Clinical analysis of immunotherapy rechallenge in advanced gastric cancer / 中华肿瘤杂志

Objective: To evaluate the efficacy and influencing factors of programmed death protein 1 (PD-1) monoclonal antibody rechallenge therapy in advanced gastric cancer (GC). Methods: The clinical data of patients with advanced GC who were treated with anti-PD-1 rechallenge in Henan Cancer Hospital from January 2020 to December 2021 were collected retrospectively. The progression-free survival (PFS) was defined as the time from the first or second used of anti-PD-1 treatment to the date of disease progression or the last follow-up, named PFS(1) and PFS(2), respectively. Kaplan-Meier method and Log rank test were used for survival analysis, Cox proportional hazard model was used to analyze the influencing factors. Results: A total of 60 patients with anti-PD-1 rechallenge therapy were collected, the median follow-up time was 12.2 months. The median progression-free survival (PFS(2)) of anti-PD-1 rechallenge therapy was 2.9 months, the objective response rate (ORR) was 16.7%, and the disease control rate (DCR) was 55.0%. The median PFS(2) of the first and second anti-PD-1 identical and different rechallenge treatment was 3.5 months and 1.9 months (P=0.007) respectively. The median PFS(2) of positive PD-L1 expression in rechallenge therapy was 3.4 months, ORR was 22.7%, and DCR was 63.6%; the median PFS(2) was 4.5 months, ORR was 27.3%, and DCR was 54.5% in patients with median PFS(1)≥6 months. Multivariate analysis showed that peritoneal metastasis was independently associated with anti-PD-1 rechallenge therapy with PFS(2) (HR=2.327, 95% CI, 1.066-5.082, P=0.034). The incidence of adverse reactions in grade 1-2 and grade 3-4 of anti-PD-1 rechallenge therapy was 83.3%, and 35.0%, respectively, and the safety was controllable. Conclusion: Rechallenge therapy with anti-PD-1 is a feasible treatment in advanced GC, but the screening of suitable population for rechallenge therapy still needs prospective data analysis and verification.

Postoperative ocular surface changes in acute attack eye and contralateral eye with angle-closure glaucoma and cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the postoperative ocular surface changes in acute attack eye and contralateral eye with primary angle-closure glaucoma(PACG)and cataract.METHODS: A total of 40 patients with monocular acute PACG combined with cataract who admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to January 2022 were selected. Trabeculectomy combined with phacoemulsification and intraocular lens implantation was carried out in the acute attack eyes, and phacoemulsification and intraocular lens implantation were carried out in the contralateral eyes. The ocular surface disease index(OSDI)questionnaire, noninvasive first tear film break-up time(NifBUT), noninvasive average tear film break-up time(NiaBUT)and tear meniscus height(TMH)were assessed preoperatively and 1, 3 and 6mo postoperatively.RESULTS: The OSDI scores of the included patients at 1 and 3mo postoperatively(14.72±3.07, 11.39±2.24)were significantly higher than those preoperatively(9.68±1.98; all P<0.0083), and there was no significant difference between 6mo postoperatively(10.18±1.84)and preoperatively. NifBUT of the acute attack eyes at 1 and 3mo postoperatively was significantly lower than that preoperatively, and NiaBUT of the acute attack eyes at 1, 3 and 6mo postoperatively was significantly lower than that preoperatively(all P<0.0083). The NifBUT and NiaBUT of the contralateral eyes at 1mo postoperatively were significantly lower than those preoperatively(all P<0.0083), and there was no significant difference between 3 and 6mo postoperatively and preoperatively. There was no significant difference in TMH of the attack eyes and the contralateral eyes postoperatively and preoperatively(P>0.05).CONCLUSION: The stability of tear film after surgery of PACG and cataract is decreased. The acute attack eye needs 6mo or even longer to recover, while the contralateral eye needs roughly 3mo.

Effect of improved partial graft excision in the treatment of infected arteriovenous grafts / 中华肾脏病杂志

Objective:To investigate the effect of improved partial graft excision (iPGE) in the treatment of infected arteriovenous grafts (AVG).Methods:It was a single-center retrospective study. A cohort database study of patients who underwent surgery for infected AVG from January 2019 to July 2022 was conducted. The cases were divided into total graft excision (TGE) group and iPGE group, and the postoperative reinfection rate and surgery-related complications, such as bleeding, nerve injury and limb ischemia, in the two groups were analyzed. The primary patency rate and the secondary patency rate at 3 months and 6 months after the surgery in the iPGE group were analyzed.Results:(1) General information: A total of 47 cases were included in the study. Among these 47 cases, 14 cases had undergone iPGE of infected AVG, and 33 cases had undergone TGE. The study population was of an average age of 59 years (21-81 years), including 18 males and 29 females. Dialysis age was 36 (14, 72) months. AVG age was 18 (4, 36) months. The shortest AVG age was half a month, and the longest AVG age was 72 months. (2)Comparative analysis of the two groups: The reinfection rate of the iPGE group was 21.4% (3/14), and the reinfection rate of the TGE group was 0 (0/33). The reinfection rate of the iPGE group was higher than that of the TGE group, and the difference was statistically significant (Fisher exact test, P=0.022). For 11 patients in the iPGE group (excluding 3 cases with reinfection), the shortest follow-up period was 5 months and the longest follow-up period was 18 months. In the iPGE group, the primary patency rate at 3 months was 72.7% (8/11), and the primary patency rate at 6 months was 72.7% (8/11); the secondary patency rate at 3 months was 100% (11/11) and the secondary patency rate at 6 months was 90.9% (10/11). There was no brachial artery rupture, nerve injury or limb ischemia in the iPGE group. In the TGE group, 1 case underwent secondary repair of brachial artery due to brachial artery rupture, and there was no nerve injury or limb ischemia in other cases. Conclusions:During the treatment of infected AVG, iPGE can preserve the original fistula, and avoid central venous catheterization. At the same time, the operation difficulty and risk are relatively low. Although the reinfection rate of iPGE is slightly higher than that of TGE in this study, the reinfection rate of iPGE is lower than that reported in the previous study. The key to prevent reinfection is to grasp the reasonable surgical adaptation signs in preoperative evaluation, perform intraoperative reevaluation and control surgical operation details. The iPGE represents an acceptable method for the treatment of some particular patients with infected AVG.

Cell HE staining smears and paired cell paraffin sections in detection of epithelial growth factor receptor gene of pleural fluid specimens / 中南大学学报(医学版)

OBJECTIVES@#The advanced non-small cell lung cancer (NSCLC) patients with pleural effusion have no opportunity for surgery treatment. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are the first-line drugs for these patients with EGFR-sensitive mutation. However, the disease progression and drug update during or after treatment of EGFR-TKIs bring more challenges and puzzles to clinical diagnosis and treatment, which inevitably requires archived pleural cell samples for EGFR re-examination or comparative study. Understanding the DNA quality of archived pleural fluid samples and effectively using archival data of pleural fluid cells are of great significance for tracing the origin of cases and basic medical research. This study aims to evaluate the consistency of EGFR mutant gene expression between the 2 methods, and to explore a reliable way for preserving cytological data and making full use of cytological archival data via cell HE staining smear and cell paraffin section.@*METHODS@#A total of 57 pleural fluid cytology cases in the Department of Pathology of China Aerospace Center Hospital from October 2014 to April 2021 were selected. Tumor cells were detected by cell HE staining smears and immunohistochemical staining for TTF-1 and Napsin A in the paired cell paraffin sections. There were more than 200 tumor cells in cell HE staining smear and the proportion of tumor cells were ≥70% in matched cell paraffin sections. Patients with 2 cell smears (one for cell data retention and the other for DNA extraction) were selected as the research subjects, and 57 pleural fluid samples were enrolled. EGFR gene mutation was detected by amplification refractory mutation system-polymerase chain reaction in 57 paired cell HE staining smears and cell paraffin sections. DNA concentration was 2 ng/μL. Cell HE smear was amplified side-by-side with DNA samples from paired cell paraffin sections. Result determination was according to the requirements of the reagent instructions. The external control cycle threshold (Ct) value of the No. 8 well of the samples to be tested was between 13 and 21, which was considered as successful and reliable samples. When the Ct value of EGFR gene mutation was <26, it was considered as positive; when the Ct value was between 26 and 29, it was critical positive; when the Ct value was equal or more than 29, it was negative. ΔCt value was the difference between mutant Ct value and externally controlled Ct value. The smaller the ΔCt value was, the better the quality of DNA of the detected sample was.@*RESULTS@#Among the 57 pleural effusion samples, 42 patients were hospitalized with pleural effusion as the first symptom, accounting for 73.7% (42/57). EGFR mutation was detected in 37 samples [64.9% (37/57)]. The mutation rate for 19del was 37.8% (14/37) while for L858R was 48.6% (18/37). Females were 56.7% (21/37) of mutation cases. The mutation consistency rate of cell HE staining smear and matched cell paraffin sections was 100%. The ΔCt values of cell HE staining smears were less than those of matched cell paraffin sections. The mutation Ct values of 37 cytological samples were statistically analyzed according to the preservation periods of the years of 2014-2015, 2016-2017, 2018-2019, and 2020-2021. There were significant differences in cell paraffin section in the years of 2014-2015 and 2016-2017 compared with the years of 2018-2019 and 2020-2021, while no significant differences were found in cell HE staining smear. Statistical analysis of externally controlled Ct values of 57 cytological samples showed that there were significant differences between cell HE staining smears and cell paraffin section in the years of 2014-2015 and 2016-2017, compared with the years of 2018-2019 and 2020-2021. The mutational Ct values of 37 paired cell blocks and smears were all <26, and the externally controlled Ct values of 57 paired cell paraffin sections and HE staining smears were all between 13 and 21.@*CONCLUSIONS@#The DNA quality of cell HE smears and matched cell paraffin section met the qualified requirements. Two methods possess show an excellent consistency in detecting EGFR mutation in NSCLC pleural fluid samples. The DNA quality of cell HE staining smear is better than that of cell paraffin sections, so cell HE staining smear can be used as important supplement of the gene test source. It should be noted that the limitation of cell HE staining smears is non-reproducibility, so multiple smears of pleural fluid are recommended to be prepared for multiple tests.

Application research of multi-dimensional interaction combined with PBL teaching in emergency and critical care nursing practice teaching / 中华医学教育探索杂志

Objective:To explore the value of multi-dimensional interaction combined with problem-based learning (PBL) teaching in the nursing practice teaching of emergency and critical care.Methods:A total of 110 nursing students who practiced in the First Affiliated Hospital of Xinjiang Medical University from June 2019 to March 2020 were selected as the control group, and the traditional teaching was adopted. In addition, 89 nursing students who practiced from June 2020 to December 2020 were selected as the research group, and multi-dimensional interaction combined with PBL teaching was adopted. The teaching quality was assessed through the comprehensive scores of the nursing students (departure examination + regular performance assessment) and nursing students' feedback on the teaching. SPSS 22.0 was used for t-test and Chi-square test. Results:The comprehensive scores of the nursing students in the research group were higher than those in the control group, and the difference was statistically significant ( P<0.001). Compared with the control group, the nursing students in the research group believed that multi-dimensional interaction combined with PBL teaching could improve nursing knowledge and skills, overall clinical nursing ability, self-management ability, clinical thinking ability, and the ability to analyze, judge and solve clinical nursing problems, group cooperation ability, communication ability between doctors, nurses and patients, emergency ability and rescue ability, and professional quality, with statistically significant differences ( P<0.001). Conclusion:Multi-dimensional interaction combined with PBL teaching can improve the theoretical and clinical practice level of nursing interns, and at the same time help to cultivate nursing talents with excellent comprehensive quality.

Establishment and verification of the multi-dimensional peripheral contrast sensitivity function measurement based on Bayesian probability estimation algorithm / 中华实验眼科杂志

Objective:To evaluate the feasibility and accuracy of a multi-dimensional peripheral quick contrast sensitivity function (pqCSF) measurement established based on Bayesian probability estimation algorithm.Methods:A cross-sectional study was conducted.Nineteen eyes of 12 healthy emmetropic subjects in Zhongshan Ophthalmic Center of Sun Yat-sen University from September 2017 to March 2018 were included, with an average age of (22.92±2.91) years.The average spherical power and cylindrical power were (-0.34±0.52)D and (-0.30±0.42)D, respectively, and the average uncorrected vision acuity was≥1.0.Based on the Bayesian probability algorithm, the peak contrast sensitivity γ max, the peak spatial frequency ? max, the bandwidth β and the low contrast intercept δ were used to quickly describe the contrast sensitivity function (CSF) curve of the full spatial frequency through multi-dimensional pqCSF method.The 16 peripheral visual field positions of all subjects were tested at 6°, 12°, 18° and 24° eccentricity of the superior, inferior, the temporal and nasal visual field by the pqCSF method, but the 18° eccentricity of temporal field, which was near the physiological blind spot, was excluded.The area under Log CSF (AULCSF) of different peripheral visual fields and the Log CSF of 19 spatial frequencies (distributed at equal intervals in logarithmic units) were compared.This study followed the Declaration of Helsinki, and the study protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University (No.2018KYPJ017). Written informed consent was obtained from each subject prior to any examination. Results:With the increase of eccentricity in different visual fields, the AULCSF decreased gradually, and there were significant differences in AULCSF between different eccentricities (all at P<0.05). The AULCSF of the nasal and temporal visual field at 6°, 12° and 24° eccentricity was significantly larger than that of the superior and inferior visual field (all at P<0.05). As the distance from the fovea was increased, the pqCSF, the AULCSF, and the high-frequency cutoff were all decreased, and the standard deviation of AULCSF was increased gradually. Conclusions:The pqCSF method can depict a relatively complete peripheral CSF curve of a wide peripheral visual field, and reflect the function quality of the peripheral vision comprehensively and accurately.

Application of multidisciplinary cooperation model in the prevention of acquired dysphagia in ICU / 中国实用护理杂志

Objective:To explore the clinical effect of multidisciplinary cooperation model in the prevention of acquired dysphagia in ICU.Methods:A multidisciplinary team was set up to collect 118 patients in Neurosurgery ICU of our hospital as the research object. The patients were divided into the experimental group and the control group, 59 cases in each group. The control group implemented the routine nursing measures of ICU, and the experimental group implemented the multidisciplinary cooperative nursing mode. The incidence of ICU acquired swallowing disorders (ICU-ASD) and complications of the two groups were compared.Results:There was no significant difference between the two groups in the incidence of swallowing dysfunction 24 hours after tracheal extubation ( P>0.05). The incidence of swallowing dysfunction 48 hours and 72 hours after tracheal extubation in the control group was 11.86% (7/59) and 16.95% (10/59) respectively, while the test group was 1.69% (1/59) and 3.39% (2/59) respectively. The difference was statistically significant ( χ 2values were 4.827 to 7.230, P< 0.05 or 0.01); the incidence of aspiration, aspiration pneumonia and malnutrition in the control group were 11.86% (7/59), 10.17% (6/59) and 8.47% (5/59), respectively, while the test group were 1.69% (1/59), 0 and 0, respectively, with statistically significant difference ( χ 2value was 4.827, P< 0.05). Conclusion:Multidisciplinary cooperation model can effectively prevent the incidence of ICU-ASD, and ultimately reduce the incidence of complications.

Clinical features and prognosis analysis of Philadelphia chromosome-positive chronic myeloid leukemia with additional chromosomal abnormalities / 白血病·淋巴瘤

Objective:To investigate the clinical characteristics and prognosis of Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML) patients with additional chromosomal abnormalities.Methods:The data of 351 CML patients with Ph-positive in the Affiliated Hospital of Qingdao University from January 2009 to January 2019 were retrospectively analyzed. The bone marrow chromosomal karyotype analysis of all patients was performed by using R-banding technique. The clinical characteristics and karyotype of Ph-positive CML patients with additional chromosomal abnormalities at initial diagnosis were summarized, and Kaplan-Meier was used to analyze the differences in overall survival (OS) of patients with different karyotypes.Results:Among 351 patients with Ph-positive CML, 32 (9.1%) cases had variant translocation. At initial diagnosis, 47 cases had additional chromosomal abnormalities including 29 cases in chronic phase accounting for 9.15% (29/317) of all patients in chronic phase, 3 cases in accelerated phase accounting for 25.00% (3/12) of all patients in accelerated phase, 15 cases in blast crisis accounting for 68.18% (15/22) of all patients in blast crisis; there was a statistically significant difference in the chromosomal abnormalities rate of all different phases ( χ2=50.799, P<0.05). Among 47 Ph-positive CML patients with additional chromosomal abnormalities, 13 patients had complex karyotypes with more than 3 additional chromosomal abnormalities, the proportion of complex karyotypes in chronic phase, accelerated phase and blast crisis was 13.79% (4/29), 33.33% (1/3) and 53.33% (8/15), respectively, and the difference was statistically significant ( χ2=9.26, P<0.05). The study showed that the most common additional chromosomal abnormalities in chronic phase were double Ph (48.28%, 14/29) and -Y (10.34%, 3/29), while the most common chromosomal abnormalities in the blast crisis were +8 (26.67%, 4/15) and double Ph (26.67%, 4/15). Kaplan-Meier survival analysis showed that at initial diagnosis the OS time of patients with additional chromosomal abnormalities was worse than that of those with the non-additional chromosomal abnormalities group ( χ2 = 61.138, P<0.05). The OS of patients with complex karyotypes for Ph - positive CML patients with additional chromosomal abnormalities at initial diagnosis was worse than that of patients with non-complex karyotypes, and the difference was significant ( χ2 = 4.945, P < 0.05). Conclusions:The additional chromosomal abnormalities is closely related to the progression of CML, and the prognosis of CML patients with additional chromosomal abnormalities is poorer than that of patients with only Ph translocation. Moreover, the more complex the additional chromosomes are, the more likely blastic changes are, and the poorer prognosis. And additional chromosomeal abnormalities during the treatment of CML patients may also lead to the progression of blastic changes.

Status of health-promoting lifestyle and influencing factors for caregivers of children with neurodevelopmental disorders / 中华行为医学与脑科学杂志

Objective:To describe the health-promoting lifestyle of caregivers of children with neurodevelopmental disorders and analyze its influencing factors.Methods:A total of 352 caregivers of children with neurodevelopmental disorders in a hospital in Shenzhen were investigated by questionnaire.The main caregivers were investigated with health-promotion lifestyle scale Ⅱ.Generalized linear model was used to analyze the influencing factors of the health promoting lifestyle score of the caregivers by SPSS 20.0 and R 3.6.0 softwares.Results:The total score of health promotion lifestyle for caregivers of children with neurodevelopmental disorders was (127.66±17.87). The standardized score was (62.05±8.96), with the highest standardized score being (69.62±11.04) for the nutrition dimension and the lowest score being (51.67±11.45) for the physical activity dimension.The difference between the groups was statistically significant ( F=62.780, P<0.01). The results of linear regression analysis showed that the education level ( "junior college" vs "primary and junior high school" : β=14.524, t=3.054, P=0.002; "undergraduate and above" vs "primary and junior high school" : β=18.561, t=3.936, P<0.001), care time ( ">3 years" vs " <1 year" : β=-7.156, t=-3.687, P=0.003), and family income ( "10 000-20 000 yuan/ month" vs "<5 000 yuan/month" : β=14.351, t=3.050, P=0.002) were the influencing factors of health promotion lifestyle of caregivers. Conclusion:The life style of caregivers should be paid attention to.It is necessary to help them improve their health-promoting lifestyle through multiform health promotion methods.

Polymorphisms of Ionotropic Glutamate Receptor-Related Genes and the Risk of Autism Spectrum Disorder in a Chinese Population

OBJECTIVE: To evaluate the association of GRIK2 and NLGN1 with autism spectrum disorder in a Chinese population. METHODS: We performed spatio-temporal expression analysis of GRIK2 and NLGN1 in the developing prefrontal cortex, and examined the expression of the genes in ASD cases and healthy controls using the GSE38322 data set. Following, we performed a case-control study in a Chinese population. RESULTS: The analysis using the publicly available expression data showed that GRIK2 and NLGN1 may have a role in the development of human brain and contribute to the risk of ASD. Later genetic analysis in the Chinese population showed that the GRIK2 rs6922753 for the T allele, TC genotype and dominant model played a significant protective role in ASD susceptibility (respectively: OR=0.840, p=0.023; OR=0.802, p=0.038; OR=0.791, p=0.020). The NLGN1 rs9855544 for the G allele and GG genotype played a significant protective role in ASD susceptibility (respectively: OR=0.844, p=0.019; OR=0.717, p=0.022). After adjusting p values, the statistical significance was lost (p>0.05). CONCLUSION: Our results suggested that GRIK2 rs6922753 and NLGN1 rs9855544 might not confer susceptibility to ASD in the Chinese population.

Role of Th17 Cells, Interleukin-17 and Matrix Metalloproteinase-13 in Pathogenesis of Henoch-Schonlein Purpura / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the immunopathogenesis of Henoch-Schonlein purpara (HSP) by detecting the levels of Th17 cells, IL-17 and matrix metallo proteinase-13 (MMP-13) in peripheral blood and the expression of IL-17 in skin lesions at acate phase of HSP.</p><p><b>METHODS</b>Th17 cell ratio in peripheral blood of HSP group and healthy control group was defected by flow cytometry, the plasma levels of IL-17 and MMP-13 in HSP group and healthy control group were defected by ELISA, and expression level of IL-17 in skin lesion of HSP group and skin tissue of healthy control group was deternined by: immunohistochemistry method.</p><p><b>RESULTS</b>the ratio of Th17 cells in periphral blood of HSP group (1.21±0.59%) was very signif cantly higher than that in peripheral blood of control group (0.71±0.26%) ( t=4.907, P<0.01). The plasma levels of IL-17 and MMP-13 at acute phase of HSP were very significantly higher than those in control group (64.58±36.21) pg/ml vs (26.16±14.90) pg/ml and (17.57±5.40) pg/ml vs (11.53±4.40) pg/ml respectively (t=6.183, P<0.01 and t=5.022, P<0.01). The integrool optical density of IL-17 in skin lesin tissue of HSP group (7.26±2.34) was higher than that in control group (4.61±1.82) ( t=2.877, P<0.01).</p><p><b>CONCLUSION</b>Th17 cells, IL-17 and MMP-13 may be involved in the immunological pathogenesis of HSP.</p>

Burden status quo and influencing factors of main caregivers in stroke patients with home enteral nutrition / 重庆医学

Objective To investigate the burden status quo of caregivers in stroke patients with home enteral nutrition and to analyze the factors influencing the caregivers burden.Methods A total of 202 direct caregivers in stroke patients with enteral nutrition treatment during hospitalization period in this hospital and continued home enteral nutrition after discharge from hospital were collected as the study subjects.The Caregiver Burden Inventory,Self—Rating Anxiety Scale,Self—Rating Depression Scale,patients and caregivers general condition questionnaire were adopted to conduct the survey.The burden level status of caregivers and its related influencing factors were statistically analyzed.Results The results showed that the burden total score in 202 caregivers receiving the investigation was (50.17± 9.75) points.The univariate analysis results showed that that the age of caregivers,family income per capita level,whether caregivers having negative emotions (anxiety or depression),care time,NIHSS scores of patients and feeding mode burden score had statistical differences (P＜0.05).The multivariate analysis results showed that the care time of caregivers,feeding mode,accompanying anxietyor depression in caregivers,NIHSS scores of patients were the main influencing factors of caregivers burden(P＜0.05).Conclusion The caregivers have a great burden in caring the patients,which should arouse attention.

Research based on the e-ICU merge bundle care as the hospital management mode for key indicators devoted to improve the medical quality / 中国实用护理杂志

Objective To discuss the quality improvement effect of the video monitoring management model based on digital ICU for the centralized monitoring of the ICU key index. Methods Selected the ICU key monitoring indicators developed cluster monitoring bundle, using digital ICU monitoring system and clinical management combining synchronous quality supervision and management, developed targeted measures to improve and supervise the implementation, in order to improve the medical quality. Based on the digital ICU in our hospital ICU implementation of key indicators of cluster monitoring and management information for first months the baseline data were compared before and after each index improvement and effect. Results Compared with the pre- implementation period and the baseline survey period, the monitoring times continued to increase by 6 times compared with the baseline. The overall correct implementation rate of the centralized monitoring bundle was increased from 88％(20859/23562) to 98％(107436/109629)from the baseline survey period to July , and the overall correct implementation rate was maintained at about 98 ％ from July to October. Conclusion The management model based on the cluster monitoring of the key indexes of digital ICU can help to improve and improve the medical quality of ICU effectively and continuously, which is beneficial to the management of medical quality in ICU.

Development of Orthographic Awareness, Morphological Awareness and Rapid Automatized Naming of Elementary-level Students in China:A Longitudinal Analysis from Grades 1 to 4 / 华中科技大学学报（医学）（英德文版）

The longitudinal study sought to examine the dynamic development of cognitive skills for reading among elementary-level students in Mainland China.Two groups of students in first (n=164,mean age=6.65 years at first test) and second grade (n=202,mean age=7.73 years at first test) were followed on orthographic awareness,morphological awareness and rapid automatized naming (RAN) for two years.The children exhibited significant improvement in orthographic awareness,morphological awareness and RAN from grades 1 to 4.More importantly,to the orthographic and morphological awareness,while the children took a leap from grade 1 to 2 and grade 3 to 4,the progress developed at relatively slow rates from grade 2 to 3.In order to assure children's development of orthographic and morphological awareness,evidence-based orthographically and morphologically enhanced instruction is needed for Chinese children in the early elementary years,especially for those at the stage from grade 2 to 3.

Development of Orthographic Awareness, Morphological Awareness and Rapid Automatized Naming of Elementary-level Students in China:A Longitudinal Analysis from Grades 1 to 4 / 华中科技大学学报（医学）（英德文版）

The longitudinal study sought to examine the dynamic development of cognitive skills for reading among elementary-level students in Mainland China.Two groups of students in first (n=164,mean age=6.65 years at first test) and second grade (n=202,mean age=7.73 years at first test) were followed on orthographic awareness,morphological awareness and rapid automatized naming (RAN) for two years.The children exhibited significant improvement in orthographic awareness,morphological awareness and RAN from grades 1 to 4.More importantly,to the orthographic and morphological awareness,while the children took a leap from grade 1 to 2 and grade 3 to 4,the progress developed at relatively slow rates from grade 2 to 3.In order to assure children's development of orthographic and morphological awareness,evidence-based orthographically and morphologically enhanced instruction is needed for Chinese children in the early elementary years,especially for those at the stage from grade 2 to 3.

Efficacy and Safety of Teriflunomide in Chinese Patients with Relapsing Forms of Multiple Sclerosis: A Subgroup Analysis of the Phase 3 TOWER Study / 中华医学杂志(英文版)

Background@#Disease-modifying therapy is the standard treatment for patients with multiple sclerosis (MS) in remission. The primary objective of the current analysis was to assess the efficacy and safety of two teriflunomide doses (7 mg and 14 mg) in the subgroup of Chinese patients with relapsing MS included in the TOWER study.@*Methods@#TOWER was a multicenter, multinational, randomized, double-blind, parallel-group (three groups), placebo-controlled study. This subgroup analysis includes 148 Chinese patients randomized to receive either teriflunomide 7 mg (n = 51), teriflunomide 14 mg (n = 43), or placebo (n = 54).@*Results@#Of the 148 patients in the intent-to-treat population, adjusted annualized relapse rates were 0.63 (95% confidence interval [CI]: 0.44, 0.92) in the placebo group, 0.48 (95% CI: 0.33, 0.70) in the teriflunomide 7 mg group, and 0.18 (95% CI: 0.09, 0.36) in the teriflunomide 14 mg group; this corresponded to a significant relative risk reduction in the teriflunomide 14 mg group versus placebo (-71.2%, P = 0.0012). Teriflunomide 14 mg also tended to reduce 12-week confirmed disability worsening by 68.1% compared with placebo (hazard ratio: 0.319, P = 0.1194). There were no differences across all treatment groups in the proportion of patients with treatment-emergent adverse events (TEAEs; 72.2% in the placebo group, 74.5% in the teriflunomide 7 mg group, and 69.8% in the teriflunomide 14 mg group); corresponding proportions for serious adverse events were 11.1%, 3.9%, and 11.6%, respectively. The most frequently reported TEAEs with teriflunomide versus placebo were neutropenia, increased alanine aminotransferase, and hair thinning.@*Conclusions@#Teriflunomide was as effective and safe in the Chinese subpopulation as it was in the overall population of patients in the TOWER trial. Teriflunomide has the potential to meet unmet medical needs for MS patients in China.@*Trial Registration@#ClinicalTrials.gov, NCT00751881; https://clinicaltrials.gov/ct2/show/NCT00751881?term=NCT00751881&rank=1.

The Association of GSDMB and ORMDL3 Gene Polymorphisms With Asthma: A Meta-Analysis

PURPOSE: ORM1-like 3 (ORMDL3) belongs to a highly conserved protein family which is anchored as transmembrane protein in the endoplasmic reticulum. Gasdermin B (GSDMB) is adjacent to ORMDL3 on chromosome 17q21.2 and belongs to the gasdermin-domain containing the protein family (GSDM family). Recent reports suggest that GSDMB and ORMDL3 are associated with asthma in several populations. However, genetic association studies that examined the association of GSDMB and ORMDL3 gene variants with asthma showed conflicting results. To assess whether combined evidence shows the association between GSDMB/ORMDL3 polymorphism and asthma. METHODS: A bibliographic search from MEDLINE identified 13 original articles using the search keywords 'GSDMB', 'ORMDL3', and 'asthma'. An updated literature-based meta-analysis involving 6,691 subjects with asthma, 9,281 control individuals, and 1,360 families were conducted. Meta-odds ratios (ORs) and 95% confidence intervals (CIs) based on the fixed effects model or the random effects model depended on Cochran's Q-statistic and I2 values. Data from case-control and TDT studies were analyzed in an allelic model using the Catmap software. RESULTS: We selected and identified 3 SNPs of ORMDL3 associated with asthma (rs8076131: OR=1.10; 95% CI, 1.02-1.20; P=0.012. rs12603332: OR=1.15; 95% CI, 1.05-1.25; P=0.002. rs3744246: OR=1.10; 95% CI, 1.02-1.17; P=0.008) and 1 SNP of GSDMB associated with asthma (rs7216389: OR=1.37; 95% CI, 1.27-1.47; P<0.01). Publication bias was estimated using modified Egger's linear regression test proposed by Harbordetal and revealed no evidence of biases. Furthermore, cumulative meta-analysis in chronological order showed the inclination toward significant association for rs7216389 and rs12603332 with continually adding studies, and the inclination toward null-significant association for rs3744246 and rs8076131. CONCLUSIONS: Moderate evidence exists for associations of the ORMDL3 rs8076131, rs12603332, and rs3744246 and GSDMB rs7216389 variants with asthma. Large sample size and representative population-based studies and TDT studies with homogeneous asthmatic patients and well-matched controls are warranted to confirm this finding.

Clinical efficacy of four kinds drug oral medicine for 10 days sequential therapy for eradication of helicobacter pylori infection of children / 中国综合临床

Objective To investigate the clinical efficacy and safety of four kinds of drug oral medicine for 10 days sequential therapy for eradication of helicobacter pylori (Hp) infection of children.Methods One hundred and thirty children with Hp infection in the First Hospital of Datong from Apr.2013 to Apr.2014 were randomly divided into two groups with 65 cases in each group.Patients in the observation group were treated with four kinds of oral drug 10 d sequential therapy with omeprazole and amoxicillin-clavulanate potassium at first 5 d and then omeprazole,clarithromycin and metronidazole for the late 5 d.Patients in the control group were received standard triple therapy with omeprazole,clarithromycin and amoxicillin clavulanate potassium for 10 d.After treatment for 1 month,the Hp eradication rate,treatment rate,adverse reaction were evaluated and compared by 14C urea breathe test.Result The clinical efficacy rate of observation group was 93.8 ％ (61/65),significantly higher than that in control group (75.4％,49/65).Meanwhile,Hp eradication rate in observation group was 90.8％ (59/65),significantly higher than that in control group (67.7％,44/65).The differences were significant(x2 =8.51,10.52; P ＜ 0.05).The incidence of adverse reaction of observation group was 10.8％ (7/65),lower than that of the control group 15.4％ (10/65),and the differences was significant(x2 =0.61,P ＞ 0.05).Conclusion There are high Hp eradication and relatively safe of four kinds of oral drug 10 d sequential therapy clinical in treatment of Hp infection of children.It is worthy of clinical promotion.

Analysis of PAH-DNA adducts and gene polymorphisms of CYP1A1 and GSTM1 in lymphoma patients / 白血病·淋巴瘤

Objective To explore the relationship between PAH-DNA adducts and CYP1A1,GSTM1 gene polymorphisms and lymphoma.Methods PAH-DNA adducts from bone marrow of lymphoma patients and control cases were determined by competitive ELISA.The genotypes of both CYP1A1 and GSTM1 were detected by PCR-based restriction fragment length polymorphisms (PCR-RELP).Results The level of PAH-DNA adducts in lymphoma patients [(2 498±1 250) pg/ml] was significantly higher than that in control [(1 882±797) pg/ml] (t =0.006,P ＜ 0.05).CYP1A1 mutant genotype and GSTM1 null genotype had increased risk of lymphoma,with OR being 1.36 (95 ％ CI 0.56-3.31,P ＞ 0.05),4.03 (95 ％ CI 1.51-10.76,P ＜ 0.05),respectively.GSTM1 null genotype individuals with PAH-DNA level higher (or equal) than 2 200 pg/ml had increased risk of lymphoma.Conclusions The content of PAH-DNA adducts and the occurrence of lymphoma may have a certain correlation.GSTM1 null genotype may be linked to lymphoma and increase the risk.

Genomics in personalized cancer medicine and its impact on early drug development in China: report from the 6th Annual Meeting of the US Chinese Anti-Cancer Association (USCACA) at the 50th ASCO Annual Meeting / 癌症

The 6th Annual Meeting of the United States Chinese Anti-Cancer Association (USCACA) was held in conjunction with the 50th Annual Meeting of American Society of Clinical Oncology (ASCO) on May 30, 2014 in Chicago, Illinois, the United States of America. With a focus on personalized medicine, the conference featured novel approaches to investigate genomic aberrations in cancer cells and innovative clinical trial designs to expedite cancer drug development in biomarker-defined patient populations. A panel discussion further provided in-depth advice on advancing development of personalized cancer medicines in China. The conference also summarized USCACA key initiatives and accomplishments, including two awards designated to recognize young investigators from China for their achievements and to support their training in the United States. As an effort to promote international collaboration, USCACA will team up with Chinese Society of Clinical Oncology (CSCO) to host a joint session on "Breakthrough Cancer Medicines" at the upcoming CSCO Annual Meeting on September 20th, 2014 in Xiamen, China.