BACKGROUND The prognostic value of late gadolinium enhancement(LGE)derived from cardiovascular magnetic resonance(CMR)is well studied,and several new metrics of LGE have emerged.However,some controversies remain;there...BACKGROUND The prognostic value of late gadolinium enhancement(LGE)derived from cardiovascular magnetic resonance(CMR)is well studied,and several new metrics of LGE have emerged.However,some controversies remain;therefore,further discussion is needed,and more precise risk stratification should be explored.AIM To investigate the associations between the positivity,extent,location,and pattern of LGE and multiple outcomes in dilated cardiomyopathy(DCM).METHODS PubMed,Ovid MEDLINE,and Cochrane Library were searched for studies that investigated the prognostic value of LGE in patients with DCM.Pooled hazard ratios(HRs)and 95%confidence intervals were calculated to assess the role of LGE in the risk stratification of DCM.RESULTS Nineteen studies involving 7330 patients with DCM were included in this metaanalysis and covered a wide spectrum of DCM,with a mean left ventricular ejection fraction between 21%and 50%.The meta-analysis revealed that the presence of LGE was associated with an increased risk of multiple adverse outcomes(all-cause mortality,HR:2.14;arrhythmic events,HR:5.12;and composite endpoints,HR:2.38;all P<0.001).Furthermore,every 1%increment in the extent of LGE was associated with an increased risk of all-cause mortality.Analysis of a subgroup revealed that the prognostic value varied based on different location and pattern of LGE.Additionally,we found that LGE was a stronger predictor of arrhythmic events in patients with greater left ventricular ejection fraction.CONCLUSION LGE by CMR in patients with DCM exhibited a substantial value in predicting adverse outcomes,and the extent,location,and pattern of LGE could provide additional information for risk stratification.展开更多
BACKGROUND Chronic myeloid leukemia(CML)is a malignant hematologic malignancy that can progress to blast phase with a myeloid or lymphoid phenotype.Some patients with CML can also progress to blast crisis phase;howeve...BACKGROUND Chronic myeloid leukemia(CML)is a malignant hematologic malignancy that can progress to blast phase with a myeloid or lymphoid phenotype.Some patients with CML can also progress to blast crisis phase;however,the transformation of CML into Philadelphia-positive lymphoma is extremely rare.CASE SUMMARY We present a patient with CML who experienced a sudden transformation to anaplastic large-cell lymphoma(ALCL)after 7 mo of treatment with imatinib,during which she had achieved partial cytogenetic response as well as early molecular response.The patient noticed a mass in her left shoulder,the biopsy data of which were consistent with ALCL;moreover,her lymphoma cells exhibited BCR-ABL gene fusion.The patient was diagnosed with Philadelphia-positive ALCL that progressed from CML,and was thus treated with the second generation tyrosine kinase inhibitor nilotinib.Six months later,the mass had totally disappeared and the BCR-ABL fusion gene was undetectable in the peripheral blood.To our knowledge,this is the first patient known to have developed Philadelphia-positive ALCL transformed from CML.CONCLUSION Unexplained lymphadenopathy or an extramedullary mass in a patient with CML may warrant a biopsy and testing for BCR-ABL fusion.展开更多
Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis.Methods:Electronic searching"China Knowledge Network","Wanfang ...Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis.Methods:Electronic searching"China Knowledge Network","Wanfang Database","Vip Database","Chinese Biomedical Literature Database",PubMed,Embase,The Cochrane Library,all published on the prescription of Peitu Shengjin prescription comparison H1 antihistamine In randomized controlled trials(RCTs)of drug treatment of allergic rhinitis,two researchers screened the literature according to the inclusion and exclusion criteria,and conducted Meta-analysis using RevMan5.3 software.Results:A total of 22 studies were involved,involving a total of 1463 subjects,including 822 in the treatment group and 641 in the control group.Meta-analysis results show that compared with oral H1 antihistamines,Peitu Shengjin prescription can improve the total effective rate of allergic rhinitis(RR=1.19,95%CI[1.14,1.24],P<0.00001);reduce recurrence Rate(RR=0.46,95%CI[0.23,0.90],P=0.02);reduce serum IL-6(MD=-17.33,95%CI[-21.96,-12.70],P<0.00001)and serum IL-8(MD=-100.35,95%CI[-175.18,-25.52],P=0.009);reduce the patient’s total score of symptoms and signs(SMD=-1.21,95%CI[-1.82,-0.61],P<0.0001)And TCM symptom scores(SMD=-0.98,95%CI[-1.28,-0.68],P<0.00001);superior to the control group in improving patients'nasal congestion,nasal itching,and turbinate/nasal mucosa enlargement,in improving runny nose There is no obvious advantage compared with the control group in terms of sneezing symptoms;in terms of safety,there are fewer mild adverse reactions in the treatment group(RD=-0.05,95%CI[-0.09,-0.00],P=0.04).Conclusion:Compared with H1 antihistamine,Peitu Shengjin prescription can improve clinical efficacy,improve patients'symptoms and signs and TCM symptoms,regulate immune function,and is not easy to relapse and has good safety.展开更多
Objective:To comprehensively evaluate the influencing factors of cough variant asthma(CVA)disease progression by meta-analysis,and to provide a reference for clinical work.Methods:comprehensive retrieve relevant asses...Objective:To comprehensively evaluate the influencing factors of cough variant asthma(CVA)disease progression by meta-analysis,and to provide a reference for clinical work.Methods:comprehensive retrieve relevant assessment of cough variant asthma(CVA),the influence factors of disease progression of literature researchers a number of independent screens and quality evaluation,literature into literature,data extraction,into the literature of quality evaluation of the Newcastle-Ottawa(Newcastle-Ottawa Scale,NOS)Scale,Meta-analysis using RevMan 5.3 software,effect size for odds ratio(OR).Results:a total of 664 patients with CVA were included in the 7 English pieces of literature and 3 Chinese pieces of literature,among which 195 patients developed typical asthma.Family history of asthma[OR=14.12,95%Cl(7.79,25.59)],allergic condition[OR=5.70,95%Cl(2.02,16.13)],low FEV1/FVC[MD=-4.44,95%Cl(-5.28,-2.91)]were risk factors for the development of cough variant asthma(CVA).Conclusion:family history of asthma,allergic constitution,and low FEV1/FVC are risk factors for the progression of cough variant asthma(CVA).However,the mechanism of CVA progression to typical asthma is still unclear,and whether airway hyperresponsiveness is a risk factor is still controversial and needs to be further explored by clinicians and researchers.展开更多
基金the Research Grant of the National Natural Science Foundation of China,No.81801674Sichuan Province Science and Technology Support Program,No.2021YJ0242.
文摘BACKGROUND The prognostic value of late gadolinium enhancement(LGE)derived from cardiovascular magnetic resonance(CMR)is well studied,and several new metrics of LGE have emerged.However,some controversies remain;therefore,further discussion is needed,and more precise risk stratification should be explored.AIM To investigate the associations between the positivity,extent,location,and pattern of LGE and multiple outcomes in dilated cardiomyopathy(DCM).METHODS PubMed,Ovid MEDLINE,and Cochrane Library were searched for studies that investigated the prognostic value of LGE in patients with DCM.Pooled hazard ratios(HRs)and 95%confidence intervals were calculated to assess the role of LGE in the risk stratification of DCM.RESULTS Nineteen studies involving 7330 patients with DCM were included in this metaanalysis and covered a wide spectrum of DCM,with a mean left ventricular ejection fraction between 21%and 50%.The meta-analysis revealed that the presence of LGE was associated with an increased risk of multiple adverse outcomes(all-cause mortality,HR:2.14;arrhythmic events,HR:5.12;and composite endpoints,HR:2.38;all P<0.001).Furthermore,every 1%increment in the extent of LGE was associated with an increased risk of all-cause mortality.Analysis of a subgroup revealed that the prognostic value varied based on different location and pattern of LGE.Additionally,we found that LGE was a stronger predictor of arrhythmic events in patients with greater left ventricular ejection fraction.CONCLUSION LGE by CMR in patients with DCM exhibited a substantial value in predicting adverse outcomes,and the extent,location,and pattern of LGE could provide additional information for risk stratification.
基金Supported by the Jiangxi“5511”Science and Technology Innovation Talent Project,No.20171BCB18003。
文摘BACKGROUND Chronic myeloid leukemia(CML)is a malignant hematologic malignancy that can progress to blast phase with a myeloid or lymphoid phenotype.Some patients with CML can also progress to blast crisis phase;however,the transformation of CML into Philadelphia-positive lymphoma is extremely rare.CASE SUMMARY We present a patient with CML who experienced a sudden transformation to anaplastic large-cell lymphoma(ALCL)after 7 mo of treatment with imatinib,during which she had achieved partial cytogenetic response as well as early molecular response.The patient noticed a mass in her left shoulder,the biopsy data of which were consistent with ALCL;moreover,her lymphoma cells exhibited BCR-ABL gene fusion.The patient was diagnosed with Philadelphia-positive ALCL that progressed from CML,and was thus treated with the second generation tyrosine kinase inhibitor nilotinib.Six months later,the mass had totally disappeared and the BCR-ABL fusion gene was undetectable in the peripheral blood.To our knowledge,this is the first patient known to have developed Philadelphia-positive ALCL transformed from CML.CONCLUSION Unexplained lymphadenopathy or an extramedullary mass in a patient with CML may warrant a biopsy and testing for BCR-ABL fusion.
基金Research and Development project of"Ten Diseases and ten Drugs"of Beijing Municipal Commission of Science and Technology(No.Z141100002214018)。
文摘Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis.Methods:Electronic searching"China Knowledge Network","Wanfang Database","Vip Database","Chinese Biomedical Literature Database",PubMed,Embase,The Cochrane Library,all published on the prescription of Peitu Shengjin prescription comparison H1 antihistamine In randomized controlled trials(RCTs)of drug treatment of allergic rhinitis,two researchers screened the literature according to the inclusion and exclusion criteria,and conducted Meta-analysis using RevMan5.3 software.Results:A total of 22 studies were involved,involving a total of 1463 subjects,including 822 in the treatment group and 641 in the control group.Meta-analysis results show that compared with oral H1 antihistamines,Peitu Shengjin prescription can improve the total effective rate of allergic rhinitis(RR=1.19,95%CI[1.14,1.24],P<0.00001);reduce recurrence Rate(RR=0.46,95%CI[0.23,0.90],P=0.02);reduce serum IL-6(MD=-17.33,95%CI[-21.96,-12.70],P<0.00001)and serum IL-8(MD=-100.35,95%CI[-175.18,-25.52],P=0.009);reduce the patient’s total score of symptoms and signs(SMD=-1.21,95%CI[-1.82,-0.61],P<0.0001)And TCM symptom scores(SMD=-0.98,95%CI[-1.28,-0.68],P<0.00001);superior to the control group in improving patients'nasal congestion,nasal itching,and turbinate/nasal mucosa enlargement,in improving runny nose There is no obvious advantage compared with the control group in terms of sneezing symptoms;in terms of safety,there are fewer mild adverse reactions in the treatment group(RD=-0.05,95%CI[-0.09,-0.00],P=0.04).Conclusion:Compared with H1 antihistamine,Peitu Shengjin prescription can improve clinical efficacy,improve patients'symptoms and signs and TCM symptoms,regulate immune function,and is not easy to relapse and has good safety.
文摘Objective:To comprehensively evaluate the influencing factors of cough variant asthma(CVA)disease progression by meta-analysis,and to provide a reference for clinical work.Methods:comprehensive retrieve relevant assessment of cough variant asthma(CVA),the influence factors of disease progression of literature researchers a number of independent screens and quality evaluation,literature into literature,data extraction,into the literature of quality evaluation of the Newcastle-Ottawa(Newcastle-Ottawa Scale,NOS)Scale,Meta-analysis using RevMan 5.3 software,effect size for odds ratio(OR).Results:a total of 664 patients with CVA were included in the 7 English pieces of literature and 3 Chinese pieces of literature,among which 195 patients developed typical asthma.Family history of asthma[OR=14.12,95%Cl(7.79,25.59)],allergic condition[OR=5.70,95%Cl(2.02,16.13)],low FEV1/FVC[MD=-4.44,95%Cl(-5.28,-2.91)]were risk factors for the development of cough variant asthma(CVA).Conclusion:family history of asthma,allergic constitution,and low FEV1/FVC are risk factors for the progression of cough variant asthma(CVA).However,the mechanism of CVA progression to typical asthma is still unclear,and whether airway hyperresponsiveness is a risk factor is still controversial and needs to be further explored by clinicians and researchers.
