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Objective:To establish an early clinical prediction model for patients with chronic liver disease who are coinfected with hepatitis E virus (HEV), and quickly evaluate the probability of severe hepatitis in patients.Methods:A retrospective analysis was conducted on 87 patients with chronic liver diseases who were hospitalized at the Third Affiliated Hospital of Sun Yat-sen University from May 2018 to September 2023. Clinical features and laboratory indexes were analyszed and patients were classified to severe (TBIL >171 μmol/L with PTA <40%) and non-severe (TBIL <171 μmol/L with PTA >40%) groups. and Independent factors identified using LASSO regression were incorporated into a novel nomogram to identify patients at high risk of severe hepatitis in the early stages. The performance of the nomogram was evaluated using the area under the curve and the mean absolute error of the calibration curve.Results:Significant difference was observed in the serum total bile acid (TBA) level between the severe group [240.00 (183.30, 268.70) umol/L] and the non-severe group [93.40 (20.10, 271.70) μmol/L, U=269.00, P=0.002]. Additionally, the levels of apolipoprotein A1 (APOA1) [0.32 (0.18, 0.48) g/L] and uric acid (UA) [156.15 (117.00, 202.00) μmol/L] were significantly lower in the severe group compared to the non-severe group (APOA1: [0.77 (0.63, 1.06) g/L, U=71.00, P<0.001]; UA: [334.05 (243.70, 401.00) μmol/L, U=83.00, P<0.001]). The researchers developed a nomogram, which incorporated two independent factors (APOA1 and UA) and an additional variable (TBA), exhibiting a strong predictive ability, with an area under the curve (AUC) of 0.963 (95% confidence interval: 0.927-0.998) and a well-fitted calibration curve. Positive and negative predictive values of 94.0% and 88.2% were calculated, and a nomogram score of 129 or greater was considered indicative of a higher likelihood of developing severe illness. Conclusions:This nomogram offers a rapid and accurate means of evaluating the probability of severe illness in patients with chronic liver disease after overlapping infection with HEV, which can accurately and effectively predict the risk of severe illness in patients.
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Objective:To translate the University of Rhode Island Change Assessment of voice scale(URICA-Voice) into Chinese and test its reliability and validity. Methods:The URICA-Voice scale was converted into Chinese by literal translation, cultural adjustment, expert consultation, pre-investigation, and back translation. Convenience sampling was used to recruit patients at four speech therapy centers from February to May 2022. Then the Chinese version of the scale was distributed to them, and the reliability and validity of the scale were tested after data collection. Cronbach ɑ was used to evaluate the reliability. The critical ratio method and Pearson correlation coefficient were used for item analysis. Item-level content validity, scale-level content validity, and confirmatory factor analysis were used to test the validity of the scale. Results:A total of 247 valid questionnaires were collected. ①Item analysis: the critical ratios between a high-score and low-score groups of 32 items were all statistically significant(P<0.01) and all the critical ratios were above 3.00. The Pearson correlation between 32 items and the total score was significant(P<0.01). ②Validity analysis: I-CVI=1.00, S-CVI/Ave=1.00, χ²/df=2.30, RMSEA=0.07. Except for item 9 and 23, the standardized factor loading coefficients of other items were all above 0.50. AVE of the four dimensions of the scale was all above 0.50, and the combined reliability of the four dimensions was all above 0.70. The correlation coefficients between dimensions were less than the square root of the AVE of the dimension itself. ③Reliability analysis: the Cronbach ɑ of the whole scale was 0.94, and the Cronbach ɑ of the four dimensions were 0.88, 0.92, 0.94, and 0.88 respectively. Conclusion:The Chinese version of URICA-Voice has good reliability and validity, and can be used as a specific measurement tool for evaluating the compliance of voice training in China.
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Humanos , China , Idioma , Reprodutibilidade dos Testes , Inquéritos e Questionários , VozRESUMO
Breast cancer is a fatal disease with the highest incidence among women. Patients with breast cancer are in the stage of disease treatment and rehabilitation for a long time, and their self-management ability significantly affect their disease prognosis and quality of life. As a new type of medical care model, mobile health has been widely applied to the health management of patients with cancer, providing patients with a convenient and accessible health support system. This article reviewed the current status of self-management of patients with breast cancer, the concept of mobile health and its application in self-management of patients of breast cancer, and the future suggestions as well. The aim was to provide reference for the rehabilitation management of patients with breast cancer and future research in our country.
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Objective:To analyze the clinical characteristics and pathogen distributions of the patients with bone and joint infection.Methods:The clinical data and etiological results of 225 patients with bone and joint infection from January 2008 to October 2020 in Huashan Hospital, Fudan University were retrospectively analyzed.Statistical analysis was conducted by chi-square test.Results:Of the 225 cases with bone and joint infection, 75.6%(170/225) were extremities and other osteomyelitis, 16.0%(36/225) were suppurative arthritis, 8.4%(19/225) were spinal osteomyelitis. Non-implants related infection accounted for 80.4%(181/225) of the cases, while 19.6%(44/225) of the cases were implants related infection. The main clinical manifestations were localized pain (48.4%(109/225)), dyskinesia (47.6%(107/225)), localized swelling (28.9%(65/225)), fever (28.0%(63/225)), and increased purulent exudation (24.9%(56/225)). The proportions of localized pain (55.8%(101/181)) and fever (31.5%(57/181)) of non-implants infection were higher than those of implants infection (18.2%(8/44) and 13.6%(6/44), respectively), while the proportion of increased purulent exudation in implants infection (50.0%(22/44)) was higher than that in non-implants infection (18.8%(34/181)). There were all significant differences between the two groups ( χ2=15.49, 5.60 and 18.45, respectively, all P<0.050). Of the 225 cases, 63 cases(28.0%) had complications with other site infection, especially soft tissue infection and bloodstream infection. A total of 106 strains of pathogens were isolated from 225 specimens, 58.5%(62/106) of them were Gram positive bacterium.Among them, 34.0%(36/106) were Staphylococcus aureus, with the rate of methicillin resistant Staphylococcus aureus (MRSA) isolation accounting for 11.3%(12/106). Laboratory tests showed that 40.4%(91/225) of the patients had elevated erythrocyte sedimentation rate (ESR), 32.9%(74/225) patients had elevated C-reactive protein (CRP). Proportions of patients with elevated ESR (43.6%(79/181)) and CRP (37.6%(68/181)) in non-implants infection were significantly higher than those in implants infection (27.3%(12/44) and 13.6%(6/44), respectively). There were significant differences between the two groups ( χ2=3.94 and 9.19, respectively, P=0.047 and 0.002, respectively). Conclusions:The main clinical manifestations of bone and joint infection are localized pain, dyskinesia, localized swelling, fever and increased purulent exudation. Patients with bone and joint infection are easy to be complicated with soft tissue infection and bloodstream infection, and often accompanied by increased ESR and CRP levels. Gram positive bacterium are the main pathogens.
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Objective@#To understand the current status and influencing factors of anti-drug ability of college students in Beijing, and provide suggestions for drug education in universities.@*Methods@#A total of 966 students from 11 universities in Beijing were investigated with a self-designed questionnaire. and the data was analyzed with quantitative statistical analysis method.@*Results@#The average types of drug college students are aware of was 6.64. Among the average cognitive drugs of college students in Beijing,the full score rate of drug resistance was 68.12%. Gender, different majors, and frequency of receiving drug prevention education were influential factors of drug knowledge and anti-drug ability of college students (χ 2=41.38,18.20,11.02,P<0.05). The commonest educational method was themed lectures (80.33%), and the Internet had played an increasingly important role in education (76.60%). Anti-drug short-movies was the most interesting education method for college students (79.30%), with a penetration rate of 42.44%. The number of drugs awared and the ability of anti-drugs improved significantly through the "6.27" project.@*Conclusion@#The anti-drug propaganda and education should be strengthened among the students majoring in sport arts, and the function of anti-drug videos should be greatly exploited to maximize the effect of education.
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Acute ischemic stroke (AIS) is one of the main causes of death and disability in adults, which has brought a heavy burden to society and families. The intertwined process of thrombosis and thrombus inflammation plays a key role in the pathogenesis of AIS. The latest studies find that C-type lectin-like receptor 2 (CLEC-2) may play an important role in cerebral ischemia/reperfusion injury in mice by promoting thrombus inflammation, and its level is related to the progression of AIS and prognoses of patients with AIS. The author reviews the physiological and pathological effects of CLEC-2 and its related research progress in AIS, with a view to provide new research evidences for the occurrence and development of AIS and related treatments.
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Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer-related death. Molecular targeted therapy for lung cancer, especially non-squamous non-small cell lung cancer, has developed rapidly and achieved good results. Several studies have found that fibroblast growth factor receptor (FGFR) signaling supports cancer cell proliferation and stimulates angiogenesis through different mechanisms, which plays a role in the development and progression of several tumors. This indicates that the inhibitions of FGFR signaling pathway may inhibit the proliferation of cancer cells. Dysregulation of FGFR signaling has been observed in some types of malignancy, including lung squamous cell carcinoma (LUSC), making FGFR a potential therapeutic target for LUSC. This review focuses on the role of FGFR signaling and some FGFR inhibitors in LUSC.
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Physiologically based pharmacokinetics (PBPK) is one of the main research fields of pharmacometrics, and it plays an important role at all the stages of drug development and clinical practice. In early drug discovery and development, human pharmacokinetics (PK) could be predicted by PBPK modeling using in silico, in vitro and preclinical in vivo data. During clinical studies, PBPK model could be used to investigate the effects of various physiological and pathological factors on PK, such as age, gender, liver/kidney impairment, and to guide dose adjustment of special population (pregnant women, children, etc.). Furthermore, PBPK modeling is now becoming more appealing with the ability to predict drug-drug interaction (DDI) in the case of co-administration of multiple drugs. In recent years, the application of PBPK modeling in industry has increased widely. Also, regulatory agencies have recognized the potential of PBPK and its impact on labeling recommendations. As the popularity of model-informed drug development, the combination of PBPK modeling with other commonly used modeling methods, such as population pharmacokinetics (PopPK), pharmacokinetic/pharmacodynamic (PK/PD) modeling and model-based meta-analysis (MBMA), has shown attractive advantages. In this paper, the origin and development, as well as the application status of PBPK are introduced briefly, and the application of PBPK modeling merged with PopPK, PK/PD and MBMA is reviewed.
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With the increasing cost of drug development and clinical trials, it is of great value to make full use of all kinds of data to improve the efficiency of drug development and to provide valid information for medication guidelines. Model-based meta-analysis (MBMA) combines mathematical models with meta-analysis to integrate information from multiple sources (preclinical and clinical data, etc.) and multiple dimensions (targets/mechanisms, pharmacokinetics/pharmacodynamics, diseases/indications, populations, regimens, biomarkers/efficacy/safety, etc.), which not only provides decision-making for all key points of drug development, but also provides effective information for rational drug use and cost-effectiveness analysis. The classical meta-analysis requires high homogeneity of the data, while MBMA can combine and analyze the heterogeneous data of different doses, different time courses, and different populations through modeling, so as to quantify the dose-effect relationship, time-effect relationship, and the relevant impact factors, and thus the efficacy or safety features at the level of dose, time and covariable that have not been involved in previous studies. Although the modeling and simulation methods of MBMA are similar to population pharmacokinetics/pharmacodynamics (Pop PK/PD), compared with Pop PK/PD, the advantage of MBMA is that it can make full use of literature data, which not only improves the strength of evidence, but also can answer the questions that have not been proved or can not be answered by a single study. At present, MBMA has become one of the important methods in the strategy of model-informed drug development (MIDD). This paper will focus on the application value, data analysis plan, data acquisition and processing, data analysis and reporting of MBMA, in order to provide reference for the application of MBMA in drug development and clinical practice.
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227 cases of international telemedicine consultations were studied, to summarize the experiences, identify the process and characteristics of such consultation. Based on such, standardized management is applied in such aspects as organizational framework, consultation contents and forms, process, expenses, quality control, implementation and outcomes, and problems found. These efforts keep improving consultation quality in order to promote development of China′s international telemedicine consultation and new models.
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It is of important significant to predict the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus infection in clinic. Various risks scoring systems can achieve better prediction effect by integrating a variety of risk factors, but they still need to be perfected. Recent researches have found that some genotypes and genetic variations are associated with the occurrence of HCC and they can indicate the tumorigenesis of HCC. Some known or newly discovered indicators such as WFA+ -M2BP can be used to predict the occurrence of HCC independently or jointly. With the development of research, more genes, indicators as well as newly built scoring system will be utilized to predict the occurrence of HCC in clinic.
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It is of important significant to predict the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus infection in clinic.Various risks scoring systems can achieve better prediction effect by integrating a variety of risk factors,but they still need to be perfected.Recent researches have found that some genotypes and genetic variations are associated with the occurrence of HCC and they can indicate the tumorigenesis of HCC.Some known or newly discovered indicators such as WFA +-M2BP can be used to predict the occurrence of HCC independently or jointly.With the development of research,more genes,indicators as well as newly built scoring system will be utilized to predict the occurrence of HCC in clinic.
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Objective To evaluate the value of MRI in diagnosis of brachial plexus injury in infants.Methods MRI manifestations and electromyography(EMG) data of 14 cases were analyzed retrospectively.Kappa statistic was used to analyze the consistency between the two methods.Results Pure preganglionic injuries were found in 5 cases,preganglionic and postganglionic combined injuries occurred in 9 cases.MRI features of preganglionic injuries include:absence of roots in spinal canal (7 cases),nerve root enlargement (1 case),nerve sleeve dilation (3 cases),pseudomeningoceles (5 cases) and the dura thickening (3 cases).MRI features of postganglionic injuries include:trunk thickening with hyperintensity in STIR images(14 cases),adjacent structure disorder and edema (1 cases).The consistency of MRI and EMG was good (κ=0.752,P<0.05).Conclusion MRI is an efficient method for demonstrating preganglionic and postganglionic injuries,and can provide reliable information for early diagnosis and treatment for brachial plexus injury in infants.
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Objective To explore the diagnostic value of prenatal MRI in fetal Joubcrt syndrome and related disorders (JSRD).Methods Prenatal MRI data of 5 JSRD fetuses were analyzed retrospectively.The ratio of AP diameters of crown to root of molar tooth sign,the ratio of AP diameters of isthmus to interpeduncular fossa,and the ratio of the transverse to AP diameters of the roof of the fourth ventricle on the axial images of the midbrain were measured.Results Molar tooth signs were observed in 5 fetuses on the axial images of midbrain.The cerebellar vermis disappeared,and cleft sign was observed.Enlarged cisterna magna was observed in 3 fetuses.The ratios of AP diameters of crown to root were 0.58-0.90,of AP diameters of isthmus to interpeduncular fossa were 0.84-1.00,and of transverse to AP diameters of the fourth ventricle roof were 0.42-0.60.Conclusion Molar tooth sign and cleft sign were characteristic findings for JSRD on MRI,therefore being helpful to prenatal diagnosis of JSRD.
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Objective To study any changes in the surface electromyography of the paraspinal muscles before and after surgery in patients with degenerative lumbar kyphosis.Methods Thirty patients with lumbar degenerative kyphosis (LDK) were enrolled and underwent pedicle subtraction osteotomy.Surface electromyograms were recorded before the operation and 3 months afterward to observe the myoelectric activity of the paraspinal muscles.The electromyograms were also compared with those of healthy counterparts.Results The preoperative average EMG (AEMG) values in the LDK group in static standing were significantly higher than those of the control group.After the operation the values had decreased significantly,but were still significantly higher than in the control group.The preoperative AEMG values of the LDK group from the L1-2 segment during torso stretching were significantly lower than those of the control group.They increased significantly after the operation and were no longer significantly different from the control groups' readings.The pre-and post-operative AEMG values from the L4-5 segment were not significantly different and remained significantly lower than in the control group.During lifting and holding the mean power frequency slopes of the LDK group were significantly lower than those of the controls both before and after the operation,though the postoperative slopes were significantly higher than the preoperative ones.Conclusion Patients with lumbar degenerative kyphosis have obvious paraspinal muscle weakness and severe fatigue.Early pedicle subtraction osteotomy can significantly improve the functional status of the paravertebral muscles in the short term.
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Objective To study the serum levels of PSA, PAP joint detection in diagnosis of prostate cancer and the effect of estrogen on it.Methods60 patients with prostate cancer were selected in Jinyun County People's Hospital department of urology patients, giving diethylstilbestrol 3mg, oral once a day, and give Aspirin Enteric-coated Sustained Release Tablets 100mg oral, once daily, for 2 consecutive months.At the same time, we selected 60 cases of patients with benign prostatic hyperplasia, normal control group of 60 healthy subjects were the same period.Using radioimmunoassay, were observed inprostatic hyperplasia group, normal control group, the prostate cancer group before treatment, the prostate cancer group after treatment, serum PSA, PAP levels, as well as the group before and after treatment in patients with prostate cancer IPSS score index.ResultsThe prostate cancer group, serum PSA, PAP levels were significantly higher than that of benign prostatic hyperplasia group and normal control group, the difference was statistically significant (P<0.05);no significant difference was found between the prostatic hyperplasia group and normal control group, PSA in prostate cancer positive detection rate and the detection sensitivity is 78.33% the specificity was 70%, the index of PAP in prostate cancer, and the positive detection rate and the detection sensitivity was 53.33%, specificity index reached 93.33%;PSA for prostate cancer detection positive rate and sensitivity was higher than that of PAP, but the specificity is less than PAP, the difference is statistically significant (P<0.05) after treatment;the prostate cancer group, serum PSA, PAP levels were improved, compared with that before treatment, serum PSA, PAP levels decreased significantly, the difference was statistically significant (P<0.05);and after the treatment, the prostate cancer group of prostate symptoms have improved, compared with before treatment, IPSS score decreased significantly, the difference was statistically significant (P<0.05).ConclusionThe combined detection of serum PSA, PAP in the diagnosis of prostate cancer can improve the sensitivity and specificity, and can be used for early diagnosis of prostate cancer;estrogen can lower their level, improve the symptoms of prostate cancer, inhibit the progress of the disease.
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AIM To investigate the curative effects of Kuntai Capsules (Coptidis Rhizoma,Scutellariae Radix,Asini Corii Colla,etc.) on rat model for primary ovarian insufficiency (POI) caused by 4-vinylcyclohexene diepoxide (VCD).METHODS Seventy-five weaned 21-day old rats were divided equally into five groups randomly:control group,model group,low-,medium-,and high-dosage Kuntain group.Except the control group was given sesame oil rats,other four groups were given intraperitoneal injection of VCD solution.According to vaginal smear of rats,eight rats in each group were selected,the levels of FSH (follicle-stimulating hormone),LH (leuteinizing hormone),E2 (estradiol) and AMH (anti-Mullerian hormone) were measured,and morphological changes of ovary and uterus were observed.RESULTS Compared to the control group,FSH level in rats' serum of the model group significantly increased while AMH and E2 levels significantly decreased,and LH level rose;Kuntai Capsules significantly decreased FSH level while increased AMH level;The wet weight of rats' ovary in the model group was lighter than that in the control group.The ovary weight of Kuntai Capsules low-dosage group was increased;the number of follicles at all levels and corpora lutea of rats in the model group were decreased.After the treatment with Kuntai Capsules,the number of follicles at all levels and corpora lutea were increased;light microscopy manifested decreased uterine glands of the tube wall,reduced glandular cavity.After the treatment with Kuntai Capsules,the number of uterine glands increased and the gland cavity expanded.CONCLUSION Kuntai Capsules may slowdown the functional decline rate of ovarian.
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Objective To analyze the therapeutic effect of percutaneous transhepatic cholangial drainage (PTCD) in the treatment of bile duct obstruction in patients with malignant hilar bile duct carcinoma,and to discuss the clinical application and practical value of PTCD.Methods A total of 55 patients with malignant biliary obstruction were divided into the PTCD group (30 cases who recieved percutaneous transhepatic cholangial drainage) and the control group (25 cases who recieved endoscopic stent implantation).Observed the preoperative and postoperative biochemical indexes of PTCD group,including serum total bilirubin (TB),serum direct bilirubin (DB),serum alanine aminotransferase (ALT) and serum glutamic acid amino turn shift of aspartate aminotransferase(AST) and serum alkaline phosphatase(AKP).Compared the effect rate and postoperative survival time of the two groups through postoperative follow-up.Results The TB,DB,ALT,AST and APK of PTCD group one week after operation changed obviously compared with the relative index before opreation with statistically significant differences (P<0.05), which indicated a significant improvement of biochemical indicators.The treatment efficiency of the PTCD group and the control group were 83.3% and 64.0% respectively, and survival time of the two groups were(7.5±2.6)months and(4.8±2.8)months respectively.Results of the PTCD group was significantly better than that of the control group,and the differences were statistically significant(P<0.05).Conclusion All the patients with PTCD get better biochemical indicators and longer postoperative survival time,and the interventional therapy PTCD can be used as an effective clinical treatment method for bile duct obstruction with malignant hilar bile duct carcinoma.
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Objective To observe the effect of electroacupuncture and nerve and tendon gliding exercises on mild to moderate carpal tunnel syndrome.Methods Forty patients with mild to moderate carpal tunnel syndrome were randomly divided into an observation group and a control group,each of 20.Both groups were given neurotrophic drugs.The observation group was additionally provided with electroacupuncture and nerve and tendon gliding exercises,while the control group was given routine health education for 4 weeks.The Boston carpal tunnel syndrome questionnaire (BCTQ),a visual analogue scale (VAS),thumb and middle finger to wrist motor conduction velocity (MCV),sensory nerve action potentials (SNAPs),median nerve distal motor latency (DML) and the amplitude of compound muscle action potential (CMAP) of the musculi abductor pollicis brevis were evaluated.Results There were no significant differences in any of the measurements between the two groups before the treatment.After four weeks of treatment,significantly better improvement was observed in the average SCV of the thumb and wrist,the SCV of the digitus medius and wrist,the SNAP of the thumb and wrist,the SNAP of the digitus medius and wrist,the DML of the nervus medianus and the CMAP of the abductor pollicis brevis in the observation group compared to before the treatment and compared to the control group.Moreover,there was a significant decrease in the observation group's average BCTQ symptom score and function score and in their VAS ratings.However,in the control group significant differences were only found in the average SCV of the thumb and wrist,the DML of the nervus medianus and in their VAS ratings.Conclusions Electroacupuncture and nerve and tendon gliding exercises can significantly relieve symptoms and restore hand function.They are worth applying in clinical practice.
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Objective:To detect precancerous lesions of gastric cancer and biopsy tissue vascular endothelial growth factor (VEGF)and mutant p53 gene(mtp53)expression,to explore the development of clinical significance of VEGF and mutant p53 gene in gastric cancer.Methods:19 cases by endoscopic biopsies of normal gastric tissues,22 cases of intestinal metaplasia,47 cases of gastro-intestinal mucosal dysplasia, 54 cases of gastric cancer samples by immunohistochemical staining to detect the expression levels of VEGF and mtp53′s.Results: The expression levels of VEGF, mtp53 in normal gastric mucosa, intestinal metaplasia, dysplasia, and gradually increased gastric cancer was the law.mtp53 of VEGF expression in gastric carcinoma and compared with normal gastric tissue,intestinal metaplasia was significantly higher(P0.05). Conclusion: The abnormal expression of VEGF and mutant p53 may be related to the degree of deterioration of the stomach tissue lesions related.