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Introducción : La Organización Mundial de la Salud (OMS) efectuó recomendaciones en relación con la recopilación y notificación de datos agregados semanales de COVID-19. Objetivo : Investigar el grado de cumplimiento de las recomendaciones elaboradas por la OMS para la notificación de casos y muertes de COVID-19 en la Argentina durante el año 2020 a 2022, y comparar la notificación de muertes con el número de defunciones por COVID-19 consolidadas en el registro de estadísticas vitales del país. Materiales y métodos : Estudio cuantitativo descriptivo, basado en revisión documental y en fuentes de datos secundarias. Se utilizó los reportes diarios de información epidemiológica y la base de datos Dataset, COVID-19 casos registrados en la República Argentina. Adicionalmente, para estimar la omisión en los registros epidemiológicos de fallecimientos por COVID-19 en los años 2020 y 2021, se cotejaron los resultados de las bases de datos Dataset COVID-19 con la base de las Estadísticas vitales de mortalidad por causa de defunción, proporcionadas por la Dirección de Estadísticas e Información en Salud (DEIS). Se analizaron las variables recomendadas por la OMS para la notificación de casos y muertes por COVID-19. En cuanto a las consideraciones éticas relacionadas con el uso de la información utilizada en este trabajo, las bases de datos cumplen con lo estipulado por la Ley Nacional N° 17.622 de Resguardo del Secreto Estadístico, garantizando que la información mantiene el carácter confidencial y reservado del informante. Resultados: Del análisis de los reportes diarios, durante 2020 se observó que, de los 13 indicadores recomendados, 9 presentan datos algunos meses y los 4 restantes no se relevaron; en 2021 solo 7 indicadores presentaron datos algunos meses, y en 2022 solo 3 indicadores se continuaron informando. Respecto al análisis de la base de datos Dataset COVID-19, la mayoría fueron captadas. Respecto a la comparación de los valores de las defunciones registradas por el sistema de vigilancia epidemiológica y por la DEIS para los años 2020 y 2021, las muertes registradas fueron superiores en el registro de la DEIS (9,6% y 14,2%). Conclusiones : El Estado argentino cumplió con gran parte de las recomendaciones que establece la OMS para la notificación de los casos de COVID-19. Estudios posteriores deberían analizar otros componentes de la calidad de los datos, así como la oportunidad de los registros de defunciones, característica necesaria para la toma de decisiones en salud pública.
Introduction : The World Health Organization (WHO) establishes recommendations regarding the collection and reporting of weekly aggregated data on COVID-19. Objective : To investigate the degree of compliance with the recommendations made by the WHO for the reporting of COVID-19 cases and deaths in Argentina during the years 2020 to 2022, and to compare death notifications with the number of COVID-19 deaths recorded in the country's vital statistics registry. Materials and methods : Descriptive quantitative study, based on a documentary review and secondary data sources. Daily reports of epidemiological information and the Dataset database containing registered COVID-19 cases in the Argentine Republic were used. Additionally, to estimate the omission in the epidemiological records of COVID-19 deaths in the years 2020 and 2021, the results of the Dataset COVID-19 databases were compared with the vital statistics death registry on cause of death, provided by the Directorate of Statistics and Health Information (DEIS, by its acronym in Spanish). The variables recommended by the WHO for the reporting of COVID-19 cases and deaths were analyzed. As for the ethical considerations related to the use of the information in this study, the databases comply with the provisions of National Law 17,622 on the Protection of Statistical Secrecy, ensuring that the information remains confidential and reserved for the informant. Results : From the analysis of daily reports, it was observed that in 2020, out of the 13 recommended indicators, 9 had data for some months, and the remaining 4 were not reported. In 2021 only 7 indicators had data for some months, and in 2022 only 3 indicators continued to be reported. Regarding the analysis of the Dataset COVID-19 database, most data were captured. In comparing the values of deaths recorded by the epidemiological surveillance system and by the DEIS for the years 2020 and 2021, the deaths recorded were higher in the DEIS registry (9.6% and 14.2%). Conclusions : The Argentine state largely complied with the recommendations established by the WHO for the reporting of COVID-19 cases. Subsequent studies should analyze other components of data quality, as well as the timeliness of death records, a necessary characteristic for public health decision-making.
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La utilización de herramientas tecnológicas en la docencia condiciona el desarrollo de nuevas destrezas intelectuales en los estudiantes, lo que les facilita la aplicación de estrategias de investigación, mejora sus capacidades de una forma integral, les ayuda a enfrentar las dificultades y exigencias del mundo y les permite adquirir un aprendizaje más significativo para poder desenvolverse en el ámbito socioeducativo. Con vistas a cumplir lo anterior, se desarrolló un repositorio institucional de recursos educativos abiertos para la Universidad Virtual de Salud, a partir del empleo de herramientas tecnológicas libres y de código abierto que permiten la estandarización e interoperabilidad entre cada uno de los repositorios establecidos en el Sistema Nacional de Salud, con lo cual se garantizará una lógica de organización académica.
The use of digital technologies in teaching determines the development of new intellectual skills in students, which facilitates the application of investigation strategies, improves their capabilities in an integral way, helps them face the difficulties and demands of the current world and allows them to acquire more significant learning to have a good performance in the socio-educational environment. With a view to fulfilling the above, an institutional repository of open educational resources was developed for the Virtual Health University, based on the use of free and open-source technology tools that allow the standardization and interoperability among each of the repositories established in the National Health System, which will guarantee logic of academic organization.
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Objective To conduct signal mining of adverse events(AEs)of allopurinol and febuxostat based on FAE-RS database,and to explore their potential drug risks and promote rational and safe clinical drug use.Methods The adverse event report data of febuxostat and allopurinol in 22 quarters from the first quarter of 2017 to the second quarter of 2022 were ex-tracted from FAERS database,and the signal mining of febuxostat and allopurinol adverse events(AE)was carried out using ROR method and PRR method.Results There were 5 060 AE reports for allopurinol,concentrated in patients aged≥60 years,in-volving 25 items of system organ classification(SOC),mainly in skin and subcutaneous tissue diseases(40.01%).It was found that 12 SOC categories were not mentioned in the instructions.For febuxostat,there were 905 AE reports,involving 17 SOC items,mainly in cardiac organ diseases(40.17%),and 2 items were not involved in the instructions.Allopurinol and febuxostat were as-sociated with infection and infectious diseases(5.51%,0.49%)and hepatobiliary diseases(5.35%,0.87%),However,these as-sociations were included in the instructions of allopurinol.Allopurinol was associated with the reproductive system and breast dis-eases(0.55%),pregnancy,puerperium and perinatal conditions(0.03%),but febuxostat was not found to be involved in the a-bove SOC.Conclusion The inclusion of adverse reactions in the instructions for allopurinol is relatively inadequate compared to buprostat,and the newly discovered involvement of systemic organs and AE can provide a reference for improving allopurinol in-structions.This study found that allopurinol and febuxostat allopurinol and febuxostat involved system differences,which can pro-vide reference for clinical individualized treatment.
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To analyze simulated patient studies and their developmental trajectory, a comprehensive review was conducted using VOS viewer software. PubMed and CNKI databases were searched for 4 164 articles related to simulated patients. By creating keyword clouds and comparison tables, the current status and development trends of simulated patient studies at home and abroad were analyzed, and visual analysis was conducted based on these findings. Additionally, the analysis encompassed various metrics such as the number of published articles, journals, authors, and institutions involved. The findings reveal that the simulated patient studies focus on education, examination, and communication. Chinese studies on simulated patients initially demonstrated an upward trend but followed with a decline, whereas English studies have exhibited a steady upward trajectory. The application of simulated patients spans diverse fields including diagnostics, internal medicine, surgery, and medical practitioner exams, thereby greatly contributing to the advancement of medical education. It is anticipated that the number of simulated patient studies will continue to surge in the upcoming years.
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Objective By screening key genes and related pathways for hepatic fibrosis treatment through bioinformatics analysis,the differentially expressed genes of hepatic fibrosis patients were mined to predict potential therapeutic targets for liver fibrosis.Methods Gene expression profiles GSE197112 were obtained from GEO database.Differentially expressed genes were screened by Limma.DAVID online database was used to conduct GO enrichment analysis and KEGG signaling pathway enrichment analysis of differentially expressed genes.The protein-protein interaction(PPI)network diagram of differentially expressed genes were obtained from STRING database and visualize by Cytoscape software.At the same time,the plug-in CytoHubba in Cytoscape software was used to screen the target genes of hepatic fibrosis.Results A total of 399 differentially expressed genes were screened(P<0.01,∣log2FC∣>1.5),including 300 down-regulated genes and 99 up-regulated genes.These genes were mainly involved in GO biological processes such as mitosis checkpoint,DNA replication,chromosome segregation,cell division,apoptosis,adaptive immune response and so on,and mainly regulated the intestinal immune network for IgA production,progesterone-mediated oocyte maturation,human T-cell leukemia virus 1 infection,cell cycle,antigen processing and presentation,p53 signaling pathway,cancer transcription disorder,cell adhesion molecules and so on.Five target genes were screened by Cytoscape software:TTK,KIF2C,ASPM,DLGAP5,PBK.Conclusion In this study,399 differentially expressed genes and 5 target genes in hepatic fibrosis were screened by bioinformatics methods,which play key roles in the biological processes related to hepatic fibrosis,and provide a new direction for the pharmacological treatment of liver fibrosis.
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Objective:To construct the regulatory network of competitive endogenous RNA(ceRNA)and explore the mo-lecular mechanism of ischemic stroke(IS)by using bioinformatic analysis to screen the differentially-expressed genes. Method:The expression profiles of miRNA,mRNA and lncRNA in IS were downloaded from the NCBI GEO database.Differentially-expressed miRNAs,lncRNAs,and mRNAs were identified by the limma package in R software.The prediction of the relationship of lncRNA-miRNA and miRNA-mRNA were performed by starBase,miRDB and miRwalk databases.The results of prediction and differential analysis were taken to inter-sect and screened out differentially-expressed target mRNA(DETmRNAs),Kyoto Encyclopedia of Genes and Genomes(KEGG)and gene ontology(GO)enrichment analysis was performed by using the DAVID database.The protein-protein interaction(PPI)network was constructed by using the STRING database and the core tar-get genes in the network were identified by Cytoscape software. Result:A total of 20 differentially-expressed miRNAs,1512 lncRNAs,and 278 mRNAs were identified,and a ceRNA network was successfully constructed with the interactions of 5 lncRNAs-6 miRNAs-102 mRNAs in IS.The 285 DETmRNAs functions are mostly involved in the biological process such as chromatin organization,negative regulation of phosphoprotein phosphatase activity,or cell cycle.KEGG mainly enriched the signaling pathway including leukocyte trans-endothelial migration and platelet activation.The top 10 core genes were CREB1,MAPK1,GSK3B,SP1,PIK3R1,NR3C1,NCOR1,NFATC1,SETD2,and NSD1. Conclusion:The construction of the ceRNA network can help to further understand the molecular mechanism of IS and screen potential biomarkers,providing clues to further define rehabilitation targets and develop reha-bilitation strategies.
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Objective To search for the reports of adverse events of levofloxacin use in children using the FAERS database,and to mine and analyze the data to provide reference for safe clinical use.Methods The data reported of adverse events of levofloxacin use in children from January 1,2004 to June 30,2023 were retrieved through the OpenVigil 2.1 platform,and the relevant data were analyzed based on the reporting odds ratio(ROR)method.Results A total of 484 cases of adverse events of levofloxacin in children were retrieved,and 94 positive risk signals were found.The main systemic organs involved were various musculoskeletal and connective tissues,gastrointestinal system,systemic and administration sites,and the top five positive signals were Dimycodes infection(ROR=822.87),tendon pain(ROR=563.71),Mycobacterium ulcers infection(ROR=352.65),tendon rupture(ROR=341.91),and immune reconstitution inflammatory syndrome-related tuberculosis(ROR=310.84).The top five positive signals not mentioned in the label were Mycobacterium ulcerans infection(ROR=352.65),immune reconstitution inflammatory syndrome-associated tuberculosis(ROR=310.84),central nervous system tuberculoma(ROR=102.85),linear IgA disease(ROR=82.68),and increased intracranial pressure(ROR=32.46).Conclusion In addition to the known adverse events,levofloxacin is used in children,and the risk signal intensity of adverse reactions such as increased intracranial pressure and tuberculosis-related diseases is high,so it is recommended to carefully select and strengthen relevant safety monitoring.
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Objective:To construct the risk prediction nomogram model of acute kidney injury (AKI) with R language and traditional statistical methods based on the large sample clinical database, and verify the accuracy of the model.Methods:It was a a retrospective case control study. The patients who met the diagnostic criteria of AKI in Tongji Hospital of Tongji University from January 1 to December 31, 2021 were screened in the clinical database, and the patients with monitored serum creatinine within 48 hours but without AKI were included as the control group. The demographic data, disease history, surgical history, medication history and laboratory test data were collected to screen the risk factors of AKI in clinic.Firstly, based on multivariate logistic regression analysis and forward stepwise logistic regression analysis, the selected risk factors were included to construct the nomogram model. At the same time, cross validation, bootstrap validation and randomly split sample validation were used for internal verification, and clinical data of patients in the sane hospital after one year (January to December, 2022) were collected for external verification. The receiver-operating characteristic curve was used to determine the discrimination of the model, and calibration curve and decision curve analysis were carried out to evaluate the accuracy and clinical net benefit, respectively.Results:A total of 5 671 patients were enrolled in the study, with 1 884 AKI patients (33.2%) and 3 787 non-AKI patients (66.7%). Compared with non-AKI group, age, and proportions of surgical history, renal replacement therapy, hypertension, diabetes, cerebrovascular accident,chronic kidney disease, drug use histories and mortality in AKI group were all higher (all P<0.05). Multivariate logistic regression analysis showed that the independent influencing factors of AKI were surgical history, hypertension, cerebrovascular accident, diabetes, chronic kidney disease, diuretics, nitroglycerin, antidiuretic hormones, body temperature, serum creatinine, C-reactive protein, red blood cells, white blood cells, D-dimer, myoglobin, hemoglobin, blood urea nitrogen, brain natriuretic peptide, aspartate aminotransferase, alanine aminotransferase, triacylglycerol, lactate dehydrogenase, total bilirubin, activated partial thromboplastin time, blood uric acid and potassium ion (all P<0.05). Finally, the predictive factors in the nomogram were determined by forward stepwise logistic regression analysis, including chronic kidney disease, hypertension, myoglobin, serum creatinine and blood urea nitrogen, and the area under the curve of the prediction nomogram model was 0.926 [95% CI 0.918-0.933, P<0.001]. The calibration curve showed that the calibration effect of nomogram was good ( P>0.05). The decision curve showed that when the risk threshold of nomogram model was more than 0.04, the model construction was useful in clinic. In addition, the area under the curve of receiver-operating characteristic curve predicted by nomograph model in external validation set was 0.876 (95% CI 0.865-0.886), which indicated that nomograph model had a high discrimination degree. Conclusion:A nomogram model for predicting the occurrence of AKI is established successfully, which is helpful for clinicians to find high-risk AKI patients early, intervene in time and improve the prognosis.
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Empowered by the rapid development of artificial intelligence technology and information security technology, basic medicine, translational medicine, and clinical medicine have entered a new era. In this process, the relevant data such as text, genetics, images, and videos have increased at an astonishing rate. Traditional specialized disease databases cannot adapt to the multimodality of data and the multicentralization of data sources in the present/future. Therefore, establishing a next-generation multimodal and multicenter collaborative specialized disease database that is suitable for secure data sharing and ethical in clinical research is essential. This paper expounds the concept and basic framework of developing a next-generation clinical research disease database with universal use, emphasizing the establishment of a multimodal data integration mechanism, a multicenter collaborative system supported by privacy-preserving computing, highly intelligent software and hardware entities, and an integrated operational management mode. It also introduces the application of this concept in the construction of a breast cancer three-dimensional life database, a project of China Breast Cancer Innovation Alliance.
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【Objective】 To examine risk factors for acute pancreatitis (AP) in individuals with chronic alcohol consumption habits. 【Methods】 The study incorporated participants from the initial survey (2006-2010) and subsequent follow-ups (2014+) taken from the UK Biobank database, with the observation period ending on November 30, 2022. During this period, 176 individuals were newly diagnosed with AP, while 59,512 remained unaffected. Vital characteristics of the target population, such as their medical histories, surgical experiences and dietary patterns, were collected during the enrolment phase (2006-2010). The Cox proportional hazard model was employed to ascertain whether these characteristics were potent risk factors for AP. Concurrently, a subgroup from the target population with documented drinking behavior was selected. The multivariate Cox proportional hazard model was utilized to analyze the relationship of the established factors, variances in alcohol consumption, and increased alcohol intake (Δ) with the onset of AP, and whether the additional alcohol intake served as a risk factor. 【Results】 Multivariate analysis revealed that consumption quantity of cooked vegetables inversely correlated with AP risk (HR=0.44, 0.39, 0.42 and 0.41 for one, two, three and four+ tablespoons per day, respectively, as compared to non-consumers). Coffee consumption (2-3 cups per day) also reduced AP risk (HR=0.45 for 2 cups/day; HR=0.39 for 3 cups/day as compared to non-coffee drinkers). However, those with biliary disease without cholecystectomy exhibited a marked increase in AP risk (HR=7.82), which reduced albeit remained elevated for those with biliary disease post-cholecystectomy (HR=2.15). Subgroup analysis showed minimal impact of alcohol intake levels on AP incidence. Yet, increased alcohol consumption (Δ of 1 bottle/week) was linked to a heightened AP risk (HR=1.05, 95% CI:1.02-1.09, P<0.05). 【Conclusion】 Among longstanding alcohol consumers, a diet rich in cooked vegetables and moderate coffee consumption offers protective effects against AP. Conversely, biliary disease (particularly without cholecystectomy) and elevated alcohol intake present considerable risk factors for the development of this condition.
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【Objective】 To investigate the relationship between the initial serum ammonia level and the risk of ICU and hospital mortalities in critically ill patients without hepatic disease. 【Methods】 A retrospective cohort study was conducted among patients admitted to the eICU Collaborative Research Database (eICU-CRD) for a single admission who had serum ammonia test records within 48 hours of the first ICU admission and had no hepatic disease. The age, sex, ethnicity, Acute Physiologic and Chronic Health Evaluation Ⅳ score (APACHE Ⅳ score), treatment methods, complications, and outcomes were extracted. Univariable and multivariable Logistic regression were used to analyze the relationship between serum ammonia level and the risk of mortality. Interactions were used to analyze whether the relationship between serum ammonia level and the risk of mortality differed in subgroups of APACHE Ⅳ scores, age, sex, and ethnicity; subgroup analyses were made. 【Results】 A total of 1 674 patients were included. The multivariable Logistic regression showed that for every 10 μg/dL increase in ammonia, the risk of ICU death increased by 6.9% (OR=1.069, 95% CI: 1.036-1.104), and the risk of hospital death increased by 4.6% (OR=1.046, 95% CI: 1.017-1.076). The risk of ICU death was 1.7 times greater in patients with initial ammonia level of 49-82 μg/dL than in those with <49 μg/dL (OR=1.700, 95% CI: 1.165-2.482), the risk of ICU death was 2.862 times greater in patients with a level of ≥82 μg/dL compared to those with <49 μg/dL (OR=2.862, 95% CI: 1.792-4.570), and the risk of hospital death was 1.844 times higher in the ≥82 μg/dL group than in the <49 μg/dL group (OR=1.844, 95% CI: 1.213-2.804). There were no significant differences between initial ammonia level and the risk of mortalities in different subgroups of APACHEⅣ scores, age, sex, or ethnicity. 【Conclusion】 In critically ill patients without hepatic disease, elevated initial serum ammonia level after ICU admission is associated with a high risk of ICU and hospital mortality.
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【Objective】 To analyze the expression of lncRNA SNHG25 in prostate cancer and its significance, so as to explore the biomarkers and potential therapeutic targets for the diagnosis and prognosis of this disease. 【Methods】 Based on the TCGA database, differential, survival, and clinical correlation analyses of SNHG25 were performed.SNHG25 expression in prostate cancer was analyzed in the UALCAN database to determine its relationship with the clinical and pathological characteristics.The lncRNA-miRNA-mRNA correlation analysis was performed.The relevant ceRNA regulatory network was constructed.Prostate cancer samples were divided into high and low SNHG25 expression groups, and differential SNHG25 related genes were filtered and then enriched. 【Results】 SNHG25 expression was significantly upregulated in prostate cancer specimens compared to normal prostate specimens (P0.05).Regulatory networks of SNHG25/miR-330-3p/DLX1 and RPL22L1 were constructed. 【Conclusion】 SNHG25 is highly expressed in prostate cancer tissues and correlated with poor prognosis.SNHG25 expression does not significantly correlate with age, T-stage, N-stage, and Gleason score.SNHG25/miR-330-3p/DLX1 and RPL22L1 regulatory networks may play an important role in the development of prostate cancer.SNHG25 may become a biomarker and potential therapeutic target for prostate cancer.
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【Objective】 To investigate the effects of radical prostatectomy (RP) or brachytherapy (BT) on the prognosis of patients with high-risk prostate cancer as initial treatment, in order to provide a reference for the selection of clinical treatment options. 【Methods】 The clinical data of 133 191 patients diagnosed with high-risk prostate cancer and treated with RP or BT during 2005 and 2014 were extracted from the SEER database.The 5-year and 10- year cancer-specific survival (CSS) and overall survival (OS) were compared with K-M analysis and univariate and multivariate Cox regression.The clinical data of another 253 patients diagnosed with high-risk prostate cancer in Subei People’s Hospital during 2015 and 2020 were collected, including 153 patients who received RP and 100 patients who received BT.The 5-year biochemical progress-free survival (bPFS) and CSS were compared with K-M analysis. 【Results】 Univariate analysis of SEER data showed that BT was associated with a higher risk of death (HR=1.319, 95%CI: 1.256-1.386, P<0.001); age, marital status and TNM stage were associated with higher risk of death (P<0.001).Multivariate analysis, adjusted for relevant variables, showed that BT did not result in a higher risk of death compared with RP (HR=0.964, 95%CI:0.924-0.996, P=0.808). The OS curve showed that the longer the observed survival time, the better OS of RP as compared to BT (P<0.001); however, the CSS survival curve showed that the longer the observed survival time, the better CSS of BT compared to RP (P<0.001).The single-center data analysis showed no significant difference between BT and RP in the 5-year bPFS (P=0.263) and CSS (P=0.946). 【Conclusion】 For patients with high-risk prostate cancer, there is a significant difference in the prognosis of the two treatments if there is no adjustment of age, marital status, TNM stage and other factors, and the efficacy of RP is better than that of BT, especially in patients with survival more than 10 years.However, there is no statistically significant difference in the prognosis after the possible confounding factors are adjusted.Therefore, the initial treatment choice for these patients should be weighed from multiple perspectives, and patients’ choices must be respected after they are fully informed.
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【Objective】 To investigate the clinical features and prognostic factors of elderly patients with localized renal cell carcinoma after operation. 【Methods】 Clinical data of all elderly patients (60-100 years old) with localized renal cell carcinoma who underwent primary tumor resection during 2004 and 2017 in United States National Cancer Institute (SEER) database were collected.The clinical features, surgical methods and prognosis were analyzed.According to the surgical methods, the patients were divided into partial nephrectomy (PN) group and radical nephrectomy (RN) group.The effects of the two surgical methods on the prognosis were compared. 【Results】 A total of 20 348 patients were included.The median survival time was 164 months, and the 3-, 5- and 10-year cumulative overall survival rates were 91.1%, 84.2% and 64.4%, respectively.Multivariate Cox analysis showed that age, sex, race, histological grade, T stage and surgical method were independent prognostic factors for overall survival (P0.05). 【Conclusion】 Old age, male, black, non-chromophobe cell carcinoma, low degree of differentiation, high T stage of tumor and RN are independent risk factors for the prognosis of elderly patients with localized renal cell carcinoma.PN is the main treatment method and has remarkable therapeutic effects.
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OBJECTIVE To mine and analyze the post-marketing adverse drug event （ADE） signals of irinotecan in adults and children populations， and to provide a reference for clinical safe medication. METHODS ADE reports of irinotecan from the first quarter of 2004 to the first quarter of 2023 in the US FDA adverse event reporting system database were extracted and the risk signals of irinotecan were detected through the reporting odds ratio and proportional reporting ratio. Statistical analysis was performed for ADE reports and signals of patients aged＜18 years （children） and ≥18 years （adults）. RESULTS A total of 8 013 ADE reports with irinotecan as the primary suspect drug were identified， including 7 656 and 357 ADE reports in adults and children， respectively. A total of 518 and 75 ADE signals were detected in the adults and children， and the mainly involved systems and organs including gastrointestinal disorders， blood and lymphatic system disorders， systemic disorders and various reactions at the administration site， etc. Most of the top 20 ADE signals in terms of frequency were documented in the drug instructions of irinotecan. New ADE signals in adults included peripheral neuropathy， oral mucosal inflammation， pulmonary embolism， epidermal nevus syndrome and reproductive toxicity， while hypertension， progressive neoplasms， tumor lysis syndromes， and embolism were new ADE signals in children. CONCLUSIONS The above new suspected high-risk signals not mentioned in the instructions should raise a high level of alertness in clinical practice of irinotecan.
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OBJECTIVE To mine and analyze the post-marketing adverse drug event （ADE） signals of irinotecan in adults and children populations， and to provide a reference for clinical safe medication. METHODS ADE reports of irinotecan from the first quarter of 2004 to the first quarter of 2023 in the US FDA adverse event reporting system database were extracted and the risk signals of irinotecan were detected through the reporting odds ratio and proportional reporting ratio. Statistical analysis was performed for ADE reports and signals of patients aged＜18 years （children） and ≥18 years （adults）. RESULTS A total of 8 013 ADE reports with irinotecan as the primary suspect drug were identified， including 7 656 and 357 ADE reports in adults and children， respectively. A total of 518 and 75 ADE signals were detected in the adults and children， and the mainly involved systems and organs including gastrointestinal disorders， blood and lymphatic system disorders， systemic disorders and various reactions at the administration site， etc. Most of the top 20 ADE signals in terms of frequency were documented in the drug instructions of irinotecan. New ADE signals in adults included peripheral neuropathy， oral mucosal inflammation， pulmonary embolism， epidermal nevus syndrome and reproductive toxicity， while hypertension， progressive neoplasms， tumor lysis syndromes， and embolism were new ADE signals in children. CONCLUSIONS The above new suspected high-risk signals not mentioned in the instructions should raise a high level of alertness in clinical practice of irinotecan.
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Objective To explore the construction and visualization for knowledge graph of Ling Shu(Spiritual Pivot),with a view to providing ideas for the structured storage and display of the theoretical knowledge of the ancient Chinese medical books.Methods Using the professional idea of constructing knowledge graphs for reference,text mining technology was applied to construct the thesaurus,and then word division,entity recognition,and relationship extraction for the original text of Ling Shu were performed to get the elements of knowledge graph construction.The graph database Neo4j was used for the storage and query of the knowledge graph,and then the visual display of the knowledge graph was achieved.Results The 1 216 high-quality words consisting of the thesaurus of Ling Shu were obtained,and the construction of the knowledge graph of the theory of Ling Shu was realized.The constructed knowledge graph basically displayed the traditional Chinese medicine theories such as the correlation of visceral manifestations with essence qi,and the relationship between emotions and the five-zang organs described in Ling Shu,which made the retrieval and utilization of the related entities and relationships possible,and provided ideas for the structured storage and display of the theoretical knowledge of the ancient books of Chinese medicine.Conclusion The knowledge graph construction technology can be used to obtain the Chinese medicine theoretical knowledge graph of Ling Shu,and to display the knowledge connections of yin-yang and the five elements,and the internal organs and meridians expressed in the Ling Shu.The construction of the knowledge graph and its storage in the graph database enable the knowledge graph involved in the text of Ling Shu to be displayed in the form of visualized semantic network graph,and also make the embedding of other search systems such as the semantic search and semantic wiki possible,which will be helpful for the development of Chinese medicine intelligent medical services.
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Vascular surgery is an emerging clinical discipline with a wide range of categories and disease types.In theoretical teaching,a large amount of vivid imaging materials and vascular reconstruction photos are needed to effectively display the clinical manifestation.During internship training,there are not enough patients in the ward to cover common or frequently-occurring diseases of vascular surgery.As a result,development of a clinical case data-base is of great significance for the teaching of vascular surgery.This article mainly introduces the establishment and preliminary application of a clinical case database in vascular surgery teaching at Beijing Tiantan Hospital affiliated to Capital Medical University.
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Objective To investigate the predisposing factors carried out in patients with secondary primary esophageal cancer and the related factors affecting its prognosis.Methods Patients with pathologically definite esophageal cancer diagnosis from 2000-2019 in the Surveillance/Epidemiology and End Results(SEER)database were selected,from which the data of patients with other malignancies as the first and esophageal cancer as the second primary(Secondary Primary Esophageal cancer-SPE)were screened,and logistic regression was used to analyze the independent risk factors in patients with secondary primary esophageal cancer,and the independent risk factors affecting the prognosis of such patients were analyzed by Cox proportional hazard model.Results A total of 13520 patients with multiple primary malignancies with esophageal cancer,including a total of 8308 patients with secondary primary esophageal cancer.Multiple logistic analysis showed that age,tumor site,tumor differentiation,pathological examines,SEER neoplasm invasiveness and regional lymph node adoption were independent factors influencing the occurrence of SPE,while multiple Cox risk proportion analysis suggested that age,year of diagnosis,race,tumor differentiation,SEER neoplasm invasiveness,surgery,chemotherapy,radiotherapy,and triple therapy were independent risk factors influencing SPE.Conclusion This study identified risk factors for secondary primary esophageal cancer,and surgery may be an effective treatment for SPE,which clinicians can use as a reference for diagnosis and treatment.
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Objective:To illustrate the characteristics of the distribution of prophages among the Group A Streptococcus(GAS) by mining the existing whole genome sequencing of the GAS, performing bioinformatic analyses, extracting data about prophages, and analyzing the state of prophages in the genome and genetic composition of some prophages. Methods:It was a retrospective study.Genome assembly sequences of GAS reported in GenBank till May 2020 were collected, and the important background information of these strains was sorted out to create a local genomic database.A phylogenetic tree of the whole genome of GAS was conducted using the bioinformatics software.The core genome was analyzed, and potential prophages and their integrity in the genome were predicted to obtain the characteristics of the distribution of prophages.Genotype types, number of core genes, and number, length and carrying rate of prophages in the database for GAS were analyzed.Results:A database containing the genome sequence of 2 529 GAS strains was established, involving 140 emm genotypes.These strains were isolated from 19 countries from East Asia, Europe, America and Oceania.Stratified by the disease background, these strains were mainly divided into invasive infection, non-invasive infection and immune sequelae.Prophage analysis of 1 798 genomes showed that at least one complete prophage was detected in 1 366 (76.0%) genomes.The number of complete prophages of each strain ranged from 0 to 6, and the length ranged from 32.8 to 62.6 kb, which was mainly 30-40 kb in length.The phiHKUssa, phiHKUvir and phiHKU488 were the most common prophages present in dominant clones circulated in China in recent years, which mainly carried virulence genes like the speC, spd1 and ssa. Conclusions:Prophages are widely distributed in the genome of GAS, which are of great significance in the evolution and expansion of dominating clones and thus reshape the population structure within the emm genotype.The establishment of a local genome database provides important baseline data for molecular epidemiological surveillance.