Evaluación de la condición física en poblaciones de 6 a 14 años de México y Cuba

El presente estudio constituye un trabajo trascendente en el área del conocimiento de la condición física y representa el resultado de investigaciones realizadas en la República de Cuba y en los Estados Unidos Mexicanos como respuesta a la solicitud de ambos países. Fue diseñado estadísticamente, para representar datos oficiales y altamente confiables, con el objetivo de conocer el estado de la condición física de las dos naciones y valorar así, el efecto de los programas de Educación Física que se aplican. Se contó con el apoyo de las organizaciones deportivas y de cultura física al conformar los estudios, cuidadosamente tratados en el diseño de muestra, para ello se contó con un equipo de estadísticos especialistas que tuvieron a su cargo el procesamiento de la información. Los datos de este estudio se consideraron limitados para la publicación y una vez desclasificados se dan conocer. Se utilizaron iguales metodologías en su aplicación, lo que resulta una información valiosa para el perfeccionamiento de los planes y programas que en el campo de la Licenciatura en Cultura Física y se brinda una información que, en su comparación, llama a la reflexión de los especialistas de Educación Física, para continuar el perfeccionamiento de estas especialidades, en general.

O presente estudo constitui um trabalho transcendental na área do conhecimento da aptidão física e representa o resultado de uma pesquisa realizada na República de Cuba e nos Estados Unidos Mexicanos em resposta à solicitação de ambos os países. Foi projetado estatisticamente para representar dados oficiais e altamente confiáveis, com o objetivo de conhecer o estado da aptidão física em ambos os países e, assim, avaliar o efeito dos programas de Educação Física aplicados. As organizações esportivas e de cultura física foram apoiadas na elaboração dos estudos, cuidadosamente tratadas no desenho da amostra, com a ajuda de uma equipe de estatísticos especializados que foram responsáveis pelo processamento das informações. Os dados deste estudo foram considerados limitados para publicação e, uma vez desclassificados, são tornados públicos. Foram utilizadas as mesmas metodologias em sua aplicação, o que resulta em informações valiosas para o aprimoramento dos planos e programas no campo da cultura física e fornece informações que, em sua comparação, exigem a reflexão dos especialistas em educação física, a fim de continuar o aprimoramento dessas especialidades em geral.

The present study constitutes a transcendent work in the area of knowledge of physical condition and represents the result of research carried out in the Republic of Cuba and in the United Mexican States in response to the request of both countries. It was designed statistically, to represent official and highly reliable data, with the objective of knowing the state of the physical condition of the two nations and thus evaluating the effect of the Physical Education programs that are applied. It was had the support of sports and physical culture organizations when forming the studies, carefully treated in the sample design, for this it was had a team of specialist statisticians who were in charge of processing the information. The data from this study was considered limited for publication and will be released once declassified. The same methodologies were used in its application, which is valuable information for the improvement of plans and programs in the field of the Bachelor's Degree in Physical Culture and information is provided that, in comparison, calls for reflection by specialists. of Physical Education, to continue the improvement of these specialties, in general.

Hypothesis of Genetic Diversity Selection in the Occurrence and Development of Lung Cancer: Molecular Evolution and Clinical Significance / 中国肺癌杂志

So far, the monoclonal hypothesis of tumor occurrence and development cannot be justified. The genetic diversity selection hypothesis for the occurrence and development of lung cancer links Mendelian genetics with Darwin's theory of evolution, suggesting that the genetic diversity of tumor cell populations with polyclonal origins-monoclonal selection-subclonal expansion is the result of selection pressure. Normal cells acquire mutations in oncogenic driver genes and have a selective advantage over other cells, becoming tumor initiating cells; In the interaction with the tumor microenvironment (TME), the vast majority of initiating cells are recognized and killed by the human immune system. If immune escape occurs, the incidence of malignant tumors will greatly increase, and subclonal expansion, intratumour heterogeneity, etc. will occur. This article proposed the hypothesis of genetic diversity selection and analyzed its clinical significance.
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Multiple Myeloma (Part 1) - Update on Epidemiology, Diagnostic Criteria, Systemic Treatment and Prognosis / Mieloma múltiplo (Parte 1) - Atualização sobre epidemiología, critérios diagnósticos, tratamento sistêmico e prognóstico

Abstract Multiple myeloma (MM) is a hematological malignancy characterized by unregulated and clonal proliferation of plasma cells in the bone marrow; these cells produce and secrete an anomalous monoclonal immunoglobulin, or a fragment of this, called M protein. The clinical manifestations of MM result from the proliferation of these plasmocytes, the excessive production of monoclonal immunoglobulin and the suppression of normal humoral immunity, leading to hypercalcemia, bone destruction, renal failure, suppression of hematopoiesis and humoral immunity, increasing the risk for the development of infections. The increase in life expectancy of the world population led to a concomitant increase in the prevalence of MM, a pathology that usually affects the elderly population. The aim of this review is to update the reader on epidemiology, diagnostic criteria, differential diagnosis with other monoclonal gam-mopathies, systemic treatment and prognosis of MM.

Resumo O mieloma múltiplo (MM) constitui neoplasia maligna de origem hematológica caracterizada pela proliferação desregulada e clonal de plasmócitos na medula óssea; estas células produzem e secretam imunoglobulina monoclonal anômala, ou um fragmento desta, denominado proteína M. As manifestações clínicas do MM decorrem da proliferação destes plasmócitos, da produção excessiva de imunoglobulina monoclonal e da supressão da imunidade humoral normal, levando à hipercalcemia, destruição óssea, insuficiência renal, supressão da hematopoiese e da imunidade humoral,aumentandooriscoparaodesenvolvimento de infecções. O aumento na expectativa de vida da população mundial levou a concomitante incremento na prevalência do MM, patologia que habitualmente acomete a população idosa. O objetivo desta revisão é atualizar o leitor sobre a epidemiologia, critérios diagnósticos, diagnóstico diferencial com outras gamopatias monoclonais, tratamento sistêmico e prognóstico do MM.

Risk of malignancy in thyroid nodules classified as Bethesda categories III, III - subcategories and IV: 2.5 years study

Introduction: Thyroid fine-needle aspiration cytology (FNAC) has gained significance as a quick, safe, and relatively simple method to differentiate malignant from benign thyroid nodules and is regarded as the gold-standard first-line diagnostic test in the evaluation of thyroid nodules. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) established a standardized, category-based reporting system for thyroid FNAC with each category having an implied cancer risk. However, the optimal management of thyroid nodules in the Bethesda III and IV categories is controversial, given the variable malignancy rates. Aims/Objectives: (1) Analysis of the cytomorphological characteristics of patients with categories III and IV of “TBSRTC.” (2) Assessment of risk of malignancy of TBSRTC category III, IV, and substratification of TBSRTC category III. Materials and Methods: A retrospective and prospective study of cases categorized under TBSRTC as category III and IV at a tertiary-care center. Cytological along with their histological results were compared. Results: We identified an overall malignancy rate of 33% for nodules belonging to Bethesda category III and a malignancy rate between 19% and 33% for Bethesda category IV. Also, a significantly higher risk of malignancy in subcategories with nuclear and architectural atypia (66.6%) than only architectural atypia (28.7%). Conclusion: Although surgery is recommended in most of these cases, cytomorphology helps to predict the final histopathological findings with greater accuracy. Substratification of category III into subgroups may help reduce the heterogeneity of the atypia of undetermined significance/follicular lesion of undetermined significance category and more.

Clinical characteristics and progression risk factors for patients with monoclonal gammopathy of undetermined significance / 中华血液学杂志

Objective: To analyze the clinical presentation and progression risk factors of patients with monoclonal gammopathy of undetermined significance (MGUS) in China. Methods: We retrospectively assessed the clinical features and disease progression of 1 037 patients with monoclonal gammopathy of undetermined significance between January 2004 and January 2022 at Peking Union Medical College Hospital. Results: A total of 1 037 patients were recruited in the study, including 636 males (63.6%) , with a median age of 58 (18-94) years. The median concentration of serum monoclonal protein was 2.7 (0-29.4) g/L. The monoclonal immunoglobulin type was IgG in 380 patients (59.7%) , IgA in 143 patients (22.5%) , IgM in 103 patients (16.2%) , IgD in 4 patients (0.6%) , and light chain in 6 patients (0.9%) . 171 patients (31.9%) had an abnormal serum-free light chain ratio (sFLCr) . According to the Mayo Clinic model for risk of progression, the proportion of patients in the low-risk, medium-low-risk, medium-high risk, and high-risk groups were 254 (59.5%) , 126 (29.5%) , 43 (10.1%) , and 4 (0.9%) , respectively. With a median follow-up of 47 (1-204) months, 34 of 795 patients (4.3%) had disease progression, and 22 (2.8%) died. The overall progression rate was 1.06 (0.99-1.13) /100 person-years. Patients with non-IgM MGUS have a markedly higher disease progression rate per 100 person-years than IgM-MGUS (2.87/100 person-years vs 0.99/100 person-years, P=0.002) . The disease progression rate per 100 person-years in non-IgM-MGUS patients of Mayo classification low-risk, medium-low risk and medium-high risk groups were 0.32 (0.25-0.39) /100 person-years, 1.82 (1.55-2.09) /100 person-years, and2.71 (1.93-3.49) /100 person-years, which had statistically difference (P=0.005) . Conclusion: In comparison to non-IgM-MGUS, IgM-MGUS has a greater risk of disease progression. The Mayo Clinic progression risk model applies to non-IgM-MGUS patients in China.

Pitfalls in clinical genetics

With the increasing availability of genetic tests, more doctors are offering and ordering such tests for their patients. Ordering a genetic test appears to be a simple process of filling in paperwork, drawing 3 mL of blood in an ethylenediaminetetraacetic acid tube and receiving a test report. This is identical to sending off a full blood count. However, it is far more complex than that. There are many potential pitfalls, as shown by the increasing number of complaints and lawsuits filed against doctors and allied health staff. Furthermore, clinical genetics involves more than just ordering tests; in fact, focusing on genetic tests alone is a potential pitfall. In this review, we discuss the common pitfalls in clinical genetics and how doctors can avoid these pitfalls to ensure patient safety and to safeguard their practice.

Expression and Clinical Significance of Exosome Component 4 in Newly Diagnosed Patients with Diffuse Large B-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To explore the expression of Exosome Component 4（EXOSC4） in the tissues of newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL) and its clinical significance.@*METHODS@#The expression of EXOSC4 protein in the tissues of 181 newly diagnosed DLBCL patients was analyzed by immunohistochemical staining. Clinical data were collected. The correlation between EXOSC4 protein expression in the tissues of newly diagnosed DLBCL patients and clinical features were analyzed and its prognostic significance.@*RESULTS@#The positive rate of EXOSC4 protein expression was 68.51% in the tissues of 181 newly diagnosed DLBCL patients. These patients were divided into two groups, with 44 cases in high expression group and 137 cases in low expression group. There were no significant differences in age, gender, B symptoms, serum lactate dehydrogenase (LDH) level, Eastern Cooperative Oncology Group (ECOG) score, Ann Arbor stage, extranodal disease, International Prognostic Index (IPI) score, National Comprehensive Cancer Network IPI (NCCN-IPI) score, and cell origin between the two groups (P>0.05). Cox multivariate regression analysis showed that high EXOSC4 protein expression in tissues was an independent poor prognostic factor for OS and PFS in newly diagnosed DLBCL patients (all P<0.05). K-M survival analysis showed that newly diagnosed DLBCL patients with high EXOSC4 protein expression had significantly shorter overall survival (OS) and progression free survival (PFS) than those patients with low EXOSC4 protein expression (all P<0.05).@*CONCLUSION@#High EXOSC4 protein expression in tissues of newly diagnosed DLBCL patients is an independent poor prognostic factor for survival.

Construction of a prediction model for postoperative prognosis in patients with resectable cholangiocarcinoma based on SIRT2 expression / 浙江大学学报·医学版

OBJECTIVES@#To develop a prediction model for postoperative prognosis in patients with cholangiocarcinoma (CCA) based on the expression of silence information regulator 2 (SIRT2).@*METHODS@#The differential expression of SIRT2 between CCA and normal tissues was analyzed using TCGA and GEO databases. Gene set enrichment analysis (GSEA) was used to explore potential mechanisms of SIRT2 in CCA. The expression of SIRT2 protein in CCA tissues and normal tissues (including 44 pairs of specimens) was also detected by immunohistochemistry (IHC) staining in 89 resectable CCA patients who underwent surgical treatment in The First Affiliated Hospital of Bengbu Medical College between January 2016 and December 2021. The relationship between SIRT2 expression and clinicopathological characteristics and prognosis of CCA patients was analyzed. A survival prediction model for patients with resectable CCA was constructed with COX regression results, the calibration curve and the time-dependent receiver operating characteristic curve (ROC) were used to evaluate the performance of the constructed model, and the predictive power between this model and the AJCC/TNM staging system (8th Edition) was compared.@*RESULTS@#SIRT2 mRNA was overexpressed in CCA tissues as shown in TCGA and GEO databases. IHC staining showed that SIRT2 protein expression in CCA tissues was significantly higher than that in adjacent non-tumor tissues. GSEA results showed that elevated SIRT2 expression may be involved in multiple metabolism-related signaling pathway, such as fatty acid metabolism, oxidative phosphorylation, amino acid metabolism, etc. SIRT2 expression level was related to serum triglycerides level, tumor size and lymph node metastasis (all P<0.05). The survival analysis results showed that the patients with higher SIRT2 expression had a significant lower overall survival (OS) than patients with lower SIRT2 expression (P<0.05). Univariate COX regression analysis suggested that pathological differentiation, clinical stage, postoperative treatment and SIRT2 expression level were associated with the prognosis of CCA patients (all P<0.05). Multivariate regression analysis confirmed that clinical stage and SIRT2 expression level were independent predictors of OS in postoperative CCA patients (both P<0.05). A nomogram based on SIRT2 for prediction of survival in postoperative CCA patients was constructed. The C-index of the model was 0.675, and the area under the time-dependent ROC curve (AUC) for predicting survival in the first, second, and third years was 0.879, 0.778, and 0.953, respectively, which were superior to those of AJCC/TNM staging system (8th Edition).@*CONCLUSIONS@#SIRT2 is highly expressed in CCA tissues, which is associated with poor prognosis in patients with resectable CCA. The nomogram developed based on SIRT2 may have better predictive power than the AJCC/TNM staging system (8th Edition) in prediction of survival of postoperative CCA patients.

Expression changes and clinical significance of serum neuron-specific enolase and squamous cell carcinoma antigen in lung cancer patients after radiotherapy

Abstract Objective: To explore the changes and clinical significance of serum Neuron-Specific Enolase (NSE) and Squamous Cell Carcinoma antigen (SCC) in patients with lung cancer before and after radiotherapy. Methods: 82 patients with lung cancer were treated with radiotherapy, and effective clinical intervention was given during the radiotherapy process. The patients were followed up for 1 year after radiotherapy and were divided into a recurrence and metastasis group (n = 28) and a non-recurrence and metastasis group (n = 54) according to their prognosis. Another 54 healthy volunteers examined in the present study's hospital during the same period were selected as the control group. To compare the changes of NSE and SCC levels in serum in patients with lung cancer at admission and after radiotherapy, and to explore their clinical significance. Results: After intervention, NSE and SCC levels in the serum of the two groups of patients were significantly lower than those before intervention, and the levels of CD4+ and CD4+/CD8+ were significantly higher than those before intervention (p < 0.05); the level of CD8+ was not significantly different from that before intervention (p > 0.05). And NSE and SCC levels in the intervention group were significantly lower than those in the routine group, the levels of CD4+, CD4+/CD8+ were significantly higher than those in the routine group (p < 0.05). Conclusion: NSE and SCC in serum can preliminarily evaluate the effect of radiotherapy in patients with lung cancer and have a certain predictive effect on prognosis.

MSRSGC: A prospective study of heterogenous group atypia of undetermined significance

Context: Many standard books, literatures, and internet described the characteristic lineament of each salivary gland lesion. Nevertheless, there are dozens of disarray, confusion, and unmanageable morphological features regarding proper reporting. To fight with these issues, Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced in 2018, but still the third category, Atypia of undetermined significance (AUS), poses difficulties for the pathologists and clinicians for a definite interpretation. Aim: The aim is to analyze the risk of neoplasia (RON) and risk of malignancy (ROM) of Milan's category III (AUS) by subdividing into six groups based on cytolomorphology. Settings and Design: The duration of study was from March 2018 to may 2021 with the focus on ROM and RON of all Milan's categories with especial attention on AUS. Methods and Material: Result of total 329 Fine Needle Aspiration Cytology of salivary glands was categorized according to MSRSGC. On the basis of cytomorphology, further subtyping of AUS and its cytohistopathology correlation was done. The ROM and RON of each subtype was analyzed. Statistical Analysis: All data were calculated by existing formulas. Results: Out of 329 aspirates, 24 (07.29%) cases belong to AUS with availability of histology in 13 (54.17%) cases. RON and ROM was 84.62% and 53.85%, respectively. Cases of lymphocytes with nuclear atypia (L-NA) was the most prevalent (29.17%). The RON were 60.00%, 68.57,% 84.62%, 94.87%, 87.50%, 100%, 100% and the ROM were 20.00%, 11.42%, 53.85%, 05.13%, 43.75%, 83.33% and 100% in each Milan's categories I, II, III, IVa, IVb, V, and VI, respectively. ROM was the highest in cystic fluid with nuclear atypia (C-NA) (100.0%), followed by basaloid cells (75%), L-NA (66.675), and SC (50%), but ROM was zero in NA and oncocytic cells. Conclusions: Subgrouping of AUS helps to dissipate the muddiness and provide more exact and reproducible diagnostic and prognostic tool.

Significancia Estadística en Ciencias de la Salud: Limitaciones y Alternativas / Statistical significance in the field of health sciences: limitations and alternatives

Introducción. La prueba de significancia de la hipótesis nula (PSHN) constituye la herramienta más usada para evaluar hipótesis científicas y tomar decisiones al respecto, en especial en ciencias de la salud. Sin embargo, por décadas ha estado en el centro del debate, ya que se han identificado varios problemas conceptuales y de interpretación. Se realizó una revisión de artículos científicos que ilustran las críticas de esta controversia y su relevancia en el ámbito de la investigación en salud. Algunas alternativas para la PSHN son una adecuada interpretación del valor p, uso de intervalos de confianza, incluir el tamaño del efecto y adoptar un marco de inferencia bayesiana. En todos los casos en que se utilice PSHN, su uso debe ser claramente justificado.

Background. Null hypothesis significance testing (NSHT) constitutes the most widely applied tool for the evaluation of scientific hypotheses and decision making in health sciences. However, the method has been the centre of a heated debate where various criticisms related to conceptual and interpretational problems. A review of scientific articles that illustrate the criticisms of this controversy and its relevance in the field of health research was carried out. Some alternatives for the NSHT are an adequate interpretation of the p-value, use of confidence intervals, including the effect size and adopting a Bayesian inference framework. In all cases where NSHT is used, its use should be clearly justified.

Variation of plantaris muscle: a case report with clinical significance / Variación del músculo plantar: reporte de un caso con significado clínico

SUMMARY: The plantaris muscle is located between the soleus and gastrocnemius muscles, within the posterior calf group. Due to degeneration and its loss of plantar-flexion function, the muscle is vestigial in human beings, but it retains clinical significance. Few cases of variation in the plantaris muscle have been reported, and this, therefore, appears to be rare. Nonetheless, absence of this muscle was identified via the dissection of a left lower limb (male), which also indicated the absence of an attachment in the usual position. The present report, which addresses such variation, may provide both inspiration and reference points for the clinical treatment of so-called "tennis leg", and for the use of plantaris muscle for the purposes of clinical, autologous graft repair.

RESUMEN: El músculo plantar se ubica entre los músculos sóleo y gastrocnemio, dentro del grupo posterior de la pierna. Debido a la degeneración y la pérdida de la función de flexión plantar, el músculo es un vestigio en los seres humanos, pero conserva su importancia clínica. Se han informado pocos casos de variación en el músculo plantar y, por lo tanto, esto parece ser raro. No obstante, se observó la ausencia de este músculo durante la disección de un miembro inferior izquierdo (masculino). El presente informe, que aborda dicha variación, puede proporcionar puntos de referencia para el tratamiento clínico de la llamada "pierna de tenista" y para el uso del músculo plantar con fines de reparación clínica con injerto autólogo.

Variations in the origin of the superior laryngeal artery and their clinical significance: a case report with a proposal for a new classification / Variaciones en el origen de la arteria laríngea superior y su significado clínico: reporte de un caso con una nueva propuesta de clasificación

SUMMARY: The superior laryngeal artery is the primary vessel providing the blood supply to the larynx. Commonly, it is derived from the superior thyroid artery. Different variations in the origin have been described in the current literature; knowledge of such variations is crucial for various surgical interventions of the larynx and surgical procedures in the lateral region of the neck regarding the carotid triangle. It should be noted that radiological studies, such as selective angiography of the thyroid gland, can also be misleading in cases of variations. Herein, we describe a case of bilateral superior laryngeal artery originating directly from the external carotid artery of the neck. The arteries at first have a transverse course and then pierce through the thyrohyoid membrane alongside internal laryngeal nerves. Moreover, we also review the known variations in the origin of the superior laryngeal artery and propose a new classification of all known variations.

RESUMEN: La arteria laríngea superior es el vaso principal que proporciona el suministro de sangre a la laringe. Comúnmente, se deriva de la arteria tiroidea superior. Han sido descritas diferentes variaciones en su origen y el conocimiento de éstas resulta crucial para las intervenciones quirúrgicas realizadas en la laringe, como también en los procedimientos quirúrgicos que se llevan a cabo en la región lateral del cuello, respecto al triángulo carotídeo. Cabe señalar que los estudios radiológicos, como la angiografía selectiva de la glándula tiroides, también pueden ser engañosos en casos de variaciones anatómicas. Aquí, describimos un caso de arteria laríngea superior bilateral que se originaba directamente de la arteria carótida externa. Las arterias al inicio tenían un curso transversal y luego atravezaban la membrana tirohioidea junto con los nervios laríngeos internos. Revisamos también las variaciones conocidas en el origen de la arteria laríngea superior y proponemos una nueva clasificación de todas las variaciones conocidas.

Clustered Origin of the Left Coronary Artery from the Left Sinus of Valsalva: Uncharacteristic Developmental Event in the Temporally Regulated Process

Coronary artery development is a sequential and progressively regulated process. However, there are a number of reports available on the disturbance to this temporal process resulting in variations of the artery. In these instances, the function of the coronary arteries was normal in providing blood supply to the heart. The normal and abnormal coronary artery development has been studied using a variety of approaches and the knowledge continues to evolve. The cadaveric specimen was obtained from the “willed body program” for the purpose of student dissection. During the cadaveric dissection of a 94-year old male Caucasian we observed that the left coronary artery arose from the coronary ostium in a cluster of multiple branches. A detailed study of the origin of the left coronary artery showed that there is one ostium from which multiple branches arose. The right coronary artery arose normally from the right coronary ostium. The coronary veins were normal and returned the blood through the coronary sinus to the right atrium. The anomalous finding is discussed in the light of what is already known about the normal coronary artery development and rationalize a possible explanation. We conclude that the abnormal development of the coronary artery is rarely detrimental and provides adequate blood circulation to the heart. However, knowledge of such malformation is important in clinical practice.

Pharmacokinetics and clinical significance of drugs for improving nonalcoholic fatty liver disease / 中国临床药理学与治疗学

Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease in China. There is no specific drug approved for marketing at home and abroad. At present, some adjuvant drugs are mainly used to improve the progress of the disease. Being familiar with and mastering the pharmacokinetic characteristics is very important for the selection and use of drugs. According to the characteristics of drug absorption, distribution, metabolism and excretion, reasonable drugs are selected to improve the therapeutic effect and reduce adverse reactions. Therefore, this paper reviews the pharmacokinetics and clinical significance of drugs commonly used to improve nonalcoholic fatty liver disease in hope of providing basis for clinical medication.

Research progress of genetic testing in male infertility / 中华检验医学杂志

About 15% of the world's population at child-bearing age suffer from infertility. After cancer and cardiovascular and cerebrovascular diseases, the infertility will become the third-largest intractable disease. Among the causes of infertility, male factors account for about half. As a main male factor, genetic factor has become the focus of reproductive research in recent years. Therefore, to formulate a corresponding diagnosis and treatment scheme for male infertility, accurate genetic testing is needed. It is an effective means to meet the demand of high fertility and solve the problem of population decline in current society.

Interpretation and reflection of Traditional Chinese Medicine registration evidence system in Canada / 国际中医中药杂志

Traditional Chinese Medicine (TCM) products could be registered as natural health products (NHPs) in Canada. Its registration process could be mainly divided into simple-application, traditional-application and non-traditional application. By analyzingi the TCM registration evidence system and its safety, effectiveness and quality required by different registration categories in Canada, we found that "simple-application" procesure needs to submit evidence based on the parameters of a component in the monograph. As for "traditional application", TCM products need to be used at least 50 years with, traditional material or Pharmacopoeia can be used as evidence; As for non-traditional application, TCM products need to provide evidence according to the disease risk level, and most of them need to provide scientific experiment evidence. Therefore, from the experience of TCM registration evidence system in Canada, the registration of TCM products should pay attention to improve the its classification method, refining its evidence requirements and data types, promoting the formulation of monograph of TCM, realizing the scientific evaluation and rapid review of classic famous prescriptions, and promoting the inheritance and innovative development of TCM in China.

Analysis on the registration of Chinese patent medicines in Canada and its referantial significance to the international registration of Traditional Chinese Medicines / 国际中医中药杂志

By searching for the Canadian Licensed Natural Health Products Database, (LNHPD), this paper analyzed the characteristics and current status of 92 Chinese patent medicines successfully registered and listed in Canada, and found that the enterprises of successfully registered enterprises are mainly located in areas with better development condition of Traditional Chinese Medicine (TCM) such as Beijing, Guangdong and Tianjin; The successfully registered Chinese patent medicines include 64 kinds of single medicine or medicine with single active ingredient (69.6%) and 28 kinds of compound medicine (30.4%), the forms of the dosage are mainly tablets and capsules, which have the characteristics of accuracy in dosage and stable physicochemical properties. There are also granules, solutions, powders and other dosage forms, which can be preserved for a long time and have low requirements on technic and environment. These Chinese patent medicines are mainly used to treat respiratory and circulatory system diseases, some are used to treat urogenital and digestive system diseases, and few are used to treat difficuilt diseases like tumors, diabetes. There are some other health care products. It is suggested to strengthen the connection between domestic standards of TCM registration and international standards, and promote the scientific and technological capacity of relevant enterprises, and encourage enterprises to strengthen international registration of advantageous products, so as to accelerate the speed of international development of TCM in China.

Progress of diagnosis and treatment of monoclonal gammopathy of neural significance / 白血病·淋巴瘤

Monoclonal gammopathy of neural significance (MGNS) belongs to the category of monoclonal gammopathy of clinically significance. It is an early-stage disease that mainly occurs in peripheral nerves and is not sufficient for the diagnosis of multiple myeloma or lymphoma. MGNS needs to be differentiated from neuropathies due to POEMS syndrome and light-chain amyloidosis; if necessary, nerve biopsy can be performed to clarify the relationship between peripheral nerve symptoms and lymphoplasmacytic disease. Treatment of MGNS is recommended to give intravenous gammaglobulin, plasma exchange and targeted anti-lymphoplasmacytic tumour therapy such as CD20 monoclonal antibody. Early recognition and intervention of MGNS, with multidisciplinary cooperation, will help to reduce the risk of malignancy and the incidence of disability.

Familial Waldenstrom macroglobulinemia: report of 6 cases and review of literature / 白血病·淋巴瘤

Objective:To investigate the familial inheritances, clinical features, treatments and outcomes of familial Waldenstrom macroglobulinemia (WM) patients.Methods:The clinical manifestations, laboratory examinations, diagnosis and treatments, and follow-up data of 6 familial WM patients who were admitted to Yancheng No.1 People's Hospital from June 2002 to July 2019 were retrospectively analyzed, and the literature was reviewed.Results:Among 6 WM patients, 4 patients had dizziness and fatigue at the onset, 1 patient had recurrent low-grade fever and abnormal sweating as the first manifestations, 1 patient was hospitalized due to pulmonary infection, and WM was found later. Two brothers of the patients were diagnosed with WM, another 2 brothers of the patients had IgM-type monoclonal gammopathy of undetermined significance (MGUS) during the physical examination. All the 6 patients were middle-aged/elderly men, with a median age of 63 years old (51-70 years old). The median follow-up time were 71.5 months (4-217 months), and by the end of the follow-up (June 2020), 2 cases died of pulmonary infection, and 1 of them developed acute myeloid leukemia; the other 4 cases were in regular chemotherapy. Two IgM-MGUS patients were followed up without symptoms.Conclusions:WM patients have familial aggregation, and their clinical manifestations are highly heterogeneous. Patients with family history may have poor prognosis. It is necessary to strengthen the awareness of WM and family history screening.