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Polycystic ovary syndrome(PCOS)is a common gynecological disease in clinic.Based on years of clinical practice,Professor ZHU Ling believes that the pathogenesis of PCOS is characterized by yang deficiency of kidney and spleen,and internal retention of phlegm and fluid,which accords with the pathogenesis nature of phlegm-retention.With reference to the pathogenic site of PCOS,PCOS can be allocated to the category of"phlegm-retention in uterus".Following the principle of"phlegm-retention resolved with warm herbs"established by ZHANG Zhong-Jing,Shenqi Pills plus Ling Gui Zhu Gan Decoction(aka,Shen Ling Decoction)recorded in Jin Gui Yao Lve(Synopsis of the Golden Chamber)can be used for the treatment of PCOS to warm yang and resolve phlegm-retention,dissolve phlegm and remove dampness,regulate menstruation and promote gestation,and significant efficacy can be achieved.The treatment of PCOS based on the principle of"phlegm-retention resolved with warm herbs"will provide a reference for clinical treatment of PCOS.
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ObjectiveTo analyze the research status and trends in low-level occupational benzene exposure. Methods Articles on low-level occupational benzene exposure from Chinese and English journals from January 1st, 2000, to December 31th, 2022 were retrieved using the Web of Science and the China National Knowledge Infrastructure, and a bibliometric analysis was conducted. Results A total of 327 articles were included in the analysis, comprising 216 English articles and 111 Chinese articles. i) The number of articles published in English fluctuates greatly over the years, without a trend of continuous growth or decline. Authors from 359 research institutions in 45 countries and regions have published relevant English articles in 97 kinds of journals, involving 281 grants from 226 foundations. The top three countries in terms of articles amount were the United States, Italy, and China, with 81, 46, and 43 papers, respectively. The English articles mainly focused on mechanistic research at the genetic level, such as hematotoxicity, oxidative stress, and DNA damage. ii) The number of Chinese articles increased gradually after 2012, with the growth peak in 2017. Authors from 127 research institutions in 26 provinces, autonomous regions, and municipalities published Chinese articles in 51 kinds of journals, involving 154 grants from 78 foundations. Chinese articles tended to focus on benzene-induced hematotoxicity and occupational health damage. Conclusion Most studies on low-level occupational benzene exposure were conducted in China, the United States and Italy, focused on hematotoxicity. Monitoring international research topics and hotspots of the field has certain reference value for related research in China.
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Objective To understand the infection status of patients with maintenance hemodialysis(MHD)in Guizhou Province,and provide basis for the prevention and control of hemodialysis-related infection.Methods MHD patients in hemodialysis centers of 124 secondary and or higher grade medical institutions in Guizhou Province from July to December 2022 were surveyed.Survey content included the general conditions of patients,hemodialysis-related conditions,infection of pathogens of blood-borne diseases,and other infection-related conditions.Results A total of 15 114 MHD patients were surveyed,with age mainly ranging from 36 to<60 years old(55.83%).Hemodialysis history ranged mainly from 1 year to<5 years(59.37%),and the frequency of hemodi-alysis was mainly 3 times per week(73.91%).Autologous arteriovenous fistula(AVF)was the major vascular access for dialysis,with a total of 12 948 cases(85.77%).The main primary disease was chronic renal failure(99.89%).The infection rates of hepatitis B virus(HBV),hepatitis C virus(HCV),human immunodeficiency vi-rus(HIV),and Treponema pallidum in MHD patients were 5.29%,0.64%,0.24%,and 1.70%,respectively.HBV infection rates among MHD patients of different ages,different numbers of dialysis hospitals,and dialysis in-stitutions of different scales showed statistically significant differences(all P<0.05).HCV infection rates among MHD patients of different ages,with different dialysis times and from institutions of different scales were signifi-cantly different(all P<0.05).TP infection rates among MHD patients of different ages and different numbers of dialysis hospitals were all significantly different(all P<0.05).Infection rates of HBV and HCV in MHD patients aged from 36 to 60 years old(not included)were relatively higher(6.10%and 0.84%,respectively).Patients with dialysis time ≥10 years had a higher HCV infection rate(1.64%).Infection rates of HCV,HIV,and TP in pa-tients dialyzed in medical institutions with ≥90 dialysis beds were relatively higher(0.74%,0.28%,and 1.94%,respectively).Medical institutions with<30 dialysis beds had the highest HBV infection rate(18.64%).There were 9 cases(0.06%)of vascular puncture infection,12 cases(0.08%)of bloodstream infection,7 cases(0.05%)of vascular access-related bloodstream infection,and 30 cases(0.20%)of pulmonary infection.Vascular access-re-lated bloodstream infection rate and pulmonary infection rate among MHD patients with different types of vascular access showed statistically significant difference(all P<0.05).Vascular access-related bloodstream infection rate(0.37%)and pulmonary infection rate(1.10%)of patients with non-cuffed catheters vascular access were higher than those of other types.Conclusion MHD patients in Guizhou Province are mainly middle-aged and young peo-ple,with more males than females.The dialysis frequency is mostly 3 times per week,and AVF is the major vascu-lar access.MHD patients are prone to complications such as infections of HBV,HCV,HIV,and TP,as well as bloodstream infection and pulmonary infection.
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Objective To investigate the current situation and influencing factors of latent tuberculosis infection(LTBI)among close contacts of positive etiology pulmonary tuberculosis(PTB)patients,provide basis for formula-ting intervention measures for LTBI.Methods A multi-stage stratified cluster random sampling method was used to select close contacts of positive etiology PTB patients from 39 districts and counties in Chongqing City as the study objects.Demographic information was collected by questionnaire survey and the infection of Mycobacterium tuberculosis was detected by interferon gamma release assay(IGRA).The influencing factors of LTBI were analyzed by x2 test and binary logistic regression model.Results A total of 2 591 close contacts were included,the male to female ratio was 0.69∶1,with the mean age of(35.72±16.64)years.1 058 cases of LTBI were detected,Myco-bacterium tuberculosis latent infection rate was 40.83%.Univariate analysis showed that the infection rate was dif-ferent among peoples of different age,body mass index(BMI),occupation,education level,marital status,wheth-er they had chronic disease or major surgery history,whether they lived together with the indicator case,and whether the cumulative contact time with the indicator case ≥250 hours,difference were all statistically significant(all P<0.05);infection rate presented increased trend with the increase of age and BMI(both P<0.001),and decreased trend with the increase of education(P<0.05).Logistic regression analysis showed that age 45-54 years old(OR=1.951,95%CI:1.031-3.693),age 55-64 years old(OR=2.473,95%CI:1.279-4.781),other occupations(OR=0.530,95%CI:0.292-0.964),teachers(OR=0.439,95%CI:0.242-0.794),students(OR=0.445,95%CI:0.233-0.851),junior high school education or below(OR=1.412,95%CI:1.025-1.944),BMI<18.5 kg/m2(OR=0.762,95%CI:0.586-0.991),co-living with indicator cases(OR=1.621,95%CI1.316-1.997)and cumu-lative contact time with indicator cases ≥250 hours(OR=1.292,95%CI:1.083-1.540)were the influential fac-tors for LTBI(all P<0.05).Conclusion The close contacts with positive etiology PTB have a high latent infection rate of Mycobacterium tuberculosis,and it is necessary to pay attention to close contacts of high age,farmers,and frequent contact with patients,and take timely targeted interventions to reduce the risk of occurrence of disease.
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Objective To investigate a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae(CRKP)healthcare-associated bloodstream infection(HA-BSI),provide reference for effective control of CRKP in-fection.Methods The characteristics of CRKP infected patients and the risk factors for the event transmission in an adult hematology department of a teaching hospital in June 2022 were obtained by field epidemiological investigation.The specimens of environmental target strains were co-llected by blood nutrient agar inoculation,the removal status of environmental microorganisms and the effect of infection control after implementing control measures were com-pared.Results There were a total of 6 cases of CRKP HA-BSI,with an attacking rate of 1.29%(6/464),which was significantly higher than 0 during the same period in 2021,and difference was statistically significant(P=0.011).In environmental hygiene monitoring,the detection rate of CRKP was 2.27%(1/44),which was from the surface of bed curtain in the living unit of infected patients,homology analysis with CRKP detected from 2 patients revealed that the 16s RNA of 3 CRKP strains was completely identical,with a similarity of 100%.Seven house-keeping genes of 3 CRKP strains were all identical and belonged to the ST11 type.Comprehensive control measures were taken:appropriate closure of the ward,centralized isolation of patients,terminal disinfection of the ward,reg-ular health care workers and relative restriction of their activity areas.After the measures were taken,the qualified rate of microbial colony count in the ward increased compared to before taking the measures(2.27%vs 68.89%,P<0.001),with a statistically significant difference,there were no more CRKP infected cases after the intervention,indicating that the control measures were effective.Conclusion This outbreak was caused by ST11 type of common CRKP in China,and laminar bed curtains are carriers of pathogen transmission.It is speculated that non-standard cleaning and disinfection,as well as inadequate implementation of hand hygiene are the main causes for transmis-sion.Adopting an appropriate strategy of closing the ward and concentrating patient isolation can quickly and effec-tively prevent the transmission of the event.
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Objective@#To identify high risk behaviors and infection related factors among young adult males diagnosed with HIV/AIDS in Shandong Province, to provide evidence for targeted AIDS prevention and control strategies.@*Methods@#By using convient sampling method, an face to face in depth interview on HIV related behaviors was conducted among young adult males newly diagnosed with HIV/AIDS in Shandong Province in July 2021.@*Results@#A total of 31 young adult males diagnosed with HIV/AIDS were interviewed. All were male and infected through homosexuality behavior. Average age was (20.6±1.8) years. Totally 90.3% (28/31) were enrolled in tertiary education at the time of diagnosis. The findings revealed that 93.5% (29/31) of participants got infection due to unprotected homosexual behavior with the temporary partner whose HIV infection status was unknown, and 86.2% (25/29) got in touch with these temporary partner by social software. The awareness rate of knowledge about AIDS among all the participants was 100%, however, 83.9% (26/31) reported occasion condom usage while having homosexual behavior, and 16.1% (5/31) never did. Totally 74.2% (23/31) of the young adult males diagnosed with HIV/AIDS had a history of HIV testing before diagnosis.@*Conclusion@#The primary high risk behavior of HIV infection in young adult students are unawareness of HIV infection status for temporary sexual partner and the separation of knowing and doing. A targeted strategy should be developed to control the spread of HIV in young adult students.
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The use of digital means has made the public health emergency management more efficient and convenient. However, in the practice of managing public health emergencies, there are dilemmas in the protection of personal health information, such as the imperfect legal system, the weakened right of informed consent and control, the lack of reasonable norms in the collection and use of information, and the disclosure of personal health information. To solve the dilemma of personal health information protection, it is necessary to improve the corresponding legal mechanism, strengthen the classification of health information, standardize the behavior of health information collection and use, enhance the technical support of personal health information protection, build a system combining law and technology, and protect the security of personal health information.
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Objective: To examine the radiomics model based on high-resolution T2WI and diffusion weighted imaging (DWI) in predicting microsatellite stability in patients with stage Ⅱ and Ⅲ rectal cancer. Methods: From February 2016 to October 2020, 175 patients with stage Ⅱ and Ⅲ rectal cancer who met the inclusion criteria were retrospectively collected. There were 119 males and 56 females, aged (63.9±9.4) years (range: 37 to 85 years), including 152 patients with microsatellite stability and 23 patients with microsatellite instability. All patients were randomly divided into the training group (n=123) and the validation group (n=52) with a ratio of 7∶3. The region of interest was labeled on the T2WI and DWI images of each patient using the ITK-SNAP software, and PyRadiomics was used to extract seven kinds of radiomics features. After removing redundant features and normalizing features, the least absolute shrinkage and selection operation were used for feature selection. One clinical model, three radiomics models and one clinical-radiomics model were constructed in the training group based on a support vector machine. The area under receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy were used to evaluate the performance of the models in the verification group. Results: Three clinical features (age, degree of tumor differentiation, and distance from the lower edge of the tumor to the anal edge) and six radiomics features (two DWI-related features and four T2WI-related features) most related to microsatellite status of rectal cancer patients were selected. The AUC of the clinical-radiomics model in the training group was 0.95. In the validation group, the AUC was 0.81, better than the clinical model (0.68, Z=0.71, P=0.04), and equivalent to the T2WI+DWI model (0.82, Z=0.21, P=0.83). Conclusions: Radiomic features based on preoperative T2WI and DWI were related to microsatellite stability in patients with stage Ⅱ and Ⅲ rectal cancer and showed a high classification efficiency. The model based on the features provided a noninvasive and convenient tool for preoperative determination of microsatellite stability in rectal cancer patients.
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ObjectiveTo explore the mediating effect of rumination on the relationship between insomnia and suicidal ideation in adolescents with depressive disorder, so as to provide guidance for the preventions of suicidal ideation. MethodsA total of 302 adolescents with major depressive disorder in Department of Psychosomatic Medicine of Deyang People's Hospital from January to December 2020 and met the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) clinical significance criterion for depressive disorder were enrolled. All individuals were assessed using Insomnia Severity Index (ISI), Ruminative Response Scale (RRS) and Positive and Negative Suicide Ideation (PANSI). Then the mediating effect of rumination in the relation between insomnia and suicidal ideation in adolescents with major depression disorder was analyzed using Process v3.2 model 4, and testified with the bias-corrected non-parametric percentile Bootstrap method. ResultsISI scores in adolescents with major depression disorder were positively correlated with PANSI score (r=0.400, P<0.01), and were positively correlated with RRS total score, obsessive thinking and introspection factor score (r=0.378, 0.360, 0.333, P<0.01). RRS score was also positively correlated with PANSI score (r=0.292, P<0.01). Rumination exerted a partial mediating effect on the relationship between insomnia and suicidal ideation (β=0.174, 95% CI: 0.098~0.261). ConclusionThe relationship between insomnia and suicidal ideation in adolescents with depressive disorder is partially mediated by rumination, additionally, insomnia can affect suicidal ideation in adolescents with depressive disorder both directly and indirectly through rumination.
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BackgroundChronic superficial gastritis (CSG) is a common clinical disease in children. The emotional behavior of CSG children is susceptible due to them suffering from such disease at young age. ObjectiveTo explore the impact of coping strategies on emotional behavior and the effect of family function in children with CSG, and to provide references for clinical intervention in CSG children with emotional behavior problems. MethodsA total of 177 children with CSG admitted to Anhui Children's Hospital from June 2019 to January 2023 were selected as the research subjects. Investigation on family function, emotional and behavioral problems and coping strategies of children was conducted by employing the Family APGAR index (APGAR), the Strengths and Difficulties Questionnaire (SDQ) and Coping Strategies Questionnaire (CSQ). The structural equation model was used to test the mediating effect of family function between coping strategies and emotional behaviors. ResultsThe APGAR score was negatively correlated with both SDQ score and negative coping strategies score (r=-0.507, -0.551, P<0.01), but was positively correlated with positive coping strategy score (r=0.579, P<0.01). The positive coping strategy score was negatively correlated with SDQ score (r=-0.539, P<0.01), while the negative coping strategy score was positively correlated with SDQ score (r=0.543, P<0.01). The result showed that family function played a partial mediating role between positive coping strategies and emotional behavior [indirect effect was -0.133 (95% CI: -0.256~-0.079, P<0.01), accounting for 29.40% of the total effect]. The same mediating effect happened between negative coping strategies and emotional behavior [indirect effect was 0.093 (95% CI: 0.198~0.045, P<0.01), accounting for 28.50% of the total effect]. ConclusionCoping strategies of CSG children can affect emotional behavior directly and indirectly with family function playing a partial intermediary effect.
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AIM:To investigate the effect of vision therapy system 4D combined with stereoscopic 3D technology training for the treatment of amblyopia.METHODS: Prospective study. A total of 102 children with amblyopia who attended the clinic from January 2018 to January 2022 were selected, and they were randomly assigned into two groups by computer, with 51 cases in each group. Control group received stereoscopic 3D technology training, while observation group participated in vision therapy system 4D on the basis of control group. Then the overall effective rate, binocular visual function, spherical equivalent(SE), axial length(AL), mean corneal curvature(Km), best corrected visual acuity(BCVA)and visual evoked potential were compared between two groups.RESULTS: The overall efficacy rate was 94.1% in observation group, which was obviously higher than control group(74.5%; P<0.05). The improvement in binocular vision parameters simultaneous perception, total fusion, and stereoacuity were all more remarkable in observation group than in control group(P<0.05). The △SE, △AL and △Km yielded no statistical difference between two groups(P>0.05). The latency of two spatial frequencies(1°grid and 15'grid)showed a decline in both groups, and the decline was more notable in observation group than in control group(P<0.05). In both groups, BCVA improved, and the improvement was more significant in observation group compared with control group(P<0.05).CONCLUSION: Application of vision therapy system 4D combined with stereoscopic 3D technology training for amblyopia can effectively ameliorate the visual acuity, promote the reconstruction of simultaneous perception, total fusion, and stereoacuity without additional risk of myopic shift, and improve visual pathway function in children.
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This study was aimed to investigate the effect of hypoxia on lipopolysaccharide (LPS)-induced CXC-chemokine ligand-10 (CXCL10) expression and the underlying mechanism. C57BL/6J mice were randomly divided into control, hypoxia, LPS, and hypoxia combined with LPS groups. The LPS group was intraperitoneally injected with 0.5 mg/kg LPS, and the hypoxia group was placed in a hypobaric hypoxia chamber (simulated altitude of 6 000 m). The serum and hippocampal tissue samples were collected after 6 h of the treatment. The levels of CXCL10 in the serum and hippocampal tissue of mice were detected by ELISA. The microglia cell line BV2 and primary microglia were stimulated with hypoxia (1% O2) and/or LPS (100 ng/mL) for 6 h. The mRNA expression level of CXCL10 and its content in culture supernatant were detected by real-time quantitative PCR and ELISA, respectively. The phosphorylation levels of nuclear factor κB (NF-κB) signaling pathway-related proteins, p65 and IκBα, were detected by Western blot. Moreover, after NF-κB signaling pathway being blocked with a small molecular compound, PDTC, CXCL10 mRNA expression level was detected in the BV2 cells. The results showed that in the LPS-induced mouse inflammatory model, hypoxia treatment could promote LPS-induced up-regulation of CXCL10 in both serum and hippocampus. Compared with the cells treated with LPS alone, the expression of CXCL10 mRNA and the content of CXCL10 in the culture supernatant of BV2 cells treated with hypoxia combined with LPS were significantly increased. The CXCL10 mRNA level of primary microglial cells treated with hypoxia combined with LPS was significantly up-regulated. Compared with the cells treated with hypoxia or LPS alone, the phosphorylation levels of p65 and IκBα in the BV2 cells treated with hypoxia combined with LPS were significantly increased. PDTC blocked the induction of CXCL10 gene expression by LPS in the BV2 cells. These results suggest that hypoxia promotes LPS-induced expression of CXCL10 in both animal and cell models, and NF-κB signaling pathway plays an important role in this process.
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Animales , Ratones , Quimiocinas CXC/farmacología , Hipoxia , Ligandos , Lipopolisacáridos/farmacología , Ratones Endogámicos C57BL , Microglía/metabolismo , FN-kappa B/metabolismo , Inhibidor NF-kappaB alfa/farmacología , ARN Mensajero/metabolismoRESUMEN
The present study aims to construct an elderly vitality index evaluation system and develop a comprehensive vitality evaluation scale for the elderly to reasonably evaluate the vitality level of the elderly in China, so as to provide a reference for promoting the realization of "active aging" and "healthy aging". Literature research and in-depth interview were used to collect the senile vitality sensitive indexes. The indexes were screened and corrected by Delphi expert consultation method, item analysis method based on classical test theory, factor analysis method, and reliability and validity analysis method. The analytic hierarchy process was used to calculate the weight of each level of indexes. An elderly vitality evaluation system including 4 first-level indexes and 24 second-level indexes was constructed. The consistency test results of all levels of indicators showed that the consistency index (CI) and consistent ratio (CR) were both less than 0.1, which met the requirements and showed satisfactory consistency. The weights of exercise vitality, nutritional vitality, psychological vitality and social vitality were 0.263, 0.141, 0.455 and 0.141, respectively. In conclusion, the comprehensive vitality scale constructed for the Chinese elderly is reliable and scientific, and can be used to evaluate the vitality of the elderly.
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Humanos , Anciano , Proceso de Jerarquía Analítica , Reproducibilidad de los Resultados , Técnica Delphi , Envejecimiento , China , Encuestas y CuestionariosRESUMEN
The present study aims to establish comprehensive evaluation models of physical fitness of the elderly based on machine learning, and provide an important basis to monitor the elderly's physique. Through stratified sampling, the elderly aged 60 years and above were selected from 10 communities in Nanchang City. The physical fitness of the elderly was measured by the comprehensive physical assessment scale based on our previous study. Fuzzy neural network (FNN), support vector machine (SVM) and random forest (RF) models for comprehensive physical evaluation of the elderly people in communities were constructed respectively. The accuracy, sensitivity and specificity of the comprehensive physical fitness evaluation models constructed by FNN, SVM and RF were above 0.85, 0.75 and 0.89, respectively, with the FNN model possessing the best prediction performance. FNN, RF and SVM models are valuable in the comprehensive evaluation and prediction of physical fitness, which can be used as tools to carry out physical evaluation of the elderly.
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Anciano , Humanos , Aptitud Física , Redes Neurales de la Computación , Ejercicio Físico , Aprendizaje AutomáticoRESUMEN
Outpatient information management system is an important part of hospital information system,which plays an important role in hospital management,patient treatment,medical insurance reimbursement and settlement.This study integrated the application modes of big data,cloud computing,Internet of things and other cutting-edge technologies of artificial intelligence,focused on the intelligent decision support and whole-process simplified management of the diagnosis and treatment behavior of clinical TCM physicians,and developed a cloud intelligent TCM outpatient system for primary medical care.The system has intelligent medical functions such as intelligent prescription monitoring driven by the rule engine and intelligent recommendation of traditional Chinese medicine knowledge.It seamlessly connects with the intelligent four-diagnosis instrument for information collection and medical order input,and realizes the cloud storage,computing,distribution,management,service and outpatient process,multi-directional and convenient management mode.
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@#Objective To share a case of anti-glutamate decarboxylase 65 antibody stiff-person syndrome and autoimmune polyendocrinopathy syndrome type Ⅱ,to improve clinicians' understanding of this disease. Methods The clinical data of a 51-year-old woman who was admitted to the affiliated hospital of a Neurology Institute in Anhui Province in 2022 was retrospectively analyzed,and the relevant literature was reviewed. Results Patients' clinical to repeatedly lumbago,lumbar abdomen and the stiffness of lower limbs with unable to characteristics of early misdiagnosed as separate conversion disorder,after the inspection found that serum and cerebrospinal fluid resistance to glutamic acid decarboxylase antibody positive 65,thyroglobulin antibody and higher peroxidase antibody degrees,fasting and postprandial 2 hours blood sugar,glycosylated hemoglobin,Neuroelectrophysiology showed that the continuous motor unit potential was mainly distributed by body axis muscles in the resting state. The patient was diagnosed as anti-glutamic acid decarboxylase 65 antibody SPS and APS-Ⅱ (Hashimoto's thyroiditis,type 1 diabetes mellitus),and the condition improved after immunotherapy and symptomatic treatment. Conclusion Although anti-glutamate decarboxylase 65 antibody SPS complicated with APS-Ⅱ has certain clinical specificity,it is easy to be misdiagnosed and missed because of its rarity,especially in the early course of disease.
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Glucose transporter 1(GLUT1)overexpression in tumor cells is a potential target for drug therapy,but few studies have reported screening GLUT1 inhibitors from natural or synthetic compounds.With cur-rent analysis techniques,it is difficult to accurately monitor the GLUT1 inhibitory effect of drug molecules in real-time.We developed a cell membrane-based glucose sensor(CMGS)that integrated a hydrogel electrode with tumor cell membranes to monitor GLUT1 transmembrane transport and screen for GLUT1 inhibitors in traditional Chinese medicines(TCMs).CMGS is compatible with cell membranes of various origins,including different types of tumors and cell lines with GLUT1 expression knocked down by small interfering RNA or small molecules.Based on CMGS continuous monitoring technique,we inves-tigated the glucose transport kinetics of cell membranes with varying levels of GLUT1 expression.We used CMGS to determine the GLUT1-inhibitory effects of drug monomers with similar structures from Scutellaria baicalensis and catechins families.Results were consistent with those of the cellular glucose uptake test and molecular-docking simulation.CMGS could accurately screen drug molecules in TCMs that inhibit GLUT1,providing a new strategy for studying transmembrane protein-receptor interactions.
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Periodontology is one of the important disciplines in oral clinical medicine, which covers a wide range of subjects and intersects with many basic disciplines. Under the environment of the implementation of modular teaching in Shanghai Jiao Tong University School of Medicine, the assessment method with separate propositions for the teaching and research section is still adopted. There is a mismatch between the assessment mode and the curriculum setting; the basic subject propositions are difficult to be combined with clinical cases; the knowledge point assessment is single, and the students' ability to integrate the knowledge points cannot be assessed. The development and construction of the comprehensive examination database for periodontology was based on curriculum integration, gathering the teaching backbones of various disciplines, focusing on periodontology, radiating all related disciplines, unifying the proposition outline, proposition type, proposition principle, combining with relevant knowledge points of various disciplines based on clinical cases, and tried to apply to clinical students majoring in stomatology. The use of the examination database promotes students' ability to flexibly apply theoretical knowledge to clinical case analysis, further promotes the reform of modular teaching, lays a solid foundation for future clinical work, and meanwhile provides an important basis for directions of the teaching and research section.
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Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.
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Adulto , Humanos , Adolescente , Mesilato de Imatinib/efectos adversos , Incidencia , Antineoplásicos/efectos adversos , Estudios Retrospectivos , Pirimidinas/efectos adversos , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Resultado del Tratamiento , Benzamidas/efectos adversos , Leucemia Mieloide de Fase Crónica/tratamiento farmacológico , Aminopiridinas/uso terapéutico , Inhibidores de Proteínas Quinasas/uso terapéuticoRESUMEN
Reduced chemotactic migration of polymorphonuclear neutrophil (PMN) in sepsis patients leads to decreased bacterial clearance and accelerates the progression of sepsis disease. Quantification of PMN chemotaxis in sepsis patients can help characterize the immune health of sepsis patients. Microfluidic microarrays have been widely used for cell chemotaxis analysis because of the advantages of low reagent consumption, near-physiological environment, and visualization of the migration process. Currently, the study of PMN chemotaxis using microfluidic chips is mainly limited by the cumbersome cell separation operation and low throughput of microfluidic chips. In this paper, we first designed an inertial cell sorting chip to achieve label-free separation of the two major cell types by using the basic principle that leukocytes (mainly granulocytes, lymphocytes and monocytes) and erythrocytes move to different positions of the spiral microchannel when they move in the spiral microchannel under different strength of inertial force and Dean's resistance. Subsequently, in this paper, we designed a multi-channel cell migration chip and constructed a microfluidic PMN inertial label-free sorting and chemotaxis analysis platform. The inertial cell sorting chip separates leukocyte populations and then injects them into the multi-channel cell migration chip, which can complete the chemotaxis test of PMN to chemotactic peptide (fMLP) within 15 min. The remaining cells, such as monocytes with slow motility and lymphocytes that require pre-activation with proliferative culture, do not undergo significant chemotactic migration. The test results of sepsis patients ( n=6) and healthy volunteers ( n=3) recruited in this study showed that the chemotaxis index (CI) and migration velocity ( v) of PMN from sepsis patients were significantly weaker than those from healthy volunteers. In conclusion, the microfluidic PMN inertial label-free sorting and chemotaxis analysis platform constructed in this paper can be used as a new tool for cell label-free sorting and migration studies.