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Objective:To investigate the characteristics of congenital hypothyroidism (CH) in premature infants and analyze the predictors of transient congenital hypothyroidism(TCH) and permanent CH (PCH).Methods:A retrospective study was conducted on the preterm infants with CH born in Beijing from January 2008 to June 2018. They were screened, diagnosed and treated by the Beijing Neonatal Disease Screening Center. They were assigned into TCH and PCH groups according to the clinical prognosis. Univariate analysis and Logistic regression analyses were used to determine the predictors of PCH, and the receiver operating characteristic curve (ROC) was drawn to determine the best cut-off point.Results:A total of 2 216 892 newborns were screened, 15 382 were initially screened positive, the median time of screening was 4(4,10) d after birth, and the median time of postnatal reexamination was 30(22,42) d after birth, 14 576 newborns were reexamined, the reexamination rate was 94.8%. A total of 92 preterm infants were diagnosed with CH, of which 60 were TCH, accounting for 65.2%; 28 were PCH, accounting for 30.4%; and 4 were lost to follow-up, accounting for 4.3%. Univariate analysis showed that in the PCH group, the abnormal rate of thyroid B-ultrasound, levothyroxine (LT4) dose at 1-year old, thyrotropin (TSH) level at 2 years old, LT4 dose at 2 years old, LT4 dose and free thyroxine (FT4) level at 3 years old were higher than those in the TCH group. Logistic regression analysis revealed that abnormal B-ultrasound ( OR=12.184,95% CI 2.270~65.403), and elevated TSH level at 2 years old ( OR=2.033,95% CI 1.280~3.228),increased LT4 dose at 3 year old ( OR=21.435,95% CI 3.439~133.584) are the risk factors for PCH. The maximum area under ROC curve was 0.798 at 3 years old (95% CI 0.680~0.916), the best cut-off point was 1.3 μg/(kg·d) for the 3-year-old drug dose; followed by 2-year-old TSH level, which was 0.683 (95% CI 0.548~0.817), the best cut-off point was 4.51 μIU/ml. Conclusions:TCH accounted for a large proportion of preterm infants with CH. During the follow-up, the increased LT4 dose at 3 years old and the elevated TSH level at 2 years old were the early predictors of PCH.
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Background/Aims@#Existing hepatocellular carcinoma (HCC) prediction models are derived mainly from pretreatment or early on-treatment parameters. We reassessed the dynamic changes in the performance of 17 HCC models in patients with chronic hepatitis B (CHB) during long-term antiviral therapy (AVT). @*Methods@#Among 987 CHB patients administered long-term entecavir therapy, 660 patients had 8 years of follow-up data. Model scores were calculated using on-treatment values at 2.5, 3, 3.5, 4, 4.5, and 5 years of AVT to predict threeyear HCC occurrence. Model performance was assessed with the area under the receiver operating curve (AUROC). The original model cutoffs to distinguish different levels of HCC risk were evaluated by the log-rank test. @*Results@#The AUROCs of the 17 HCC models varied from 0.51 to 0.78 when using on-treatment scores from years 2.5 to 5. Models with a cirrhosis variable showed numerically higher AUROCs (pooled at 0.65–0.73 for treated, untreated, or mixed treatment models) than models without (treated or mixed models: 0.61–0.68; untreated models: 0.51–0.59). Stratification into low, intermediate, and high-risk levels using the original cutoff values could no longer reflect the true HCC incidence using scores after 3.5 years of AVT for models without cirrhosis and after 4 years of AVT for models with cirrhosis. @*Conclusions@#The performance of existing HCC prediction models, especially models without the cirrhosis variable, decreased in CHB patients on long-term AVT. The optimization of existing models or the development of novel models for better HCC prediction during long-term AVT is warranted.
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Objective To investigate the impact of the change in anti-hepatitis B virus (HBV) therapy indication on treatment rate and the features of the population requiring treatment. Methods The treatment-naïve patients with chronic hepatitis B (CHB) in the China Registry of Hepatitis B (CR-HepB) database were selected as subjects, and related demographic, virological, hematological, and biochemical data were collected. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results A total of 3640 treatment-naïve CHB patients were included in this study, among whom 64.4% were male, 68.7% had an age of 30-59 years, and 46.8% had an indeterminate clinical stage. According to the 2015 and 2019 editions of Guidelines for the prevention and treatment of chronic hepatitis B and the 2022 edition of expert consensus, the number of patients who had the indication for antiviral therapy was 625(17.2%), 1333(36.6%), and 2890(79.4%), respectively. The number of patients requiring treatment was increased by 1557 according to the 2022 edition of expert consensus, among whom 1424(91.5%) met the treatment threshold of alanine aminotransferase (ALT) > 30 U/L for male patients or ALT > 19 U/L for female patients. The additional patients requiring treatment according to the 2022 edition of expert consensus had significantly higher levels of ALT and HBV DNA and significantly lower scores of APRI and FIB-4 than the additional patients requiring treatment according to the 2019 edition of Guidelines (all P < 0.05). Conclusion The expansion of antiviral therapy indications for CHB may significantly increase the proportion of CHB patients receiving antiviral treatment and help mild CHB patients at the risk of disease progression to receive timely treatment and achieve the improvement in long-term prognosis.
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Objective:The paper aims to investigate the current situation and influencing factors of clinical research data sharing of gastroenterology collaboration network of Beijing municipal hospitals so as to provide reference basis for establishing data sharing mode of collaboration center.Methods:A total of 13 gastroenterology department of Beijing municipal hospital collaboration network units enrolled the research. Each department selected 10-15 clinicians for a questionnaire survey. A total of 157 valid questionnaires were collected.Results:The awareness rate of public data platform(realized at least one) is 81.5%. The rate of browsing public data platform is 65.6%. The rate of downloading and uploading rare data are 13.4% and 1.3%, respectively. As the level of professional titles increases, the proportion of clinicians realizing and downloading raw data has increased significantly( P<0.05). In this survey, 31.3% clinicians used the sharing data from other hospitals within the research group and 53.5% clinicians indicated that there is the data sharing platform based on hospital information system within their hospital/department. The rate of willing to share clinical data is 73.3%. However, a majority of clinicians are inclined to accept the sharing within the research group/hospital, and they prefer to share their data when their papers or research results are published. Data storage is mainly numerical and text structured data. Sharing risk, sharing platform, sharing system and data itself are the top four factors affecting data sharing. Conclusions:Relevant departments should strive to establish sharing mechanism, build sharing platforms, refine the sharing access qualification and improve the sharing awareness of medical personnel so as to lay a necessary foundation for further open sharing of big data on digestive diseases.
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It is of great clinical significance to achieve accurate prediction of clinical endpoints in patients with chronic hepatitis B (CHB), identify the patients at a high risk of decompensated cirrhosis or hepatocellular carcinoma, and thus strengthen intervention to reduce the corresponding mortality rate. With reference to the published predictive models for clinical endpoints in CHB patients, this article elaborates on the thoughts and basic steps of establishing predictive models from the aspect of methodology, hoping to provide a reference for future studies on predictive models for hepatitis B.
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Medical ethics has a long history and rich connotations.It has developed from the simple "medical morality" of ancient times to the modem medical ethics.The basic principles of medical ethics include autonomy,non-maleficence,beneficence,justice,and so on.Researchers often conduct clinical researches in the balance between achievements and ethical norms.Clinical researchers of surgery should have a deep understanding of medical ethical principles and strictly abide by medical ethics.Ethics committee should strictly perform their duties and play the role of inspection and supervision.Modem medical knowledges should be popularized throughout the society to make clinical research correctly understood.Adhering principles of ethics first,people orientation and cooperation practice,with patients' benefit as evaluation criteria,balance of surgical "Dao" and "Shu" can be achieved.
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Allogeneic hematopoietic stem cell transplantation and donor lymphocyte infusion for multiple myeloma (MM) can induce graft-versus-myeloma immunity and long-term survival,but limited efficacy and associated toxicities have prevented its widespread application.Cellular immunotherapies and vaccines are explored to induce more specific,reliable,and potent antimyeloma immune responses with less treatmentrelated risk.Advances in molecular biology,basic and applied immunology,have led to several promising approaches such as genetically engineered T cells with chimeric antigen receptors and T-cell receptors targeting myeloma-specific epitopes,vaccine primed ex vivo expanded autologous T cells,expanded marrowinfiltrating lymphocytes,and plasma cell/dendritic cell fusion vaccines.The combination of these emerging therapies to immunomodulatory drugs and inhibitors of programmed death-1 T-cell regulatory pathways could improve the outcome for MM patients.This article reviews the latest progress of cellular and vaccine immunotherapy for MM at the 58th American Society of Hematology (ASH) Annual Meeting,and discusses how these therapies might integrate and synergize with existing treatment paradigms.
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The quality of SCI papers is one of the objective indexes of evaluation on scientific and technological strength and research capabilities.This paper introduced a comprehensive management strategy to promote the publication of SCI papers with high impact factors,in terms of such dimensions ass research orientation,financial and technical support,personnel training,and scientific research management platform.The short and long term effects of the comprehensive management strategy system were analyzed using the SCI papers publication data and IF data from 201 1 to 2014 at the hospital,as a reference for building a scientific management system of SCI papers for the administrators.
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<p><b>OBJECTIVE</b>To perform a comparative assessment of the performance of FibroTouch and FibroScan in patients with hepatitis B.</p><p><b>METHODS</b>A total of 211 patients with hepatitis B, including cases of chronic hepatitis B (CHB) and of compensated cirrhosis, were enrolled for study between June and November of 2013. The patients underwent FibroScan testing (group 1) and FibroTouch testing (group 3), after which the operator examined a time motion ultrasound image from the FibroScan test and located a specific liver portion for focused FibroTouch testing (group 2). The consistency between the two tests' results was investigated by Pearson's correlation analysis, and the difference of liver stiffness between CHB patients and compensated cirrhosis patients was investigated by the two independent samples t-test or Mann-Whitney U test.</p><p><b>RESULTS</b>The values of liver stiffness were 5.30 (4.30,8.65) in group 1,6.10 (4.70,8.90) in group 2, and 5.70 (4.50, 8.00) in group 3 (all P < 0.05); the Pearson correlation coefficients were all more than 0.8 (P < 0.05) and there was no statistically significant difference found between the results from FibroScan and FibroTouch.The values of liver stiffness were significantly different between the CHB patients and the compensated cirrhosis patients (P < 0.05). The rates of successful detection were 100% for FibroTouch and 97% for FibroScan.</p><p><b>CONCLUSION</b>FibroTouch and FibroScan have good consistency in the evaluation of the degree of liver fibrosis. FibroTouch has a higher rate of successful detection than FibroScan.</p>
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Humans , Elasticity Imaging Techniques , Hepatitis B, Chronic , Pathology , Liver Cirrhosis , DiagnosisABSTRACT
Objective To assess the reliability and validity of the center for epidemiological studies depression scale (CES-D) in rural populations. Methods CES-D was administered to 330 rural residents in Jinzhou and Zhuanghe district of Dalian city. Hamilton Rating Scale for Depression (HAM-D) was used as standards to assess the discriminant validity and criterion validity. Statistical analysis included Pearson's correlations and the exploratory factor analysis. Results The Cronbach α was 0.74,and the average item-total correlation was 0.59. Two factors were extracted by using exploratory factor analysis:affective and somatic symptoms and interpersonal problems. The range of factor loading was between 0.42 and 0.83. CES-D mean scores were significantly different between the depressive group (22.80±10.28) and non-depressive group (15.36±5.76. t =2.60,P =0.01). The correlation coefficient between CES-D and HAM-D was 0.50( P <0.01). Conclusion The reliability and validity of CES-D for rural populations is acceptable.
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Objective:To explore differences in beha viors and quality of life between asthmatic and non-asthmatic children . Methods:Be haviors and quality of life were assessed in the 84 children with asthma and healthy children,4-11 years of age .Results :Behavioral problems were more prevalent in asthmatics than non-asthmatics.The major beha vior al problems in children with asthma were recession, physical complaints,anxiety/ de pression,and social intercourse.The children with asthma were less satisfact ory than healthy children with respect to quality of life especially on anxiety,depressi on and somatic feelings.Conclusion:Asthma contribut es to the developmen t of behavioral problem and adversely affects the children's quality of life.
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objective To investigate the differences in behaviors between asthmatic and nonasthmatic children , and to evaluate the psychological interventions. Method Behaviors were investigated in the 84 children with asthma and 84 healthy children, After psychological interventions of 3～4 months, the effects were evaluated in 18 asthmatic children. Results Behavioral problems were more prevalent in asthmatics than nonasthmatics,behavioral problems were different in asthmatic children of different severity and gender,psychological interventions as well as drug therapy have beneficial effects on controling of asthmatic symptoms. Conclusions Asthma contributes to the development of behavioral problems,Psychological intervention in child with asthma has many positive effects on controling the symptom and miniming the bad behaviors.
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Objective To explore the antagonistic effect of Ziyin Xiehuo Recipe(ZYXHR,Recipe for nourishing kidney yin and purging ministerial fire) on estrogen-like activity of environmental endocrine disruptors,nonylphenol(NP) and mixture of NP and bisphenol A(BPA). Methods Totally 30 three-week-old female SD rats were randomly divided into control group(fed with corn oil),exposed group A (feeding NP100 mg / kg ),exposed group B (feeding NP 50 mg/kg+ BPA 200 mg/kg ),treatment group A (NP 100 mg/kg + ZYXHR),treatment group B (NP 50 mg/kg+ BPA 200 mg/kg + ZYXHR). After 15 days of treatment,the uterine weight gain and PCNA protein expression were detected. Results As compared with those of the control group,Uterine wet weight,uterus organ coefficient,thickness of endometrium and smooth muscle,and the height of endometrial glands and glandular epithelium significantly increased in exposed group A and B (P