Fitting Degrees of Animal Models of Diarrhea-irritable Bowel Syndrome with Clinical Characteristics of Western Medicine and Traditional Chinese Medicine / 中国实验方剂学杂志

Diarrhea-irritable bowel syndrome （IBS-D） is one of the common functional bowel diseases in clinical practice. Since it pathogenesis is complex and has not been fully elucidated， effective treatment methods remains to be developed for this disease. Establishing the animal models of IBS-D in accordance with the clinical characteristics of traditional Chinese medicine （TCM） and Western medicine helps to reveal the pathogenesis of this disease and improve the treatment plan. The fitting degree of an animal model with clinical characteristics is an indicator to evaluate the effectiveness of the animal model in simulating the disease characteristics of Western medicine and the syndromes of TCM based on the latest diagnostic standards. By reviewing the relevant articles about the animal models of IBS-D， we discovered that rats were the preferred animals for modeling， and the models were mainly induced by single factors， double factors， or the combination of multiple factors. The established animal models mainly present symptoms or signs associated with visceral hypersensitivity or/and gastrointestinal motility abnormalities. The single factor-induced rat models of IBS-D had high fitting degrees with the clinical characteristics of Western medicine but low fitting degrees with the TCM syndromes. The animal models induced by two or more factors had high but varied fitting degrees with the clinical characteristics of Western medicine. In addition， the animal models of IBS-D considering TCM syndromes mainly focuses on the syndrome of liver depression and spleen deficiency， and few models were established for the syndromes of spleen-kidney Yang deficiency， spleen-stomach dampness-heat， spleen deficiency and dampness excess， and cold and heat in complexity. Therefore， it is essential to improve the existing or develop new animal models of IBS-D in the future， so as to provide more tools for deciphering the mechanisms of TCM and Western medicine and developing treatment methods for this disease.

Clinical Characteristics and Potential Risk Factors Analysis of Liver Injury Related to Epimedii Folium Preparation / 中国实验方剂学杂志

ObjectiveThis paper aims to analyze the clinical characteristics and medication rationality of liver injury related to Epimedii Folium preparation （EP） and explore the possible risk factors of liver injury， so as to provide a reference for the safe clinical application of Epimedii Folium （EF）. MethodA retrospective analysis was conducted on liver injury cases related to EP from 2012 to 2016. ResultThe number of reported liver injury cases and the proportion of severe cases related to the use of EP show an increasing trend， indicating the objective existence of liver injury caused by EP. There are more cases of liver injury related to EP in women than in men， with an onset age range of 15-91 years old and a median onset age of 60 years old （median onset ages for men and women are 59 and 60 years old， respectively）. The time span from taking EP alone to the occurrence of liver injury is 1-386 days， with a median of 38 days. The time span from taking both EP and Western medicine to the occurrence of liver injury is 1-794 days， with a median of 34 days. EF-related liver injury preparations are mostly composed of traditional Chinese medicines that promote immunity and tonify the liver and kidney， indicating that immune stress in the body may be the mechanism of liver injury caused by the use of EP alone or in combination. There is no increasing trend of toxicity with time or dose in the liver injury caused by EP. By further exploring its risk factors， it is found that patients have unreasonable medication methods such as excessive dosage， repeated use， and multi-drug combination， which may also be one of the important risk factors for EF-related liver injury. ConclusionEP has a certain risk of liver injury and should be emphasized in clinical diagnosis and treatment. Immune stress may be the mechanism of liver injury caused by EP， and in clinical use， it is necessary to be vigilant about the risk of liver injury caused by unreasonable use and combined use with Western medicine.

Clinical characteristics and outcomes of 176 patients with acute necrotizing mediastinitis: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective To investigate the etiology, symptoms, diagnosis, surgical treatment, and outcomes of acute necrotizing mediastinitis (ANM) in order to guide future diagnosis and treatment of ANM. Methods The clinical data of patients with ANM referred to West China Hospital, Sichuan University from March 2012 to April 2021 were retrospectively analyzed. The etiology, clinical manifestations, demographic characteristics, bacterial culture results, surgical approach and prognostic factors of these patients were summarized. Results A total of 176 patients were enrolled in this study. The median age was 60 ( 0-84) years. There were 124 (70.5%) males and 52 (29.5%) females. The most common origin of infection was neck (n=66, 37.5%). The most common symptom was fever (n=85, 48.3%). Streptococcus constellatus represented the most common pathogens in secretion culture. Surgical treatment was administered to 119 (67.6%) patients through different approaches, including 54 (30.7%) patients of cervical approach, 9 (5.1%) patients of thoracotomy, 18 (10.2%) patients of video-assisted thoracoscopic surgery (VATS), 7 (4.0%) patients of cervical combined with thoracotomy, 30 (17.0%) patients of cervical combined with VATS, and 1 (0.6%) patient of subxiphoid approach. Among this cohort, 144 (81.8%) patients were cured, while 32 (18.1%) patients died. Age-adjusted Charlson comorbidity index (OR=2.95, P=0.022), perioperative sepsis (OR=2.84, P=0.024), and non-surgical treatment (OR=2.41, P=0.043) were identified as independent predictors of poor outcomes. Conclusion For patients with corresponding history and manifestations of ANM, it is crucial to go through imaging examination to confirm the presence of an abscess and guide the selection of surgical approach. Once the diagnosis of ANM is made, it is imperative to promptly perform surgical intervention for effective drainage. Our study highlights the significance of age-adjusted Charlson comorbidity index, perioperative sepsis and surgical treatment in predicting patients’ outcomes.

Clinical characteristics of patients with puerperal schizophrenia / 四川精神卫生

BackgroundWomen may develop severe symptoms of stress disorder following childbirth， which may be exposed to a risk of developing mental health problems， and even lead to the recurrence of the illness in female patients with schizophrenia， while comparatively limited research has been undertaken concerning the clinical characteristics and treatment of puerperal schizophrenia in China. ObjectiveTo explore the clinical characteristics of puerperal schizophrenia， so as to provide references for the clinical treatment. MethodsA total of 24 patients with puerperal schizophrenia who were hospitalized in the female ward of adult psychiatry department of the Affiliated Brain Hospital of Guangzhou Medical University from 2012 to 2020 and met the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） diagnostic criteria for schizophrenia were included as puerperal group. Another 48 non-puerperal women with schizophrenia were concurrently enrolled as control group. Then the basic data， scores on Positive and Negative Symptom Scale （PANSS） and the discharge medication were recorded. ResultsThe percentages of newly onset and positive family history of psychosis in puerperal group were larger than those in control group， with statistical significance （χ2=9.321， 5.240， P<0.05 or 0.01）. Puerperal group scored higher on PANSS excitement factor （t=-2.220， P<0.05） and lower on negative factor （t=3.377， P<0.01） compared with control group. In terms of discharge medication， puerperal group reported a higher dosage of antipsychotic drugs （t=-2.095， P<0.05）， and a larger proportion of combined use of benzodiazepines or antidepressants （χ²=21.316， 5.114， P<0.05 or 0.01） compared with control group， with statistical significance. ConclusionPatients with puerperal schizophrenia display increased ratings of excitement symptoms and decreased ratings of negative symptoms， which necessitates the use of high doses of antipsychotic drugs， and combined use of benzodiazepines and antidepressants.

Clinical-epidemiological characterization of human anal papilloma virus infection coloproctology unit: Central University Hospital Dr. "Antonio Maria Pineda"

Human papillomavirus (HPV) infection is one of the most common sexually transmitted viral diseases. A descriptive cross-sectional study was conducted with the purpose of clinically and epidemiologically characterizing anal HPV infection in patients who attended the Benign Orificial Pathology Consultation of the Coloproctological Unit at the Dr. "Antonio María Pineda" Central University Hospital, during the period March 2022 -February 2023, by selecting 288 patients whose average age was 47.09 ± 14.61 years, being the 41-50 years old group (29.17%) and the 51-60 years old group (19.44%) the most affected groups by pathologies of the anal region, with a predominance of male (54.17%). The sociodemographic characteristics with the highest frequency included married (48.61%) and single (47.22%); secondary level of education (44.44%) and traders (18.05%) and housewives (15, 28%) as predominant occupations. The risk factors were represented by onset of sexual intercourse between 16-20 years of age (65.28%), heterosexuality (91.67%), 22.22% reported having anal sex and 5.56% oral sex. Likewise, 5.56% were reported with a history of genital HPV and 4.17% were HIV positive. In addition, 48.61% stated not to use condoms. The initial clinical diagnosis included hemorrhoidal disease (30.55%), anal fistula (25%) and anal fissure (18.05%), and one patient (1.39%) with anal HPV infection. Anal cytology results showed 8.33% flat epithelial cells with cytopathic changes suggestive of HPV infection and 1.39% squamous cells with cytopathic changes suggestive of HPV infection: 50% mild inflammatory negative for malignancy and 33.33% flat epithelial cells without atypia. In conclusion, the anal cytology investigation should continue to determine the actual frequency of anal HPV infection. (AU)

Assess the Depression and Quality of Life among Women Suffering from Selected Gynaecological Cancers Attending Oncology Units of Selected Hospitals

Backgrounds: Gynecological cancers are significant and probable life-threatening diseases that harm patients' physical and psychological health. The leading cause of death in female抯 psychological problems like depression endure and can cause an extra burden during their treatment. Therefore, this study helps evaluate depression and well-being among gynaecological malignancies. Methods: Women's depression was evaluated by a standardized CES-D Scale and QOL by WHOQOL Bref scale, a sample of 100 women with cancers admitted at HSK and Kerudi cancer hospital, Bagalkot was selected using a purposive sampling technique, descriptive survey design was adopted. Statistical data were tested and scrutinized using descriptive and inferential analysis. Results: 100% of women had moderate depression. The mean percentage of depression score was 61.45% with mean and SD (37�9). Of the women, 71 % had moderate, 21%had poor, and 8% had good QOL. The mean percentage of QOL of women was 48.1% with mean and SD (62.5�.1). A Strong relation was found between depression scores with your family members known to you (?=4.52, p<0.05), Area of residence (?=3.88, p<0.05), and whether you have undergone previously any surgery for the treatment of cancer (?=8.93, p<0.05). No association was found between QOL scores with study variables. A Negative correlation (r=-0.27, p<.05) was found between depression and Total QOL scores. Conclusion: Most patients have moderate depression and moderate QOL. This study is effective in identifying depression and QOL

Características epidemiológicas y clínicas autorreportadas en pacientes con obesidad y COVID-19: un estudio de corte transversal / Epidemiological and clinical characteristics self-reported in patients with obesity and COVID-19 disease: a cross-sectional study

RESUMEN INTRODUCCIÓN En Argentina, la obesidad en adultos es una problemática con una prevalencia media de 25,4%. En la relación entre COVID-19 y obesidad, se observa mayor prevalencia de sobrepeso/obesidad y enfermedad severa entre los pacientes con COVID-19. Por ello, el objetivo del estudio fue conocer las características clínicas y epidemiológicas en pacientes con diagnóstico de obesidad sobrevivientes a la infección por SARS-CoV-2. MÉTODOS Se realizó un estudio observacional descriptivo y analítico de corte transversal. Se aplicó una encuesta autoadministrada. RESULTADOS La mediana de edad fue 41 años, y hubo un 69,9% de mujeres. Los síntomas de presentación más prevalentes fueron astenia (86,7%), anosmia (64,5%) y tos (64%). Con respecto a los síntomas persistentes luego de las 12 semanas del diagnóstico, los más prevalentes fueron astenia (52,9%), trastornos de sueño (32,4%) y falta de concentración/memoria (31,7%). Hubo mayor riesgo en mujeres (OR: 2,86; IC95%: 2,23-3,67) con obesidad (OR: 1,58; IC95%: 1,16-2,16). La enfermedad grave en obesos fue casi el triple comparado con no obesos (15,7% vs. 5,4%; p<0,001). DISCUSIÓN Los pacientes obesos mostraron síntomas de presentación que orientan a un estado inflamatorio sistémico, con disnea y tos más frecuentes, y tienen mayor prevalencia de enfermedad grave y neumonía, así como mayor riesgo de desarrollar síntomas persistentes, sobre todo si las personas son mujeres y sedentarias.

ABSTRACT INTRODUCTION In Argentina, obesity in adults is a problem with an average prevalence of 25.4%. The relationship between COVID-19 and obesity shows a higher prevalence of overweight/obesity and severe disease among patients with COVID-19. Therefore, the objective of the study was to know the clinical and epidemiological characteristics of patients diagnosed with obesity who survived SARSCoV- 2 infection. METHODS A descriptive and analytical cross-sectional observational study was carried out. A self-administered survey was applied. RESULTS The median age was 41 years and 69.9% were women. The most prevalent presenting symptoms were asthenia (86.7%), anosmia (64.5%) and cough (64%). Regarding persistent symptoms 12 weeks after diagnosis, the most prevalent ones were asthenia (52.9%), sleep disorders (32.4%) and lack of concentration/memory (31.7%). The risk was higher for women (OR: 2.865; CI95%: 2.23-3.67) with obesity (OR: 1.58; CI95%: 1.16-2.16). Severe disease in obese was almost threefold that in non-obese patients (15.7% vs. 5.4%; p<0.001). DISCUSSION Obese patients showed presenting symptoms that point to a systemic inflammatory state, with dyspnea and cough being more common, and have a higher prevalence of severe disease and pneumonia, as well as a higher risk of developing persistent symptoms, especially if they are women and sedentary.

Reporte preliminar de las características sociodemográficas y clínicas de los pacientes con hemopatías malignas: experiencia de un hospital universitario

Introducción: debido a su amplia diversidad clínica y biológica, es de gran importancia para el médico conocer cómo se presentan los pacientes diagnosticados con una hemopatía maligna. Objetivo: describir las características sociodemográficas y clínicas de los pacientes con diagnóstico de una hemopatía maligna que consultaron en un Hospital Universitario de Paraguay. Metodología: estudio observacional, retrospectivo, descriptivo, de corte transversal, con muestreo no probabilístico, de casos consecutivos. Se incluyó a pacientes adultos, de ambos sexos, registrados en el archivo de Hematología del Hospital de Clínicas de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción (Paraguay), con diagnóstico confirmado por anatomía patológica de una neoplasia hematológica, según la clasificación de la Organización Mundial de la Salud, durante el periodo comprendido entre enero 2019 y agosto de 2021. Se estudiaron variables sociodemográficas y clínicas. Resultados: se estudió a 129 pacientes. El 58 % correspondía al sexo masculino. La edad promedio de los pacientes fue de 50,3±17,38. La mayoría de los pacientes procedía del Departamento Central de Paraguay (56,58 %). La mayoría de los pacientes (n=37) fue diagnosticado con un linfoma de tipo no Hodgkin o con una neoplasia con origen en células plasmáticas (n=32). El tiempo promedio de aparición de los síntomas hasta la consulta fue de 3,5 meses. El síntoma más reportado fue la astenia (35 %). La palidez fue el hallazgo positivo más frecuente al examen físico. Las comorbilidades más frecuentes fueron la hipertensión arterial (39,44 %) y la diabetes mellitus (15,59 %). Discusión: el paciente típico con una hemopatía que consulta en el Hospital de Clínicas es hombre, mayor de 50 años, proveniente del Departamento Central, consulta por astenia, presenta palidez al examen físico y ha tardado más de 3 meses en consultar. Se le ha diagnosticado un linfoma no Hodgkin y tiene comorbilidades cardiovasculares o metabólicas.

Introduction: due to their wide clinical and biological diversity, it is of great importance for the physician to know how patients diagnosed with a hematological malignancy present. Objective: to describe the sociodemographic and clinical characteristics of patients diagnosed with a hematological malignancy who consulted at a University Hospital in Paraguay. Methods: observational, retrospective, descriptive, cross-sectional, retrospective, descriptive, cross-sectional study, with non-probabilistic sampling of consecutive cases. We included adult patients, of both sexes, registered in the Hematology file of the Hospital de Clínicas of the Faculty of Medical Sciences of the National University of Asunción (Paraguay), with diagnosis confirmed by pathological anatomy of a hematological neoplasm, according to the classification of the World Health Organization, during the period from January 2019 to August 2021. Sociodemographic and clinical variables were studied. Results: 129 patients were studied. Fifty-eight percent were male. The mean age of the patients was 50.3±17.38. Most of the patients were from the Central Department of Paraguay (56.58 %). Most of the patients (n=37) were diagnosed with a non-Hodgkin's lymphoma or a neoplasm with plasma cell origin (n=32). The average time from symptom onset to consultation was 3.5 months. The most reported symptom was asthenia (35%). Pallor was the most frequent positive finding on physical examination. The most frequent comorbidities were arterial hypertension (39.44%) and diabetes mellitus (15.59%). Discussion: the typical patient with a hemopathy who consults at the Hospital de Clínicas is male, over 50 years of age, from the Central Department, consults for asthenia, presents pallor on physical examination and has taken more than 3 months to consult. He has been diagnosed with non-Hodgkin's lymphoma and has cardiovascular or metabolic comorbidities.

Relationship between quality of life and sociodemographic, clinical and lifestyle characteristics of patients undergoing hemodialysis

Introduction: In chronic diseases, QoL depends on several factors such as the type and duration of the disease, its treatment and side effects, the severity of symptoms, medication effects, patient age, limitations and self-care capacity. In chronic kidney disease it has also become a measure of health outcome.Objective: assess the association between QoL and socioeconomic, lifestyle and clinical factors of patients on HD.Methods: This is a cross-sectional epidemiological census, carried out among 1,024 patients on hemodialysis from all hemodialysis units at the metropolitan region in the Espirito Santo's, Brazil . Sociodemographic, lifestyle and clinical characteristics data were used. QoL was assessed using the Short-Form health Survey-36 (SF-36). Data were analysed by multiple linear regression.Results: The best QoL was represented by mental health (72.16) and the worst QoL by the physical aspect (26.78). After multiple linear regression, predictors of QoL were identified, with emphasis on males, a predictor of better QoL for 5 of the 8 domains and the summaries of the physical and mental components. Education, associated with 5 domains, gives greater reference to income. Physical activity was a predictor of 7 of the 8 QoL domains and the summary of the physical component. Among the clinical variables, the number of complications is associated with 7 of the 8 domains and summaries of the physical and mental components.Conclusion: Male sex is highlighted as a predictor of better physical and mental health and elderly people with better mental health, despite the impairment in physical health. The absence of physical activity is associated with worse physical and mental health. Clinically, having 3 or more intradialytic complications was associated with worse physical and mental QoL

Clinical Characteristics and Obstetric Outcomes of Pregnant Women Who Underwent Surgery for Adnexal Torsion / 中山大学学报(医学科学版)

ObjectiveTo explore the clinical characteristics and obstetric outcomes of pregnant women who underwent surgery for adnexal torsion at different gestational weeks. MethodsA retrospective study was done on 39 women who underwent surgery for adnexal torsion during pregnancy in the First Affiliated Hospital， Sun Yat-sen University between March 2013 and March 2023， with 18 cases in 1st trimester （<14 weeks）， 11 in 2nd trimester （14-27+6 weeks） and 10 in 3rd trimester （≥28 weeks）. The clinical characteristics， treatment and obstetric outcomes were compared among the three groups. ResultsThe 1st trimester group had higher proportion of assisted reproductive technology （ART） use than the 2nd and 3rd trimester groups （P=0.026）. There was no significant difference in the clinical manifestations， including abdominal pain， nausea， vomiting and fever among the three groups， while elevated white blood cells （WBC） counts was more commonly seen in the 2nd and 3rd trimester groups. Adnexal masses <5 cm in diameter occurred in 0， 18.2%， and 10.0% of cases in 1st， 2nd and 3rd trimester groups respectively （P=0.014）. No statistical significance was found in the location of twisted adnexa， number of circles or pathological nature. The 1st trimester group had a higher sensitivity of ultrasound in the diagnosis of adnexal torsion compared with the 2nd and 3rd trimester groups （77.8%， 36.4%， 20.0%； P=0.008）. More laparoscopic surgery were performed in the 1st trimester group than the other two groups （55.6% ， 27.3%， 0.0%； P=0.008）. There was no significant difference in gestational week of delivery， delivery mode， newborn gender， neonatal birth weight and follow-up of newborns among the three groups. The 3rd trimester group showed a higher risk of preterm delivery （P=0.050）. ConclusionsDuring the 1st trimester of pregnancy， adnexal torsion is more common in patients using ART and ultrasound plays a crucial role in the diagnosis. During the 2nd and 3rd trimester， adnexal torsion should be suspected in patients with abdominal pain and elevated WBC but no aspetic inflammation. Laparoscopic surgery is safe for adnexal torsion during pregnancy and can achieve a favorable maternal and neonatal outcome.

Medical visit status and clinical features in patients with IgG4 related disease / 北京大学学报(医学版)

OBJECTIVE@#To understand the medical treatment and clinical characteristics of patients with IgG4-related disease (IgG4-RD) with complex clinical manifestations and easy to be misdiagnosed and missed, and to improve the recognition of this disease among doctors from relevant medical departments.@*METHODS@#A retrospective analysis was conducted on the medical records of patients diagnosed with IgG4-RD who were hospitalized and discharged from Peking University Third Hospital from January 1, 2012 to December 31, 2022. The patient' s medical visit status, clinical manifestations, laboratory examinations, diagnosis, and treatment information were summarized.@*RESULTS@#A total of 116 patients diagnosed with IgG4-RD were included in this study, with a male to female ratio of 2. 52∶ 1 and an average age of (61.83±10.80) years. The departments for initial visits were gastroenterology, general surgery, and ophthalmology. While the departments responsible for definitive diagnosis were gastroenterology, rheumatology and immunology, and respiratory medicine. Twenty-one patients (18. 10%) required consultation and treatment from three or more departments before receiving a definitive diagnosis. The median time from symptom onset to the initial clinic visit was 2 (1, 7) months, and the median time from symptom onset to diagnosis was 1 (1, 12) month. Twenty-four patients (20.69%) underwent surgical resection of the affected sites before diagnosis. According to the classification criteria of IgG4-RD, sixty-eight (58.62%) cases were diagnosed definitively, eight (6.9%) cases were likely to be diagnosed, and 40 (34.48%) cases were suspected to be diagnosed. In the 68 definitively diagnosed patients, the most commonly affected organs were submandibular gland, the pancreas, biliary tract, parotid in sequence. The median serum IgG4 (IgG4, immunoglobulin G4) level was 6.16 (3. 61, 12. 30) g/L. Fifty-seven patients (83.82%) were treated with glucocorticoids, and 14 patients (20.59%) were treated with immunosuppressants. The use of immunosuppressants was mainly in the rheumatology and immunology department (78. 57%).@*CONCLUSION@#IgG4-RD is more common in elderly males, with submandibular gland, the pancreas, biliary tract, and parotid being most commonly affected. The distribution of initial visit departments in patients is wide. The proportion of definitive diagnosis based on pathology is relatively low. In terms of treatment, the main approach is steroid treatment, while the use of immunosuppres-sants is not widespread.

Expression and Clinical Significance of Exosome Derived MiR-181b-5p in Children with Acute Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the expression level of exosome derived miR-181b-5p in different disease stages of children with acute lymphoblastic leukemia and its relationship with clinical characteristics.@*METHODS@#Bone marrow plasma samples of 86 children with ALL were collected. Exosomes were extracted by exosome extraction kit, and RNA in exosomes was extracted by TRIzol method. The levels of miR-181b-5p in the blood plasma exosomes of the patients in the newly diagnosed group, relapse group, remission group and control group were detected by qRT- PCR. The difference of miR-181b-5p expression level in each group was compared and analyzed, and the relationship between miR-181b-5p expression level and clinical characteristics was analyzed.@*RESULTS@#The expression level of exosomal miR-181b-5p in the newly diagnosed group and the relapsed group was significantly lower than that in the remission group and the control group (P< 0.05). The expression level of exosomal miR-181b-5p in T-ALL children was higher than that in B-ALL children (P<0.05). The expression level of plasma exosomal miR-181b-5p in male children was higher than that in female children (P<0.01).@*CONCLUSION@#Exosome derived miR-181b-5p changes dynamically in the course of ALL children, and can be used as a marker miRNA to monitor disease status. Exosomes can transmit information in the tumor microenvironment and serve as a potential carrier for biomolecular targeted therapy.

Fever in the initial stage of IIM patients: an early clinical warning sign for AE-ILD

Abstract Background Fever is a common symptom of Idiopathic inflammatory myopathies (IIM). However, the exact correlation between fever and the prognosis of IIM is still unclear. This study aims to clarify if the IIM patients initiated with fever are associated with poorer outcomes. Methods This was a single-center retrospective cohort study. Data were collected from 79 newly diagnosed, treatment-naive IIM patients in the Affiliated Wuxi People's Hospital of Nanjing Medical University (Wuxi, Jiangsu, China) from November 2016 to June 2020. According to the presence or absence of fever at the onset, the IIM patients were divided into two groups(fever group n = 28, without fever group n = 51) Clinical characteristics, laboratory data, treatment, and outcomes were recorded. The Kaplan-Meier and log-rank tests were used to compare the all-cause mortality, relapse rate, and acute exacerbation of interstitial lung disease (AE-ILD) incidence. The association of fever with the outcomes was assessed in the unadjusted and adjusted forward logistic regression model. Results Compared with the non-fever group, the age at onset of the fever group was higher, and mechanic's hands (MH) and interstitial lung disease (ILD) were more common. Systemic inflammation (CRP and ESR) was significantly higher in the fever group, while the level of albumin(ALB) and muscle enzymes were lower. The fever group seemed to be received more aggressive treatment, with higher dose glucocorticoids and higher rates of intravenous immunoglobulins(IVIG) use. The all-cause mortality rate and the incidence rate of AE-ILD were higher in the fever group. Even adjusted for the age at onset and treatments, fever was significantly associated with AE-ILD and all-cause mortality. Conclusion Our study has demonstrated that fever at initial diagnosis is associated with AE-ILD and mortality. Fever should serve as an early clinical warning sign for poor outcomes in IIM patients.

Clinical Characteristics of Geographic Tongue in Patients with Primary Sjögren's Syndrome / 中国实验方剂学杂志

ObjectiveTo analyze the clinical characteristics of geographic tongue in patients with primary Sjögren's syndrome （pSS）. MethodPatients with pSS treated in the China-Japan Friendship Hospital from December 2018 to October 2021 were enrolled and divided into different groups according to the presence of geographic tongue or the severity. Phi correlation analysis，Chi-square test， and Mann-Whitney test were used to analyze the clinical characteristics of patients with geographic tongue. ResultA total of 182 pSS patients were included in this study，including 75 （41.2%） patients with geographic tongue and 107 （58.8%） without geographic tongue. Partial exfoliation was more common than total exfoliation， and the anterior part of the tongue was the most common exfoliation site. The number of patients with severe geographic tongue was more than those with mild-to-moderate geographic tongue. Compared with pSS patients without geographic tongue，those with geographic tongue were more common in fissured tongue （92.0%/41.1%，χ2=48.491，P<0.05），red or crimson tongue （48.0%/23.3%，χ2=12.009，P<0.05），Yin deficiency syndrome （100.0%/43.9%，χ2=62.739，P<0.05），and Qi deficiency syndrome （94.7%∶50.5%，χ2=40.046，P<0.05），less common in phlegm-dampness syndrome （33.3%/72.0%，χ2=26.709，P<0.05），and showed higher proportions in hyperglobulinemia （89.3%/65.4%，χ2=13.547，P<0.01），ANA ≥1∶160 （78.1%/57.3%，χ2=8.227，P<0.01），and positive RF （51.4%/36.5%，χ2=3.877，P<0.05）. Compared with pSS patients with mild geographic tongue，pSS patients with moderate-to-severe geographic tongue had higher proportions in hyperglobulinemia （98.1%/68.2%，χ2=14.617，P<0.01），positive anti-CENP-B （26.0%/4.8%，χ2=4.214，P<0.05），and reduced complement 3 （26.4%/4.5%，χ2=4.647，P<0.05）. The geographic tongue was positively associated with fissured tongue （φ=0.531），Yin deficiency syndrome （φ=0.587），and Qi deficiency syndrome （φ=0.469），negatively associated with phlegm-dampness syndrome （φ=-0.447），and weakly associated with tongue color （φ<0.4）. There was no statistical difference in the disease activity index between patients with or without geographic tongue and severity. ConclusionMore than 40% of pSS patients had geographic tongue accompanied by fissured tongue. Geographic tongue is positively associated with Yin deficiency syndrome and Qi deficiency syndrome，and negatively associated with phlegm-dampness syndrome， indicating that treatment should be based on tonifying Qi and nourishing Yin. Compared with pSS patients without geographic tongue， those with geographic tongue may have higher positive rate of some immune indicators，which deserves further exploration.

Clinical Characteristics and Diagnostic Methods of Pulmonary Mucormycosis / 中山大学学报(医学科学版)

ObjectiveTo summarize the clinical features and prognosis of pulmonary mucormycosis （PM） in southern China， and to explore the diagnostic value of metagenomic next generation sequencing （mNGS） in PM. MethodsThe clinical manifestations， diagnosis， treatment and prognosis of patients diagnosed with PM in The First Affiliated Hospital of Sun Yat-sen University from January 1， 2019 to January 31， 2022 who had undergone mNGS detection in lung tissue or alveolar lavage fluid were collected retrospectively. A total of 14 patients with PM were included， including 4 patients with confirmed diagnosis and 10 patients with clinical diagnosis. ResultsAll patients had underlying medical conditions， with hematological malignancies and diabetes being the most common. The most common symptoms were fever （n = 10）， cough （n = 9） and shortness of breath （n = 9）. Consolidation was the most common sign of chest CT， followed by mass， mostly with cavity. On laboratory tests， decreased CD4+T lymphocytes， elevated CD8+T lymphocytes， and decreased CD4+/CD8+ ratio， and presentation with pleural effusion indicate poor prognosis. The positive rate of mNGS diagnosis was 78.5%， which was significantly higher than that of histopathology （50%）， fungus rapid fluorescence staining （61.5%） and fungal culture （23.1%） of bronchoalveolar lavage fluid. ConclusionsPulmonary mucormycosis is more likely to occur in patients with underlying diseases or who are immunocompromised. The clinical manifestations lack specificity. The low CD4/CD8 ratio and presentation of pleural effusion on CT imaging indicate poor prognosis of patients. mNGS is a rapid， convenient and sensitive method for the diagnosis of PM， which has advantages in the diagnosis of pulmonary mucormycosis.

Analysis of incidence and clinical characteristics of osteonecrosis of femoral head in patients with systemic lupus erythematosus treated with glucocorticoid: A descriptive study based on a prospective cohort / 中国修复重建外科杂志

OBJECTIVE@#To describe the disease characteristics of osteonecrosis of the femoral head (ONFH) in patients with systemic lupus erythematosus (SLE) who experiencing prolonged glucocorticoid (GC) exposure.@*METHODS@#Between January 2016 and June 2019, 449 SLE patients meeting the criteria were recruited from multiple centers. Hip MRI examinations were performed during screening and regular follow-up to determine the occurrence of ONFH. The cohort was divided into ONFH and non-ONFH groups, and the differences in demographic baseline characteristics, general clinical characteristics, GC medication information, combined medication, and hip clinical features were compared and comprehensively described.@*RESULTS@#The age at SLE diagnosis was 29.8 (23.2, 40.9) years, with 93.1% (418 cases) being female. The duration of GC exposure was 5.3 (2.0, 10.5) years, and the cumulative incidence of SLE-ONFH was 9.1%. Significant differences ( P<0.05) between ONFH and non-ONFH groups were observed in the following clinical characteristics: ① Demographic baseline characteristics: ONFH group had a higher proportion of patients with body mass index (BMI)<20 kg/m 2 compared to non-ONFH group. ② General clinical characteristics: ONFH group showed a higher proportion of patients with cutaneous and renal manifestations, positive antiphospholipid antibodies (aPLs) and anticardiolipin antibodies, severe SLE patients [baseline SLE Disease Activity Index 2000 (SLEDAI-2K) score ≥15], and secondary hypertension. Fasting blood glucose in ONFH group was also higher. ③ GC medication information: ONFH group had higher initial intravenous GC exposure rates, duration, cumulative doses, higher cumulative GC doses in the first month and the first 3 months, higher average daily doses in the first 3 months, and higher proportions of average daily doses ≥15.0 mg/d and ≥30.0 mg/d, as well as higher full-course average daily doses and proportion of full-course daily doses ≥30.0 mg/d compared to non-ONFH group. ④ Combined medications: ONFH group had a significantly higher rate of antiplatelet drug use than non-ONFH group. ⑤ Hip clinical features: ONFH group had a higher proportion of hip discomfort or pain and a higher incidence of hip joint effusion before MRI screening than non-ONFH group.@*CONCLUSION@#The incidence of ONFH after GC exposure in China's SLE population remains high (9.1%), with short-term (first 3 months), medium-to-high dose (average daily dose ≥15 mg/d) GC being closely associated with ONFH. Severe SLE, low BMI, certain clinical phenotypes, positive aPLs, and secondary hypertension may also be related to ONFH.

A comparative study of the clinical characteristics of spotted fever and severe fever with thrombocytopenia syndrome / 中国热带医学

@#Abstract: Objective To investigate the differences in epidemiological and clinical characteristics of patients with spotted fever (SF) and severe fever with thrombocytopenia syndrome (SFTS). Methods A total of 86 patients with SF and 113 patients with SFTS who were laboratory-confirmed in the second-level and above hospitals in Lu'an City from January 2017 to January 2022 were selected. The basic data, epidemiological history, clinical data and laboratory test results of the two diseases were retrospectively analyzed for comparison. Results The proportion of male in SF group was 32.56% (28/86), and the proportion of male in SFTS group was 53.98% (61/113), the difference was statistically significant (χ2=9.067, P<0.01). The proportions of abdominal pain and diarrhea in the SF group were (3.49%, 3/83) and (21.24%, 24/113), which were significantly lower than corresponding (6.98%, 6/86) and (46.90%, 53/113) in the SFTS group (χ2=13.121, 37.322, P<0.01). The incidences of rash and eschar in SF group were 95.35% (82/86) and 20.93% (18/86), which were significantly higher than corresponding 1.77% (2/113) and 0.88% (1/113) in SFTS group (χ2=175.311, 22.721, P<0.01). The levels of leukocytes, platelets and C-reactive protein in the SF group were significantly higher than those in the SFTS group, and the levels of transaminase, lactate dehydrogenase and D-dimer were significantly lower than those in the SFTS group, and the differences were statistically significant (all P<0.05). Conclusions The rash and inflammatory reaction are more obvious in SF patients, while the liver function, myocardial function and coagulation function are significantly impaired in SFTS patients.

Incidence trend of clinical characteristics and outcome of lung cancer in Ma'anshan District / 公共卫生与预防医学

Objective To investigate the incidence trend, clinical characteristics and prognosis of lung cancer in Ma'anshan area. Methods The data of 398 lung cancer patients admitted to the Department of Respiratory and Critical Care Medicine, Maanshan People's Hospital in Ma'anshan area from January 2018 to May 2022 were selected, and the composition ratio of age, sex, histology and outcome data and its change trend over time were analyzed. Results The minimum age of lung cancer patients in this area was 35 years old, the maximum age was 92 years old, and the average age was (69.94 ± 9.76) years old . The patients were mainly from 70 to 79 years old, followed by 60 to 69 years old and >80 years old . The number of patients was decreasing year by year . The patients with squamous cell carcinoma transferred from 60 to 69 years old to 70 to 79 years old, and adenocarcinoma mainly concentrated in 70 to 79 years old . The incidence of squamous cell carcinoma increased (P=0.006), while that of adenosquamous carcinoma decreased (P=0.005) . The improved discharge rate of lung cancer was increasing year by year (P<0.001) , and the cured discharge rate (P=0.044) was decreasing year by year. The improved discharge rate of men was increasing year by year (P=0.039) , while the improved discharge rate of women was decreasing and then increasing, and the improved discharge rate in 2020 was the lowest (P=0.027) . The mortality increased with age (P=0.002). Conclusion From 2018 to 2022, the number of patients in Ma'anshan area will decrease year by year . The patients were mainly in the 70-79 age group . The incidence rate of adenocarcinoma was the highest , while the incidence rate and age of squamous cell carcinoma were on the rise . The overall improvement discharge rate is increasing year by year , and the cure discharge rate is decreasing year by year. The improvement discharge rate for men is increasing year by year , and vice versa for women.

Fitting Degrees of Cathartic Colon Animal Models with Disease Characteristics of Western Medicine and Syndrome Characteristics of Traditional Chinese Medicine / 中国实验方剂学杂志

Cathartic colon （CC） is a common and refractory digestive system disease， with the pathogenesis not fully clarified. The effective therapies other than laxatives and surgery remain to be developed for CC. Therefore， establishing the CC animal models that fit the disease characteristics of western medicine and syndrome characteristics of traditional Chinese medicine （TCM） is an important link to promote the research on this disease. The fitting degree of animal models with the latest Chinese and western medical diagnostic criteria is an indicator to assess the effectiveness of the animal models in simulating the disease characteristics of western medicine and syndrome characteristics of TCM. The literature review showed that the model animals， drugs and their dosage forms， doses， administration methods， and modeling period of CC varied in different studies， and the available CC animal models presented different fitting degrees with the disease characteristics of western medicine and syndrome characteristics of TCM. Rats were the preferred animals for the modeling of CC. Rhei Radix et Rhizoma preparations were commonly used for model inducing， which， however， may cause water electrolyte disorders， decreased immunity， and even death of animals at the late stage of modeling. The animals were modeled by gradually increasing the starting dose， while the starting dose and increasing dose varied. The maintenance dose was determined based on 50% of the animals having loose stools， and the end for a cycle was determined as the time when loose stools disappeared in 80% of animals. The modeling always lasted for 2-3 cycles， approximately 2-4 months. The CC models established with Rhei Radix et Rhizoma granules and rhein had high fitting degrees with the disease and syndrome characteristics. In addition， the CC animal models of TCM syndromes were still in the exploration stage. There were only the animal models of four TCM syndromes： liver depression and spleen deficiency， both Qi and Yin deficiency， Qi stagnation and blood stasis， and spleen and kidney deficiency. Efforts should be made to establish the animal models that meet the characteristics of disease of western medicine and syndromes of TCM， so as to facilitate the research on CC mechanism and drug development.

Clinical characteristics and prognosis of Omicron epidemic in Guang’an / 中国胸心血管外科临床杂志

@#Objective     To analyze the clinical characteristics of the Guang’an Omicron epidemic and summarize the management experiences and practices in pandemic prevention and control of major infectious diseases. Methods     Retrospective analysis was performed on patients infected with coronavirus disease (COVID-19), afterwards treated and observed in the isolation ward of Guang’an People’s Hospital and the shelter of Guang’an City from May 9 to June 26, 2022. The characteristics of patients at different age stages and the related factors affecting the severity, re-positive and negative conversion was analyzed. Results     Finally 1 278 patients were collected, including 508 males and 770 females, with an average age of 41.3±22.6 years. Among them, 1 054 patients were asymptomatic carriers. The overall severe rate was 0.86%, the severe rate of the high-risk group was 3.06%. The median negative conversion time was 10.0 days and re-positive rate was 7.36%. Patients aged>60 years were 2.589 times more likely to have a longer negative conversion time than those aged≤60 years (95%CI 1.921-3.489, P<0.001). Conclusion     The clinical characteristics of Guang’an COVID-19 epidemic are mainly that the elderly with high risk factors are more likely to develop severe cases, have longer clearance time, and re-positve is more likely to occur.