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1.
Article in English | WPRIM | ID: wpr-906675

ABSTRACT

@#BACKGROUND: A national standardized emergency medicine (EM) curriculum for medical students, including specific competencies in procedural skills, are absent in many countries. The development of an intensive simulating training program in EM, based on a tight schedule, is anticipated to enhance the competency of medical students. METHODS: A 3-day intensive EM training program, consisting of four procedural skills and 8-hour case-based learning (CBL), was developed by experienced physicians from the EM department in Peking Union Medical College Hospital (PUMCH). Medical students from Peking Union Medical College (PUMC) and Tsinghua University (THU) participated in the training. Three written tests were cautiously designed to examine the short-term (immediately after the program) and long-term (6 months after the program) efficacy of the training. After completion of the training program, an online personal appraisal questionnaire was distributed to the students on WeChat (a mobile messaging App commonly used in China) to achieve anonymous self-evaluation. RESULTS: Ninety-seven out of 101 students completed the intensive training and took all required tests. There was a significant increase in the average score after the intensive simulating training program (pre-training 13.84 vs. 15.57 post-training, P<0.001). Compared with the pre-training test, 63 (64.9%) students made progress. There was no significant difference in scores between the tests taken immediately after the program and 6 months later (15.57±2.22 vs. 15.38±2.37, P=0.157). Students rated a higher score in all diseases and procedural skills, and felt that their learning was fruitful. CONCLUSIONS: The introduction of a standardized intensive training program in EM focusing on key competencies can improve clinical confidence, knowledge, and skills of medical students toward the specialty. In addition, having such a program can also enhance student’s interest in EM as a career choice which may enhance recruitment into the specialty and workplace planning.

2.
Chinese Journal of Rheumatology ; (12): 441-444,c7-1, 2021.
Article in Chinese | WPRIM | ID: wpr-910192

ABSTRACT

Objective:To identify dermatopathological features of patients with dermatomyositis (DM) and analyze its correlation with cutaneous diseases activity.Methods:The clinical data and skin biopsies of 48 patients were collected. The relevance was analyzed using Spearman's correlation analysis. The two groups were compared using Chi-square test or Fisher's exact test. Multi-factors line regression model was established to analyze the relationship between cutaneous disease activity and dermatopathological features.Results:The most common dermatopathological feature was perivascular inflammation (37 cases, 88%), followed by epidermal atrophy (22 cases, 52%) and melanocyte loss (20 cases, 48%), basal vacuolization (15 cases, 36%). The incidence of basal vacuolization ( χ2=9.110, P=0.022), interface dermatitis ( χ2=11.672, P=0.005) and mucin deposition ( χ2=7.795, P=0.029) were significantly different in patients with myositis specific antibody (MSA) subgroup. The patients with positive tranional intermediary factor-1 (anti-TIF1-γ) antibody had higher incidence of interface dermatitis and basal vacuolization, and patients with melanoma differentiation-associated gene 5 (anti-MDA5) antibody had lower incidence of interface dermatitis. Interface dermatitis was positively associated with epidermal atrophy ( r=0.371, P=0.016) and parakeratosis ( r=0.316, P=0.041). Pigment inco-ntinence was positively associated with basal vacuolization ( r=0.384, P=0.012). Multi-factor line regression showed interface dermatitis was positively related to cutaneous disease area and severity index (CDASI). Conclusion:The dermatopathological features is different in subgroup of patients with DM ( β=10.295, P=0.004). Interface dermatitis is a marker of cutaneous disease activity, and its pathogenesis may be different from that of perivascular inflammation. Keratinocytes may be involved in the pathological process in interface dermatitis.

3.
Article in Chinese | WPRIM | ID: wpr-906055

ABSTRACT

Objective:To explore the correlations of the severity of heart failure related to coronary heart disease arising from Qi deficiency and blood stasis with cardiac function indexes, energy metabolism indexes, coagulation function indexes, and inflammatory factors, in order to provide a scientific basis for further research on the biological foundation of this disease. Method:Two hundred patients with heart failure related to coronary heart disease of Qi deficiency and blood stasis syndrome were collected and then classified into mild, moderate and severe groups according to their scores of Qi deficiency and blood stasis syndrome. Meanwhile, 40 healthy persons confirmed by physical examination during the same period were included into the control group. Such biological indexes as cardiac function indexes, energy metabolism indexes, coagulation function indexes, and inflammatory factors were determined in patients of each group for comparison. Then the Spearman rank correlation analysis was conducted to figure out the correlations between differential indexes and the severity of Qi deficiency and blood stasis syndrome, followed by the determination of risk factors for the severity of Qi deficiency and blood stasis syndrome by ordered logistic regression analysis. Result:The cardiac function indexes, energy metabolism indexes, coagulation function indexes, and inflammatory factors in patients with heart failure related to coronary heart disease arising from Qi deficiency and blood stasis varied significantly. There were significant statistical differences in the levels of N-terminal pro-B-type natriuretic peptide (NT-ProBNP), 6-minute walk test (6MWT), heart-type fatty acid-binging protein (H-FABP), prothrombin time (PT), activated partial thromboplastin time (APTT), tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), and nitric oxide (NO) among the mild, moderate, and severe groups (<italic>P</italic><0.05). The severity of Qi deficiency and blood stasis syndrome was positively correlated with NT-ProBNP (<italic>r</italic>=0.144), PT (<italic>r</italic>=0.173), and APTT (<italic>r</italic>=0.144), but negatively with 6MWT (<italic>r</italic>=-0.287). The 6MWT[odds ratio(OR)=0.995, 95% confidence interval(CI) 0.991-0.998),<italic>P</italic><0.01] and APTT(OR=1.088,95%CI 1.021-1.157,<italic>P</italic><0.01) were independent risk factors affecting the severity of heart failure related to coronary heart disease arising from Qi deficiency and blood stasis. Conclusion:The severity of heart failure related to coronary heart disease of Qi deficiency and blood stasis syndrome is closely related to NT-ProBNP, 6MWT, H-FABP, PT, APTT, TNF-<italic>α</italic>, and NO. Moreover, 6MWT and APTT can be used as independent risk factors to evaluate the severity of patients with heart failure related to coronary heart disease due to Qi deficiency and blood stasis.

4.
Article in Chinese | WPRIM | ID: wpr-905932

ABSTRACT

Objective:To observe the clinical effect of compound Guizhencao granule (CGG) on grade 1 hypertension patients with dampness heat and blood stasis syndrome and its influence on related biological indicators and safety indexes. Method:A randomized,double-blind,placebo-controlled clinical trial design was used. 80 subjects who met the inclusion criteria were randomly divided into the treatment group (40 cases) and control group (40 cases). On the basis of health education,patients in the treatment group received 6.5 g CGG,twice daily,for four weeks. Patients in the control group received CGG simulant in a similar dosing scheme. The 24-hour ambulatory blood pressure monitoring(24 h ABPM),traditional Chinese medcine(TCM) syndrome score,angiotensin Ⅱ (AngⅡ),endothelin-1 (ET-1),homocysteine(Hcy) and safety indexes were observed. Result:Compared with that before treatment, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the consulting room in the treatment group were significantly lower (<italic>P</italic><0.01), and there was no significant difference in the control group;The daytime DBP and 24 h DBP in the control group decreased significantly (<italic>P</italic><0.01), and the 24 h SBP, 24 h DBP, daytime SBP, daytime DBP, nighttime SBP and nighttime DBP in the treatment group decreased significantly (<italic>P</italic><0.01). The total effective rate of 24 h ABPM on the nighttime blood pressure was 57.14% (20/35) in the treatment group, which was significantly higher than 28.57% (10/35) in the control group (<italic>Z</italic>=-2.310, <italic>P</italic><0.05); The total effective rate of daytime blood pressure and 24-hour blood pressure treatment group increased, but the difference was not statistically significant. The TCM syndrome score of two groups was significantly lower than that of the control group before treatment (<italic>P</italic>< 0.05, <italic>P</italic>< 0.01), and that of the treatment group was significantly lower than that of the control group after treatment (<italic>P</italic><0.01). The total effective rate of TCM syndrome score in the treatment group was 51.43% (18/35), which was significantly higher than 28.57% (10/35) in the control group (<italic>χ</italic><sup>2</sup>= 9.973, <italic>P</italic><0.05). Compared with that before treatment, the levels of ET-1 and Hcy in the control group decreased significantly (<italic>P</italic><0.05), and the levels of Ang Ⅱ, ET-1 and Hcy in the treatment group decreased significantly (<italic>P</italic><0.01); Compared with the control group after treatment, the levels of Ang Ⅱ and ET-1 in the treatment group decreased significantly (<italic>P</italic> < 0.01). Conclusion:CGG is safe and effective in reducing the blood pressure level,improving the TCM syndrome score,and regulating related biological indicators of patients with Grade 1 hypertension.

5.
Article in Chinese | WPRIM | ID: wpr-905870

ABSTRACT

Objective:To evaluate the clinical efficacy and safety of Longmu Zhuanggu granule for the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency. Method:This multicenter stratified, block-randomized, double-blind, double-dummy, positive drug (pidotimod granule) parallel controlled, and non-inferiority trail intended to included 240 children patients and divided them into the experimental group (<italic>n</italic>=120) and the control group (<italic>n</italic>=120) at the ratio of 1∶1. Patients in both groups were treated for eight successive weeks and followed up for 12 months. The cure rates, numbers of respiratory infections, average courses of disease, curative effects of traditional Chinese medicine (TCM) syndrome, curative effects of individual symptoms, curative effects of immune indexes, and safety indexes between the two groups were observed and compared. Result:A total of 237 subjects were collected from 10 research centers, including 119 cases in the control group and 118 in the experimental group. There were 236 cases enrolled into the full analysis set (FAS), 210 into the per-protocol set (PPS), and 236 into the safety set (SS). The baseline data of the two groups were not significantly different from each other, indicating that they were comparable. The cure rates of the experimental group and control group were 75.21% (88/117) and 73.95%(88/119), respectively, with the 95% confidence interval (CI) of difference between the two groups being 1.26% (-9.85%,12.37%) for FAS and 3.81% (-6.28%,13.90%) for PPS. The 95% CI fell within the 10% non-inferiority margin, implying that non-infertility test of the cure rate in the treatment of endpoint disease was valid, and the conclusions of FAS and PPS analysis were consistent. There was no significant difference in the number or course of upper respiratory infection, bronchitis, and pneumonia. The difference in curative effects of TCM syndrome between the two groups after four weeks of treatment was not remarkable. After eight weeks of treatment, the total effective rate of the experimental group was 84.62%(99/117), statistically higher than 78.15%(93/119) of the control group(<italic>χ</italic><sup>2</sup>=-3.26,<italic>P</italic><0.05). There were no significant differences in the disappearance rates of individual symptoms between the two groups after four weeks of treatment. After eight weeks of treatment, the experimental group and control group exhibited the disappearance rates of 67.50%(54/80) and 47.37%(36/76) for shortness of breath and laziness to speak, 75.00%(54/72) and 53.33%(40/75) for poor appetite, 54.55%(60/110) and 37.84%(42/111) for hyperhidrosis, respectively, with obviously better outcomes observed in the experimental group (<italic>P</italic><0.05,<italic>P</italic><0.01). The inter-group comparison revealed significant differences in immune indexes after eight weeks of treatment. As demonstrated by comparison with the situations before treatment, IgA, IgG, IgM, and CD4 did not change significantly after treatment. Except for CD8 in the experimental group (<italic>P</italic><0.05), there was no significant difference in other immune indexes before and after treatment There was no significant difference in the incidence of adverse reactions. Conclusion:Longmu Zhuanggu granule is not inferior to pidomod granule in the treatment of children recurrent respiratory infection due to lung-spleen Qi deficiency, and it exhibits good safety, implying its promising clinical application value.

6.
Journal of Clinical Hepatology ; (12): 2380-2383, 2021.
Article in Chinese | WPRIM | ID: wpr-904952

ABSTRACT

Objective To investigate the value of optical trocar insertion technique in establishing pneumoperitoneum in patients undergoing laparoscopic surgery after previous abdominal surgery. Methods A total of 29 patients, with a history of abdominal surgery, who planned to undergo laparoscopic liver surgery were enrolled and randomly divided into optical trocar insertion group and open approach group. The independent samples t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the Fisher's exact test was used for comparison of categorical data between groups; the Mann-Whitney U test was used for comparison of ranked data between groups. Results There were no procedure-related complications in either group. Compared with the open approach group, the optical trocar insertion group had a significantly shorter time required to establish pneumoperitoneum [35.00 (21.00-46.00) seconds vs 180.00 (152.50-252.50) seconds, U =0, P < 0.001] and a significantly smaller incision length [1.10(1.00-1.20) cm vs 2.80(2.45-3.00) cm, U =0, P < 0.001]. Conclusion Both optical trocar insertion and open approach for establishing pneumoperitoneum is relatively safe in patients undergoing laparoscopic liver surgery after previous abdominal surgery, while optical trocar insertion has the advantages of high efficiency and minimal invasiveness in establishing pneumoperitoneum.

7.
Journal of Clinical Hepatology ; (12): 2380-2383, 2021.
Article in Chinese | WPRIM | ID: wpr-904902

ABSTRACT

Objective To investigate the value of optical trocar insertion technique in establishing pneumoperitoneum in patients undergoing laparoscopic surgery after previous abdominal surgery. Methods A total of 29 patients, with a history of abdominal surgery, who planned to undergo laparoscopic liver surgery were enrolled and randomly divided into optical trocar insertion group and open approach group. The independent samples t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the Fisher's exact test was used for comparison of categorical data between groups; the Mann-Whitney U test was used for comparison of ranked data between groups. Results There were no procedure-related complications in either group. Compared with the open approach group, the optical trocar insertion group had a significantly shorter time required to establish pneumoperitoneum [35.00 (21.00-46.00) seconds vs 180.00 (152.50-252.50) seconds, U =0, P < 0.001] and a significantly smaller incision length [1.10(1.00-1.20) cm vs 2.80(2.45-3.00) cm, U =0, P < 0.001]. Conclusion Both optical trocar insertion and open approach for establishing pneumoperitoneum is relatively safe in patients undergoing laparoscopic liver surgery after previous abdominal surgery, while optical trocar insertion has the advantages of high efficiency and minimal invasiveness in establishing pneumoperitoneum.

8.
Article in Chinese | WPRIM | ID: wpr-904483

ABSTRACT

Objective:To obtain the temporal and spatial trends on prostate cancer mortality in China from 2004 to 2018. Methods:The data of prostate cancer mortality was collected from 605 national disease surveillance sites and age-standardized according to the demographic structure of China in 2000. The crude mortality rate (CMR) and age-standardized mortality rate (ASMR), and the ratio of ASMRs of rural to urban areas(RR), were calculated to analyze the distributions of the mortality of prostate cancer stratified by age, sex, region (rural/urban areas, eastern/central/western areas) or time. Results:The temporal trend on the CMR of prostate cancer from 2004 to 2018 increased significantly (APC=5.23%,P<0.001), whereas the trend on the ASMR did not change (APC=0.65%,P=0.336). The ASMR of urban areas was higher than that of rural areas(P<0.05). The temporal trend on the ASMR of urban or rural did not change(P>0.05). The same trend was detected for the RR value (P>0.05). The ASMR of eastern urban areas was higher than that of the central or the western urban areas. The ASMR of eastern rural areas was higher than that of central and western areas. In the eastern areas, both the temporal trends for the ASMRs of the urban and the rural increased (The urban: APC=1.6%, P=0.015; the rural: APC=1.02%, P=0.013). However, the RR values for the East, the Center or the West did not change. The ASMR of the people over 60 years old was higher than that of the people under 60 years old. However, the temporal trends on the ASMRs of the group under 60 years old or the group over 60 years did not change (P>0.05). The ASMR of the people under 60 years old in 2018 was significantly lower than that in 2004(P=0.004). Conclusion:A significant correlation exists between the death of prostate cancer and age. The mortality of prostate cancer in urban is higher than that in rural. The current screening strategy for prostate cancer has a limited impact on the prognosis of prostate cancer patients in China. Stratified refinement of prostate cancer screening strategies for people aged over 60 years in urban areas and the causal prophylaxis of prostate cancer are priorities for future prostate cancer prevention and control.

9.
Article in Chinese | WPRIM | ID: wpr-904481

ABSTRACT

Objective:To analyze bladder cancer mortality in China from 2004 to 2018. Methods:The dataset of bladder cancer mortality from 2004 to 2018, based on 605 national surveillance sites and regularly published by the Chinese Center for Disease Control and Prevention, was collected and age-standardized according to the demographic structure of China in 2000. The crude mortality rate (CMR), the age-standard mortality rate (ASMR), and the ratio of ASMRs of rural to urban areas(RR)were calculated to analyze the distributions of the mortality of bladder cancer stratified by age, sex, region (rural/urban areas, eastern/central/western areas) or time. Results:The CMR of bladder cancer in China from 2004 to 2018 was 1.69/105, and the ASMR was 1.09/105. The temporal trend on the CMR of bladder cancer from 2004 to 2018 increased significantly (APC=2.91%,P<0.001), whereas the trend on the ASMR decreased a little (APC=-1.29,P=0.008). The temporal trend on the CMR of bladder cancer in the males increased (APC=3.29%,P<0.001), whereas the trend on the ASMR did not change. The temporal trend on the CMR of bladder cancer in the female increased (APC=2.12%,P<0.001), whereas the trend on the ASMR decreased (APC=-1.94,P=0.008). Both the CMR and ASMR of urban areas were higher than those of rural areas (P<0.05). However, the temporal trend on the ASMR of bladder cancer in the urban decreased significantly (APC=-2.05%,P=0.002), mainly exhibited in eastern and western urban. The ASMR of eastern urban areas was higher than that of western urban areas. The temporal trend on the ASMR of bladder cancer in the rural did not change (P>0.05), and no differences in the ASMR were detected between eastern, central and western rural areas. The gaps between rural and urban areas in the eastern (P<0.001) or western (P=0.002) region reduced. Although the temporal trend on the ASMR in urban people over 40 years old decreased significantly, the ASMR of urban people over 60 years old was much higher than that of other age groups in the urban or any age groups in rural areas. Conclusion:The age group over 60 years old in the urban is the major target population for bladder cancer prevention and treatment. Screening, diagnosis and treatment for bladder cancer in rural should be strengthened.

10.
Mycobiology ; : 406-420, 2021.
Article in English | WPRIM | ID: wpr-902741

ABSTRACT

Gloeostereum incarnatum has edible and medicinal value and was first cultivated and domesticated in China. We sequenced the G. incarnatum monokaryotic strain GiC-126 on an Illumina HiSeq X Ten system and obtained a 34.52-Mb genome assembly sequence that encoded 16,895 predicted genes. We combined the GiC-126 genome with the published genome of G. incarnatum strain CCMJ2665 to construct a genetic linkage map (GiC-126 genome) that had 10 linkage groups (LGs), and the 15 assembly sequences of CCMJ2665 were integrated into 8 LGs. We identified 1912 simple sequence repeat (SSR) loci and detected 700 genes containing 768 SSRs in the genome; 65 and 100 of them were annotated with gene ontology (GO) terms and KEGG pathways, respectively. Carbohydrate-active enzymes (CAZymes) were identified in 20 fungal genomes and annotated; among them, 144 CAZymes were annotated in the GiC-126 genome. The A mating-type locus (MAT-A) of G. incarnatum was located on scaffold885 at 38.9 cM of LG1 and was flanked by two homeodomain (HD1) genes, mip and beta-fg. Fourteen segregation distortion markers were detected in the genetic linkage map, all of which were skewed toward the parent GiC-126. They formed three segregation distortion regions (SDR1–SDR3), and 22 predictive genes were found in scaffold1920 where three segregation distortion markers were located in SDR1. In this study, we corrected and updated the genomic information of G. incarnatum. Our results will provide a theoretical basis for fine gene mapping, functional gene cloning, and genetic breeding the follow-up of G. incarnatum.

11.
Article in English | WPRIM | ID: wpr-897419

ABSTRACT

Purpose@#Platelet-related indices, including mean platelet volume (MPV) and plateletocrit (PCT), have been reported as new prognostic factors of overall survival (OS) in many cancers, but not yet in biliary tract cancer (BTC). We intended to assess these indices in predicting OS in BTC patients with the aim to build a new prognostic model for patients with BTC after surgical resection. @*Materials and Methods@#Survival analysis and time receiver operating characteristic analysis were applied to screen the platelet indices. Univariate and multivariate Cox analyses were used to identify independent prognostic factors and develop a new prognostic model. Harrell’s C-statistics, calibration curves, and decisive curve analysis were used to assess the model. @*Results@#MPV and platelet distribution width (PDW)/PCT showed the best prognostic accuracy among the platelet indices. In multivariable analysis, factors predictive of poor OS were presence of nodal involvement, Non-radical surgery, poor tumor differentiation, carbohydrate antigen 19-9 > 100 U/mL, MPV > 8.1 fl, and PDW/PCT > 190. The new model was found to be superior to the TNM staging system and our new staging system showed higher discriminative power. @*Conclusion@#MPV and PDW/PCT have high prognostic value in BTC patients, and the novel staging system based on these two indices showed good discrimination and accuracy compared with the American Joint Committee on Cancer 7th TNM staging system.

12.
Mycobiology ; : 406-420, 2021.
Article in English | WPRIM | ID: wpr-895037

ABSTRACT

Gloeostereum incarnatum has edible and medicinal value and was first cultivated and domesticated in China. We sequenced the G. incarnatum monokaryotic strain GiC-126 on an Illumina HiSeq X Ten system and obtained a 34.52-Mb genome assembly sequence that encoded 16,895 predicted genes. We combined the GiC-126 genome with the published genome of G. incarnatum strain CCMJ2665 to construct a genetic linkage map (GiC-126 genome) that had 10 linkage groups (LGs), and the 15 assembly sequences of CCMJ2665 were integrated into 8 LGs. We identified 1912 simple sequence repeat (SSR) loci and detected 700 genes containing 768 SSRs in the genome; 65 and 100 of them were annotated with gene ontology (GO) terms and KEGG pathways, respectively. Carbohydrate-active enzymes (CAZymes) were identified in 20 fungal genomes and annotated; among them, 144 CAZymes were annotated in the GiC-126 genome. The A mating-type locus (MAT-A) of G. incarnatum was located on scaffold885 at 38.9 cM of LG1 and was flanked by two homeodomain (HD1) genes, mip and beta-fg. Fourteen segregation distortion markers were detected in the genetic linkage map, all of which were skewed toward the parent GiC-126. They formed three segregation distortion regions (SDR1–SDR3), and 22 predictive genes were found in scaffold1920 where three segregation distortion markers were located in SDR1. In this study, we corrected and updated the genomic information of G. incarnatum. Our results will provide a theoretical basis for fine gene mapping, functional gene cloning, and genetic breeding the follow-up of G. incarnatum.

13.
Article in English | WPRIM | ID: wpr-889715

ABSTRACT

Purpose@#Platelet-related indices, including mean platelet volume (MPV) and plateletocrit (PCT), have been reported as new prognostic factors of overall survival (OS) in many cancers, but not yet in biliary tract cancer (BTC). We intended to assess these indices in predicting OS in BTC patients with the aim to build a new prognostic model for patients with BTC after surgical resection. @*Materials and Methods@#Survival analysis and time receiver operating characteristic analysis were applied to screen the platelet indices. Univariate and multivariate Cox analyses were used to identify independent prognostic factors and develop a new prognostic model. Harrell’s C-statistics, calibration curves, and decisive curve analysis were used to assess the model. @*Results@#MPV and platelet distribution width (PDW)/PCT showed the best prognostic accuracy among the platelet indices. In multivariable analysis, factors predictive of poor OS were presence of nodal involvement, Non-radical surgery, poor tumor differentiation, carbohydrate antigen 19-9 > 100 U/mL, MPV > 8.1 fl, and PDW/PCT > 190. The new model was found to be superior to the TNM staging system and our new staging system showed higher discriminative power. @*Conclusion@#MPV and PDW/PCT have high prognostic value in BTC patients, and the novel staging system based on these two indices showed good discrimination and accuracy compared with the American Joint Committee on Cancer 7th TNM staging system.

14.
Chinese Medical Journal ; (24): 2438-2446, 2021.
Article in English | WPRIM | ID: wpr-921152

ABSTRACT

BACKGROUND@#Since the outbreak of coronavirus disease 2019 (COVID-19), human mobility restriction measures have raised controversies, partly because of the inconsistent findings. An empirical study is promptly needed to reliably assess the causal effects of the mobility restriction. The purpose of this study was to quantify the causal effects of human mobility restriction on the spread of COVID-19.@*METHODS@#Our study applied the difference-in-difference (DID) model to assess the declines of population mobility at the city level, and used the log-log regression model to examine the effects of population mobility declines on the disease spread measured by cumulative or new cases of COVID-19 over time after adjusting for confounders.@*RESULTS@#The DID model showed that a continual expansion of the relative declines over time in 2020. After 4 weeks, population mobility declined by -54.81% (interquartile range, -65.50% to -43.56%). The accrued population mobility declines were associated with the significant reduction of cumulative COVID-19 cases throughout 6 weeks (ie, 1% decline of population mobility was associated with 0.72% [95% CI: 0.50%-0.93%] reduction of cumulative cases for 1 week, 1.42% 2 weeks, 1.69% 3 weeks, 1.72% 4 weeks, 1.64% 5 weeks, and 1.52% 6 weeks). The impact on the weekly new cases seemed greater in the first 4 weeks but faded thereafter. The effects on cumulative cases differed by cities of different population sizes, with greater effects seen in larger cities.@*CONCLUSIONS@#Persistent population mobility restrictions are well deserved. Implementation of mobility restrictions in major cities with large population sizes may be even more important.


Subject(s)
COVID-19 , China/epidemiology , Cities , Humans , SARS-CoV-2
15.
Chinese Journal of Urology ; (12): 485-490, 2021.
Article in Chinese | WPRIM | ID: wpr-911055

ABSTRACT

Objective:To evaluate the safety and efficacy of Toumai ? endoscopic robotic system in radical prostatectomy. Methods:This study was a single-center phase Ⅲ randomized controlled study. From June 2020 to January 2021, patients with prostate cancer who met the inclusion criteria in Changhai Hospital Affiliated to Naval Military Medical University were divided into the experimental group and the control group by random table method. Inclusion criteria included aged 18 to 80 years, pathologically diagnosed as prostate cancer, clinical stage ≤T 2N 0M 0. Exclusion criteria included patients requiring emergency surgery, having serious cardiovascular diseases and cannot tolerate surgery, having participated in other investigational drug or device clinical trials within the last 3 months. The experimental group used Toumai ? laparoscopic robotic system, and the continence group used the Da Vinci robotic system. The patients in both groups underwent radical prostatectomy via a transabdominal approach, which was performed by two surgeons. The clinical characteristics between the two groups were compared, related adverse events were recorded, and PSA and urinary continence were followed up one month after the operation. Results:A total of 44 patients were enrolled in this study, including 22 cases in the experimental group and 22 cases in the control group. The mean age of patients in the trial group and the control group was (67.7±7.5) years and (66.4±6.3) years, respectively. The median PSA at diagnosis was 10.5 (7.7, 23.7) ng/ ml and 13.5 (8.9, 24.7) ng/ ml, respectively. Biopsy Gleason score of 6, 7, 8 and 9 in experimental group were 13.6% (3/22), 68.2% (15/22), 4.5% (1/22) and 13.6% (3/22), respectively, and in the control group were 4.5% (1/22), 59.1% (13/22), 22.7% (5/22) and 13.6% (3/22) respectively. The middle risk and high risk group in the experimental group was 50.0% (11/22), 50.0% (11/22), and the control group was 36.4% (8/22), 63.6% (14/22). There was no statistical difference between the two groups.The operations in both groups were successfully performed. There were no conversions to open or laparoscopic surgeries, and no Clavien-Dindo grade Ⅲcomplications. There was no significant difference in the estimated blood loss during the operation [(109.1±51.6)ml vs.(94.5±51.6)ml] and the blood transfusion rate [9.1%(2/22)vs. 4.5%(1/22)] in both groups. The operation time was significantly higher in the experimental group than that in the control group [164.5(130.5, 214.3) min vs. 88.0(65.3, 110.5)min, P<0.001]. The positive rate of surgical margin was 13.6% (3/22) in the experimental group and 36.4% (8/22) in the control group, respectively, showing no significant difference. The pathologic stages of pT 2, pT 3a and pT 3bin experimental group were 63.6% (14/22), 13.6% (3/22) and 22.7% (5/22), respectively, while those in control group were 36.3% (8/22), 40.9% (9/22) and 22.7% (5/22), respectively, showing no significant difference. The recovery rates of urine control in the experimental group and the control group were 22.7% (5/22) and 22.7% (5/22), respectively. The median PSA in the experimental group and the control group were 0.055 (0.021, 0.103) ng/ ml and 0.032 (0.010, 0.089) ng/ ml, respectively, with no statistical difference. Conclusions:The Toumai ? endoscopic robotic system can successfully perform radical prostatectomy, based on insignificant difference from Da Vinci robotic system in safety and efficacy. The short-term follow-up showed that tumor control and urinary continence have recovered well in the test group. The long-term effect of the new system on tumor control and functional recovery after radical prostatectomy needs further multi-center studies.

16.
Chinese Journal of Biotechnology ; (12): 2513-2521, 2021.
Article in Chinese | WPRIM | ID: wpr-887817

ABSTRACT

Human secreted phospholipase A2 GIIE (hGIIE) is involved in inflammation and lipid metabolism due to its ability of hydrolyzing phospholipids. To reveal the mechanism of substrate head-group selectivity, we analyzed the effect of mutation of hGIIE on its activity and selectivity. hGIIE structural analysis showed that E54 might be related to its substrate head-group selectivity. According to the sequence alignment, E54 was mutated to alanine, phenylalanine, and lysine. Mutated genes were cloned and expressed in Pichia pastoris X33, and the enzymes with mutations were purified with 90% purity by ion exchange and molecular size exclusion chromatography. The enzymatic activities were determined by isothermal microthermal titration method. The Km of mutant E54K towards 1,2-dihexyl phosphate glycerol decreased by 0.39-fold compared with that of wild type hGIIE (WT), and the Km of E54F towards 1,2-dihexanoyl-sn-glycero-3-phosphocholine increased by 1.93-fold than that of WT. The affinity of mutant proteins with phospholipid substrate was significantly changed, indicating that E54 plays an important role in the substrate head-group selectivity of hGIIE.


Subject(s)
Humans , Kinetics , Mutation , Phospholipases A2, Secretory , Phospholipids , Saccharomycetales , Substrate Specificity
17.
Article in Chinese | WPRIM | ID: wpr-882504

ABSTRACT

Objective:To explore the efficacy of apatinib combined with S-1 capsule in the treatment of patients with advanced recurrent and metastatic esophageal cancer.Methods:A total of 140 patients with advanced esophageal cancer were selected as test subjects from January 2017 to January 2019 in Shandong Tai′an Cancer Prophylaction-Therapeutic Hospital. These patients were randomly divided into observation group (72 cases) and control group (68 cases) using random number table method. The patients in the observation group were treated with oral apatinib combined with S-1 chemotherapy, and the patients in the control group was only given S-1 chemotherapy. The short-term and long-term efficacy and adverse reactions of the two groups were observed.Results:The objective remission rates of the observation group was 38.9% (28/72), higher than that in the control group (22.1%, 15/68), with a statistically significant difference ( χ2=4.655, P=0.031). The disease control rate of the observation group was 88.9% (64/72), higher than that in the control group (61.8%, 42/68), and there was a significant difference between the two groups ( χ2=13.993, P<0.001). The median progression-free survival of the observation group and the control group was 5.9 months and 2.7 months respectively, the median overall survival was 14.8 months and 7.9 months respectively, and there were significant differences between the two groups ( χ2=5.477, P=0.026; χ2=6.083, P=0.014). The adverse reactions of the two groups were mild, grade 1-2, mainly including fatigue, leukopenia, hand-foot syndrome, hypertension and proteinuria, with incidences of 59.7% (43/72), 50.0% (36/72), 8.3% (6/72), 12.5% (9/72), 9.7% (7/72) in the observation group, and 51.5% (35/68), 57.4% (39/68), 17.6% (12/68), 4.4% (3/68), 4.4% (3/68) in the control group, there were no significant differences between the two groups ( χ2=0.965, P=0.326; χ2=0.760, P=0.383; χ2=2.708, P=0.100; χ2=2.919, P=0.088; χ2=0.794, P=0.373). Conclusion:Apatinib combined with S-1 is effective, safe and tolerable in the treatment of recurrent and metastatic esophageal cancer.

18.
Acta Pharmaceutica Sinica ; (12): 1670-1676, 2021.
Article in Chinese | WPRIM | ID: wpr-881567

ABSTRACT

Dammarane-type triterpenoid saponins are regarded as the main active constituents of Gynostemma longipes C.Y.Wu. By using MCI and silica gel column chromatography, as well as preparative HPLC, we isolated four new dammarane-type triterpenoid saponins from the polar saponin fraction of G. longipes C.Y.Wu. Their structures were determined by comprehensive analyses of NMR and MS data and identified as (20S)-3β,20,21-trihydroxydammar-19-oxo-24-ene-3-O-{[α-L-rhamnopyranosyl(1→2)]-[β-D-xylopyranosyl(1→3)]-α-L-arabinopyranosyl}-21-O-β-D-glucopyranosyl(1→6)-β-D-glucopyranoside (1), (20S)-3β,20,21-trihydroxydammar-24-ene-19-oxo-3-O-[α-L-rhamnopyranosyl(1→2)]-[β-D-xylopyranosyl(1→3)]-α-L-arabinopyranosyl-21-O-α-L-rhamnopyranosyl(1→6)-β-D-glucopyranoside (2), (20S)-3β,19,20,21-terahydroxydammar-24-ene-3-O-{[α-L-rhamnopyranosyl(1→2)]-[β-D-xylopyranosyl(1→3)]-α-L-arabinopyranosyl}-21-O-[β-D-glucopyranosyl(1→6)]-β-D-glucopyranoside (3), (20S)-3β,20,21-trihydroxydammar-24-ene-3-O-{[α-L-rhamnopyranosyl(1→2)]-[β-D-glucopyranosyl(1→3)]-β-D-glucopyranosyl}-21-O-[β-D-glucopyranosyl(1→6)]-β-D-glucopyranoside (4). Compounds 1-4 are new dammarane-type triterpenoid saponins which contain five glycosyl residues.

19.
Article in Chinese | WPRIM | ID: wpr-881495

ABSTRACT

Objective:To understand the contamination and antimicrobial resistance of Vibrio parahaemolyticus in seafood sold in a place of Zhejiang Province, and to provide basic data for the prevention and control of food-borne diseases caused by V. parahaemolyticus. Methods:V. parahaemolyticus was isolated and identified from seafood according to GB 4789.7—2013 method. The virulence genes were identified by real-time fluorescent PCR, and the antimicrobial sensitivity test was performed by Kirby-Bauer method. Results:V. parahaemolyticus was isolated from 55 of 210 seafood samples. The detection rate was 26.19%, and the detection rates of different species were quite different. None of the 55 isolates contained virulence genes tdh and trh, while all isolates have species-specific genes tlh and toxR. Most isolates were resistant to ampicillin and amoxicillin, with the same antimicrobial resistance rate of 96.36%. All isolates were fully sensitive to ampicillin/sulbactam, tetracycline, ciprofloxacin, levofloxacin, loxacin and chloramphenicol. Conclusion:V. parahaemolyticus contamination is common in sold seafood. The antimicrobial resistance of the isolates has reached a certain level. Monitoring of the pollution status of V. parahaemolyticus in seafood should be strengthened and the aquaculture and clinical use of antibiotics should be standardized.

20.
Article in Chinese | WPRIM | ID: wpr-879122

ABSTRACT

Classic prescriptions, hospital preparations and famous traditional Chinese medicine(TCM) experience prescriptions are the main sources of new drug development and innovation. The multi-components and multi-targets treatment characteristics of TCM are advantages, but at the same time, broad indications, unclear clinical positioning and lack of evidence-based evidence support are the key problems affecting the play of TCM efficacy and restricting its promotion and application. The hot in recent research was to how to break through the bottleneck, precise clinical positioning, highlight the advantages of the classic TCM prescriptions, and complete the transformation from clinical practice, clinical research to clinical evidence, but at the same time, it is also the difficulty. The clinical research model of the combination of disease and syndrome can fully reflect the ancient medical case evidence of classic TCM prescriptions, the historical experience of human used and the characteristics of syndrome differentiation and treatment, and highlight the advantages of Chinese medicine. At the same time, under the modern disease classification system and research mode, is conducive to established the standardized clinical evidence report and evaluation system, is conducive to promote the integration of clinical research evidence, and avoids excessive attenuation of information. Based on the previous work of our team, the intention of this study was to make a comment about the key points of the post-marketing evaluation of the classic TCM prescriptions under the combination of disease and syndrome and includes key points:(1)With the syndrome as the carrier, connected with the classical prescription and clinical diseases, focused on the clinical positioning on macroscopically.(2)The combination of syndrome visualization, standardization and pharmacological molecular basis, focus on clinical precise positioning in microscopic.(3)Innovating therapeutic effect evaluation methods, reflecting the curative effect characteristics based on syndrome differentiation.(4)The combination of "randomized controlled evidence-based studies" and "real world evidence-based evaluation", focusing on clinical advantages, fully evidence-based evidence.(5)Make full use of clinical registration studies and pay attention to safety.


Subject(s)
Drugs, Chinese Herbal/therapeutic use , Humans , Marketing , Medicine, Chinese Traditional , Prescriptions , Reference Standards
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