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Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.
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Objective To detect the changes of cellular immune level in patients with different grades of glioma in perioperative period, and to investigate its relationship with the postoperative intracranial infection. Methods A total of 53 patients with glioma newly diagnosed by pathology who underwent the surgical treatment in the First Hospital of Shanxi Medical University from September 2017 to September 2018 were collected. According to the World Health Organization (WHO) classification criteria, the patients were divided into the low-grade group (grade Ⅰ-Ⅱ, 21 cases) and the high-grade group (grade Ⅲ-Ⅳ, 32 cases). The peripheral blood at the time of 1 day before the operation, 1 day and 7 days after the operation was drawn to detect the T lymphocyte subsets, and then the differences of cell immunity indexes from different grade gliomas were analyzed. The relationship between immune level and postoperative intracranial infection was analyzed. SPSS 22.0 statistical software was used to analyze the data. Results The levels of CD3+, CD4+, CD8+, CD4+CD25+Foxp3+and CD4+/CD8+in the high-grade group at the time of 1 day before the operation were (54.09±4.25)%, (31.93±3.08)%, (34.23±2.48)%, (9.66±1.47)%, 0.93±0.06, respectively; the levels at the time of 1 day after the operation were (48.84±3.69)%, (27.49±2.41)%, (34.99±2.96)%, (11.09±1.70)%, 0.84± 0.05, respectively; the levels at the time of 7 days after the operation were (59.45 ±3.47)%, (33.59 ±2.66)%, (31.99±1.97)%, (7.45±1.48)%, 1.05±0.07, respectively. The levels of CD3+, CD4+, CD8+, CD4+CD25+Foxp3+and CD4+/CD8+in the low-grade group at the time of 1 day before the operation were (62.37±6.57)%, (34.88± 4.43)%, (30.16 ±3.75)%, (6.30 ±1.29)%, 1.16 ±0.11, respectively; the levels at the time of 1 day after the operation were (55.44 ±7.25)%, (29.05 ±4.04)%, (31.66 ±3.13)%, (7.95 ±1.67)%, 0.92 ±0.11, respectively; the levels at the time of 7 days after the operation were (67.73 ±7.18)%, (35.55 ±4.95)%, (28.10 ±3.12)%, (5.50 ± 1.25)%, 1.27±0.12, respectively. The levels of CD3+, CD4+, CD4+/CD8+before and after the operation in the high-grade group were lower than those in the low-grade group (all P< 0.05), while the levels of CD8+and CD4+CD25+Foxp3+were higher than those in the low-grade group (all P<0.05). Compared with the levels at the time of 1 day before the operation, the levels of CD3+, CD4+, CD4+/CD8+at the time of 1 day after the operation of both groups were decreased, while the levels of CD8+and CD4+CD25+Foxp3+were increased (all P< 0.05). The levels of CD3+, CD4+and CD4+/CD8+ at the time of 7 days after the operation in the both groups were increased, while the levels of CD8+ and CD4+ CD25+ Foxp3+ were decreased (all P< 0.05). Among 53 patients, 8 cases had postoperative intracranial infection, and the infection rate was 15.09%. Age, duration of surgery, pathological stage, and intraoperative blood transfusion were the independent affecting factors of postoperative intracranial infection of cerebral glioma (OR= 1.513, P= 0.024; OR= 1.722, P<0.01; OR= 1.365, P= 0.001; OR= 1.262, P< 0.01). Conclusions The peripheral blood cellular immune level of glioma patients is related with the malignancy of glioma. The inhibition degree of the cellular immunity could be relieved after the resection of glioma. The detection of T lymphocyte subsets could be considered as an evaluating index for the malignancy and prognosis in patients with glioma. The clinical detection of cellular immune can play a positive role in predicting and preventing the postoperative intracranial infection in patients with glioma.
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Objective:To measure serum levels of salusins and catestatin and analyze their correlation in patients with essential hypertension (EH) .Methods :A total of 90 EH patients were selected as hypertension group .According to blood pressure level ,they were further divided into hypertension stage 1 group (n=31) ,hypertension stage 2 group (n=30) and hypertension stage 3 group (n=29) .Another 40 normotensive subjects undergoing physical examina‐tion were selected as normal control group .Enzyme linked immunosorbent assay (ELISA) was used to measure ser‐um levels of salusins and catestatin , and the correlation between serum levels of salusins and catestatin was analyzed . Results :Compared with normal control group ,there were significant reductions in serum levels of salusins [ (3.01 ± 0.66) ng/ml vs .(1.44 ± 0.42) ng/ml ,(1.35 ± 0.89) ng/ml ,(1.41 ± 0.32) ng/ml] and catestatin [(132.24 ± 7.55) ng/ml vs .(89.22 ± 6.12) ng/ml vs .(82.51 ± 8.37) ng/ml ,(83.34 ± 4.47) ng/ml] in hypertension stage 1 ,stage 2 and stage 3 group , P0.05 all) .Pearson correlation analysis indicated that serum salusins level had no correlation with catestatin level ( r=0.363 , P>0.05) in normal control group ,while serum salusins level was significant positively correlated with catestatin level (r=0.723 ,P<0.01) in hypertension group .Conclusion:Serum levels of salusins and catestatin significantly reduce and they is positive correlation in patients with hyperten‐sion .Along with blood pressure level rises ,serum catestatin level reduces .
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Objective:To explore changes of plasma levels of catestatin (CST)and brain natriuretic peptide (BNP)in patients with chronic heart failure (CHF)and their correlation.Methods:A total of 60 CHF patients treated in our department of cardiology from Jun 2014 to Dec 2014 were enrolled as CHF group,another 60 healthy subjects un- dergoing physical examination were regarded as normal control group.Enzyme linked immunosorbent assay was used to measure plasma levels of CST and BNP in two groups,then the results were compared.Linear correlation analysis was used to analyze the correlation between plasma levels of CST and BNP.Results:Compared with normal control group,there were significant rise in plasma levels of CST [(0.40±0.15)ng/L vs.(0.88±0.34)ng/L]and BNP [(30.84±12.56)ng/L vs.(678.21±120.35)ng/L]in CHF group,P<0.01 both.Linear correlation analysis indi- cated that plasma CST level was significant positively correlated with BNP level (r=0.38,P<0.05).Conclusion:Catestatin level is significant positively correlated with the most sensitive cardiac function index—brain natriuretic peptide level,suggesting that it could be used as a new biochemical marker diagnosing or excluding heart failure.
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Objective: To explore change of plasma endogenous hydrogen sulfide content before and after late open vasculature in patients with myocardial infarction and its significance. Methods: A total of 60 patients with primary myocardial infarction, who didn’t receive thrombolytic therapy and lesion locations had been confirmed by coronary angiography, were divided into group of successfully open after occlusion in proximal segment of left anterior descending artery (LAD group, n=20), group of successfully open after occlusion in proximal segment of right coronary artery (RCA group, n=20) and group of successfully open after occlusion in proximal segment of both above arteries (LAD + RCA group, n=20). Spectrophotometry method was used to measure concentration of endogenous H2S before and after open vasculature in all groups. Results: Compared with endogenous H2S level before open vasculature, there were significant increase in endogenous H2S level in LAD group [(24.44+3.27) μmol/L vs. (37.47+2.38) μmol/L], RCA group [(24.48+3.60) μmol/L vs. (37.22+2.56) μmol/L] and LAD + RCA group [(20.41+2.22) μmol/L vs. (30.34+2.37) μmol/L] after open vasculature, P<0.05 all. Conclusion: Concentration of endogenous hydrogen sulfide significantly increases after open vasculature in patients with myocardial infarction; it may be beneficial for prognosis of patients.