02). Correlation analysis found that CCI, history of fracture, history of falls, hip bone mineral density T value and parathyroid hormone were all related to the health-related quality of life in OP patients (P<0.05). Binary Logistic regression analysis suggested that the right hip bone mineral density T value (P=0.02), CCI (P=0.01), fracture history (P=0.03) and fall history (P=0.01) were the risk factors that affect the health-related quality of life in OP patients.@*CONCLUSION@#The burden of comorbidities among middle-aged and elderly OP populations in Beijing is relatively heavy, and the health management of such populations should be further strengthened, specifically the combination of multiple comorbidities should be given high priority. Comorbid factors are of great importance for the diagnosis and treatment strategy of OP patients, which could further improve the quality of life.

Clinical effects of autologous follicular unit extraction transplantation in the treatment of small area secondary cicatricial alopecia after burns / 中华烧伤杂志

Objective: To explore the clinical effects of autologous follicular unit extraction (FUE) transplantation in the treatment of small area secondary cicatricial alopecia (hereinafter referred to as cicatricial alopecia) after burns. Methods: A retrospective observational study was carried out. According to the adopted treatment methods, 18 patients (12 males and 6 females, aged (29±6) years) who received autologous FUE transplantation for small area cicatricial alopecia after burns from March 2017 to November 2019 in the First Affiliated Hospital of Air Force Medical University were included in FUE transplantation group, and 18 patients (13 males and 5 females, aged (33±5) years) who were treated with expanded flap transplantation for small area cicatricial alopecia after burns by the same surgery team during the same period in the same hospital were included in expanded flap transplantation group. All the patients were followed up for more than 1 year. At the last follow-up, the follicular unit density in the transplanted area was measured by Folliscope hair detection system and the hair survival rate was calculated; the visual analogue scale (VAS) method was adopted to evaluate the treatment effect; patients were asked their satisfaction with the treatment effect and the occurrence of complications during follow-up; the hair growth and the scalp thickness, pain, pruritus, pigmentation, and surface roughness of the transplanted area were recorded. Data were statistically analyzed with Fisher's exact probability test and independent sample t test. Results: At the last follow-up, the follicular unit density in the transplanted area of patients in FUE transplantation group was (46.8±2.0)/cm2, which was significantly higher than (42.5±4.3)/cm2 in expanded flap transplantation group (t=3.84, P<0.01); the hair survival rates of patients were similar between the two groups (P>0.05). At the last follow-up, VAS scores evaluating the treatment effect of patients were similar between the two groups (P>0.05); the satisfaction score of patients toward the treatment effect in FUE transplantation group was 8.6±1.1, which was significantly higher than 7.6±0.8 in expanded flap transplantation group (t=2.89, P<0.01). During the follow-up, no inflammation or infection occurred in patients of the two groups, but only 2 patients in expanded flap transplantation group had postoperative pain. At the last follow-up, the transplanted area of patients in the two groups was covered with new hair, and the hair growth direction was basically consistent with the surrounding normal hair; scalp thickness, pain, pruritus, pigmentation, and surface roughness of the transplanted area of patients were similar between the two groups (P>0.05). Conclusions: Autologous FUE transplantation has better long-term follicular unit density and patients' satisfaction than expanded flap transplantation in the treatment of small area cicatricial alopecia after burns, showing better postoperative effect and a good prospect of clinical application.

Modified Banxia Baizhu Tianmatang Combined with Acupuncture for Migraine (Wind-phlegm Upset Syndrome) Observe / 中国实验方剂学杂志

Objective:To observe theclinical efficacy of modified Banxia Baizhu Tianmatang combined with acupuncture on migraine with wind phlegm disturbance syndrome， and the regulatory effect on neurovasoactive peptide and vascular endothelial activator. Method:Two hundred and fifty patients were randomly divided into control group （75 cases） and observation group （75 cases）. Patients in Two group got acupuncture for 6 times， 1 time/day， after a day of rest， they got placebogranules of Banxia Baizhu Tianmatang， 10 g/time， 2 times/day. Patients in observation group got Banxia Baizhu Tianmatang， 1 dose/day， and also the same acupuncture with the therapyof control group. And the treatment lasted for 4 weeks. At the half， 1^st， 2^nd， 6^th， 12^th， 24^th， and 48^th hour after treatment， VAS were scored， rate of pain relief within 6， 12， and 24 hours， disappearance rate and recurrence rate of pain within 72 hours， migraine attack times， headache duration and headache degree before 4 weeks of treatment， during the treatment and after the treatment were recorded. Before and after treatment， accompanying symptoms， wind phlegm disturbance syndrome， headache impact test version-6 （HIT-6） and the migraine disability assessment questionnaire （MIDAS） were scored. And levels of calcitonin gene-related peptide （CGRP）， nitric oxide （NO）， endothelin-1 （ET-1）， pituitary adenylate cyclase activating peptide （PACAP）， S100B protein， substance P（SP）， von Willebrand factor （vWF） and fibrinogen （FIB） were detected. And safety was evaluated. Result:VAS in two groups decreased at different time points （<italic>P<</italic>0.01）， and VAS in observation group at 6^th， 12^th， 24^thand 48^th hour after treatment were lower than those in control group （<italic>P<</italic>0.01）. The rate of pain relief in observation group at 6^th and 12^th hours after treatment and the disappearance rate of pain at 72^th hour were 67.14%（47/70）， 87.14% （61/70） and 92.86% （65/70）， which were higher than 50.00% （34/68）， 70.59% （48/68） and 79.41% （54/68） in control group. The recurrence rate of pain in observation group was 21.43% （15/70）， which was lower than 39.71% （27/68） in control group （<italic>P<</italic>0.05）. During the treatment and drug withdrawal， times of migraine attack， headache duration and headache degree were all less than those in control group （<italic>P<</italic>0.01）. Scores of accompanying symptoms， wind phlegm disturbance syndrome， HIT-6 and MIDAS were all lower than those in control group （<italic>P<</italic>0.01）. The clinical effect was better than that in control group （<italic>Z</italic>=2.106， <italic>P<</italic>0.05）. Levels of CGRP， PACAP， S100B protein， SP， ET-1， vWF and FIB were lower than those in control group， while level of NO was higher than control group （<italic>P<</italic>0.01）. Conclusion:Modified Banxia Baizhu Tianmatang combined with acupuncture had a better instant analgesic effect， with a significant effect on continuing analgesia and reducing headache recurrence. It can also alleviate migraine symptoms and accompanying symptoms， andreduce the impact of migraine on daily life and the degree of disability. Its mechanism may be related to the regulation of neurovasoactive peptides and vascular endothelial substances. It is worth for further study.

Serum Insulin-Like Growth Factor Binding Protein 7 as a Potential Biomarker in the Diagnosis and Prognosis of Esophagogastric Junction Adenocarcinoma

Background/Aims@#Esophagogastric junction adenocarci-noma (EJA) is a malignant tumor associated with high mor-bidity and has attracted increasing attention due to a rising incidence and low survival rate. Pathological biopsy is the gold standard for diagnosis, but noninvasive and effective tests are lacking, resulting in diagnoses at advanced stages.This study explored the diagnostic value of insulin-like growth factor binding protein 7 (IGFBP7) in EJA. @*Methods@#A total of 120 EJA patients and 88 normal controls were recruited, and their serum levels of IGFBP7 were measured by enzymelinked immunosorbent assay. Receiver operating character-istic (ROC) curve analysis was used to assess the diagnostic value, and Pearson chi-square analysis was used to evaluate the correlation between IGFBP7 and clinical parameters. Ka-plan-Meier survival analysis was carried out to assess the ef-fect of IGFBP7 on overall survival (OS). @*Results@#The levels of IGFBP7 were higher in both early- and late-stage EJA patients than in normal controls (p<0.001). The area under the ROC curve for EJA patients was 0.794 (95% confidence interval [CI], 0.733 to 0.854), with a cutoff value of 2.716 ng/mL, a sensitivity of 63.3% (95% CI, 54.0% to 71.8%) and a specific-ity of 90.9% (95% CI, 82.4% to 95.7%). For the diagnosis of early-stage EJA, the same cutoff value and specificity were obtained, but the sensitivity of IGFBP7 was 54.3% (95% CI, 36.9% to 70.8%). Patients with low IGFBP7 protein expres-sion had lower OS than those with high expression (p=0.034).The multivariate analysis showed that IGFBP7 is an inde-pendent prognostic factor for EJA (p=0.011). @*Conclusions@#Serum IGFBP7 acts as a potential diagnostic and prognostic marker for EJA.

Correlation between Blood Flow Signal of Magnetic Resonance Imaging and Short-term Outcome in Patients with Symptomatic Severe Stenosis or Occlusion of Middle Cerebral Artery M1 segment / 中山大学学报(医学科学版)

[Objective] To investigatethe correlation between blood flow signal on three dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) and short-term outcome in patients with symptomatic middle cerebral artery (MCA) severe stenosis or MCA occlusion.[Methods] We retrospectively reviewed consecutive patients with symptomatic MCA severe stenosis or MCA occlusion.General information,clinical data and cranial imaging data were collected.Characteristics of blood flow signal on 3D-TOF-MRA for each patient were analyzed,which included:(1) blood flow signal of MCA distal to stenosis/occlusion lesion;(2) laterality of posterior cerebral artery (PCA).The correlation between characteristics of blood flow signal and short-term outcome was analyzed.[Results] Three hundred and twenty-eight patients were included in this study.There were 154 patients with symptomatic MCA severe stenosis and the rest of them had symptomatic MCA occlusion.Poor blood flow signal of distal MCA independently correlated with poor shortterm outcome in patients with severe MCA stenosis.[Odds Ratio (OR) 0.32,95％ Confident Interval (CI) 0.14～0.72].PCA laterality was not related with short-term outcome in these patients (OR,2.28,95％ CI,0.85～6.15).PCA laterality independently correlated with poor short-term outcome in patients with MCA occlusion.(OR,3.54,95％ CI,1.32～ 9.78).Blood flow signal of distal MCA was not related with short-term outcome in these patients (OR,0.58,95％ CI,0.22～1.48).[Conclusion] Blood flow signal on 3D-TOF-MRA correlates with short-term outcome in patients with symptomatic MCA severe stenosis or occlusion but the characteristics differs between severe MCA stenosis and occlusion patients.Anterograde blood flow (blood flow signal of MCA distal to stenosis lesion) for patients with severe MCA stenosis and retrograde blood flow (PCA laterality) for patients with MCA occlusion correlates with shot-term outcome.

Changes of histopathology and molecular indicators in breast cancer after neoadjuvant chemotherapy / 临床与实验病理学杂志

Purpose To observe the changes of histopathology and expression levels of ER, PR, HER-2 and Ki-67 in breast cancer after neoadjuvant chemotherapy (NTC), and to evaluate the relationship between the curative effect and clinico-pathological characteristics of breast cancer. Methods 93 ca-ses of invasive breast cancer with NTC were collected and retro-spectively analyzed. Pathologic evaluation of chemotherapeutic effect were evaluated by Miller-Payne (MP) grading system. Results Tumor cells, tumor stroma and lymph nodes status presented different histopathological changes after NTC. There were significant relationship between curative effect and patients age (Z=-1.993, P=0.046 ), histological grade (χ2=7.261, P=0.027), molecular subtypes (χ2=8.289, P=0.040), while it had no statistical relationship between curative effect and tumor size (Z=-1.091, P=0.275) and lymph node status (Z=-1.107, P = 0.268). Expression of ER, PR, HER-2 and Ki-67 showed different degrees of change before and after NTC. The concordance rates of ER, PR, HER-2 and Ki-67 were 81.0％, 72.2％, 83.5％ and 55.7％, respective-ly. And there was no significant difference in expression of these four molecular indicators before and after NTC (χ2 =0.428, P=0.934). Conclusion The histomorphology of tumor cell, tumor stroma and lymph node status can be influenced by NTC. Objective evaluation of the changes of histopathology and molecular indicators after NTC may valuable in predicting clinical prognosis and guiding individual treatment of breast cancer.

Survey of schistosomiasis KAP and influencing factors of behaviors among residents in Jiangsu Province / 中国血吸虫病防治杂志

Objective To understand the schistosomiasis control knowledge,attitude,and practice(KAP),and influenc-ing factors of behaviors among residents in Jiangsu Province,so as to provide the evidence for making effective health education and health promotion models. Methods The probability proportionate to size sampling(PPS)and multi-stage sampling meth-ods were adopted to sample the research objects. A questionnaire survey of schistosomiasis control KAP was conducted in the res-idents of 16 to 69 years old in schistosomiasis endemic areas of Jiangsu Province,and the results were statistically analyzed. Re-sults The total awareness rate of the participants was 95.98%for schistosomiasis control knowledge. The correct rates of atti-tude and practice were 89.06%and 77.43%,respectively. The awareness/correct rates of knowledge,attitude and practice re-duced in turns significantly(χ2=1282.96,P<0.01). The knowledge awareness rate of fishermen and boatmen was 90.98%, but their attitude correct rate was only 53.81%(χ2=120.52,P<0.01). The unconditional logistic regression analysis showed that with the education level increasing,their practice correct rate rose,and the participants with the college degree or above had a higher correct rate compared to illeterate ones(OR=6.411,95%CI:4.896-8.395). The practice correct rate of the fisher-men and boatmen was only 5.1%of the rate of the farmers(OR=0.051,95%CI:0.029-0.091). Conclusions The total aware-ness rate of basic knowledge of schistosomiasis prevention and control in the residents of Jiangsu Province has reached the re-quirements in the"National Schistosomiasis Control Long-term Planning Outline(2004-2015)",but the correct rate of behav-iors is low. The education level,occupation and residential areas affect the health behaviors of schistosomiasis prevention and control. Therefore,it is necessary to carry out targeted health promotion activities to promote the formation of healthy lifestyle and behaviors.

Effect of water conservancy schistosomiasis control projects combined with molluscicide to control Oncomelania hupensis snails in rivers connecting with Yangtze River in Pukou District,Nanjing City / 中国血吸虫病防治杂志

Objective To evaluate the effect of the water conservancy schistosomiasis control projects combined with mollus-cicide to control Oncomelania hupensis snails in the rivers connecting with the Yangtze River. Methods The water conservancy schistosomiasis control projects of Zhujiashan River,Qili River and Gaowang River were chosen as the study objects in Pukou District,Nanjing City. The data review method and field investigation were used to evaluate the effect of the water conservancy schistosomiasis control projects combined with molluscicide to control O. hupensis snails. Results After the projects of the wa-ter level control and concrete slope protection and mollusciciding were implemented,the snails in the project river sections were completely eliminated. The snail diffusion did not happen in the inland irrigation area too. In the outside of the river beach , though the snails still existed,the snail densities plunged below 1.0 snail per 1.0 m2. Conclusion The comprehensive mea-sures of the combination of water level control,concrete slope protection and mollusciciding can effectively control and eliminate the snails,and prevent the snails from spreading.

Study on Oncomelania hupensis snails infected with Schistosoma japonicum miracidia under different conditions in snail-existent non-endemic areas of schistosomiasis in Nantong City / 中国血吸虫病防治杂志

Objective To understand the forming cause of the Oncomelania hupensis snail-existent non-endemic areas of schistosomiasis(SENEAS),and to verify the conclusion of previous studies,so as to provide the evidence for schistosomiasis monitoring in such areas in Nantong City,Jiangsu Province. Methods The controlled field tests were carried out to observe the O. hupensis snails artificially infected by schistosome miracidia in SENEAS. The influence of the soil from SENEAS and the en-demic areas on O. hupensis snails artificially infected by miracidia were observed. Results All the experimental snails could be infected by schistosome miracidia except the smooth-shell snails from Tangyuan Village in the controlled field test environment of SENEAS or the endemic areas. The infection rates of the smooth-shell snails were lower than those of the ribbed-shell snails , but there were no statistically significant differences. The mortality rates of the smooth-shell snails were higher than those of the ribbed-shell snails,which were statistically significant (χ2Xindian = 135.118,χ2Shuangdian = 122.836,χ2Baipu =154.436,χ2Dingyan =138.288,χ2Control=151.923,all P<0.01). There were no significant differences in the infection rates of snails between each test group of the soil from SENEAS and the endemic areas(χ2Rugao=0.071,χ2Rudong=0.216,both P>0.05). Also there was no signifi-cant difference between each test group and the control group without soil(χ2=7.148,P>0.05). Conclusion It is likely to form the spread of schistosomiasis in SENEAS in Nantong City with sufficient amount of infection source of schistosomiasis im-ported. It is still necessary to implement the surveillance of schistosomiasis and O. hupensis snails in Nantong City.