A comparative study of outcome of teaching related to suicide risk assessment using mobile app versus conventional teaching for undergraduate medical students

Background: In India, the leading cause of mortality for those aged 15–39 in 2016 was reported to be suicide. Despite these alarming statistics, efforts to prevent suicide are nevertheless thwarted by a number of obstacles to getting help. Timely identification is essential to ensuring that people at risk of suicide receive the right care and assistance. The World Health Organization’s mental health action plan advocates employing self-help treatments through electronic and mobile technologies in addition to other steps to promote accessibility to and availability of evidence-based mental health services with encouraging results. With encouraging results, technology has been utilized to give self-help and guided psychological therapies, and it may be employed as a low-intensity and low-cost tactic to reach a bigger population in need of care. Aims and Objectives: The objectives of this study were to study the comparison of mobile application versus conventional teaching techniques for implementation of suicide risk assessment among medical students. Materials and Methods: Study comprises MBBS students. Sample size was calculated to be 138, with 67 in Group A (conventional teaching) and 67 in Group B (mobile teaching). Week 1 and 2 – students were randomly allocated into Group A and B. Both the groups were taught about suicide risk assessment. Results: We found that 87.61% found the mobile application easier to comprehend than the conventional teaching methods. Conclusion: Mobile application learning for implementation of suicide risk assessment in MBBS students is non-inferior to conventional teaching methods.

Optimization of Popping Parameters and Nutritional Profiling of Kodo Millet Pops

Aims: This study investigates the optimization of popping parameters to enhance the nutritional profile of Kodo millet pops Study Design: Experimental design. Place and Duration of Study: The present study was conducted During 2023-2024 at Department of Foods and Nutrition, Post Graduate and Research Centre (PGRC), Professor Jayashankar Telangana State Agricultural University, Rajendranagar, Hyderabad (India). Methodology: Kodo millet analyzed for physical parameters viz.Popping capacity, Bulk density, True density, Expansion ratio and popped ratio. Functional properties of Kodo millet grains such as Water absorption capacity, water solubility index, oil absorption capacity; and nutritional properties like moisture, fat, ash, crude fiber, carbohydrates, protein, energy, Starch; Minerals like Sodium, potassium, Iron, Zinc, Calcium. Results: The analysis revealed that in Kodo millet pops, physical parameters such as popping capacity, true density, and bulk density decreased. The popped ratio decreased notably for KM29 (14%, 18%, 22%), while the expansion ratio showed a decrease with increased moisture content. Functional properties like water solubility index and water absorption capacity significantly increased (p ? 0.05), whereas oil absorption capacity decreased significantly in KMC2514 (6.48%) and KMM2914 (78.70%).There was a significant decrease (p ? 0.05) in moisture content for KMM2914 (42.8%) and KMC2514 (50.5%), ash content for KMM2914 (7.6%) and KMC2514 (3.84%), crude fiber for KMM2914 (16.7%) and KMC2514 (15.6%), protein for KMM2914 (4.16%) and KMC2514 (0.41%), fat for KMC2514 (31.4%) and KMM2914 (30.81%), starch for KMM2914 (0.17%) and KMC2514 (0%), and energy for KMC2514 (5.73%) and KMM2914 (6.3%), whereas carbohydrate content increased significantly (p ? 0.05).Mineral analysis showed significant increases (p ? 0.05) in calcium, iron, zinc, and sodium content, while potassium content decreased significantly (p ? 0.05) in KMM2914 (50.57%) and KMC2514 (51.7%).

The comparison of digital microscopy with conventional microscopy in the teaching of oral pathology: A questionnaire-based study

Introduction and Aim: The purpose of this study was to assess undergraduate dental students’ perceptions regarding the application of digital microscopy as opposed to conventional microscopy when studying dental histology and ground section slides. Materials and Methods: A validated questionnaire comprising of 8 questions comparing the clarity of images, overall level of understanding and the more effective teaching technique between conventional microscopy and digital microscopy was prepared and circulated amongst 100 first-year BDS (Bachelor of Dental surgeon) students. The participants were asked to observe the dental histology and ground section slides, following a detailed discussion of the same, focused on the same field, under both conventional and digital microscopes, and then were asked to answer the questionnaire. The results were collected and sent for statistical analysis. Results: When comparing the level of clarity, understanding, and effectiveness of communication and discussions, 90.9% of students preferred digital microscopy over conventional microscopy in the case of ground section slides and 83.8% for histology slides with frequencies of 90 and 83 respectively. When comparing the level of clarity, understanding, and effectiveness of communication and discussions,90.9% of students preferred digital microscopy over conventional microscopy in the case of ground section slides and 83.8% for histology slides with frequencies of 90 and 83 respectively. Conclusion: Students largely preferred digital microscopy over conventional microscopy when studying both ground section slides, as well as histopathological sections. The ease of storing the slides and capturing images is also an added advantage

Randomized control trial to find the safety and efficacy of the Kiwi OmniCup system in comparison with the conventional vacuum delivery

Background: Ventouse delivery, also known as vacuum extraction, is a medical procedure employed during childbirth to assist in the safe delivery of a baby when conditions necessitate a quicker or controlled delivery to safeguard the health and well-being of both the baby and the mother.Methods: The research was conducted in the labour room of the Department of Obstetrics and Gynaecology at Baba Raghav das Medical College in Gorakhpur, Uttar Pradesh during September 2019 to August 2020 involve all pregnant women undergoing the process of normal delivery. Thorough maternal histories, physical examinations, and diagnostic tests were conducted and documented. Group A undergoing conventional vacuum extraction and group B utilizing the Kiwi OmniCup. The outcomes of the procedures were meticulously recorded.Results: Instrumental deliveries in both the Ventouse and Kiwi OmniCup groups were primarily conducted due to fetal distress, with 16 cases (40%) and 23 cases (57.5%), respectively. Other medical conditions also contributed to instrumental deliveries, accounting for 16 cases (40%) in the Ventouse group and 9 cases (22.5%) in the Kiwi OmniCup group. Maternal exhaustion led to instrumental deliveries in 8 cases (20%) in both groups.Conclusions: Instrumental deliveries, primarily ventouse and Kiwi OmniCup, were mainly performed due to fetal distress, with ventouse often requiring longer cup application and resulting in more significant blood loss, while Kiwi OmniCup led to neonatal intensive care unit (NICU) admissions primarily due to respiratory distress; however, both methods showed comparable APGAR scores and low rates of severe neonatal complications.

Cattle Artificial Insemination Service in Developing Countries: Efficiency, Major Challenges and Economic Loss: A Review

This review paper summarizes information on the efficiency, major challenges and economic loss of cattle Artificial Insemination (AI) service in developing countries. Efficiency of AI service can be measured by number of services per conception (NSC), conception rate at first insemination, and calving rate (CR). The optimum recommended NSC for profitable dairy cow ranges from 1.0-2.0. The averages of NSC of the conventional AI (1.73) and fixed time AI (1.78) in the reviewed publications were in the ranges of the recommendations of NSC. The NSC varies with animal breeds, animal factor (body condition score, age and parity), semen factor (handling procedure and quality), inseminator factor (knowledge, skill and experience), production systems, management level provided and AI breeding methods. The NSC and calving rate vary with conventional AI and fixed time AI breeding methods. Likewise, calving rate (CR) is influenced by poor semen quality, poor semen handling procedure, inadequate insemination skill, poor oestrus detection and wrong time of insemination. The average success rate (CR) of conventional AI (35.15%) in the reviewed publications is far below the success rates reported in some developing countries. Nevertheless, widespread use and longtime use of AI service on selected genotype(s) can cause cattle biodiversity loss. Dairy producers incur additional costs when cows fail to conceive at their first AI services. Moreover, challenges of AI service comprised of feed scarcity, animal diseases, climate change, poor AI infrastructure, poor livestock husbandry practices, weak livestock extension systems and incapability of Artificial Insemination Technicians (AITs). This calls designing suitable interventions to improve the efficiency of AI services. Adequate feed and high level of management should be provided to the breedable cows and heifers. AI service centers should be established as per the recommended number of breedable cows and heifers. AI inputs including AITs should be always available at each AI service center, and proper AI service recording should be practiced. Sexed semen should be used to enhance the number of replacement heifers, and capacity building should be provided to AITs and community cattle breeders. Radio, television and printed medias should be used to enhance the awareness of the community cattle breeders. Frequent extension support is essential for the success rate of the AI service.

Clinical Behavior of Self-Adhesive Composite Resin Restorations: Literature Review

Self-adhesive flowable composite resins are relatively new formulations on the market. These materials do not require the prior application of the adhesive system and, at the same time, can promote a durable seal at the tooth-restoration interface. However, there is little clinical information about these materials. Therefore, this review aimed to gather information on the clinical behavior of these self-adhesive materials by conducting a bibliographic search from 2010 to February 2024 in the PubMed, Embase, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases. Clinical follow-up studies of restorations performed with these materials were eligible for selection. The search terms used were “self-adhesive composite” or “self-adhesive flowable composite” where 14 complete articles were evaluated and 12 were selected. Only clinical follow-up studies of enamel and/or dentin restorations performed with self-adhesive resins were eligible for selection. This systematic review concluded that the self-adhesive flowable resin showed results comparable to those of the conventional flowable resin. However, studies have shown that for restorations in Class I and V cavities, self-adhesive flowable composite resin performed better than restorations in Class II cavities.

Expert opinion on the clinical use and benefits of liposomal iron in the treatment of anemia in Indian settings

Background: Several studies have reported the effectiveness and safety of liposomal iron in increasing hemoglobin levels and correcting anemia. However, there was a dearth of information regarding the prescription pattern of physicians regarding its use and advantages in the actual practice. The present survey-based study aims at gathering clinicians' perspectives regarding the clinical use and benefits of liposomal iron in the treatment of anemia in Indian settings. Methods: This cross-sectional study used a 19-item questionnaire to gather insights from specialists across different Indian settings regarding their perspectives on anemia and liposomal iron. Results: Out of 124 participants, 77% opined that liposomal iron was highly bioavailable, achieves much higher plasma iron concentration, and bypasses the extremely restrictive, normal intestinal barriers. Oral liposomal iron was preferred by 77% of clinicians for the rapid increase in hemoglobin level and 99% of clinicians reported improved patient compliance with liposomal iron therapy for anemia. According to 50% of clinicians, oral liposomal iron was effective in non-hemodialysis dependent chronic kidney diseases and 87% of clinicians reported that patients without CKD needed oral liposomal iron. Half of the respondents reported a significant increase in Hb with liposomal iron in both dialysis and non-dialysis patients. Conclusions: The survey participants reported that liposomal iron treatment for anemia was beneficial in treating both CKD and non-CKD patients. The survey findings have corroborated the advantages of liposomal iron for treating anemia such as increased bioavailability, rapid and effective increase in Hb level, better patient compliance and tolerability, decreased side effects, cost-effectiveness, and flexible dosing.

Effectiveness of Proprioceptive Neuromuscular Facilitation, Sensorimotor Training and Conventional Exercise Along With Whole Body Vibrator on Balance in Patients with Diabetic Peripheral Neuropathy

Background: Diabetic peripheral neuropathy is one of the most common complications of patients with type 2 diabetes mellitus. The study's objective was to find the comparative effects of proprioceptive neuromuscular facilitation, sensorimotor training, conventional exercise, and whole body vibrator on balance in patients with diabetic peripheral neuropathy.Methods: This was an experimental study of comparative type with 60 subjects. The study was carried out at the Faculty of Physiotherapy department, Dr. M.G.R. Educational and Research Institute, for eight weeks after its approval from the institution's review board. Clinically diagnosed diabetic mellitus patients aged 45 to 60 years were selected for the study for the last seven years. The selected participants were divided into three groups using a random sampling method. Michigan neuropathy screening instrument, berg balance scale, and Time up and test were used to assess before and after the intervention.Results: In this study, the comparative effect of Whole Body Vibrator with PNF Training, Whole Body Vibrator with sensory motor Training, and Conventional Training on MNSI, BBS, and TUG4 shows a significant difference in the Post-test of MNSI and TUG but no difference in BBS between Group A, B and C with P value <0.0001. 0.0697 and 0.0014 respectively. Group A was more effective, with mean differences of 3.625, 4.80, and 3.150 on MNSI, BBS, and TUG, compared to Group B and C.Conclusion: Regarding the statistical analysis of the data collected using MNSI, BBS, and TUG. It can be concluded that PNF, along with whole body vibrator, is a more effective intervention than sensorimotor with WBV and conventional training.

Nasogastric Tube Insertion in Anaesthetised and Intubated Adult Patients: A Comparison Between the Digital Assistance Technique and Conventional Blind Technique

Background and Aims: Nasogastric tube (NGT) insertion can be challenging in an anaesthetised patient, with the conventional method bearing a failure rate of about 50%; hence, several different techniques including a novel digital assistance technique has been tried over years. Objectives: To compare the success rates, procedure time and incidence of adverse events for NGT insertion, among the conventional and digital assistance technique in anaesthetised, intubated adult patients. Materials and methods: 80 patients, aged 18 years and above, of either sex, posted for elective surgeries, requiring nasogastric tube intraoperatively, were randomly, divided into two equal groups. After doing endotracheal intubation, NGT were inserted in patients of Group A by conventional method, and that of Group B by digital assistance technique. The procedure time was calculated from insertion of the tip of the NGT into nostril till the confirmation of its position. Number of attempts and total procedure time were recorded upto 5 times, in both the groups. Results: In the first attempt, successful NGT placement and procedure times in Group A was in 19 patients (47.5%) and 68 ± 16.4 seconds respectively while that in Group B was in 32 patients (80%) and 69 ± 13.7 seconds respectively (p value 0.026). Adverse events occurred in 35% in Group A and 15% in Group B (p value 0.069). Conclusion: The digital assistance technique appears to be a better alternative to the conventional blind technique in adult patients with better success rate, less procedure time and lesser adverse events.

Methods for Identifying Seeds of Chinese Medicinal Materials： A Review / 中国实验方剂学杂志

Seeds are the source for the production of Chinese medicinal materials. The seed authenticity and quality of directly affect the effectiveness and safety of Chinese medicinal materials. The seed quality is faced with the problems such as mixed sources， existence of adulterants and seeds stocked for years， low maturity， and low purity. To ensure the high-quality and sustainable development of the Chinese medicinal material industry， it is urgent to standardize the seed market and identify and evaluate the quality of the seeds circulating in the market. Seed identification methods include visual inspection， microscopic observation， micro-character identification， chemical fingerprinting， molecular identification， electronic nose， X-ray diffraction， electrochemical fingerprinting， spectral imaging， and artificial intelligence. These methods have different application scopes and unique advantages and disadvantages. According to the different species of Chinese herbal medicines and different requirements of testing sites， suitable methods can be selected to achieve rapid and accurate identification with low costs. In the future， the seed identification methods should be developed based on emerging technologies with interdisciplinary knowledge， and intelligent， nondestructive， and single-grain detection methods are needed for the modern Chinese medicinal material industry. This paper introduces the seed identification technologies currently applied in research and production， compares the principles， applicability， advantages， and disadvantages of different technologies， and provides an outlook on the future development of seed identification technologies， aiming to provide a reference for the identification and quality evaluation of seeds of Chinese medicinal material.

Repetitive transcranial magnetic stimulation protocols for swallowing rehabilitation in unilateral hemispheric stroke: A scoping review

Background@#Stroke is a significant health concern globally, and dysphagia has been a very common complication. Early intervention for managing dysphagia is challenging with a lack of universally accepted treatment protocols. Non-invasive repetitive transcranial magnetic stimulation (rTMS) is emerging as a treatment option for stroke dysphagia. However, there is no standardized rTMS treatment protocol for it, leading to challenges in clinical decision-making.@*Objective@#To determine available rTMS protocols for unilateral hemispheric stroke dysphagia.@*Methods@#A scoping review using PubMed, ProQuest, and EBSCOHost databases was conducted using the keywords “dysphagia,” “stroke,” “repetitive transcranial magnetic stimulation,” “conventional therapy,” and “swallowing examination.” Eligible studies published from inception to April 2020 were appraised using the Oxford Centre for Evidence-Based Medicine and analyzed qualitatively.@*Results@#Out of 42 articles, five randomized controlled trials met the eligibility criteria. A total of 108 patients with stroke and oropharyngeal dysphagia were randomized into one of the following treatment groups: (1) rTMS (unilateral or bilateral); (2) conventional dysphagia therapy (CDT); and (3) combined intervention (CI) of rTMS and CDT. The CI gave significant improvements in swallowing function and quality of life compared to CDT alone. The bilateral rTMS protocol resulted in more significant improvements than unilateral rTMS. @*Conclusion@#There are various and heterogeneous treatment protocols involving neuromodulation available for stroke dysphagia. The combination of bilateral excitatory-inhibitory rTMS and CDT seems to result in an optimal outcome for swallowing function among patients with unilateral hemispheric stroke dysphagia.

Study on the mechanism of lung injury induced by ultra-high dose rate Flash radiation therapy versus traditional radiotherapy / 中国医学装备

Radiotherapy is an important means to treat lung cancer,but it is easy to cause lung injury and reduce the quality of life of patients.Flash radiotherapy(FLASH-RT)has attracted attention due to its extremely short radiation duration and high dose rate,which can reduce toxicity of normal tissue while ensures treatment intensity of tumor.Whether Flash-RT can reduce radiation-induced lung injury has become an important research topic in recent years.Based on the literature analysis method,this review systematically assessed the effects and mechanisms of Flash-RT and radiotherapy with conventional dose rate on lung injury through searching relevant literatures at home and abroad,so as to provide scientific basis for the treatment of patients with lung cancer by reviewing the comparisons about the effects and mechanisms between Flash-RT and radiotherapy with conventional dose rate on lung injury.Compared with radiotherapy with conventional radiation rate,Flash-RT can significantly reduce lung injury and improve quality of life of patients.It is still demanded to explore the Flash-RT mechanism in future,so as to develop the Flash-RT instrument that is suitable for different tumors and to conduct larger-scale clinical researches.

Multiple myeloma and Chagas disease: qPCR as a marker for preemptive antiparasitic therapy: a case reports series and review

ABSTRACT Multiple myeloma (MM) associated with Chagas disease is rarely described. This disease and its therapy suppress T cell and macrophage functions and increase regulatory T cell function, allowing the increase of parasitemia and the risk of Chagas Disease Reactivation (CDR). We aimed to analyze the role of conventional (cPCR) and quantitative Polymerase Chain Reaction (qPCR) for prospective monitoring of T. cruzi parasitemia, searching for markers of preemptive antiparasitic therapy in MM patients with Chagas disease. Moreover, we investigated the incidence and management of hematological diseases and CDR both inside and outside the transplant setting in the MEDLINE database. We found 293 studies and included 31 of them. Around 1.9-2.0% of patients with Chagas disease were reported in patients undergoing Stem Cell Transplantation. One case of CDR was described in eight cases of MM and Chagas disease. We monitored nine MM and Chagas disease patients, seven under Autologous Stem Cell Transplantation (ASCT), during 44.56±32.10 months (mean±SD) using parasitological methods, cPCR, and qPCR. From these patients, three had parasitemia. In the first, up to 256 par Eq/mL were detected, starting from 28 months after ASCT. The second patient dropped out and died soon after the detection of 161.0 par Eq/mL. The third patient had a positive blood culture. Benznidazole induced fast negativity in two cases; followed by notably lower levels in one of them. Increased T. cruzi parasitemia was related to the severity of the underlying disease. We recommend parasitemia monitoring by qPCR for early introduction of preemptive antiparasitic therapy to avoid CDR.

Traditional Chinese Medicine Against Fibrotic Diseases： A Review / 中国实验方剂学杂志

Fibrosis can occur in diverse tissue and organs and is the common outcome as multiple chronic diseases progress. It is characterized by over-activation of fibroblasts and excessive deposition of extracellular matrix. Targeting transforming growth factor-β （TGF-β）， a classical signaling molecule in fibrosis， is currently a routine strategy for drug therapy of this disease. The use of traditional Chinese medicine （TCM） in the treatment of fibrotic diseases has been supported by mature theories. The theories emphasize that the internally-accumulated pathogens and mixed deficiency-excess underlie the shared pathology of fibrotic diseases. Qi stagnation， blood stasis， phlegm turbidity， and mass accumulation are key pathological factors. "Yin suppression by Yang" is the core thought for treatment with TCM of the disease. Pharmacological investigations reveal the scientific nature of TCM in treating fibrotic diseases， namely multilevelled and multitargeted. In other words， it refers to networked regulation of signaling activities of fibrosis-related molecules such as TGF-β/Drosophila protein homolog （Smad）， phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）， Hedgehog， Wnt/β-catenin， and inflammatory cytokines， so as to inhibit fibroblast function and provide a promising insight into novel anti-fibrotic drug. This paper summarized the conventional understanding of fibrotic disease treatment with TCM and its mechanism of action by reviewing ancient literature and modern research reports， which offers an idea for follow-up research in this field.

Analysis of Cumulative Live Birth Rate of Selective Single Embryo Transfer by Time-lapse Monitoring System and Conventional Morphological Assessment in IVF/ICSI-ET / 实用妇产科杂志

Objective:To analyse the clinical significance of selective single embryo transfer by time-lapse mo-nitoring(TLM)or conventional morphology assessment(CMA)in vitro fertilization/intracytoplasmic sperm in-jection and embryo transfer(IVF/ICSI-ET),and to initially explore the predictive value of Raman spectral analy-sis of embryo culture medium for clinical pregnancy rate.Methods:The study is a prospective randomized con-trolled clinical trial.We assigned 139 patients treated with IVF/ICSI-ET in Reproductive and Genetics Center of Suzhou Municipal Hospital from April 2019 to July 2020,which were randomly assigned to either the CMA or the TLM group.We performed selective single-embryo transfer(fresh cycle and FET)after selecting the optimal em-bryos with TLM or CMA respectively.If the patient's first embryo transfer was unsuccessful,a second one would be performed to compare the differences in the cumulative live birth rate of embryo transfer and other pregnancy outcomes between the two groups.Meanwhile,we collected 15 μl of embryo culture medium at day 3 after IVF/ISCI fertilization for Raman spectroscopy analysis.Results:There were no differences in cumulative live birth,cu-mulative clinical pregnancy,cumulative premature birth,cumulative early spontaneous abortion,cumulative ectopic pregnancy and LGA or SGA between TLM and CMA groups(P＞0.05).The Neonatal sex ratio in the TLM group was lower than that in the CMA group,but the difference was not significant(P＞0.05).Raman spectros-copy analysis of embryo culture medium predicted the clinical pregnancy rate with 67.21％accuracy.Conclu-sions:In young women with a good ovarian reserve,the advantage of using TLM to evaluate embryos is not obvi-ous,so we should remain vigilant that embryo selection based on morphokinetic parameters may affect the sex ratio.Raman spectroscopic analysis of embryo culture medium is not yet able to effectively predict the planting ability of embryos.

Investigating the value of dual-layer spectral detector CT in distinguishing resectable pancreatic ductal adenocarcinoma from mass-forming chronic pancreatitis / 中国癌症杂志

Background and Purpose:Accurate differentiation of pancreatic ductal adenocarcinoma(PDAC)from mass-forming chronic pancreatitis(MFCP)is clinically significant.The application of dual-layer spectral detector CT(DLCT)in pancreas has been explored.This study aimed to investigate the value of DLCT in distinguishing resectable PDAC from MFCP.Methods:We retrospectively collected data of 33 patients with resectable PDAC and 19 patients with MFCP admitted to Fudan University Shanghai Cancer Center from September 1,2021 to May 31,2023.Prior to surgery,patients underwent enhanced DLCT scans,including arterial phase(AP),parenchymal phase(PP)and venous phase(VP).DLCT quantitative parameters,including attenuation enhancement fraction(AEF),lesion-to-parenchyma ratio(LPR)and iodine enhancement fraction(IEF)were calculated.Difference analysis was conducted using independent sample t-test or chi-square test.Univariate and multivariate analyses were performed using binary logistic regression.Receiver operating characteristic(ROC)curves were used for performance evaluation.P＜0.05 was considered statistically significant.Results:Statistically significant differences were observed between PDAC and MFCP in AEF_AP/PP,LPR40_VP,IEF_PP/VP,carbohydrate antigen 19-9(CA19-9)and double-duct sign(all P＜0.05).The spectral combined model composed of LPR40_VP and IEF_PP/VP exhibited the best discriminatory efficacy,surpassing CA19-9,double-duct sign and AEF_AP/PP(all P＜0.05).The combined model demonstrated an area under curve(AUC)of 0.841,sensitivity of 90%,specificity of 73%,and accuracy of 79%.Conclusion:DLCT has certain potential in differentiating resectable PDAC from MFCP.Spectral quantitative parameters can complement CA19-9 and outcome shortcomings of conventional CT in distinguishing resectable PDAC from MFCP.

Application value of combined coagulation function indicators in monitoring hypercoagulable state of patients with colorectal cancer after chemotherapy / 中国癌症杂志

Background and purpose:The plasma used for routine coagulation test(CCT)can only reflect a single component at a certain coagulation time point/segment,while thromboelastography(TEG)can depict the overall dynamic process curve of coagulation and fibrinolysis,which can more independently and completely reflect the true state of the blood and can serve as a supplement to coagulation function testing.This study aimed to evaluate the application value of combined coagulation function indexes in monitoring the hypercoagulable state of patients with colorectal cancer after chemotherapy,and to explore the risk factors of thrombosis in patients with colorectal cancer after chemotherapy,so as to provide reference for clinical monitoring of hypercoagulable state.Methods:A total of 160 patients with colorectal cancer from Fudan University Shanghai Cancer Center from June 2021 to June 2023 were selected as the experimental group,and 80 healthy subjects were selected as the control group.Then the experimental group was divided into a group without thrombosis(82 cases)and a group with thrombosis(78 cases)according to whether they had thrombosis or not.The determinations of thromboelastography(TEG)[coagulation reaction time(R),coagulation formation time(K),blood clot formation rate(α-Angle),maximum amplitude(MA)and coagulation index(CI)],conventional coagulation tests(CCT)[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(Fib),D-dimer(DD),fibrinogen degradation products(FDP)]and platelet count(PLT)were studied among three groups.With or without thrombosis as the criterion of hypercoagulable state,statistically significant indicators were selected to be included in the binary logistic regression analysis,and the receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of single and combined detection of the coagulation function indicators for hypercoagulable state in patients with colorectal cancer after chemotherapy.Basic information,tumor stage and Autar score of deep vein thrombosis were collected in 160 patients with colorectal cancer.Logistic regression analysis was performed to explore the risk factors of thrombosis.This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center(number:050432-4-2108*).Results:Compared with the control group,the R,TT and PLT of the group with thrombosis were decreased(P＜0.05),while APTT,PT,DD and FDP were increased(P＜0.05).The differences in various indicators between the group with thrombosis and the control group were statistically significant(P＜0.05).Compared with the group without thrombosis,the K in the group with thrombosis decreased(P＜0.05),while Angle,MA,CI,FIB,DD and FDP all increased(P＜0.05).ROC curve analysis showed that in the assessment of hypercoagulable state in patients with colorectal cancer after chemotherapy,the area under curve(AUC)of TEG was 0.756,sensitivity was 67.5%,and specificity was 73.8%.The AUC of CCT was 0.691,sensitivity was 78.8%,and specificity was 56.2%.The combined detection AUC was 0.840,sensitivity was 80.0%,and specificity was 77.5%.In the analysis of risk factors,tumor stage,distant metastasis and Autar score were correlated with thrombus formation in patients with colorectal cancer after chemotherapy(P＜0.05),and the differences of the three risk factors in K,Angle,MA,CI,Fib,DD and FDP were statistically significant(P＜0.05).Conclusion:K,Angle,MA,CI,Fib,DD and FDP are the main indicators to reflect the hypercoagulable state,and the combined detection of TEG and CCT can better reflect the coagulation state of patients with colorectal cancer after chemotherapy.Tumor stage Ⅲ to Ⅳ,distant metastasis and high Autar score are risk factors for thrombosis.The incidence of thrombosis can be reduced by monitoring the relevant coagulation indicators in the high-risk population.

Clinical effects of Modified Sanzi Yangqin Decoction combined with acupuncture on patients with chronic obstructive pulmonary disease at stable stage complicated with sarcopenia / 中成药

AIM To explore the clinical effects of Modified Sanzi Yangqin Decoction combined with acupuncture on patients with chronic obstructive pulmonary disease at stable stage complicated with sarcopenia.METHODS Ninety-four patients were randomly assigned into control group(47 cases)for 8-week intervention of conventional treatment,and observation group(47 cases)for 8-week intervention of Modified Sanzi Yangqin Decoction,acupuncture and conventional treatment.The changes in clinical effects,TCM syndrome scores,and levels of pulmonary function indices(FVC,FEV1,FEV1/FVC),inflammatory factors(CRP,IL-6,TNF-α),muscle-specific biomarkers(MSTN,IGF-1),relevant scale scores(SARC-F,SPPB)and skeletal muscle mass index were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P<0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,inflammatory factors,MSTN,SARC-F score(P<0.05),and increased pulmonary function indices,IGF-1,SPPB score,skeletal muscle mass index(P<0.05),especially for the observation group(P<0.05).CONCLUSION For the patients with chronic obstructive pulmonary disease at stable stage complicated with sarcopenia,Modified Sanzi Yangqin Decoction combined with acupuncture exhibits significant clinical efficacy.

Clinical effects of Feining Paidu Decoction combined with conventional treatment on patients with Mycoplasma pneumoniae lobar pneumonia / 中成药

AIM To investigate the clinical effects of Feining Paidu Decoction combined with conventional treatment on patients with Mycoplasma pneumoniae lobar pneumonia.METHODS Ninety patients were randomly assigned into control group(45 cases)for 2-week intervention of conventional treatment,and observation group(45 cases)for 2-week intervention of both Feining Paidu Decoction and conventional treatment.The changes in clinical effects,TCM syndrome scores,inflammatory indices(WBC,N,CRP,ESR,PCT),inflammatory cytokines(TNF-α,IL-6,IL-8),coagulation indices(PLT,TT,PT,APTT,Fib,D-D),pulmonary imaging intergal and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P<0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,inflammatory indices,inflammatory cytokines,PLT,pulmonary imaging intergal(P<0.05),especially for the observation group(P<0.05);the observation group exhibited prolonged TT,PT,APTT(P<0.05),and decreased Fib,D-D(P<0.05),which were more obvious than those in the control group(P<0.05).No significant difference in incidence of adverse reactions was found between the two groups(P>0.05).CONCLUSION For the patients with Mycoplasma pneumoniae lobar pneumonia,Feining Paidu Decoction combined with conventional treatment can safely and effectively alleviate clinical symptoms,and improve inflammatory responses,coagulation functions.

Clinical effects of Bushen Huoxue Ointment Formula on patients with ankylosing spondylitis of Kidney Deficiency and Blood Stasis Pattern / 中成药

AIM To explore the clinical effects of Bushen Huoxue Ointment Formula on patients with ankylosing spondylitis of Kidney Deficiency and Blood Stasis Pattern.METHODS One hundred and sixty-seven patients were randomly assigned into control group(55 cases)for 2-year intervention of conventional treatment,exposure group(54 cases)for 2-year intervention of both Bushen Huoxue Decoction and conventional treatment,and high exposure group(58 cases)for 2-year intervention of Bushen Huoxue Ointment Formula,Bushen Huoxue Decoction and conventional treatment.The changes in clinical effects,BASDAI score,ASDAS-CRP,BASFI score,spinal pain score,PGA score,BASMI score,ASQoL score,SPARCC score,Kidney Deficiency and Blood Stasis Pattern score,ESR,CRP,IL-6,TNF-α,IL-17,IL-23,IL-35,NLR,PLR and safety indices were detected.RESULTS The high exposure group demonstrated more ASAS40,ASASAS5/6,BASDAI50 cases than the exposure group and the control group(P<0.05).After the treatment,the high exposure group displayed lower BASDAI score,ASDAS-CRP,BASFI score,spinal pain score,PGA score,BASMI score,SPARCC score,ASQoL score,Kidney Deficiency and Blood Stasis Pattern score,ESR,CRP,IL-6,TNF-α,IL-17,IL-23 than the other two groups(P<0.05),and higher IL-35(P<0.05).After adjusting confounding factors by logistic regression analysis,Bushen Huoxue Decoction and Bushen Huoxue Ointment Formula reduced BASDAI score,ASDAS-CRP(P<0.05),and enhanced clinical effects(P<0.05).No serious adverse reactions were found in the three groups.CONCLUSION For the patients with ankylosing spondylitis of Kidney Deficiency and Blood Stasis Pattern,Bushen Huoxue Ointment Formula can safely and effectively inhibit inflammation,reduce disease activity,alleviate bone marrow edema,improve clinical symptoms,and enhance joint functions and life quality.