Cost-effectiveness analysis of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in treatment of chronic rhinosinusitis / 中国中药杂志

This study aims to evaluate the effectiveness and economic efficiency of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of chronic rhinosinusitis(CRS). The randomized controlled trial(RCT) of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of CRS was searched against EMbase, PubMed, Cochrane Library, CNKI, VIP, SinoMed, and Wanfang. The efficacy, nasal mucociliary transport time, and safety of the therapy above in the treatment of CRS were analyzed with single-group rate and Meta-analysis, and the economy and sensitivity were evaluated from the perspective of payer. A total of 9 RCTs were included, including 1 145 patients. Meta-analysis showed that compared with Triamcinolone Acetonide Nasal Spray alone, Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of CRS patients increased the effective rate(RR=1.17, 95%CI[1.11, 1.24], P<0.000 01) and shortened the nasal mucociliary transport time(MD=-3.32, 95%CI[-5.86,-0.78], P=0.01), there was no significant difference in the incidence of adverse reactions between the two groups. The incremental cost-effectiveness analysis showed that the treatment costs of the control group and the observation group were 44.15 yuan and 1 044.96 yuan, respectively. In the Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray treatment group, 75.48 yuan was spent to improve the effective rate of CRS by 1%. The one-way sensitivity analysis indicated the days of treatment, the RR of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray, the price of unit preparation of Biyuan Tongqiao Granules, and the effective rate of Triamcinolone Acetonide Nasal Spray alone had great influence on the incremental cost-effectiveness ratio. In conclusion, Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray improves the therapeutic effect on CRS. The probabilistic sensitivity analysis showed that when the willingness to pay was greater than 7 920 yuan(less than 0.1 of GDP per capita 8 098 yuan), the combined therapy was economically superior to the control. Due to the limited number of articles published, it is necessary to carry out a real-world clinical trial of Biyuan Tongqiao Gra-nules and Triamcinolone Acetonide Nasal Spray in the treatment of CRS, so as to compare the cost-effectiveness of Biyuan Tongqiao Granules and Triamcinolone Acetonide Nasal Spray.

Associação entre vitamina D sérica e rinossinusite crônica: uma metanálise / Association between serum vitamin D and chronic rhinosinusitis: a meta-analysis

Resumo Introdução: A rinossinusite crônica é uma inflamação crônica altamente heterogênea do trato respiratório superior causada por uma disfunção imune nos seres humanos. Entretanto, a etiologia subjacente dessa doença ainda não foi bem estabelecida. Diversos estudos revelaram que anormalidades nos níveis séricos de vitamina D podem desempenhar um papel na fisiopatologia da doença. Objetivo: Fazer uma metanálise de estudos para comparar os níveis séricos de vitamina D entre pacientes com rinossinusite crônica e controles saudáveis e avaliar as potenciais associações do nível sérico de vitamina D com a ocorrência da doença. Método: Seguindo as diretrizes Prisma, bancos de dados relevantes, inclusive Pubmed, Web of Science, Embase e Cochrane Library, foram pesquisados desde a sua data de início até 1° de dezembro de 2018. A simetria do gráfico de funil (funnel plot symmetry) e o teste de Egger foram usados para detectar o viés da publicação. Os desfechos foram apresentados como diferença média ponderada e combinamos a diferença média ponderada e intervalos de confiança de 95% para estimar a diferença dos níveis séricos de vitamina D entre pacientes com rinossinusite crônica e os controles. O valor de I2 de Higgins foi usado para testar a heterogeneidade entre os estudos incluídos. Resultados: Dos 176 estudos que identificamos, apenas oito, que envolveram 337 pacientes com rinossinusite crônica e 179 controles saudáveis, preencheram os critérios e foram incluídos na metanálise. Em uma análise combinada de todos os estudos, a diminuição do nível sérico de vitamina D foi demonstrada na rinossinusite crônica (DMP = −7,80, IC95% −13,28 ± −2,31, p = 0,000). Análises de subgrupos com base no local do estudo (EUA vs. Não EUA), tipos de biomarcadores (25[OH]D3 vs. 25[OH]D) e desenho do estudo (retrospectivo vs. prospectivo) não explicaram a heterogeneidade. No entanto, o fenótipo da rinossinusite crônica (rinossinusite crônica com pólipos nasais vs. rinossinusite crônica sem pólipos nasais) pode explicar algum grau de heterogeneidade. Contudo, um nível sérico mais baixo de vitamina D foi observado em pacientes com rinossinusite crônica com pólipos nasais. Conclusão: Nossos achados indicam que o nível sérico de vitamina D pode estar associado à rinossinusite crônica, pois detectamos uma associação significante entre níveis séricos mais baixos de vitamina D em pacientes com rinossinusite crônica, especialmente na rinossinusite crônica com pólipos nasais. No entanto, mais estudos abrangentes são necessários para se chegar a conclusões abalizadas.

Metabolomics Changes of Serum and Tissues in Mice Died of Acute Tetracaine Poisoning / 法医学杂志

Objective To study the changes of metabolites in serum and tissues （kidney, liver and heart） of mice died of acute tetracaine poisoning by metabolomics, to search for potential biomarkers and related metabolic pathways, and to provide new ideas for the identification of cause of death and research on toxicological mechanism of acute tetracaine poisoning. Methods Forty ICR mice were randomly divided into control group and acute tetracaine poisoning death group. The model of death from acute poisoning was established by intraperitoneal injection of tetracaine, and the metabolic profile of serum and tissues of mice was obtained by ultra-high performance liquid chromatography-electrostatic field orbitrap high resolution mass spectrometry （UPLC-Orbitrap HRMS）. Multivariate statistical principal component analysis （PCA） and orthogonal partial least square-discriminant analysis （OPLS-DA） were used, combined with t-test and fold change to identify the differential metabolites associated with death from acute tetracaine poisoning. Results Compared with the control group, the metabolic profiles of serum and tissues in the mice from acute tetracaine poisoning death group were significantly different. Eleven differential metabolites were identified in serum, including xanthine, spermine, 3-hydroxybutylamine, etc.; twenty-five differential metabolites were identified in liver, including adenylate, adenosine, citric acid, etc.; twelve differential metabolites were identified in heart, including hypoxanthine, guanine, guanosine, etc; four differential metabolites were identified in kidney, including taurochenodeoxycholic acid, 11, 12-epoxyeicosatrienoic acid, dimethylethanolamine and indole. Acute tetracaine poisoning mainly affected purine metabolism, tricarboxylic acid cycle, as well as metabolism of alanine, aspartic acid and glutamic acid. Conclusion The differential metabolites in serum and tissues of mice died of acute tetracaine poisoning are expected to be candidate biomarkers for this cause of death. The results can provide research basis for the mechanism and identification of acute tetracaine poisoning.

Analysis of Five Mushroom Toxins in Blood by UPLC-HRMS / 法医学杂志

OBJECTIVES@#To develop a method for the simultaneous and rapid detection of five mushroom toxins (α-amanitin, phallacidin, muscimol, muscarine and psilocin) in blood by ultra-high performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS).@*METHODS@#The blood samples were precipitated with acetonitrile-water solution(Vacetonitril∶Vwater=3∶1) and PAX powder, then separated on ACQUITY Premier C18 column, eluted gradient. Five kinds of mushroom toxins were monitored by FullMS-ddMS2/positive ion scanning mode, and qualitative and quantitative analysis was conducted according to the accurate mass numbers of primary and secondary fragment ions.@*RESULTS@#All the five mushroom toxins had good linearity in their linear range, with a determination coefficient (R2)≥0.99. The detection limit was 0.2-20 ng/mL. The ration limit was 0.5-50 ng/mL. The recoveries of low, medium and high additive levels were 89.6%-101.4%, the relative standard deviation was 1.7%-6.7%, the accuracy was 90.4%-101.3%, the intra-day precision was 0.6%-9.0%, the daytime precision was 1.7%-6.3%, and the matrix effect was 42.2%-129.8%.@*CONCLUSIONS@#The method is simple, rapid, high recovery rate, and could be used for rapid and accurate qualitative screening and quantitative analysis of various mushroom toxins in biological samples at the same time, so as to provide basis for the identification of mushroom poisoning events.

Advance in Sexual Dysfunction for Patients with Breast Cancer (review) / 中国康复理论与实践

Breast cancer is one of the most common malignant tumors in women and it has a 5-year survival rate of over 80%. However, sexual dysfunction limits comprehensive rehabilitation. A correct understanding of present situation of sexual dysfunction provides the basis for its evaluation and prediction, which is of great significance to their rehabilitation. This article reported on the current situation, related factors, assessment, and prediction of sexual dysfunction in patients with breast cancer undergoing rehabilitation.

Advances in research of protein kinase A in parasites: a review / 中国血吸虫病防治杂志

Protein kinase A (PKA) is an important intracellular substance that regulates substance metabolism and biological functions, which exerts a wide range of biological effects through phosphorylation of specific serine/threonine residues in specific proteins. PKA plays an important role in the cAMP signaling pathway, and is involved in various life activities of parasites. Therefore, investigating the role of PKA in the life activities of parasites may provide insights into the development of novel anti-parasitic targets. The review mainly describes the structure and function of PKA and its role in life activities of parasites.

High-resolution Anorectal Manometry in the Diagnosis of Functional Defecation Disorder in Patients With Functional Constipation: A Retrospective Cohort Study

BACKGROUND/AIMS: High-resolution anorectal manometry (HRAM) has been considered a first-line diagnostic tool for functional defecation disorder. However, clinical studies on HRAM used in constipation patients are very limited and few studies have reported the characteristics of anorectal pressure in Chinese patients. The aim of this study is to investigate the characteristics of motility data in a cohort of Chinese patients with functional constipation. METHODS: A total of 82 consecutive patients with functional constipation who underwent a standardized HRAM were retrospectively enrolled in this study. The functional defecation disorder was classified into Rao's types. RESULTS: The mean age of 82 patients was 51 years (range, 16–83 years). Indications for anorectal manometry were functional constipation for all patients. The mean resting pressure was 69.2 ± 21.2 mmHg (range, 24.5–126.9 mmHg). The mean maximum squeezing pressure was 198.4 ± 75.6 mmHg (range, 54.2–476.9 mmHg). The mean length of the anal high pressure zone was 3.4 ± 1.0 cm (range, 0.6–4.9 cm). Sixty (73.2%) patients were diagnosed as functional defecation disorder. In attempted defecation, type I was most common (n = 24), followed by type II (n = 12), type III (n = 11), and type IV (n = 13) that were present on HRAM according to Rao's classification. In all 60 patients with functional defecation disorder, 37 were women and 23 were men. Men were significantly more likely than women to have functional defecation disorder (92.0% vs 64.9%, P = 0.014). CONCLUSION: HRAM could be used as a test for the diagnosis of functional defecation disorder and functional defecation disorder is common in Chinese patients with functional constipation.

Dexamethasone protects the glycocalyx on the kidney microvascular endothelium during severe acute pancreatitis / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#This study demonstrated that dexamethasone (DEX) protects the endothelial glycocalyx from damage induced by the inflammatory stimulus tumor necrosis factor-α (TNF-α) during severe acute pancreatitis (SAP), and improves the renal microcirculation.@*METHODS@#Ninety mice were evenly divided into 3 groups (Sham, SAP, and SAP+DEX). The SAP mice model was established by ligature of pancreatic duct and intraperitoneal injection of cerulein. Renal perfusion and function, and morphological changes of the glycocalyx were evaluated by laser Doppler velocimetry, electron microscopy, and histopathology (hematoxylin and eosin (H&E) staining), respectively. Serum levels of syndecan-1 and TNF-α were assessed by enzyme-linked immunosorbent assay (ELISA). The protective effects of dexamethasone on the glycocalyx and renal microcirculation were evaluated.@*RESULTS@#Significantly high levels of serum TNF-α were detected 3 h after the onset of SAP. These levels might induce degradation of the glycocalyx and kidney hypoperfusion, resulting in kidney microcirculation dysfunction. The application of dexamethasone reduced the degradation of the glycocalyx and improved perfusion of kidney.@*CONCLUSIONS@#Dexamethasone protects the endothelial glycocalyx from inflammatory degradation possibly initiated by TNF-α during SAP. This is might be a significant discovery that helps to prevent tissue edema and hypoperfusion in the future.

Dexamethasone protects the glycocalyx on the kidney microvascular endothelium during severe acute pancreatitis / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Objective: This study demonstrated that dexamethasone (DEX) protects the endothelial glycocalyx from damage induced by the inflammatory stimulus tumor necrosis factor-α (TNF-α) during severe acute pancreatitis (SAP), and improves the renal microcirculation. Methods: Ninety mice were evenly divided into 3 groups (Sham, SAP, and SAP+DEX). The SAP mice model was established by ligature of pancreatic duct and intraperitoneal injection of cerulein. Renal perfusion and function, and morphological changes of the glycocalyx were evaluated by laser Doppler velocimetry, electron microscopy, and histopathology (hematoxylin and eosin (H&E) staining), respectively. Serum levels of syndecan-1 and TNF-α were assessed by enzyme-linked immunosorbent assay (ELISA). The protective effects of dexamethasone on the glycocalyx and renal microcirculation were evaluated. Results: Significantly high levels of serum TNF-α were detected 3 h after the onset of SAP. These levels might induce degradation of the glycocalyx and kidney hypoperfusion, resulting in kidney microcirculation dysfunction. The application of dexamethasone reduced the degradation of the glycocalyx and improved perfusion of kidney. Conclusions: Dexamethasone protects the endothelial glycocalyx from inflammatory degradation possibly initiated by TNF-α during SAP. This is might be a significant discovery that helps to prevent tissue edema and hypoperfusion in the future.

A revelation about frequent itemset of stroke by using Apriori algorithm / 中国医学装备

Objective: To study the rule pattern of risk factor of stroke through data analysis of preliminary screening of large-scale stroke. Methods: The preliminary screening data of risk factors in stroke were gathered from the National Center for Stroke Screening and Prevention and Control. And the association rules mining was adopted in the research. The relevant risk factors of stroke in large-scale crowd were researched, and 0.1% was chose as minimum support and 10% were used as minimum confidence coefficient. The rule mode of stroke was mined by using above conditions. Results: In the nine risk factors of the table of preliminary screening, there was a weak correlation between "transient ischemic attack (TIA) in past", "hypertension", "family history of stroke" and stroke, respectively. And TIA, atrial fibrillation or valvular heart disease, family history of stroke, hypertension and diabetes were the most important risk factors. At the same time, the study found that age would become an important risk factor for stroke when patient was older than 60. Conclusions: In the 21 presumptive rule patterns with big probability, some of them has not received sufficient attention in past. And the rule pattern of risk factor of stroke provides a new diagnostic basis with value.

Design and application of medical information system in field medical support institution under new situation / 医疗卫生装备

Objective To Design a medical information system to meet the requirements for informatized medical support by the field medical support institution. Methods J2EE architecture and Java technology were applied to the design of the system, and star topology was used for network deployment. Results The system shared casualty treatment data with servicemen electronic tag and medical commanding information with logistics integrated command and control platform,so that the requirements for medical information were met in the institution.Conclusion The system improves the field medical support institution in medical support ability,treatment rate and efficacy.

The risk of human papillomavirus infection for male fertility abnormality: a meta-analysis / 亚洲男科学杂志(英文版)

Human papillomavirus (HPV) is the most common sexually transmitted virus in males and females worldwide; yet its impact upon male fertility remains unclear. The objective of this study was to evaluate the potential impact of HPV infection in semen on male fertility abnormality. A systematic literature search was performed in PubMed, Medline, Embase, Web of Science, and the Cochrane Library database for relevant publications up to May 6, 2017. The odds ratio (OR), and its corresponding 95% confidence interval (CI), was selected to represent the effect size. Statistical analysis was conducted using STATA 12.0. In total, eight articles, providing data on 1955 participants, were included in this meta-analysis. Collectively, the data suggested that HPV infection of semen was a risk factor for male fertility abnormality with an OR of 3.02 (95% CI: 2.11-4.32; I2 = 6.9%). Sensitivity analysis revealed that the results of this study were robust. In conclusion, HPV infection of semen represents a risk factor for male fertility abnormality.

Preliminary study on the clinical application of temporary treatment denture in difficult edentulous cases before complete denture restoration / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore the clinical effects of treatment denture on difficult edentulous cases before complete denture restoration.</p><p><b>METHODS</b>Thirty-six patients who experienced unsuccessful restoration of conventional complete dentures were included in this study. Treatment dentures were fabricated to solve issues such as abnormal occlusion, tissue surface problems, and neuromuscular dysfunction of the stomatognathic system caused by systemic diseases. The final complete dentures were fabricated by duplicating the treatment dentures. Jaw relation index, stability, and retention were evaluated at different stages. Oral health-related quality of life was measured using the Chinese version of Oral Health Impact Profile for edentulous subjects (OHIP-EDENT).</p><p><b>RESULTS</b>Among the 36 patients, 33 successfully completed the final restoration with positive effects.</p><p><b>CONCLUSIONS</b>Treatment denture is an effective pre-restorative option that can be used to correct abnormal occlusion, improve tissue surface problems, and aid in neuromuscular rehabilitation training. Treatment dentures contribute to the successful restoration of the final complete dentures and is worthy of clinical applications.</p>

Expressions of CXCL13, CD10 and bcl-6 in angioimmunoblastic T-cell lymphoma and peripheral T-cell lymphoma, not otherwise specified / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the value of immunomarkers CXCL13, CD10, bcl-6 in pathologic diagnosis of angioimmunoblastic T-cell lymphoma (AITL).</p><p><b>METHODS</b>One hundred and fifteen cases of AITL, 30 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) and 30 cases of reactive lymph nodes with paracortical hyperplasia (RH) encountered during the period from January, 1990 to January, 2008 were retrieved from the archival files of the Department of Pathology, West China Hospital of Sichuan University, China. The morphologic features were reviewed and compared. Immunohistochemical study was performed by SP method for CXCL13, CD10, bcl-6, CD21, CD3epsilon, CD3, CD45RO, CD20 and Ki-67. TCR-gamma gene rearrangement study was also carried out.</p><p><b>RESULTS</b>Regressed follicles were evident in 7.8% (9/115) of AITL cases, 6.7% (2/30) of PTCL, NOS cases and 83.3% (25/30) of RH cases, respectively. A marked increase of number of arborizing venules was shown in 98.3% (113/115) of AITL cases, 63.3% (19/30) of PTCL, NOS cases and 76.7% (23/30) of RH cases, respectively. In lymph nodes with paracortical hyperplasia, the expression of CXCL13, CD10 and bcl-6 were restricted to the germinal centers. In AITL, 96.5% (111/115) of cases showed CXCL13 expression, in contrast to 26.7% (8/30) of PTCL, NOS. Expression of CD10 and bcl-6 were found in the neoplastic cells in 50.4% (58/115) and 78.3% (90/115) of AITL, and 3.3% (1/30) and 3.3% (1/30) of PTCL, NOS, respectively. Irregular meshworks of CD21-positive follicular dendritic cells were found in all the AITL cases. Clonal TCR-gamma rearrangement was detected in 83% (83/100) of the AITL cases.</p><p><b>CONCLUSIONS</b>AITL is a type of lymphoma originated from the follicular helper T cells. Detailed morphologic assessment and use of immunohistochemical markers are essential for accurate diagnosis.</p>

Clinicopathologic and immunophenotypic analysis of myeloid sarcoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features of myeloid sarcoma and to evaluate the role of immunohistochemical study in diagnosis of this entity.</p><p><b>METHODS</b>Eighty-two cases of myeloid sarcoma were retrieved from the archives of Department of Pathology, West China Hospital of Sichuan University during the period from January, 1990 to February, 2005. The morphologic features were reviewed and classified according to the 2001 WHO classification for hematopoietic and lymphoid tissue tumors. Immunohistochemical study using a panel of 11 antibodies was performed on 73 cases. The survival data were collected and analyzed by SPSS 10.0.</p><p><b>RESULTS</b>The median age of patients was 35.5 years. The male-to-female ratio was 1.4:1. The sites of occurrence included lymph node (43.1%), skin (16.7%), nose (7.8%), soft tissue (7.8%) and bone (6.9%). Fifty-one cases (62.2%) represented myeloid sarcoma associated with an underlying myeloproliferative disorder and 25 cases (30.5%) represented solitary myeloid sarcoma. As for the morphology, 79 cases (96.3%) were granulocytic sarcoma, including 41 cases (51.9%) blastic type, 25 cases (31.6%) immature type and 13 cases (16.5%) differentiated type. The other 3 cases (3.7%) were monoblastic sarcoma. Immature eosinophils were found in 51 cases (64.6%) of granulocytic sarcoma, among which 13 cases (31.7%) were of blastic type. Immunohistochemical study showed that 95.9% cases (70/73) were positive for myeloperoxidase, 95.5% (63/66) for lysozyme, 95.2% (60/63) for CD68 (KP1), 90.8% (59/65) for leukocyte common antigen, 85.7% (54/63) for CD43, 77.8% (49/63) for CD117, 58.7% (37/63) for CD99, 54.0% (34/63) for CD15, 22.2% (14/63) for CD34, and 4.7% (3/64) for CD68 (PG-M1). Proliferation index, as demonstrated by Ki-67 positivity, was 0.49+/-0.22. Follow-up data was obtained in 59 of the 82 patients. The two- and five-year survival rates were 36.1% and 17.3% respectively. No significant prognostic factors were found in the survival analysis.</p><p><b>CONCLUSIONS</b>Myeloid sarcoma may precede, develop in a background of myeloproliferative disorder or even after remission of the disease. The presence of immature eosinophils is an important morphologic clue and immunohistochemical study plays an essential role in arriving at a correct diagnosis. Immunopositivity for myeloperoxidase is specific for granulocytic differentiation, while CD68 (PG-M1)-positivity suggests monocytic differentiation. Detailed clinicopathologic correlation is also helpful.</p>

Correlation between IL-1?,cagA of Helicobacter pylori and chronic gastritis / 西安交通大学学报(医学版)

0.05). Conclusion IL-1? has a higher value than cagA gene in predicting the prognosis of chronic gastritis.

Fecal calprotectin in differential diagnosis of ulcerative colitis / 西安交通大学学报(医学版)

Objective To investigate the clinical value of fecal calprotectin as a marker for diagnosis of ulcerative colitis(UC).Methods ELISA assay was used to measure the concentrations of calprotectin in feces of 30 UC patients and 20 healthy controls.The disease activity of UC was determined by Truelove Witts histological criteria.Results The level of calprotectin in feces was significantly higher in feces with active UC(578?g/g) than with inactive UC(8.4?g/g,P0.05),but significant difference existed between each active grade and inactive phase of UC.The results revealed siginificant correlation between the endoscopic grades of disease activity and fecal calprotectin concentration(r=0.85,P