Traditional Chinese medicine nursing is a unique nursingtechnique based on the theory of traditional Chinesemedicine （TCM）, taking dialectical nursing for thedisease with overall concept, combined with prevention,he...Traditional Chinese medicine nursing is a unique nursingtechnique based on the theory of traditional Chinesemedicine （TCM）, taking dialectical nursing for thedisease with overall concept, combined with prevention,health care, recovery, medical and other measures to carefor patients [1]. Many TCM nursing methods are largelycirculated among the masses. Its practicality, convenience,economy is unmatched by other modern medical methods.With the development of society, the transformation ofmedical model, the transformation of the diseasespectrum that threaten human health, the concept of“natural therapy” has been gradually praised by people.展开更多
This review explores tissue engineering as a potential solution for reproductive health issues in women caused by genetic or acquired diseases,such as premature ovarian failure or oophorectomy.The loss of ovarian func...This review explores tissue engineering as a potential solution for reproductive health issues in women caused by genetic or acquired diseases,such as premature ovarian failure or oophorectomy.The loss of ovarian function can lead to infertility,osteoporosis,and cardiovascular disease.Hormone replacement therapy is a common treatment,but it has limitations and risks.The review focuses on two main approaches in tissue engineering:scaffold-based(3D printing,electrospinning,decellularization)and scaffold-free(stem cell transplantation,organoid cultivation).Both approaches show promise in preclinical studies for creating functional ovarian tissue.Challenges include vascularization,innervation,long-term function,and safety.Despite these challenges,tissue engineering offers a potential avenue for restoring fertility and hormone balance in women with ovarian dysfunction.展开更多
BACKGROUND Heat shock proteins(HSPs)are molecular chaperones that play an important role in cellular protection against stress events and have been reported to be overex-pressed in many cancers.The prognostic signific...BACKGROUND Heat shock proteins(HSPs)are molecular chaperones that play an important role in cellular protection against stress events and have been reported to be overex-pressed in many cancers.The prognostic significance of HSPs and their regulatory factors,such as heat shock factor 1(HSF1)and CHIP,are poorly understood.AIM To investigate the relationship between HSP expression and prognosis in esophageal and esophagogastric cancer.METHODS A systematic review was conducted in accordance with PRISMA recommend-ations(PROSPERO:CRD42022370653),on Embase,PubMed,Cochrane,and LILACS.Cohort,case-control,and cross-sectional studies of patients with eso-phagus or esophagogastric cancer were included.HSP-positive patients were compared with HSP-negative,and the endpoints analyzed were lymph node metastasis,tumor depth,distant metastasis,and overall survival(OS).HSPs were stratified according to the HSP family,and the summary risk difference(RD)was calculated using a random-effect model.RESULTS The final selection comprised 27 studies,including esophageal squamous cell carcinoma(21),esophagogastric adenocarcinoma(5),and mixed neoplasms(1).The pooled sample size was 3465 patients.HSP40 and 60 were associated with a higher 3-year OS[HSP40:RD=0.22;95%confidence interval(CI):0.09-0.35;HSP60:RD=0.33;95%CI:0.17-0.50],while HSF1 was associated with a poor 3-year OS(RD=-0.22;95%CI:-0.32 to-0.12).The other HSP families were not associated with long-term survival.HSF1 was associated with a higher probability of lymph node metastasis(RD=-0.16;95%CI:-0.29 to-0.04).HSP40 was associated with a lower probability of lymph node dissemination(RD=0.18;95%CI:0.03-0.33).The expression of other HSP families was not significantly related to tumor depth and lymph node or distant metastasis.CONCLUSION The expression levels of certain families of HSP,such as HSP40 and 60 and HSF1,are associated with long-term survival and lymph node dissemination in patients with esophageal and esophagogastric cancer.展开更多
Methodological quality(risk of bias)assessment is an important step before study initiation usage.Therefore,accurately judging study type is the first priority,and the choosing proper tool is also important.In this re...Methodological quality(risk of bias)assessment is an important step before study initiation usage.Therefore,accurately judging study type is the first priority,and the choosing proper tool is also important.In this review,we introduced methodological quality assessment tools for randomized controlled trial(including individual and cluster),animal study,non-randomized interventional studies(including follow-up study,controlled before-and-after study,before-after/pre-post study,uncontrolled longitudinal study,interrupted time series study),cohort study,case-control study,cross-sectional study(including analytical and descriptive),observational case series and case reports,comparative effectiveness research,diagnostic study,health economic evaluation,prediction study(including predictor finding study,prediction model impact study,prognostic prediction model study),qualitative study,outcome measurement instruments(including patient-reported outcome measure development,content validity,structural validity,internal consistency,cross-cultural validity/measurement invariance,reliability,measurement error,criterion validity,hypotheses testing for construct validity,and responsiveness),systematic review and meta-analysis,and clinical practice guideline.The readers of our review can distinguish the types of medical studies and choose appropriate tools.In one word,comprehensively mastering relevant knowledge and implementing more practices are basic requirements for correctly assessing the methodological quality.展开更多
Background The feasibility and safety of endoscopic thyroidectomy were evaluated by an approach of systematic review of published studies in the past decade.Methods A database searching was performed on MEDLINE, Cochr...Background The feasibility and safety of endoscopic thyroidectomy were evaluated by an approach of systematic review of published studies in the past decade.Methods A database searching was performed on MEDLINE, Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials. Both comparative and non-comparative studies about endoscopic thyroidectomy were selected and analyzed. For the comparative studies, RevMan 4.2 was used for statistical analysis; and for the non-comparative studies, data analysis was performed by SPSS 13.0.Results Seven comparative studies involving 367 patients （video-assisted thyroidectomy （VAT）, 174 patients; conventional thyroidectomy （CT）, 193 patients） were included in VAT-CT group. Age, gender, operative types, and pathological diagnosis were similar. Compared with CT, the mean operative time for VAT was significantly longer （VAT, 80.0 minutes; CT, 61.9 minutes, P 〈0.01）, but the postoperative hospital stay was shorter （VAT, 1.7 days; CT, 2.5 days, P 〈0.01）. The complication rate for VAT was 6.9%, while that for CT was 9.3% （P=0.35）. Three studies analyzed the postoperative pain and cosmetic evaluation, and indicated that the VAT group was superior to the CT group, but there was no significant difference after a meta-analysis. Three comparative studies involving 273 patients （totally endoscopic thyroidectomy （TET）, 145 patients; CT, 128 patients） were included in TET-CT group and the results generally resembled that of VAT-CT group. There were 18 and 14 non-comparative studies reporting the results of VAT and TET, respectively. The mean operative time for VAT was 76.8 minutes compared with 135.8 minutes for TET. The postoperative hospital stay was 1.8 and 3.8 days for VAT and TET respectively. The rates of conversion to open surgery for VAT and TET were similar （VAT, 2.8%; TET, 3.9%, P=0.105）. The complication rate for VAT was 8.6%, while that for TET was 3.5% （P 〈0.01）.Conclusions The feasibility and safety of endoscopic thyroidectomy were initially verified and accepted, and it should be considered as a valid option, offering some advantages to patients in terms of cosmetic results and postoperative distress.展开更多
Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epi...Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.展开更多
Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic control.Hence,this study aims to explore perceived infection routes,influ...Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic control.Hence,this study aims to explore perceived infection routes,influencing factors,psychosocial changes,and management procedures for COVID-19 infected healthcare workers.Methods:This is a cross-sectional,single hospital-based study.We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29,2020.All participants completed a validated questionnaire.Electronic consent was obtained from all participants.Perceived causes of infection,infection prevention,control knowledge and behaviour,psychological changes,symptoms and treatment were measured.Results:Finally,103 professional staff with COVID-19 finished the questionnaire and was included(response rate:98.1%).Of them,87 cases(84.5%)thought they were infected in working environment in hospital,one(1.0%)thought their infection was due to the laboratory environment,and 5(4.9%)thought they were infected in daily life or community environment.Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively.Forty-three(41.8%)thought their infection was related to protective equipment,utilization of common equipment(masks and gloves).The top three first symptoms displayed before diagnosis were fever(41.8%),lethargy(33.0%)and muscle aches(30.1%).After diagnosis,88.3%staff experienced psychological stress or emotional changes during their isolation period,only 11.7%had almost no emotional changes.Arbidol(Umifenovir;an anti-influza drug;69.2%)was the drug most commonly used to target infection in mild and moderate symptoms.Conclusion:The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases.Positive psychological intervention is necessary.展开更多
BACKGROUND Chronic pulmonary aspergillosis(CPA)is a rare syndrome that is often accompanied by gradual lung tissue destruction.Voriconazole is usually employed as the first-line agent for CPA treatment.However,some pa...BACKGROUND Chronic pulmonary aspergillosis(CPA)is a rare syndrome that is often accompanied by gradual lung tissue destruction.Voriconazole is usually employed as the first-line agent for CPA treatment.However,some patients can develop hepatotoxicity and often were forced to stop voriconazole treatment.AIM To record the improving trend of liver function and the therapeutic effects in patients after lowering the trough concentration of voriconazole.METHODS This study retrospectively analyzed 12 adult CPA patients who developed hepatotoxicity during the voriconazole treatment.In these patients,the oral dose was reduced to 3/4 or 1/2 of the standard dose(4 mg/kg,twice daily),and the lower limit of voriconazole trough concentration was maintained more than 0.5μg/m L.The trend of remission of liver toxicity after drug reduction in 12 patients was recorded.During the same period,25 patients who received standard doses served as the control group.Data from the two groups were collected and analyzed for different parameters such as demographic characteristics,underlying pulmonary disorders,laboratory tests,and therapeutic effect.The differences between the two groups were statistically compared.RESULTS Hepatotoxicity occurred in 12 patients within 28-65 d after oral voriconazole treatment.Hepatotoxicity was mainly manifested by the significantly increased level of gamma-glutamyltransferase and a slight increase of alanine aminotransferase and aspartate aminotransferase.The oral dose of voriconazole was reduced to approximately 3 mg/kg in seven patients and approximately 2 mg/kg in five patients.The average trough concentrations for the 12 patients before and after voriconazole oral dose reduction were 3.17±1.47μg/m L(1.5-6.0μg/m L)and 1.70±0.78μg/m L(0.6-3.3μg/m L),respectively(P=0.02).After lowering the trough concentrations,the hepatotoxicity was alleviated in all the patients.However,gamma-glutamyltransferase levels declined slowly.After 4 mo of treatment,7 of the 12 patients were successfully treated in the low trough concentrations group(41.7%).Similarly,8 of the 25 patients in the standard treatment dose group(32.0%)were effectively treated.There was no statistical difference between the groups(P=0.72).CONCLUSION Reducing the lower limit of the voriconazole trough concentration to 0.5μg/m L can alleviate the hepatotoxicity and maintained certain clinical efficacy in CPA patients;however,patients should be closely monitored.展开更多
Objective:The short-and long-term risk factors for stroke recurrence may be different.This study is aimed to determine the risk factors for recurrence within 90 days in patients with ischemic stroke in China.Method:Th...Objective:The short-and long-term risk factors for stroke recurrence may be different.This study is aimed to determine the risk factors for recurrence within 90 days in patients with ischemic stroke in China.Method:This was cross-sectional registry-based study in Chinese medicine hospitals from eight provinces and ten cities in China between November 3,2016 and May 28,2018.Two thousand one hundred and twenty patients with ischemic stroke aged between 35 and 80 years.Stroke recurrence was defined as an outcome indicator.Computed tomography/magnetic resonance imaging was used as a diagnostic tool for stroke recurrence.Patients’age,sex,height,weight,body mass index(BMI),education level,medical history,family history,smoking,and drinking were recorded.Routine laboratory examinations were performed.Associated factors were investigated by calculating the odds ratio(OR)using logistic regression modeling.Results:In all,2120 patients were included in the study,712(33.6%)of whom were women and 1408(66.4%)were men,with a mean age of 62.84±9.35 years.Eighty-two patients experienced stroke recurrence within 90 days,and the accumulative recurrence rates of stroke were 3.9%(95%confidence interval[CI],3.0%–4.7%).The binary logistic analysis showed that previous history of one(OR=8.113;95%CI,4.497–14.637),two(OR=8.848;95%CI,4.025–9.449),or≥3 ischemic strokes(OR=24.599;95%CI,9.307–65.018),and BMI<18.5 kg/m2(OR=2.842;95%CI,1.000–8.075)were independently associated with stroke recurrence within 90 days.Conclusions:The accumulative recurrence rate of ischemic stroke was 3.9%within 90 days.Number of previous history of ischemic stroke and BMI<18.5 kg/m2 were independent risk factors for stroke recurrence.Medical history and solar terms of ischemic stroke were not found to be associated with stroke recurrence within 90 days.Effective secondary prevention for patients with a previous history of ischemic stroke is urgently needed to address this stroke recurrence burden.展开更多
BACKGROUND It remains controversial as to which pathological classification is most valuable in predicting the overall survival(OS)of patients with gastric cancer(GC).AIM To assess the prognostic performances of three...BACKGROUND It remains controversial as to which pathological classification is most valuable in predicting the overall survival(OS)of patients with gastric cancer(GC).AIM To assess the prognostic performances of three pathological classifications in GC and develop a novel prognostic nomogram for individually predicting OS.METHODS Patients were identified from the Surveillance,Epidemiology,and End Results program.Univariate and multivariate analyses were performed to identify the independent prognostic factors.Model discrimination and model fitting were evaluated by receiver operating characteristic curves and Akaike information criteria.Decision curve analysis was performed to assess clinical usefulness.The independent prognostic factors identified by multivariate analysis were further applied to develop a novel prognostic nomogram.RESULTS A total of 2718 eligible GC patients were identified.The modified Lauren classification was identified as one of the independent prognostic factors for OS.It showed superior model discriminative ability and model-fitting performance over the other pathological classifications,and similar results were obtained in various patient settings.In addition,it showed superior net benefits over the Lauren classification and tumor differentiation grade in predicting 3-and 5-year OS.A novel prognostic nomogram incorporating the modified Lauren classification showed superior model discriminative ability,model-fitting performance,and net benefits over the American Joint Committee on Cancer 8th edition tumor-nodemetastasis classification.CONCLUSION The modified Lauren classification shows superior net benefits over the Lauren classification and tumor differentiation grade in predicting OS.A novel prognostic nomogram incorporating the modified Lauren classification shows good model discriminative ability,model-fitting performance,and net benefits.展开更多
A total of 710 patients with first-ever ischemic stroke were consecutively recruited between January 2003 and December 2004 from five community hospitals/stations in five districts of Beijing, China. As of December 31...A total of 710 patients with first-ever ischemic stroke were consecutively recruited between January 2003 and December 2004 from five community hospitals/stations in five districts of Beijing, China. As of December 31, 2008, a total of 2 477 person-years were followed-up. During the five-year follow-ups, 117 adverse events occurred, including all-cause death and acute cardiovascular events （recurrent stroke, acute myocardial infarction, and sudden death）. The five-year cumulative mortality rate was 2.18/100 person-years （54 cases）, with 3.88/100 person-years （96 cases） of acute cardiovascular events and 3.02/100 person-years （75 cases） of recurrent stroke. Multiple factor analyses using the Cox proportional hazards ratio models showed that age, diabetes, and dependence of activities of daily living were independent predictors for death, acute cardiovascular disease events, or recurrent stroke. The results demonstrated that recurrent stroke was a major vascular disease that affected the prognosis of mild or moderate stroke patients. Secondary prevention of stroke patients should include active management of vascular risk factors and rehabilitation.展开更多
Objective To identify the association between PLIN 1237 polymorphism and obesity in Chinese Han adults. Methods A total of 994 adults （157 obese subjects, 322 overweight subjects, and 515 normal controls） were recru...Objective To identify the association between PLIN 1237 polymorphism and obesity in Chinese Han adults. Methods A total of 994 adults （157 obese subjects, 322 overweight subjects, and 515 normal controls） were recruited from two rural communities. PLIN 1237 polymorphism was genotyped by polymerase chain reaction-restriction-fragment-length-polymorphism （PCR-RFLP）. Association between PLIN polymorphisms and obesity status was estimated by ordinal logistic regression. Results The three genotypes of,PLIN 1237 were detected with a percentage of 54.3%, 37.1%, and 8.6% in TT, TC, and CC genotypes, respectively. For the PLIN 1237 polymorphism locus, the frequency of alleles T and C was 0.73 and 0.27, respectively. The PLIN 1237 polymorphisms were in Hardy-Weinberg equilibrium. PLIN 1237 polymorphism was not associated with obesity. The odds ratio for overweight or obesity for the CC＋TC genotype was 0.8（0.4, 1.4） in women （P=-0.4） and 0.6 （0.3, 1.3） in men （P=-0.2） after adjustment for age, education, household income and alcohol consumption, smoking, and physicalactivity. Conclusion Chinese Han adults have a lower frequency of variant-allele C in PLIN1237. PLIN1237 T〉C polymorphism is not significantly associated with obesity in northern Chinese adults.展开更多
Objective: To summarize and evaluate the evidence of guidelines and systematic reviews(SRs) of nonpharmacological interventions for mild cognitive impairment(MCI) to support the development of future guidelines and cl...Objective: To summarize and evaluate the evidence of guidelines and systematic reviews(SRs) of nonpharmacological interventions for mild cognitive impairment(MCI) to support the development of future guidelines and clinical decisions for MCI patients.Methods: Scottish Intercollegiate Guideline Network(SIGN), National Institute for Health and Clinical Excellence(NICE), American Academy of Neurology(AAN), Registered Nurses Association of Ontario(RNAO), Web of Science, PubMed, Cochrane Library, CNAHL, VIP, China National Knowledge Infrastructure(CNKI), and Wanfang Database were searched for relevant publications, including guidelines and SRs, from January 2014 to March 2019. Two authors independently screened articles, extracted data, and assessed the publications for adherence to the inclusion criteria. Appraisal of Guidelines for Research and Evaluation(AGREE II) was used to assess the quality of the guidelines, and Assessment of Multiple Systematic Reviews(AMSTAR 2) was used to assess the quality of SRs. In addition, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) approach was used to evaluate the quality of outcomes.Results: Thirty-two articles were retrieved, including 1 guideline and 31 SRs. Fourteen SRs of physical exercise for MCI, six articles describing cognitive interventions, four articles describing acupuncture, and seven articles assessing dietary interventions(including four articles employing a Mediterranean diet, one article using vitamin B supplementation, and two articles assessing the effects of tea, coffee, and caffeine) were included. The quality of the articles was very low for 4(13%), low for 10(32%), and moderate for 17(55%).Conclusions: Based on the evidence available to date, nonpharmacological interventions may improve the current cognitive function of persons with MCI. In particular, physical exercise, cognitive interventions, and acupuncture exerted promising effects. However, due to the limited number and quality of the included publications, additional high-quality reviews are needed to further confirm.展开更多
Tuberculosis is one of the top killer diseases in the globe. The aim of this study was to explore the geographic distribution patterns and clustering characteristics of the disease incidence in terms of both space and...Tuberculosis is one of the top killer diseases in the globe. The aim of this study was to explore the geographic distribution patterns and clustering characteristics of the disease incidence in terms of both space and time with high relative risk locations for tuberculosis incidence in Beijing area. A retrospective space-time clustering analysis was conducted at the districts level in Beijing area based on reported cases of sputum smear-positive pulmonary tuberculosis (TB) from 2005 to 2014. Global and local Moran’s I, autocorrelation analysis along with Ord (Gi*) statistics was applied to detect spatial patterns and the hotspot of TB incidence. Furthermore, the Kuldorff’s scan statistics were used to analyze space-time clusters. A total of 40,878 TB cases were reported in Beijing from 2005 to 2014. The annual average incidence rate was 22.11 per 100,000 populations (ranged from 16.55 to 25.71). The seasonal incidence occurred from March to July until late autumn. A higher relative risk area for TB incidence was mainly detected in urban and some rural districts of Beijing. The significant most likely space-time clusters and secondary clusters of TB incidence were scattered diversely in Beijing districts in each study year. The risk population was mainly scattered in urban and dense populated districts, including in few rural districts.展开更多
Introduction:Locomotion is a determinant of intrinsic capacity of older people and can be limited by dysfunction in locomotory organs,characterizing Locomotive Syndrome(LoS).Knowledge on locomotive problems and sarcop...Introduction:Locomotion is a determinant of intrinsic capacity of older people and can be limited by dysfunction in locomotory organs,characterizing Locomotive Syndrome(LoS).Knowledge on locomotive problems and sarcopenia,and their interface with quality of life,in the oldest old in the literature is scarce.Objective:To evaluate the correlation between LoS and sarcopenia and their influence on quality of life in oldest old.Methods:A cross-sectional study of an observational,descriptive and analytical epidemiological survey in independent older adults aged 80 and over from São Paulo,Brazil and who participated in the third wave of the LOCOMOV Project,was carried out.Sociodemographic data,comorbidities,functioning in activities of daily living,physical functioning,quality of life,and presence of sarcopenia and LoS were assessed.The statistical analyses included the Test-for-Comparing-Two-Proportions,Pearson's Correlation Coefficient,the chi-Square test and Student´s t-test.Results:Thirty oldest old with a mean age of 89.1 years were evaluated.The prevalence of LoS was high(53.3%)and correlated significantly with chronic pain(p-value 0.024),worse performance on the SPPB and Gait speed(p-value<0.001).Sarcopenia was not correlated with LoS,but worse quality of life on the physical domain was significantly associated with LoS(p-value<0.001)regardless of the presence of sarcopenia.Conclusions:LoS was highly prevalent among the oldest old studied and negatively impacted their quality of life,regardless of the presence of sarcopenia.展开更多
Objectives:To evaluate the effectiveness and safety of Qishen Yiqi Dripping Pill(QSYQ)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods:This multicentre prospective coh...Objectives:To evaluate the effectiveness and safety of Qishen Yiqi Dripping Pill(QSYQ)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods:This multicentre prospective cohort study was conducted at 40 centers in China.Patients with ACS after PCI entered either the QSYQ or Western medicine(WM)groups naturally based on whether they had received QSYQ before enrollment.QSYQ group received QSYQ(0.52 g,3 times a day for 12 months)in addition to WM.The primary endpoint included cardiac death,non-fatal myocardial infarction,and urgent revascularization.The secondary endpoint included rehospitalization due to ACS,heart failure,stroke,and other thrombotic events.Quality of life was assessed by the Seattle Angina Questionnaire(SAQ).Results:A total of 936 patients completed follow-up of the primary endpoint from February 2012 to December 2018.Overall,487 patients received QSYQ and WM.During a median follow-up of 566 days(inter quartile range,IQR,517–602),the primary endpoint occurred in 46(9.45%)and 65(14.48%)patients in QSYQ and WM groups respectively[adjusted hazard ratio(HR)0.60,95%confidence interval(CI)0.41–0.90;P=0.013].The secondary endpoint occurred in 61(12.53%)and 74(16.48%)patients in QSYQ and WM groups,respectively(adjusted HR 0.76,95%CI 0.53–1.09;P=0.136).In sensitivity analysis,the results still demonstrated that WM combined with QSYQ reduced the risk of the primary endpoint(HR 0.67,95%CI 0.46–0.98;P=0.039).Moreover,QSYQ improved the disease perception domain of the SAQ(P<0.05).Conclusions:In patients with ACS after PCI,QSYQ combined with WM reduced the incidence of the primary endpoint.These findings provide a promising option for managing ACS after PCI and suggest the potential treatment for reducing the risk of primary endpoint included cardiac death,non-fatal myocardial infarction,and urgent revascularization through intermittent administration of QSYQ.(Registration No.Chi CTR-OOC-14005552).展开更多
Background: The burden of breast cancer in women of different menopausal status has not been assessed in China previously. We aim to evaluate and project the burden of breast cancer in different menopausal status in C...Background: The burden of breast cancer in women of different menopausal status has not been assessed in China previously. We aim to evaluate and project the burden of breast cancer in different menopausal status in China. Methods: The incidence and mortality of breast cancer were estimated using the data of 554 cancer registries in 2017 and the trends of incidence and mortality of 112 cancer registries from 2010 to 2017. Data from 22 continued cancer registries from 2000 to 2017 were applied for long-term trend projection to 2030 using the Bayesian age- period-cohort model. Menopausal status was stratified by age, with premenopause defined as chronological age < 45 years, perimenopause defined as 45-54 years, and postmenopause defined as ≥ 55 years. Results: Approximately 352,300 incident cases and 74,200 deaths of breast cancer occurred in China in 2020, contributing to 2.6 million disability-adjusted life years (DALYs). Perimenopausal women had the highest inci- dence, prevalence, and DALYs rates, with the rates being 100.3 per 100,000, 819.2 per 100,000 and 723.1 per 100,000 persons. While postmenopausal women had the highest mortality rates (25.5 per 100,000 persons). From 2000 to 2017, the largest increase in incidence and mortality for breast cancer was observed in postmenopausal women with an average annual percentage change (AAPC) of 5.6% and 2.94%. The number of breast cancer cases and deaths will increase to 452,000 and 98,800 in 2030, resulting in 3.2 million DALYs. Conclusions: The burden of breast cancer is rapidly increasing in China and varies among different menopausal status. Specific prevention and control strategies for women in different menopausal status will be more helpful in reducing the rapidly growing trends of breast cancer.展开更多
Background:Pre-operative non-invasive histological evaluation of hepatocellular carcinoma(HCC)remains a challenge.Tumor perfusion is significantly associated with the development and aggressiveness of HCC.The purpose ...Background:Pre-operative non-invasive histological evaluation of hepatocellular carcinoma(HCC)remains a challenge.Tumor perfusion is significantly associated with the development and aggressiveness of HCC.The purpose of the study was to evaluate the clinical value of quantitative liver perfusion parameters and corresponding histogram parameters derived from traditional triphasic enhanced computed tomography(CT)scans in predicting histological grade of HCC.Methods:Totally,52 patients with HCC were enrolled in this retrospective study and underwent triple-phase enhanced CT imaging.The blood perfusion parameters were derived from triple-phase CT scans.The relationship of liver perfusion parameters and corresponding histogram parameters with the histological grade of HCC was analyzed.Receiver operating characteristic(ROC)curve analysis was used to determine the optimal ability of the parameters to predict the tumor histological grade.Results:The variance of arterial enhancement fraction(AEF)was significantly higher in HCCs without poorly differentiated components(NP-HCCs)than in HCCs with poorly differentiated components(P-HCCs).The difference in hepatic blood flow(HF)between total tumor and total liver flow(ΔHF=HFtumor-HFliver)and relative flow(rHF=ΔHF/HF_(liver))were significantly higher in NP-HCCs than in P-HCCs.The difference in portal vein blood supply perfusion(PVP)between tumor and liver tissue(ΔPVP)and theΔPVP/liver PVP ratio(rPVP)were significantly higher in patients with NP-HCCs than in patients with P-HCCs.The area under ROC(AUC)ofΔPVP and rPVP were both 0.697 with a high sensitivity of 84.2%and specificity of only 56.2%.TheΔHF and rHF had a higher specificity of 87.5%with an AUC of 0.681 and 0.673,respectively.The combination of rHF and rPVP showed the highest AUC of 0.732 with a sensitivity of 57.9%and specificity of 93.8%.The combined parameter ofΔHF and rPVP,rHF and rPVP had the highest positive predictive value of 0.903,and that of rPVP andΔPVP had the highest negative predictive value of 0.781.Conclusion:Liver perfusion parameters and corresponding histogram parameters(includingΔHF,rHF,ΔPVP,rPVP,and AEFvariance)in patients with HCC derived from traditional triphasic CT scans may be helpful to non-invasively and pre-operatively predict the degree of the differentiation of HCC.展开更多
Background Nowadays,there are published trials in regards to the comparison of caspofungin with liposomal amphotericin B （L-AmB）.However,these studies have a modest sample size and convey inconclusive results.The ai...Background Nowadays,there are published trials in regards to the comparison of caspofungin with liposomal amphotericin B （L-AmB）.However,these studies have a modest sample size and convey inconclusive results.The aim of this study was to review the efficacy and safety of caspofungin for the treatment of invasive fungal infections （IFIs）,compared with L-AmB.Methods Electronic databases （up to July 31,2013） PubMed and Embase databases,the Cochrane Library,and Google Scholar were searched to identify relevant trials of caspofungin and L-AmB.Analyses of efficacy and adverse outcomes were performed by relative risks （RRs） and 95% confidence intervals （C/s）.Heterogeneity was assessed by x2-test and the/2-statistic.Results Three trials were included in this meta-analysis with 1249 modified intention-to-treat （MITT） patients.The results showed that caspofungin produced equal efficacy in favorable overall response （RR=1.02,95% Cl 0.88-1.18; P=0.81） and mortality rate （RR=1.53,95% Cl 0.38-6.27,P=0.55）,safer in clinical adverse events （RR=0.20,95% Cl 0.08-0.54; P=0.001）,laboratory adverse events （RR=0.69,95% Cl 0.57-0.84; P=0.0002）,and discontinuation rate （RR=0.26,95% Cl 0.08-0.83,P=0.02）,compared with L-AmB in the treatment of patients with IFls.Conclusion Based on the results of this meta-analysis,it would appear that caspofungin was measured to have equal efficacy in clinical outcomes and safer in terms of adverse events.展开更多
基金Natural Science Foundation of Chinaproject（81603496）.
文摘Traditional Chinese medicine nursing is a unique nursingtechnique based on the theory of traditional Chinesemedicine （TCM）, taking dialectical nursing for thedisease with overall concept, combined with prevention,health care, recovery, medical and other measures to carefor patients [1]. Many TCM nursing methods are largelycirculated among the masses. Its practicality, convenience,economy is unmatched by other modern medical methods.With the development of society, the transformation ofmedical model, the transformation of the diseasespectrum that threaten human health, the concept of“natural therapy” has been gradually praised by people.
文摘This review explores tissue engineering as a potential solution for reproductive health issues in women caused by genetic or acquired diseases,such as premature ovarian failure or oophorectomy.The loss of ovarian function can lead to infertility,osteoporosis,and cardiovascular disease.Hormone replacement therapy is a common treatment,but it has limitations and risks.The review focuses on two main approaches in tissue engineering:scaffold-based(3D printing,electrospinning,decellularization)and scaffold-free(stem cell transplantation,organoid cultivation).Both approaches show promise in preclinical studies for creating functional ovarian tissue.Challenges include vascularization,innervation,long-term function,and safety.Despite these challenges,tissue engineering offers a potential avenue for restoring fertility and hormone balance in women with ovarian dysfunction.
文摘BACKGROUND Heat shock proteins(HSPs)are molecular chaperones that play an important role in cellular protection against stress events and have been reported to be overex-pressed in many cancers.The prognostic significance of HSPs and their regulatory factors,such as heat shock factor 1(HSF1)and CHIP,are poorly understood.AIM To investigate the relationship between HSP expression and prognosis in esophageal and esophagogastric cancer.METHODS A systematic review was conducted in accordance with PRISMA recommend-ations(PROSPERO:CRD42022370653),on Embase,PubMed,Cochrane,and LILACS.Cohort,case-control,and cross-sectional studies of patients with eso-phagus or esophagogastric cancer were included.HSP-positive patients were compared with HSP-negative,and the endpoints analyzed were lymph node metastasis,tumor depth,distant metastasis,and overall survival(OS).HSPs were stratified according to the HSP family,and the summary risk difference(RD)was calculated using a random-effect model.RESULTS The final selection comprised 27 studies,including esophageal squamous cell carcinoma(21),esophagogastric adenocarcinoma(5),and mixed neoplasms(1).The pooled sample size was 3465 patients.HSP40 and 60 were associated with a higher 3-year OS[HSP40:RD=0.22;95%confidence interval(CI):0.09-0.35;HSP60:RD=0.33;95%CI:0.17-0.50],while HSF1 was associated with a poor 3-year OS(RD=-0.22;95%CI:-0.32 to-0.12).The other HSP families were not associated with long-term survival.HSF1 was associated with a higher probability of lymph node metastasis(RD=-0.16;95%CI:-0.29 to-0.04).HSP40 was associated with a lower probability of lymph node dissemination(RD=0.18;95%CI:0.03-0.33).The expression of other HSP families was not significantly related to tumor depth and lymph node or distant metastasis.CONCLUSION The expression levels of certain families of HSP,such as HSP40 and 60 and HSF1,are associated with long-term survival and lymph node dissemination in patients with esophageal and esophagogastric cancer.
基金supported(in part)by the Entrusted Project of National commission on health and health of China(No.2019099)the National Key Research and Development Plan of China(2016YFC0106300)the Nature Science Foundation of Hubei Province(2019FFB03902)。
文摘Methodological quality(risk of bias)assessment is an important step before study initiation usage.Therefore,accurately judging study type is the first priority,and the choosing proper tool is also important.In this review,we introduced methodological quality assessment tools for randomized controlled trial(including individual and cluster),animal study,non-randomized interventional studies(including follow-up study,controlled before-and-after study,before-after/pre-post study,uncontrolled longitudinal study,interrupted time series study),cohort study,case-control study,cross-sectional study(including analytical and descriptive),observational case series and case reports,comparative effectiveness research,diagnostic study,health economic evaluation,prediction study(including predictor finding study,prediction model impact study,prognostic prediction model study),qualitative study,outcome measurement instruments(including patient-reported outcome measure development,content validity,structural validity,internal consistency,cross-cultural validity/measurement invariance,reliability,measurement error,criterion validity,hypotheses testing for construct validity,and responsiveness),systematic review and meta-analysis,and clinical practice guideline.The readers of our review can distinguish the types of medical studies and choose appropriate tools.In one word,comprehensively mastering relevant knowledge and implementing more practices are basic requirements for correctly assessing the methodological quality.
文摘Background The feasibility and safety of endoscopic thyroidectomy were evaluated by an approach of systematic review of published studies in the past decade.Methods A database searching was performed on MEDLINE, Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials. Both comparative and non-comparative studies about endoscopic thyroidectomy were selected and analyzed. For the comparative studies, RevMan 4.2 was used for statistical analysis; and for the non-comparative studies, data analysis was performed by SPSS 13.0.Results Seven comparative studies involving 367 patients （video-assisted thyroidectomy （VAT）, 174 patients; conventional thyroidectomy （CT）, 193 patients） were included in VAT-CT group. Age, gender, operative types, and pathological diagnosis were similar. Compared with CT, the mean operative time for VAT was significantly longer （VAT, 80.0 minutes; CT, 61.9 minutes, P 〈0.01）, but the postoperative hospital stay was shorter （VAT, 1.7 days; CT, 2.5 days, P 〈0.01）. The complication rate for VAT was 6.9%, while that for CT was 9.3% （P=0.35）. Three studies analyzed the postoperative pain and cosmetic evaluation, and indicated that the VAT group was superior to the CT group, but there was no significant difference after a meta-analysis. Three comparative studies involving 273 patients （totally endoscopic thyroidectomy （TET）, 145 patients; CT, 128 patients） were included in TET-CT group and the results generally resembled that of VAT-CT group. There were 18 and 14 non-comparative studies reporting the results of VAT and TET, respectively. The mean operative time for VAT was 76.8 minutes compared with 135.8 minutes for TET. The postoperative hospital stay was 1.8 and 3.8 days for VAT and TET respectively. The rates of conversion to open surgery for VAT and TET were similar （VAT, 2.8%; TET, 3.9%, P=0.105）. The complication rate for VAT was 8.6%, while that for TET was 3.5% （P 〈0.01）.Conclusions The feasibility and safety of endoscopic thyroidectomy were initially verified and accepted, and it should be considered as a valid option, offering some advantages to patients in terms of cosmetic results and postoperative distress.
基金supported by the National Key Research and Development Plan of China(Technology helps Economy 2020)the Fundamental Research Funds for the Central Universities(2042020kf1081)+2 种基金the Nature Science Foundation of Hubei Province(2019CFB760)the Translational Medicine and Interdisciplinary Research Joint Fund of Zhongnan Hospital of Wuhan University(ZNJC201917)the Health Commission of the Hubei Province Scientific Research Project(WJ2019H035)。
文摘Background:Urinary tract infections(UTI),urolithiasis,and benign prostatic hyperplasia(BPH)are three of the most common nonmalignant conditions in urology.However,there is still a lack of comprehensive and updated epidemiological data.This study aimed to investigate the disease burden of UTI,urolithiasis,and BPH in 203 countries and territories from 1990 to 2019.Methods:Data were extracted from the Global Burden of Disease 2019,including incident cases,deaths,disabilityadjusted life-years(DALYs)and corresponding age-standardized rate(ASR)from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to evaluate the trends of ASR.The associations between disease burden and social development degrees were analyzed using a sociodemographic index(SDI).Results:Compared with 1990,the incident cases of UTI,urolithiasis,and BPH increased by 60.40%,48.57%,and 105.70%in 2019,respectively.The age-standardized incidence rate(ASIR)of UTI increased(EAPC=0.08),while urolithiasis(EAPC=–0.83)and BPH(EAPC=–0.03)decreased from 1990 to 2019.In 2019,the age-standardized mortality rate(ASMR)of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000,respectively.BPH had the largest increase(110.56%)in DALYs in the past three decades,followed by UTI(68.89%)and urolithiasis(16.95%).The burden of UTI was mainly concentrated in South Asia and Tropical Latin America,while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe.Moreover,the ASIR and SDI of urolithiasis in high-SDI regions from 1990to 2019 were negatively correlated,while the opposite trend was seen in low-SDI regions.In 2019,the ASIR of UTI in females was 3.59 times that of males,while the ASIR of urolithiasis in males was 1.96 times higher than that in females.The incidence was highest in the 30–34,55–59,and 65–69 age groups among the UTI,urolithiasis,and BPH groups,respectively.Conclusions:Over the past three decades,the disease burden has increased for UTI but decreased for urolithiasis and BPH.The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.
基金supported by the Emergency Science and Technology Project in Hubei Province(2020FCA008)
文摘Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic control.Hence,this study aims to explore perceived infection routes,influencing factors,psychosocial changes,and management procedures for COVID-19 infected healthcare workers.Methods:This is a cross-sectional,single hospital-based study.We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29,2020.All participants completed a validated questionnaire.Electronic consent was obtained from all participants.Perceived causes of infection,infection prevention,control knowledge and behaviour,psychological changes,symptoms and treatment were measured.Results:Finally,103 professional staff with COVID-19 finished the questionnaire and was included(response rate:98.1%).Of them,87 cases(84.5%)thought they were infected in working environment in hospital,one(1.0%)thought their infection was due to the laboratory environment,and 5(4.9%)thought they were infected in daily life or community environment.Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively.Forty-three(41.8%)thought their infection was related to protective equipment,utilization of common equipment(masks and gloves).The top three first symptoms displayed before diagnosis were fever(41.8%),lethargy(33.0%)and muscle aches(30.1%).After diagnosis,88.3%staff experienced psychological stress or emotional changes during their isolation period,only 11.7%had almost no emotional changes.Arbidol(Umifenovir;an anti-influza drug;69.2%)was the drug most commonly used to target infection in mild and moderate symptoms.Conclusion:The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases.Positive psychological intervention is necessary.
文摘BACKGROUND Chronic pulmonary aspergillosis(CPA)is a rare syndrome that is often accompanied by gradual lung tissue destruction.Voriconazole is usually employed as the first-line agent for CPA treatment.However,some patients can develop hepatotoxicity and often were forced to stop voriconazole treatment.AIM To record the improving trend of liver function and the therapeutic effects in patients after lowering the trough concentration of voriconazole.METHODS This study retrospectively analyzed 12 adult CPA patients who developed hepatotoxicity during the voriconazole treatment.In these patients,the oral dose was reduced to 3/4 or 1/2 of the standard dose(4 mg/kg,twice daily),and the lower limit of voriconazole trough concentration was maintained more than 0.5μg/m L.The trend of remission of liver toxicity after drug reduction in 12 patients was recorded.During the same period,25 patients who received standard doses served as the control group.Data from the two groups were collected and analyzed for different parameters such as demographic characteristics,underlying pulmonary disorders,laboratory tests,and therapeutic effect.The differences between the two groups were statistically compared.RESULTS Hepatotoxicity occurred in 12 patients within 28-65 d after oral voriconazole treatment.Hepatotoxicity was mainly manifested by the significantly increased level of gamma-glutamyltransferase and a slight increase of alanine aminotransferase and aspartate aminotransferase.The oral dose of voriconazole was reduced to approximately 3 mg/kg in seven patients and approximately 2 mg/kg in five patients.The average trough concentrations for the 12 patients before and after voriconazole oral dose reduction were 3.17±1.47μg/m L(1.5-6.0μg/m L)and 1.70±0.78μg/m L(0.6-3.3μg/m L),respectively(P=0.02).After lowering the trough concentrations,the hepatotoxicity was alleviated in all the patients.However,gamma-glutamyltransferase levels declined slowly.After 4 mo of treatment,7 of the 12 patients were successfully treated in the low trough concentrations group(41.7%).Similarly,8 of the 25 patients in the standard treatment dose group(32.0%)were effectively treated.There was no statistical difference between the groups(P=0.72).CONCLUSION Reducing the lower limit of the voriconazole trough concentration to 0.5μg/m L can alleviate the hepatotoxicity and maintained certain clinical efficacy in CPA patients;however,patients should be closely monitored.
基金supported by Traditional Chinese Medicine Research Special Project
文摘Objective:The short-and long-term risk factors for stroke recurrence may be different.This study is aimed to determine the risk factors for recurrence within 90 days in patients with ischemic stroke in China.Method:This was cross-sectional registry-based study in Chinese medicine hospitals from eight provinces and ten cities in China between November 3,2016 and May 28,2018.Two thousand one hundred and twenty patients with ischemic stroke aged between 35 and 80 years.Stroke recurrence was defined as an outcome indicator.Computed tomography/magnetic resonance imaging was used as a diagnostic tool for stroke recurrence.Patients’age,sex,height,weight,body mass index(BMI),education level,medical history,family history,smoking,and drinking were recorded.Routine laboratory examinations were performed.Associated factors were investigated by calculating the odds ratio(OR)using logistic regression modeling.Results:In all,2120 patients were included in the study,712(33.6%)of whom were women and 1408(66.4%)were men,with a mean age of 62.84±9.35 years.Eighty-two patients experienced stroke recurrence within 90 days,and the accumulative recurrence rates of stroke were 3.9%(95%confidence interval[CI],3.0%–4.7%).The binary logistic analysis showed that previous history of one(OR=8.113;95%CI,4.497–14.637),two(OR=8.848;95%CI,4.025–9.449),or≥3 ischemic strokes(OR=24.599;95%CI,9.307–65.018),and BMI<18.5 kg/m2(OR=2.842;95%CI,1.000–8.075)were independently associated with stroke recurrence within 90 days.Conclusions:The accumulative recurrence rate of ischemic stroke was 3.9%within 90 days.Number of previous history of ischemic stroke and BMI<18.5 kg/m2 were independent risk factors for stroke recurrence.Medical history and solar terms of ischemic stroke were not found to be associated with stroke recurrence within 90 days.Effective secondary prevention for patients with a previous history of ischemic stroke is urgently needed to address this stroke recurrence burden.
基金Supported by The China Scholarship Council,No.201908050148.
文摘BACKGROUND It remains controversial as to which pathological classification is most valuable in predicting the overall survival(OS)of patients with gastric cancer(GC).AIM To assess the prognostic performances of three pathological classifications in GC and develop a novel prognostic nomogram for individually predicting OS.METHODS Patients were identified from the Surveillance,Epidemiology,and End Results program.Univariate and multivariate analyses were performed to identify the independent prognostic factors.Model discrimination and model fitting were evaluated by receiver operating characteristic curves and Akaike information criteria.Decision curve analysis was performed to assess clinical usefulness.The independent prognostic factors identified by multivariate analysis were further applied to develop a novel prognostic nomogram.RESULTS A total of 2718 eligible GC patients were identified.The modified Lauren classification was identified as one of the independent prognostic factors for OS.It showed superior model discriminative ability and model-fitting performance over the other pathological classifications,and similar results were obtained in various patient settings.In addition,it showed superior net benefits over the Lauren classification and tumor differentiation grade in predicting 3-and 5-year OS.A novel prognostic nomogram incorporating the modified Lauren classification showed superior model discriminative ability,model-fitting performance,and net benefits over the American Joint Committee on Cancer 8th edition tumor-nodemetastasis classification.CONCLUSION The modified Lauren classification shows superior net benefits over the Lauren classification and tumor differentiation grade in predicting OS.A novel prognostic nomogram incorporating the modified Lauren classification shows good model discriminative ability,model-fitting performance,and net benefits.
基金supported by the National Natural Science Foundation of China, No. 30671797 and 81072361
文摘A total of 710 patients with first-ever ischemic stroke were consecutively recruited between January 2003 and December 2004 from five community hospitals/stations in five districts of Beijing, China. As of December 31, 2008, a total of 2 477 person-years were followed-up. During the five-year follow-ups, 117 adverse events occurred, including all-cause death and acute cardiovascular events （recurrent stroke, acute myocardial infarction, and sudden death）. The five-year cumulative mortality rate was 2.18/100 person-years （54 cases）, with 3.88/100 person-years （96 cases） of acute cardiovascular events and 3.02/100 person-years （75 cases） of recurrent stroke. Multiple factor analyses using the Cox proportional hazards ratio models showed that age, diabetes, and dependence of activities of daily living were independent predictors for death, acute cardiovascular disease events, or recurrent stroke. The results demonstrated that recurrent stroke was a major vascular disease that affected the prognosis of mild or moderate stroke patients. Secondary prevention of stroke patients should include active management of vascular risk factors and rehabilitation.
基金supported by the National Science Foundation of China (No. 30671805)Henan Innovation Project for University Prominent Research Talents (No. 2006KYCX010)
文摘Objective To identify the association between PLIN 1237 polymorphism and obesity in Chinese Han adults. Methods A total of 994 adults （157 obese subjects, 322 overweight subjects, and 515 normal controls） were recruited from two rural communities. PLIN 1237 polymorphism was genotyped by polymerase chain reaction-restriction-fragment-length-polymorphism （PCR-RFLP）. Association between PLIN polymorphisms and obesity status was estimated by ordinal logistic regression. Results The three genotypes of,PLIN 1237 were detected with a percentage of 54.3%, 37.1%, and 8.6% in TT, TC, and CC genotypes, respectively. For the PLIN 1237 polymorphism locus, the frequency of alleles T and C was 0.73 and 0.27, respectively. The PLIN 1237 polymorphisms were in Hardy-Weinberg equilibrium. PLIN 1237 polymorphism was not associated with obesity. The odds ratio for overweight or obesity for the CC＋TC genotype was 0.8（0.4, 1.4） in women （P=-0.4） and 0.6 （0.3, 1.3） in men （P=-0.2） after adjustment for age, education, household income and alcohol consumption, smoking, and physicalactivity. Conclusion Chinese Han adults have a lower frequency of variant-allele C in PLIN1237. PLIN1237 T〉C polymorphism is not significantly associated with obesity in northern Chinese adults.
基金supported by Basic Science Research Program through the National Natural Science Foundation of China Youth Program(No.NNSF-81603496)
文摘Objective: To summarize and evaluate the evidence of guidelines and systematic reviews(SRs) of nonpharmacological interventions for mild cognitive impairment(MCI) to support the development of future guidelines and clinical decisions for MCI patients.Methods: Scottish Intercollegiate Guideline Network(SIGN), National Institute for Health and Clinical Excellence(NICE), American Academy of Neurology(AAN), Registered Nurses Association of Ontario(RNAO), Web of Science, PubMed, Cochrane Library, CNAHL, VIP, China National Knowledge Infrastructure(CNKI), and Wanfang Database were searched for relevant publications, including guidelines and SRs, from January 2014 to March 2019. Two authors independently screened articles, extracted data, and assessed the publications for adherence to the inclusion criteria. Appraisal of Guidelines for Research and Evaluation(AGREE II) was used to assess the quality of the guidelines, and Assessment of Multiple Systematic Reviews(AMSTAR 2) was used to assess the quality of SRs. In addition, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) approach was used to evaluate the quality of outcomes.Results: Thirty-two articles were retrieved, including 1 guideline and 31 SRs. Fourteen SRs of physical exercise for MCI, six articles describing cognitive interventions, four articles describing acupuncture, and seven articles assessing dietary interventions(including four articles employing a Mediterranean diet, one article using vitamin B supplementation, and two articles assessing the effects of tea, coffee, and caffeine) were included. The quality of the articles was very low for 4(13%), low for 10(32%), and moderate for 17(55%).Conclusions: Based on the evidence available to date, nonpharmacological interventions may improve the current cognitive function of persons with MCI. In particular, physical exercise, cognitive interventions, and acupuncture exerted promising effects. However, due to the limited number and quality of the included publications, additional high-quality reviews are needed to further confirm.
文摘Tuberculosis is one of the top killer diseases in the globe. The aim of this study was to explore the geographic distribution patterns and clustering characteristics of the disease incidence in terms of both space and time with high relative risk locations for tuberculosis incidence in Beijing area. A retrospective space-time clustering analysis was conducted at the districts level in Beijing area based on reported cases of sputum smear-positive pulmonary tuberculosis (TB) from 2005 to 2014. Global and local Moran’s I, autocorrelation analysis along with Ord (Gi*) statistics was applied to detect spatial patterns and the hotspot of TB incidence. Furthermore, the Kuldorff’s scan statistics were used to analyze space-time clusters. A total of 40,878 TB cases were reported in Beijing from 2005 to 2014. The annual average incidence rate was 22.11 per 100,000 populations (ranged from 16.55 to 25.71). The seasonal incidence occurred from March to July until late autumn. A higher relative risk area for TB incidence was mainly detected in urban and some rural districts of Beijing. The significant most likely space-time clusters and secondary clusters of TB incidence were scattered diversely in Beijing districts in each study year. The risk population was mainly scattered in urban and dense populated districts, including in few rural districts.
文摘Introduction:Locomotion is a determinant of intrinsic capacity of older people and can be limited by dysfunction in locomotory organs,characterizing Locomotive Syndrome(LoS).Knowledge on locomotive problems and sarcopenia,and their interface with quality of life,in the oldest old in the literature is scarce.Objective:To evaluate the correlation between LoS and sarcopenia and their influence on quality of life in oldest old.Methods:A cross-sectional study of an observational,descriptive and analytical epidemiological survey in independent older adults aged 80 and over from São Paulo,Brazil and who participated in the third wave of the LOCOMOV Project,was carried out.Sociodemographic data,comorbidities,functioning in activities of daily living,physical functioning,quality of life,and presence of sarcopenia and LoS were assessed.The statistical analyses included the Test-for-Comparing-Two-Proportions,Pearson's Correlation Coefficient,the chi-Square test and Student´s t-test.Results:Thirty oldest old with a mean age of 89.1 years were evaluated.The prevalence of LoS was high(53.3%)and correlated significantly with chronic pain(p-value 0.024),worse performance on the SPPB and Gait speed(p-value<0.001).Sarcopenia was not correlated with LoS,but worse quality of life on the physical domain was significantly associated with LoS(p-value<0.001)regardless of the presence of sarcopenia.Conclusions:LoS was highly prevalent among the oldest old studied and negatively impacted their quality of life,regardless of the presence of sarcopenia.
基金Supported by the Traditional Chinese Medicine Public Welfare Scientific Research Project,State Administration of Traditional Chinese Medicine of the People's Republic of China(No.201007001)Fundamental Research Funds for the Central Public Welfare Research Institutes(No.ZZ13-YQ-005 and No.ZZ13-YQ-005-C1)。
文摘Objectives:To evaluate the effectiveness and safety of Qishen Yiqi Dripping Pill(QSYQ)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods:This multicentre prospective cohort study was conducted at 40 centers in China.Patients with ACS after PCI entered either the QSYQ or Western medicine(WM)groups naturally based on whether they had received QSYQ before enrollment.QSYQ group received QSYQ(0.52 g,3 times a day for 12 months)in addition to WM.The primary endpoint included cardiac death,non-fatal myocardial infarction,and urgent revascularization.The secondary endpoint included rehospitalization due to ACS,heart failure,stroke,and other thrombotic events.Quality of life was assessed by the Seattle Angina Questionnaire(SAQ).Results:A total of 936 patients completed follow-up of the primary endpoint from February 2012 to December 2018.Overall,487 patients received QSYQ and WM.During a median follow-up of 566 days(inter quartile range,IQR,517–602),the primary endpoint occurred in 46(9.45%)and 65(14.48%)patients in QSYQ and WM groups respectively[adjusted hazard ratio(HR)0.60,95%confidence interval(CI)0.41–0.90;P=0.013].The secondary endpoint occurred in 61(12.53%)and 74(16.48%)patients in QSYQ and WM groups,respectively(adjusted HR 0.76,95%CI 0.53–1.09;P=0.136).In sensitivity analysis,the results still demonstrated that WM combined with QSYQ reduced the risk of the primary endpoint(HR 0.67,95%CI 0.46–0.98;P=0.039).Moreover,QSYQ improved the disease perception domain of the SAQ(P<0.05).Conclusions:In patients with ACS after PCI,QSYQ combined with WM reduced the incidence of the primary endpoint.These findings provide a promising option for managing ACS after PCI and suggest the potential treatment for reducing the risk of primary endpoint included cardiac death,non-fatal myocardial infarction,and urgent revascularization through intermittent administration of QSYQ.(Registration No.Chi CTR-OOC-14005552).
基金the local cancer registry staffin China for their contribution to data collection,validation,and routine analyses.We also thank the CAMS Innovation Fund for Medical Sciences(grant number:2021-I2M-1-011)that supported this study.
文摘Background: The burden of breast cancer in women of different menopausal status has not been assessed in China previously. We aim to evaluate and project the burden of breast cancer in different menopausal status in China. Methods: The incidence and mortality of breast cancer were estimated using the data of 554 cancer registries in 2017 and the trends of incidence and mortality of 112 cancer registries from 2010 to 2017. Data from 22 continued cancer registries from 2000 to 2017 were applied for long-term trend projection to 2030 using the Bayesian age- period-cohort model. Menopausal status was stratified by age, with premenopause defined as chronological age < 45 years, perimenopause defined as 45-54 years, and postmenopause defined as ≥ 55 years. Results: Approximately 352,300 incident cases and 74,200 deaths of breast cancer occurred in China in 2020, contributing to 2.6 million disability-adjusted life years (DALYs). Perimenopausal women had the highest inci- dence, prevalence, and DALYs rates, with the rates being 100.3 per 100,000, 819.2 per 100,000 and 723.1 per 100,000 persons. While postmenopausal women had the highest mortality rates (25.5 per 100,000 persons). From 2000 to 2017, the largest increase in incidence and mortality for breast cancer was observed in postmenopausal women with an average annual percentage change (AAPC) of 5.6% and 2.94%. The number of breast cancer cases and deaths will increase to 452,000 and 98,800 in 2030, resulting in 3.2 million DALYs. Conclusions: The burden of breast cancer is rapidly increasing in China and varies among different menopausal status. Specific prevention and control strategies for women in different menopausal status will be more helpful in reducing the rapidly growing trends of breast cancer.
基金supported by the Beijing Nova Program(Z201100006820069)National Key R&D Program of China(2016YFC0901400,2016YFC0901404,and 2018YFC1311706)CAMS Innovation Fund for Medical Sciences(CIFMS)(2018-I2M3-003 and 2021-I2M-1-011)。
文摘Background:Pre-operative non-invasive histological evaluation of hepatocellular carcinoma(HCC)remains a challenge.Tumor perfusion is significantly associated with the development and aggressiveness of HCC.The purpose of the study was to evaluate the clinical value of quantitative liver perfusion parameters and corresponding histogram parameters derived from traditional triphasic enhanced computed tomography(CT)scans in predicting histological grade of HCC.Methods:Totally,52 patients with HCC were enrolled in this retrospective study and underwent triple-phase enhanced CT imaging.The blood perfusion parameters were derived from triple-phase CT scans.The relationship of liver perfusion parameters and corresponding histogram parameters with the histological grade of HCC was analyzed.Receiver operating characteristic(ROC)curve analysis was used to determine the optimal ability of the parameters to predict the tumor histological grade.Results:The variance of arterial enhancement fraction(AEF)was significantly higher in HCCs without poorly differentiated components(NP-HCCs)than in HCCs with poorly differentiated components(P-HCCs).The difference in hepatic blood flow(HF)between total tumor and total liver flow(ΔHF=HFtumor-HFliver)and relative flow(rHF=ΔHF/HF_(liver))were significantly higher in NP-HCCs than in P-HCCs.The difference in portal vein blood supply perfusion(PVP)between tumor and liver tissue(ΔPVP)and theΔPVP/liver PVP ratio(rPVP)were significantly higher in patients with NP-HCCs than in patients with P-HCCs.The area under ROC(AUC)ofΔPVP and rPVP were both 0.697 with a high sensitivity of 84.2%and specificity of only 56.2%.TheΔHF and rHF had a higher specificity of 87.5%with an AUC of 0.681 and 0.673,respectively.The combination of rHF and rPVP showed the highest AUC of 0.732 with a sensitivity of 57.9%and specificity of 93.8%.The combined parameter ofΔHF and rPVP,rHF and rPVP had the highest positive predictive value of 0.903,and that of rPVP andΔPVP had the highest negative predictive value of 0.781.Conclusion:Liver perfusion parameters and corresponding histogram parameters(includingΔHF,rHF,ΔPVP,rPVP,and AEFvariance)in patients with HCC derived from traditional triphasic CT scans may be helpful to non-invasively and pre-operatively predict the degree of the differentiation of HCC.
文摘Background Nowadays,there are published trials in regards to the comparison of caspofungin with liposomal amphotericin B （L-AmB）.However,these studies have a modest sample size and convey inconclusive results.The aim of this study was to review the efficacy and safety of caspofungin for the treatment of invasive fungal infections （IFIs）,compared with L-AmB.Methods Electronic databases （up to July 31,2013） PubMed and Embase databases,the Cochrane Library,and Google Scholar were searched to identify relevant trials of caspofungin and L-AmB.Analyses of efficacy and adverse outcomes were performed by relative risks （RRs） and 95% confidence intervals （C/s）.Heterogeneity was assessed by x2-test and the/2-statistic.Results Three trials were included in this meta-analysis with 1249 modified intention-to-treat （MITT） patients.The results showed that caspofungin produced equal efficacy in favorable overall response （RR=1.02,95% Cl 0.88-1.18; P=0.81） and mortality rate （RR=1.53,95% Cl 0.38-6.27,P=0.55）,safer in clinical adverse events （RR=0.20,95% Cl 0.08-0.54; P=0.001）,laboratory adverse events （RR=0.69,95% Cl 0.57-0.84; P=0.0002）,and discontinuation rate （RR=0.26,95% Cl 0.08-0.83,P=0.02）,compared with L-AmB in the treatment of patients with IFls.Conclusion Based on the results of this meta-analysis,it would appear that caspofungin was measured to have equal efficacy in clinical outcomes and safer in terms of adverse events.
