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1.
Chinese Journal of Pediatrics ; (12): 435-441, 2022.
Article in Chinese | WPRIM | ID: wpr-935716

ABSTRACT

Objective: To explore the heterogeneity and correlation of clinical phenotypes and genotypes in children with disorders of sex development (DSD). Methods: A retrospective study of 1 235 patients with clinically proposed DSD in 36 pediatric medical institutions across the country from January 2017 to May 2021. After capturing 277 DSD-related candidate genes, second-generation sequencing was performed to analyzed the heterogeneity and correlation combined with clinical phenotypes. Results: Among 1 235 children with clinically proposed DSD, 980 were males and 255 were females of social gender at the time of initial diagnosis with the age ranged from 1 day of age to 17.92 years. A total of 443 children with pathogenic variants were detected through molecular genetic studies, with a positive detection rate of 35.9%. The most common clinical phenotypes were micropenis (455 cases), hypospadias (321 cases), and cryptorchidism (172 cases) and common mutations detected were in SRD5A2 gene (80 cases), AR gene (53 cases) and CYP21A2 gene (44 cases). Among them, the SRD5A2 mutation is the most common in children with simple micropenis and simple hypospadias, while the AMH mutation is the most common in children with simple cryptorchidism. Conclusions: The SRD5A2 mutation is the most common genetic variant in Chinese children with DSD, and micropenis, cryptorchidism, and hypospadias are the most common clinical phenotypes. Molecular diagnosis can provide clues about the biological basis of DSD, and can also guide clinicians to perform specific clinical examinations. Target sequence capture probes and next-generation sequencing technology can provide effective and economical genetic diagnosis for children with DSD.


Subject(s)
3-Oxo-5-alpha-Steroid 4-Dehydrogenase/genetics , Child , China/epidemiology , Cryptorchidism/genetics , Disorders of Sex Development/genetics , Female , Genital Diseases, Male , Genotype , Humans , Hypospadias/genetics , Male , Membrane Proteins/genetics , Penis/abnormalities , Phenotype , Retrospective Studies , Steroid 21-Hydroxylase/genetics
2.
Chinese Journal of Pediatrics ; (12): 311-316, 2022.
Article in Chinese | WPRIM | ID: wpr-935693

ABSTRACT

Objective: To investigate the relationship between body mass index (BMI) and sexual development in Chinese children. Methods: A nationwide multicenter and population-based large cross-sectional study was conducted in 13 provinces, autonomous regions and municipalities of China from January 2017 to December 2018. Data on sex, age, height, weight were collected, BMI was calculated and sexual characteristics were analyzed. The subjects were divided into four groups based on age, including ages 3-<6 years, 6-<10 years, 10-<15 years and 15-<18 years. Multiple Logistic regression models were used for evaluating the associations of BMI with sexual development in children. Dichotomous Logistic regression was used to compare the differences in the distribution of early and non-early puberty among normal weight, overweight and obese groups. Curves were drawn to analyze the relationship between the percentage of early puberty and BMI distribution in girls and boys at different Tanner stages. Results: A total of 208 179 healthy children (96 471 girls and 111 708 boys) were enrolled in this study. The OR values of B2, B3 and B4+ in overweight girls were 1.72 (95%CI: 1.56-1.89), 3.19 (95%CI: 2.86-3.57), 7.14 (95%CI: 6.33-8.05) and in obese girls were 2.05 (95%CI: 1.88-2.24), 4.98 (95%CI: 4.49-5.53), 11.21 (95%CI: 9.98-12.59), respectively; while the OR values of G2, G3, G4+ in overweight boys were 1.27 (95%CI: 1.17-1.38), 1.52 (95%CI: 1.36-1.70), 1.88 (95%CI: 1.66-2.14) and in obese boys were 1.27 (95%CI: 1.17-1.37), 1.59 (95%CI: 1.43-1.78), and 1.93 (95%CI: 1.70-2.18) (compared with normal weight Tanner 1 group,all P<0.01). Analysis in different age groups found that OR values of obese girls at B2 stage and boys at G2 stage were 2.02 (95%CI: 1.06-3.86) and 2.32 (95%CI:1.05-5.12) in preschool children aged 3-<6 years, respectively (both P<0.05). And in the age group of 6-10 years, overweight girls had a 5.45-fold risk and obese girls had a 12.54-fold risk of B3 stage compared to girls with normal BMI. Compared with normal weight children, the risk of early puberty was 2.67 times higher in overweight girls, 3.63 times higher in obese girls, and 1.22 times higher in overweight boys, 1.35 times higher in obese boys (all P<0.01). Among the children at each Tanner stages, the percentage of early puberty increased with the increase of BMI, from 5.7% (80/1 397), 16.1% (48/299), 13.8% (27/195) to 25.7% (198/769), 65.1% (209/321), 65.4% (157/240) in girls aged 8-<9, 10-<11 and 11-<12 years, and 6.6% (34/513), 18.7% (51/273), 21.6% (57/264) to 13.3% (96/722), 46.4% (140/302), 47.5% (105/221) in boys aged 9-<10, 12-<13 and 13-<14 years, respectively. Conclusions: BMI is positively correlated with sexual development in both Chinese boys and girls, and the correlation is stronger in girls. Obesity is a risk factor for precocious puberty in preschool children aged 3-<6 years, and 6-<10 years of age is a high risk period for early development in obese girls.


Subject(s)
Adolescent , Body Mass Index , Child , Child, Preschool , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Obesity/epidemiology , Overweight/epidemiology , Puberty , Puberty, Precocious , Sexual Development
3.
Chinese Journal of Surgery ; (12): 441-448, 2022.
Article in Chinese | WPRIM | ID: wpr-935619

ABSTRACT

Objective: To compare the outcomes of modified Appleby procedure and sub-adventitial divestment technique for locally advanced or borderline resectable pancreatic body cancer. Methods: A total of consecutive 58 patients(33 males and 25 females) who were diagnosed as locally advanced or borderline resectable pancreatic body cancer and underwent distal pancreatectomy at Pancreas Center, First Affiliated Hospital of Nanjing Medical University between September 2013 and May 2019 were retrospectively reviewed. The age(M(IQR)) was 62(9)years(range: 43 to 79 years). Thirty-one patients underwent distal pancreatectomy with celiac axis resection (DP-CAR) and 27 patients underwent distal pancreatectomy with sub-adventitial divestment technique(SDT). Perioperative parameters and follow-up data of these patients were analyzed. Quantitative data were compared with Wilcoxon test while categorical variables were compared with χ2 test or Fisher's exact test. Survival results were estimated by the Kaplan-Meier survival method with a Log-rank test. Results: There were no differences in age,gender,body mass index,abdominal symptoms,comorbidity or preoperative serum CA19-9 between two groups(all P>0.05). Obvious preoperative weight loss was more common in the group of SDT(48.1%(13/27) vs. 19.4%(6/31),χ²=5.431,P=0.020). Longer operative time(310(123) minutes vs. 254(137)minutes, Z=2.277,P=0.023),higher rate of combined organ resection(41.9%(13/31) vs. 14.8%(4/27),χ²=5.123,P=0.041) and longer postoperative hospital stay(15(10) days vs. 11(5)days,Z=2.292,P=0.022) were observed in the group of DP-CAR. Moreover,rate of overall morbidities was also higher (71.0%(22/31) vs. 29.6%(8/27),χ2=9.876,P=0.003),implicated by clinically relevant postoperative pancreatic fistula(61.3%(19/31) vs. 29.6%(8/27),χ2=5.814,P=0.020) in the DP-CAR group. Tumor size of the DP-CAR group was bigger(4.9(1.5)cm vs. 4.0(1.2)cm,Z=2.343,P=0.019) but no difference was seen between the DP-CAR group and SDT group in R0+R1(<1 mm) resection rate (84.0%(21/25) vs. 90.0%(18/20),P=0.678) and LNR(12.0(23.0)% vs. 9.0(18.0)%,Z=1.238,P=0.216),as well as median disease free survival(11.7 months vs. 11.4 months,Z=0.019,P=0.892) and median overall survival(16.3 months vs. 13.7 months,Z=0.172,P=0.679). Conclusions: Both DP-CAR and distal pancreatectomy with SDT are relatively safe and feasible for locally advanced or borderline resectable pancreatic body cancer. Compared with arterial resection,SDT may contribute to lower rates of postoperative complications and shorter duration of hospitalization,but no significant benefit is seen in long-term survival.


Subject(s)
Celiac Artery/surgery , Female , Humans , Male , Pancreatectomy/methods , Pancreatic Neoplasms/pathology , Postoperative Complications , Retrospective Studies
4.
Chinese Journal of Surgery ; (12): 128-133, 2022.
Article in Chinese | WPRIM | ID: wpr-935590

ABSTRACT

Objective: To compare and analyze the clinical efficacy of pancreaticoduodenectomy for distal bile duct cancer and pancreatic head cancer. Methods: Clinical data of 1 005 patients who underwent pancreaticoduodenectomy and postoperative pathological examination confirmed the diagnosis of distal bile duct cancer and pancreatic head cancer at the Pancreas Center of the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2020 were analyzed retrospectively. There were 112 cases in the distal bile duct cancer group, 71 males and 41 females,with age (M(IQR)) of 65(15) years(range: 40 to 87 years); 893 cases in the pancreatic head cancer group, 534 males and 359 females,with age of 64(13)years(range: 16 to 91 years). The differences between clinicopathological characteristics and postoperative overall survival of the two groups were analyzed by χ2 test, Fisher's exact probability method, rank sum test or log-rank test, respectively. The difference in postoperative overall survival between the two groups was compared using Kaplan-Meier method after propensity score matching (1∶1). Results: Compared with the pancreatic head cancer group,the distal bile duct cancer group had shorter operative time (240.0(134.0) minutes vs. 261.0(97.0) minutes, Z=2.712, P=0.007),less proportion of combined venous resection (4.5% (5/112) vs. 19.4% (173/893), χ²=15.177,P<0.01),smaller tumor diameter (2.0(1.0) cm vs. 3.0(1.5) cm,Z=10.567,P<0.01),higher well/moderate differentiation ratio (51.4% (56/112) vs. 38.0% (337/893), χ²=7.328, P=0.007),fewer positive lymph nodes (0(1) vs. 1(3), Z=5.824, P<0.01),and higher R0 resection rate (77.7% (87/112) vs. 38.3%(342/893), χ²=64.399, P<0.01),but with a higher incidence of overall postoperative complications (50.0% (56/112) vs. 36.3% (324/892), χ²=7.913,P=0.005),postoperative pancreatic fistula (28.6% (32/112) vs. 13.9% (124/893), χ²=16.318,P<0.01),and postoperative abdominal infection (21.4% (24/112) vs. 8.6% (77/892), χ²=18.001,P<0.01). After propensity score matching, there was no statistical difference in postoperative overall survival time between patients in the distal bile duct cancer group and the pancreatic head cancer group (50.6 months vs. 35.1 months,Z=1.640,P=0.201),and multifactorial analysis showed that tumor site was not an independent risk factor affecting the prognosis of patients in both groups after matching (HR=0.73,95%CI:0.43 to 1.23,P=0.238). Conclusions: Patients with distal bile duct cancer are more likely to benefit from early diagnosis and surgical treatment than patients with pancreatic head cancer,but with a relative higher postoperative complication rates. The different tumor origin site is not an independent risk factor for prognosis of patients with distal bile duct cancer and pancreatic head cancer after propensity score matching.


Subject(s)
Bile Ducts , Female , Humans , Male , Pancreas , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy , Retrospective Studies , Treatment Outcome
5.
Chinese Journal of Pathology ; (12): 190-195, 2022.
Article in Chinese | WPRIM | ID: wpr-935503

ABSTRACT

Objective: To investigate the value of MDM2 RNA in situ hybridization (RNA-ISH) in diagnosing atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) and dedifferentiated liposarcoma (DDL). Methods: A total of 26 ALT/WDL/DDLs diagnosed from March 2017 to May 2019 in West China Hospital, Sichuan University, Chengdu, China and 18 control cases were included. MDM2 RNA-ISH was performed on all samples and compared with the fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) regarding their performance in detecting MDM2. Results: All samples were detected successfully using the three methods. Among 26 ALT/WDL/DDLs, all cases showed MDM2 amplification and positivity for MDM2 RNA-ISH (26/26, 100%). Twenty-four (24/26, 92.3%) of the 26 tested cases were positive for MDM2 IHC while two of them were negative. Eighteen control cases were all negative for MDM2 FISH and RNA-ISH, and 15 (15/18) cases were negative for MDM2 IHC. The sensitivity and specificity of RNA-ISH were both 100%, and those of MDM2 IHC were 92.3% and 83.3%, respectively. Diffuse staining was identified in all MDM2 RNA-ISH positive ALT/WDL/DDLs, but identified in only 8/24 (33.3%) of the MDM2 IHC positive cases. Among the 11 ALT/WDL/DDL samples evaluated on tissue microarray, the positive rate of MDM2 RNA-ISH was 100% with diffuse staining in all cases. The positive rate of MDM2 IHC was 9/11 while only 1 of the 9 cases showed diffuse staining. The result of MDM2 RNA-ISH was identical to that of MDM2 FISH and was overall consistent with that of MDM2 IHC (Kappa=0.763, P<0.001). Conclusions: In ALT/WDL/DDLs, results of MDM2 RNA-ISH are highly consistent with those of FISH. MDM2 RNA-ISH is more sensitive and more specific and has more diffuse positive signals than the IHC. The findings indicate that MDM2 RNA-ISH is highly valuable for the diagnosis and differential diagnosis of ALT/WDL/DDLs.


Subject(s)
Biomarkers, Tumor/genetics , Gene Amplification , Humans , In Situ Hybridization, Fluorescence , Liposarcoma/genetics , Proto-Oncogene Proteins c-mdm2/genetics , RNA
6.
Article in Chinese | WPRIM | ID: wpr-935311

ABSTRACT

Objective: To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies. Methods: To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease. Results: In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95%CI:3.86-5.13) days, 5.12 (95%CI:4.63-5.62) days, 0.87 (95%CI:0.67-1.07) days, 11.89 (95%CI:9.81-13.98) days and 22.00 (95%CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95%CI:6.89-10.86) days and 6.18 (95%CI:1.89-10.47) days, respectively. Conclusion: The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.


Subject(s)
COVID-19 , Cohort Studies , Contact Tracing , Humans , Incidence , Prospective Studies
7.
Article in Chinese | WPRIM | ID: wpr-934600

ABSTRACT

Objective: To observe the efficacy of acupuncture combined with naloxone hydrochloride in the treatment of coma after surgery for cerebral hemorrhage and to explore its possible mechanism of action. Methods: Seventy-two patients were divided into a control group and an observation group according to the random number table method, with 36 cases in each group. The control group was treated with intravenous naloxone hydrochloride, and the observation group received additional acupuncture treatment. After 1 month of treatment, the awakening rate, Glasgow coma scale (GCS) score, cerebral edema volume, mean velocity (Vm) of the middle cerebral artery, and cerebrospinal fluid Caspase-3, and macrophage migration inhibitory factor (MIF) levels were compared between the two groups. Results: During the study, there were 2 cases of shedding in the control group and 34 remaining valid cases; 1 case of shedding in the observation group and 35 remaining valid cases. After treatment, the awakening rate was higher in the observation group than in the control group (P<0.05); the GCS score increased in both groups compared with that before treatment (P<0.05), and was higher in the observation group than in the control group (P<0.05); the volume of cerebral edema decreased in both groups (P<0.05), and was smaller in the observation group than in the control group (P<0.05); the middle cerebral artery Vm increased in both groups (P<0.05), and was higher in the observation group than in the control group (P<0.05); the cerebrospinal fluid Caspase-3 and MIF levels decreased significantly in both groups (P<0.05) and were lower in the observation group than in the control group (P<0.05). Conclusion: Acupuncture combined with naloxone hydrochloride for the treatment of coma after surgery for cerebral hemorrhage can promote patients' awakening, improve the degree of coma, reduce the volume of cerebral edema, and enhance cerebral blood flow velocity, producing a better effect than naloxone hydrochloride used alone; it may be related to its reduction of cerebrospinal fluid Caspase-3 and MIF levels.

8.
Article in Chinese | WPRIM | ID: wpr-934397

ABSTRACT

Objective:To analyze the serum and urinary amino acid (AA) profiles of urolithiasis patients to explore the potential biomarkers for clinical screening and early diagnosis.Methods:Case-control study. Serum and urine samples were collected from 74 urolithiasis patients (aged 20-82 years, 41 men, 33 female) in the department of urology of the First Affiliated Hospital of Fujian Medical University and 35 healthy controls (HC, aged 22-80 years old, 20 men, 15 female) from the health examination center from February 2015 to October 2017. Serum and urinary AA levels of patients and HC were analyzed using Gas Chromatography-Mass Spectrometry (GC-MS) based metabolomic strategy. The multivariate statistical analysis methods of principal component analysis (PCA) and orthogonal partial least squares discrimination analysis (OPLS-DA) were employed for modeling. The variable importance projection (VIP) value of OPLS-DA model>1 and P<0.05 of t test were selected to screen the differential amino acid metabolites. The diagnostic capabilities of potential markers were evaluated by receiver operating characteristic (ROC) curve and binary logistic regression analysis. Results:Five AA metabolites including serine, glutamate, aspartic acid, isoleucine and glycine were found, which had statistically significant differences between the patient group and the control group ( P<0.05) and were associated with seven metabolic pathways. Serum serine, glutamate, aspartic acid, isoleucine and urine glycine and aspartic acid were combined into an integrated marker panel whose AUC value was 0.890, the sensitivity was 78.0%, and the specificity was 96.4%. Conclusion:Five amino acids in serum and urine could be used as an integrated biomarker panel for the clinical screening and early diagnosis of urolithiasis, which could provide some experimental basis for molecular urolithiasis research.

9.
Chinese Journal of Urology ; (12): 212-216, 2022.
Article in Chinese | WPRIM | ID: wpr-933195

ABSTRACT

Objective:To systematically review the efficacy and safety of electrostimulation of the posterior tibial nerve and antimuscarinic drugs in the treatment of overactive bladder.Methods:The literature search was conducted using the PubMed, The Cochrane Library, EMbase, Medline, CNKI, CQVIP, Wanfang databases.The retrieval period was from the establishment of the database to February 2021. Literature was screened and evaluated independently by two investigators to compare the safety and efficacy of electrostimulation of the posterior tibial nerve and antimuscarinic drugs in the treatment of overactive bladder. Meta-analysis was performed using Review Manager 5.4 software.Results:A total of 11 clinical trials, including 10 randomized controlled trials and 1 cross-over study were included, involving 605 patients, including 309 in the experimental group (nerve stimulation group) and 296 in the control group(antimuscarinic drugs group). The results of meta-analysis showed as follow. For patients with non-neurogenetic overactive bladder, there was no statistically significant differences between electrostimulation of the posterior tibial nerve therapy and antimuscarinic drugs in the improvement of 24h urination frequency( MD=-0.06, 95% CI -1.67-1.54, P>0.05), 24h urge incontinence frequency( MD=0.04, 95% CI -0.46-0.54, P>0.05), symptoms scores of OAB-q questionnaire( MD=0.37, 95% CI -0.02-0.76, P>0.05)and quality of life scores( SMD=0.32, 95% CI-0.06-0.69, P>0.05). However, compared with antimuscarinic drugs, posterior tibial nerve stimulation had better efficacy satisfaction rate ( OR=1.97, 95% CI 1.16-3.36, P<0.05) and lower side effect rate ( OR=0.24, 95% CI 0.12-0.48, P<0.0001). And the results have significant statistical differences. Conclusions:Electrostimulation of the posterior tibial nerve was almost as effective as antimuscarinic drugs in improving symptoms and quality of life in patients with non-neurogenic OAB. However, compared with antimuscarinic drugs, electrostimulation of the posterior tibial nerve had a higher efficacy satisfaction rate and a lower incidence of side effects. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

10.
Article in Chinese | WPRIM | ID: wpr-931044

ABSTRACT

Objective:To compare the preservation effect of DX preservation solution and glycerin preservation solution on the corneal stromal lens.Methods:Sixty intact corneal stromal lens samples were collected during femtosecond small incision lenticule extraction (SMILE) from 60 myopic eyes of 30 subjects at Qingdao Eye Hospital of Shandong First Medical University from February 2019 to May 2019.The samples were randomized into DX preserved 1-day group, DX preserved 1-week group, glycerin preserved 1-day group, glycerin preserved 1-week group and glycerin preserved 2-week group according to the different preservation methods, with 10 samples in each group.No intervention was done in the samples of the normal control group.Trypan blue staining was used to count the number of dead cells in the corneal stromal lens.The morphological structure of the corneal stromal lens was examined with an optical microscope, and its ultrastructure was observed under the transmission electron microscope.This study adhered to the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical intervention.The study protocol was approved by an Ethics Committee of Qingdao Eye Hospital of Shandong First Medical University (No.2019-30).Results:The number of dead cells was (53.1±14.2), (50.8±9.8), (70.4±13.6) and (172.8±31.7) and (182.8±14.2) cells/field in the DX preserved 1-day group, DX preserved 1-week group, glycerin preserved 1-day group, glycerin preserved 1-week group and glycerin preserved 2-week group, respectively, showing a significant difference among the five groups ( F=16.37, P<0.05). There was no significant difference between the DX preserved 1-day group and 1-week group ( P>0.05). The number of dead cells was significantly less in the glycerin preserved 1-day group than that of the glycerin preserved 1-week group and glycerin preserved 2-week group, and the number of dead cells was significantly increased in the glycerin preserved 1-week group compared with the DX preserved 1-week group (all at P<0.05). The arrangement of collagen fibers of the corneal stromal lens was regular and the cells were intact in the normal control group, DX preserved 1-day group and DX preserved 1-week group.The tissue edema, bare cell nuclei and loose collagen fibers were found in the samples in the glycerin preserved 1-day group.The corneal stromal lens was compact and the collagen fibers were dense and the nuclei were intact in the DX preserved 1-day group and DX preserved 1-week group.The distribution of the cells was sparse and the cell structure was abnormal under the transmission electron microscope in various glycerin preserved groups. Conclusions:The structure of corneal stromal lens can be well preserved for one week by DX storage solution.The preservation effect of DX solution is better for fresh human corneal stromal lens than glycerin solution.

11.
Article in Chinese | WPRIM | ID: wpr-930959

ABSTRACT

Objective:To investigate the status of We-Media platforms opened and opera-ted by surgeons in tertiary first-class hospitals nationwide and analyze its influence on patients and surgeons.Methods:The retrospective cross-sectional investigation study was conducted. The investigation was conducted on the surgeons who had opened We-Media platforms in their units or associations through the contact of all members of the second Elite Committee of Chinese Digestive Surgery of the Chinese Journal of Digestive Surgery from November 5 to 30, 2021. Questionnaires were distributed through wechat, and the software platform was Questionnaire Star. Observation indicators: (1) results of questionnaire survey; (2) basic information of surgeons running We-Media platforms; (3) daily workload and research background of surgeons running We-Media platforms; (4) information related to We-Media platforms; (5) influence of running We-Media platforms on patients; (6) influence of running We-Media platforms on surgeons; (7) feelings and suggestion of surgeons after running We-Media platforms. Measurement data with normal distribution were expressed as Mean± SD, and count data were expressed as absolute numbers and percentages. Results:(1) Results of questionnaire survey: a total of 229 complete and valid questionnaires were collected in this survey. (2) Basic information of surgeons running We-Media platforms: of 229 surgeons, there were 195 males and 34 females, aged (40±8)years. There were 120 surgeons aged from 36-45 years, 80 surgeons aged <35 years and 29 surgeons aged >45 years. There were 86.46% (198/229) of surgeons from teaching hospitals and 74.67%(171/229) of surgeons from provincial cities. Of 229 surgeons, junior, intermediate, deputy senior and senior titles accounted for 17.90%(41/229), 27.51%(63/229), 37.12%(85/229) and 17.47%(40/229), respectively. Surgeons with working years ≤5 years, 6-10 years, 11-15 years and ≥16 years accounted for 19.21%(44/229), 22.27%(51/229), 26.64%(61/229) and 31.88%(73/229), respectively. Hepatobiliary and pancreatic surgeons, esophageal and gastrointestinal surgeons were the main specialties, accounting for 48.03%(110/229) and 14.41%(33/229), respectively. The original intentions of opening We-Media platforms (multiple choice) included increasing patient population and improving the income, accumulating cases to facilitate clinical research projects, increasing the popularity of the industry and gain peer recognition, increasing social awareness and improving spiritual satisfaction, passive assignments form units or hospitals, which accounted for 52.84% (121/229), 54.15%(124/229), 64.19%(147/229), 58.08%(133/229), 17.90%(41/229), respectively. (3) Daily workload and research background of surgeons running We-Media platforms: 60.26%(138/229) of surgeons participated in offline social welfare activities 1-3 times per year and 26.64%(61/229) of surgeons participated >3 times per year. There were 47.60% (109/229) of surgeons performing 5-10 operations per week and 33.19%(76/229) of surgeons performing >10 operations per week. In terms of scientific researches, 38.43%(88/229) of surgeons had not published high-quality English articles as the first author or co-first author, 24.89%(57/229) of surgeons had published 1-3 articles and 36.68%(84/229) of surgeons had published >3 articles. There were 51.09%(117/229) of surgeons without any longitu-dinal projects, 13.54%(31/229) of surgeons with national projects, 35.37%(81/229) of surgeons with provincial and ministerial projects. (4) Information related to We-Media platforms: there were 65.50%(150/229) of surgeons running wechat public account, 55.02%(126/229) of surgeons running consultation platform, 31.44%(72/229) of surgeons running TikTok, 21.40%(49/229) of surgeons running wechat video account (some surgeons operated multiple We-Media platforms). The time of operating the platform was <1 year in 35.81%(82/229) of surgeons, 1-3 years in 42.79%(98/229) of surgeons, >3 years in 21.40%(49/229) of surgeons, respectively. The contents of We-Media platforms were updated >2 weeks in 45.85%(105/229) of surgeons. There were 63.32%(145/229) of surgeons with We-Media platforms win-ning emotional support from their department or hospital, 12.66%(29/229) of surgeons with We-Media platforms winning financial support. There were 82.53%(189/229) of surgeons operating We-Media platforms by theirselves. The We-Media plat-form operation was smooth in 47.16%(108/229) of surgeons, unsustainable in 50.22%(115/229) of surgeons and suspended in 2.62%(6/229) of surgeons. On average, it took less than 30 minutes for 60.70%(139/229) of surgeons and 30-60 minutes for 27.07%(62/229) of surgeons to operate the We-Media platforms of surgeons every times, respec-tively. The background message or consulta-tion was allowed in 89.08%(204/229) of surgeons. The number of leaving messages was <5 times in 52.84%(121/229) of surgeons and >50 times in 6.99%(16/229) of surgeons. On average, each content in 59.39%(136/229) of surgeons were "liked" or "viewed" <100 times, and each content in 29.26%(67/229) of surgeons were "liked" or "viewed" 100-300 times. There were 60.26%(138/229) of surgeons having content with the highest "liked" or "viewed" clicks <1 000 times and 6.99%(16/229) of surgeons having content with the highest "liked" or "viewed" clicks >10 million times. On average, each content in 74.67%(171/229) of surgeons were "forwarded" <100 times, and each content in 6.55%(15/229) of surgeons were "forwarded" >300 times, respectively. The number of followers was <1 million in 87.34%(200/229) of surgeons. The We-Media audiences (multiple choices) included related professional peers, related health care professionals, patients of surgeons, general public, accounting for 42.36%(97/229), 31.00%(71/229), 52.40%(120/229), 53.71%(123/229), respectively. (5) Influence of running We-Media platforms on patients: 34.93%(80/229) of surgeons believed that the operation of We-Media platform significantly increased the number of outpatient and inpatient patients of themselves, 29.69%(68/229) of surgeons believed that the operation of We-Media platform significantly increased the number of outpatient and inpatient patients in their departments, respectively. In the view of 75.98%(174/229) of surgeons, the percent of outpatient and inpatient patients by We-Media platforms was <10%. After 6 months of We-Media operation, 39.74%(91/229) and 25.33%(58/229) of surgeons believed that inpatient and outpatient compliance was significantly improved, respectively, and 46.29% (106/229) of surgeons believed that preopera-tive and pre-chemotherapy or pre-radiotherapy conversations saved more time. (6) Influence of running We-Media platforms on surgeons: 20.09%(46/229) and 6.55%(15/229) of surgeons attributed the success to "long-term, sustainable, absorbed operation" and "important contents of We-Media platforms and wide audiences". There were 72.49%(166/229) of surgeons yet to be successful. There were 26.64% (61/229) and 22.27%(51/229) of surgeons believing that opening We-Media platforms was conducive to the association's employment and multicenter clinical research. Operating We-Media platforms was conducive to professional knowledge improvement, clinical research ability enhancement and teaching level of students, which was believed by 54.59%(125/229), 40.17%(92/229) and 48.91%(112/229) of surgeons, respectively. Although the total income in 88.65%(203/229) of surgeons increased less than 20% after 6 months of operation, 47.60%(109/229) of surgeons believed that "the sense of achievement or pleasure in work has been significantly improved", and 48.91%(112/229) of surgeons did not have the idea of quitting. There were 7.42%(17/229) of surgeons with the idea of quitting the operation of We-Media platforms. (7) Feelings and suggestions of surgeons after running We-Media platforms: the proportion of surgeons who hoped to get help from departments, hospitals, associations and the society were 61.57%(141/229), 72.05%(165/229), 47.16%(108/229) and 53.28%(122/229), respectively. Only 9.61%(22/229) of surgeons did not require help. Commercial advertisement was allowed by 40.17%(92/229) of surgeons and forbidden by 59.83%(137/229) of surgeons. In terms of alternative suggestion, 70.74%(162/229) of surgeons believed that it was necessary for the We-Media platforms to involve more doctors of different specialties, but 40.61%(93/229) of surgeons believed that relevant departments or associations should strengthen supervision under the current situation. In addition, 32.75%(75/229) of surgeons believed that the operation of We-Media platform requires more investment. The were 27.95%(64/229) of surgeons giving specific suggestions on running We-Media platforms, 7.81%(5/64) of which did not suggest a blind try.Conclusions:Most surgeons who open and operate We-Media platforms in China are faced with problems such as busy work, limited time and energy, low-income increase, and lack of professional promotion and maintenance teams and external support. Even so, there are still many surgeons who have achieved success through long-term persistence and high-quality content output, thus increasing the number of patient visits, improving their own ability and industry influence, and bringing a greater sense of professional achievement.

12.
China Pharmacy ; (12): 2299-2304, 2022.
Article in Chinese | WPRIM | ID: wpr-943077

ABSTRACT

Ulcerative colitis (UC)is a chronic inflammatory bowel disease caused by multiple factors ,and its etiology and pathogenesis remain unclear . Tofacitinib,a small molecule rapidly absorbed by oral administration ,treats UC primarily by inhibiting Janus kinase (JAK). Tofacitinib has been approved by the FDA and the European Medicines Agency for the treatment of moderate to severe UC . Many clinical studies on tofacitinib in the treatment of UC have been carried out abroad ,but there is no relevant report on its use in UC in China . This paper summarizes the relevant research advances of tofacitinib in the treatment of UC from its mechanism ,clinical application and safety . The results show that tefatinib mainly treats UC by inhibiting the expression of JAK and proinflammatory factors , regulating the overexpressed signaling transducers and activators of transcription , and repairing the intestinal mucosal barrier . Tofacitinib has good clinical efficacy ,but safety studies have shown that the risks of herpes zoster and thrombosis should not be ignored ,and the drug should be used with caution in pregnant ,children,adolescents, and elderly patients . The efficacy and safety of tofacitinib in Chinese population should be further studied in the future ,since it has not been used in UC patients in China .

13.
Chinese Journal of Oncology ; (12): 555-561, 2022.
Article in Chinese | WPRIM | ID: wpr-940922

ABSTRACT

Objective: Solid and micropapillary pattern are highly invasive histologic subtypes in lung adenocarcinoma and are associated with poor prognosis while the biopsy sample is not enough for the accurate histological diagnosis. This study aims to assess the correlation and predictive efficacy between metabolic parameters in (18)F-fluorodeoxy glucose positron emission tomography/computed tomography ((18)F-FDG PET-CT), including the maximum SUV (SUV(max)), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and solid and micropapillary histological subtypes in lung adenocarcinoma. Methods: A total of 145 resected lung adenocarcinomas were included. The clinical data and preoperative (18)F-FDG PET-CT data were retrospectively analyzed. Mann-Whitney U test was used for the comparison of the metabolic parameters between solid and micropapillary subtype group and other subtypes group. Receiver operating characteristic (ROC) curve and areas under curve (AUC) were used for evaluating the prediction efficacy of metabolic parameters for solid or micropapillary patterns. Univariate and multivariate analyses were conducted to determine the prediction factors of the presence of solid or micropapillary subtypes. Results: Median SUV(max) and TLG in solid and papillary predominant subtypes group (15.07 and 34.98, respectively) were significantly higher than those in other subtypes predominant group (6.03 and 10.16, respectively, P<0.05). ROC curve revealed that SUV(max) and TLG had good efficacy for prediction of solid and micropapillary predominant subtypes [AUC=0.811(95% CI: 0.715~0.907) and 0.725(95% CI: 0.610~0.840), P<0.05]. Median SUV(max) and TLG in lung adenocarcinoma with the solid or micropapillary patterns (11.58 and 22.81, respectively) were significantly higher than those in tumors without solid and micropapillary patterns (4.27 and 6.33, respectively, P<0.05). ROC curve revealed that SUV(max) and TLG had good efficacy for predicting the presence of solid or micropapillary patterns [AUC=0.757(95% CI: 0.679~0.834) and 0.681(95% CI: 0.595~0.768), P<0.005]. Multivariate logistic analysis showed that the clinical stage (Stage Ⅲ-Ⅳ), SUV(max) ≥10.27 and TLG≥7.12 were the independent predictive factors of the presence of solid or micropapillary patterns (P<0.05). Conclusions: Preoperative SUV(max) and TLG of lung adenocarcinoma have good prediction efficacy for the presence of solid or micropapillary patterns, especially for the solid and micropapillary predominant subtypes and are independent factors of the presence of solid or micropapillary patterns.


Subject(s)
Adenocarcinoma of Lung/diagnostic imaging , Fluorodeoxyglucose F18/metabolism , Humans , Lung Neoplasms/pathology , Multimodal Imaging/methods , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography/methods , Prognosis , Radiopharmaceuticals , Retrospective Studies , Tomography, X-Ray Computed/methods , Tumor Burden
14.
Frontiers of Medicine ; (4): 483-495, 2022.
Article in English | WPRIM | ID: wpr-939876

ABSTRACT

The pathological hallmarks of psoriasis involve alterations in T cell genes associated with transcriptional levels, which are determined by chromatin accessibility. However, to what extent these alterations in T cell transcriptional levels recapitulate the epigenetic features of psoriasis remains unknown. Here, we systematically profiled chromatin accessibility on Th1, Th2, Th1-17, Th17, and Treg cells and found that chromatin remodeling contributes significantly to the pathogenesis of the disease. The chromatin remodeling tendency of different subtypes of Th cells were relatively consistent. Next, we profiled chromatin accessibility and transcriptional dynamics on memory Th/Treg cells. In the memory Th cells, 803 increased and 545 decreased chromatin-accessible regions were identified. In the memory Treg cells, 713 increased and 1206 decreased chromatin-accessible regions were identified. A total of 54 and 53 genes were differentially expressed in the peaks associated with the memory Th and Treg cells. FOSL1, SPI1, ATF3, NFKB1, RUNX, ETV4, ERG, FLI1, and ETC1 were identified as regulators in the development of psoriasis. The transcriptional regulatory network showed that NFKB1 and RELA were highly connected and central to the network. NFKB1 regulated the genes of CCL3, CXCL2, and IL1RN. Our results provided candidate transcription factors and a foundational framework of the regulomes of the disease.


Subject(s)
Chromatin/genetics , Chromatin Assembly and Disassembly , Gene Regulatory Networks , Humans , Psoriasis/genetics , T-Lymphocytes, Regulatory
15.
Article in Chinese | WPRIM | ID: wpr-939761

ABSTRACT

The evolution throughout the whole supervision history of Class II/III safety and effectiveness related NMPA submission dossier requirements was studied in this study, meanwhile elaborating the revolution progress of clinical evaluation domestically. The relationship between submission dossier requirements and Essential Principles of Safety and Performance of Medical Devices as well as IMDRF relevant documents was deeply analyzed and illustrated, in order to comprehensively understanding the background and future reform direction of NMPA submission dossier requirements under the background of the government's deepening reform of medical device evaluation and approval system strategy.


Subject(s)
China , Device Approval , Humans
16.
Article in Chinese | WPRIM | ID: wpr-939691

ABSTRACT

AbstractObjective: To investigate the effect of γδ T cells on the proliferation, apoptosis and autophagy of multiple myeloma cells.@*METHODS@#Peripheral blood mononuclear cells (PBMNC) were isolated from healthy volunteers, and stimulated with zoledronic acid (Zol) in combination with rhIL-2. Flow cytometry analysis was used to detected the purity of γδ T cells. γδ T cells were collected and co-cultured with RPMI-8226 or U-266 cells at different effector target ratios. The proliferation of RPMI-8226 or U-266 cell lines were detected by CCK-8. Cell cycle and cell apoptosis were detected by flow cytometry and Western blot.The expressions of autophagy-related proteins were detected by Western blot.@*RESULTS@#γδ T cells can be expanded in vitro. γδ T cells could inhibit the proliferation of RPMI-8226 or U-266 cells, induced cell cycle arrest and promoted apoptosis in an effector target-dependent manner. In addition, γδ T cells could induce autophagy of myeloma cells, inhibited the expression of autophagy-related PI3K, P-AKT and P-mTOR, while increased the expression of AMPK and Beclin-1.@*CONCLUSION@#γδ T cells can inhibit the proliferation of RPMI-8226 and U-266 myeloma cells, induce cell cycle arrest, promote apoptosis, and enhance autophagy in vitro. The mechanism may be related to inhibition of PI3K/AKT/mTOR signaling pathway and/or activation of AMPK/Beclin-1 signaling pathway.


Subject(s)
AMP-Activated Protein Kinases/pharmacology , Apoptosis , Autophagy , Beclin-1/pharmacology , Cell Proliferation , Humans , Leukocytes, Mononuclear/metabolism , Multiple Myeloma/metabolism , Phosphatidylinositol 3-Kinases/metabolism , Proto-Oncogene Proteins c-akt/metabolism , T-Lymphocytes , TOR Serine-Threonine Kinases/metabolism
17.
Article in Chinese | WPRIM | ID: wpr-939685

ABSTRACT

OBJECTIVE@#To analyze clinical response of the Rituximab-based chemotherapy and prognostic features in patients with primary gastric diffuse large B-cell lymphoma (PGDLBCL).@*METHODS@#From June 2008 to December 2020, the data of 53 PGDLBCL patients were analyzed retrospectively.@*RESULTS@#The median age was 46(25-77) years old in 53 patients including 35 males and 18 females. Stomachache is the most common symptom. The diagnosis were confirmed in 47 patients by endoscopic biopsy and 6 patients by surgery. Twenty-six patients had Ⅰ/Ⅱ1 stage (Lugano staging system) disease and 27 cases had II2/IV stage disease. All patients were treated with chemotherapy, including RCHOP (25/53) and R-DA-EPOCH (28/53). Complete remission rate was 79.2%(42/53). The 3-year and 5-year overall survival (OS) rates were 77.4% and 69.8%. Univariate analysis showed that lactate dehydrogenase(LDH), Lugano stage and lesion size affected OS. Multivariate Cox regression analysis revealed that IPI score and Lugano stage were independent prognosis risk factors affecting OS. The patients in the R-DA-EPOCH group presented better survival outcomes than those in the RCHOP group with late stage (P5-year OS=0.035).@*CONCLUSION@#Rituximab in combination with chemotherapy is the backbone of therapy for PGDLBCL. IPI score and Lugano stage are independent prognosis risk factors affecting OS of PGDLBCL. R-DA-EPOCH can be superior to R-CHOP as a first-line regimen in PGDLBCL patients with late stage.


Subject(s)
Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Disease-Free Survival , Doxorubicin/therapeutic use , Female , Humans , L-Lactate Dehydrogenase , Lymphoma, Large B-Cell, Diffuse/pathology , Male , Middle Aged , Prednisone/therapeutic use , Prognosis , Retrospective Studies , Rituximab/therapeutic use , Vincristine/therapeutic use
18.
Article in Chinese | WPRIM | ID: wpr-923034

ABSTRACT

Objective To better carries out the review of the interaction between triazole antifungal drugs and statins, ensure drug safety for patients and improve the efficiency of the manual review of pharmacists. Methods The advantageous combination with less interaction between the two kinds of drug was obtained by summarizing the interaction information of triazole antifungal drugs and statins. At the same time, optimizing the process of full manual reviews for drug interaction, and the advantageous combination of the two kinds of drug will be set up in advance on the doctor side of the review system. Doctors can adjust the drug in time according to the prompts of the information system when there is a significant interaction of the two kinds of drug in the prescription or medical order, which is issued by the doctors. Results After optimization, most doctors choose the drug combination of less interaction between the two kinds of drug according to the system prompts. The number of drug combinations of significant interaction which is manually reviewed by pharmacists is significantly reduced (P<0.05), and the review efficiency is improved, the drug safety risks brought by drug interactions to patients are reduced. Conclusion Refinement review of drug interactions between triazole antifungal agents and statins based on the optimization of the pre-audit system plays a positive role in improving the safety of patients’ medication and the efficiency of pharmacists' manual auditing.

19.
Acta Pharmaceutica Sinica ; (12): 313-320, 2022.
Article in Chinese | WPRIM | ID: wpr-922930

ABSTRACT

In recent years, the targeted protein degradation technology has developed quickly, with proteolysis-targeting chimera (PROTAC) as the best-known strategy through exploring the ubiquitin-proteasome system. A number of new targeted protein degradation strategies have been emerging to expand the scope of protein degradation technology, including lysosome-targeting chimeras (LYTACs), autophagy-targeting chimeras (AUTACs), autophagosome-tethering compounds (ATTECs) and chimeras based on chaperone-mediated autophagy (CMA). The emerging methodologies have explored another important protein degradation system in eukaryotes-lysosomal systems, such as the endosome-lysosome pathway and the autophagy-lysosome pathway. This review summaries the mechanisms and features of different strategies for targeted protein degradation, with a special emphasis on the new targeted protein degradation technologies, such as their current status, advantages and limitations.

20.
Acta Pharmaceutica Sinica ; (12): 492-499, 2022.
Article in Chinese | WPRIM | ID: wpr-922915

ABSTRACT

A novel sort of nano-component was extricated and isolated from Descurainiae Semen Carbonisatum (DSC), and its hemostatic component was considered through pharmacological experiments. A muffle furnace was used to prepare DSC at 250 ℃, 300 ℃ and 350 ℃, and the DSC dialysate at each temperature was obtained by the extraction and separation method. Low-resolution transmission electron microscopy (TEM) and high-resolution transmission electron microscopy (HR-TEM) were utilized to characterize the nano-components. Ultraviolet spectroscopy (UV-Vis), fluorescence spectroscopy (FL) and infrared spectroscopy (FTIR) were utilized to measure its optical characteristics and functional group information. The anti-hemorrhagic effects were evaluated by liver bleeding tests and the related hemostatic mechanisms of the obtained nano-components were further assessed by detecting blood coagulation and PLT quantity to discuss the hemostasis mechanism. The experiments complied with the Animal Ethics Committee of Beijing University of Chinese Medicine. TEM results showed that there was a novel type of nano-component in the DSC dialysate bag, which was named DSC nano-components (DSC-NCs). The experimental results of liver bleeding in mice showed that DSC-NCs prepared at 250 ℃, 300 ℃, and 350 ℃ could reduce the bleeding time of mice liver. Among them, DSC-NCs prepared at 350 °C had the best effect. In addition, DSC-NCs prepared at various temperatures can also reduce the prothrombin time (PT) value, increase the fibrinogen (FIB) value and the platelet (PLT) value to varying degrees. DSC-NCs have a certain hemostatic effect, which may be related to the activation of the exogenous coagulation system, the increase of FIB value and the increase of platelet content. This provides a new research direction for exploring the treatment of bleeding diseases, and provides a new perspective for the potential application of DSC-NCs in the medical field.

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