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This paper provides a comprehensive analysis of the current state of intelligent ophthalmology in China, including technological advancements, academic exchange platforms, policy support, future challenges, and potential solutions. Technologically, remarkable progress have been made in various areas of intelligent ophthalmology in China, including diabetic retinopathy, fundus image analysis, and crucial aspects such as quality assessment of medical artificial intelligence products, clinical research methods, technological evaluation, and industrial standards. Researchers are constantly improving the safety and standardization of intelligent ophthalmology technology by formulating clinical application guidelines and standards. Academic exchange platforms have been established to provide extensive collaboration opportunities for professionals across diverse fields, and various academic journals serve as publication platforms for intelligent ophthalmology research. Regarding public policy, the Chinese government has not only established a supportive policy environment for the advancement of intelligent ophthalmology through various documents and regulations, but provided a legal basis and management framework. However, there are still challenges to overcome, such as technological innovation, data privacy and security, outdated regulations, and talent shortages. To tackle these issues, there is a requirement for increased technological research and development, the establishment of regulatory frameworks, talent cultivation, and greater awareness and acceptance of new technologies among patients. By comprehensively addressing these challenges, intelligent ophthalmology in China is expected to continue leading the industry's global development, bringing more innovation and convenience to the field of ophthalmic healthcare.
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Retinoblastoma is a kind of malignant eye tumor commonly seen in children, which is one of the main causes threatening children's vision and life. The diagnosis and evaluation of retinoblastoma has always been a hot topic in clinic. In the past few years, the application of artificial intelligence(AI)technology has made significant progress in the medical field, providing new opportunities and challenges for the diagnosis and treatment of retinoblastoma, for example, the use of AI algorithms to analyze massive clinical data, which can help doctors diagnose the disease more accurately and provide personalized treatment plans. In addition, AI technology also plays an important role in medical image analysis, genomics research and other aspects, which can help the development of new drugs and improve patient prognosis. This article reviews the application progress of AI in retinoblastoma.
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Objective:To investigate the therapeutic effect difference between first-line treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) and chemotherapy in non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) rare mutation.Methods:A retrospective case-control study was performed. Data of NSCLC patients with rare EGFR mutation who were treated in Shanxi Province Cancer Hospital from January 2013 to October 2019 were retrospectively analyzed. EGFR mutations in living tissues or blood were detected by using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) before first-line treatment. According to first-line treatment methods,they were divided into EGFR-TKI treatment group and chemotherapy group. Objective remission rate (ORR) and disease control rate (DCR) of both groups were compared. Kaplan-Meier method was used to draw progression-free survival (PFS) and the overall survival (OS) curves. Log-rank test was used for comparison among groups. Single-factor and multi-factor Cox proportional risk models were used to analyze the influencing factors of PFS and OS.Results:A total of 169 patients with EGFR rare mutations were included, and the age [ M (IQR)] was 63 years (12 years); there were 96 cases (56.8%) < 65 years and 73 cases (43.2%) ≥65 years; 70 (41.4%)males and 99 (58.6%) females; 55 cases (32.5%) had EGFR G719X mutation,45 cases (26.6%) had L861Q mutation, 17 cases (10.1%) had S768I mutation, and 52 cases (30.8%) had complex mutation; 55 cases (32.5%) received the first-line chemotherapy and 114 cases (67.5%) received the first-line EGFR-TKI treatment. In the chemotherapy group, ORR was 36.4% (20/55) and DCR was 85.5% (47/55); in EGFR-TKI treatment group, ORR was 72.8% (83/114) and DCR was 90.4% (103/114). The ORR of EGFR-TKI treatment group was higher than that of chemotherapy group ( χ2 = 20.70, P = 0.001), and there was no statistically significant difference in DCR between two groups ( χ2 = 1.76, P = 0.184). Subgroup analysis showed that ORR in EGFR-TKI treatment group with G719X, L861Q and complex mutations was higher than that of the corresponding mutations in chemotherapy group, and the differences were statistically significant (all P < 0.05), while there were no significant differences in DCR among subgroups (all P > 0.05). The median PFS time was 9.7 months (95% CI: 6.0-13.4 months) and 3.8 months (95% CI: 3.1-7.1 months), respectively in EGFR-TKI treatment group and chemotherapy group, and there was a statistically significant difference in PFS between the two groups ( P < 0.001). The median OS time was 25.6 months (95% CI: 18.0-37.9 months) and 31.7 months (95% CI: 18.0-42.8 months), respectively in EGFR-TKI treatment group and chemotherapy group, and there was no statistically significant difference in OS between the two groups ( P = 0.231). Multivariate Cox regression analysis showed that brain metastasis [with vs. without: HR = 2.306, 95% CI: 1.452-3.661, P < 0.001] and the first-line treatment methods (EGFR-TKI vs. chemotherapy: HR = 0.457, 95% CI:0.317-0.658, P < 0.001) were independent influencing factors for PFS of NSCLC patients with EGFR rare mutation; brain metastasis (with vs. without: HR = 2.087, 95% CI: 1.102-3.953, P = 0.024; unknown vs. without: HR = 2.118,95% CI: 1.274-3.520, P = 0.004) were independent influencing factors for OS of NSCLC patients with EGFR rare mutation. Conclusions:Compared with the first-line chemotherapy, EGFR-TKI first-line treatment could improve objective remission and PFS of NSCLC patients with EGFR rare mutation, while no OS benefit is observed.
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Objective:To evaluate the efficacy and safety of programmed death 1 (PD-1), programmed death ligand 1 (PD-L1) immune checkpoint inhibitor (ICI) monotherapy for brain metastasis in advanced non-small cell lung cancer (NSCLC), and to explore the timing of immunomonotherapy and the application of hormone on the efficacy of ICI.Methods:By searching literature in CNKI, Wanfang, VIP, PubMed, CBM, Embase, Cochrane Library and Web of Science databases, the advanced NSCLC patients with brain metastasis who received ICI treatment were identified, including patients with symptomatic brain metastasis who had received hormone therapy or brain surgery or radiotherapy. Meta-analysis was performed on the collected data to evaluate the systemic objective response rate (sORR) and intracerebral tumor objective response rate (iORR), the iORR of whether ICI monotherapy was first-line therapy, and the iORR of whether hormone was used were evaluated, and the incidence of adverse reactions was evaluated.Results:Fifteen studies were finally included, with a total of 4 033 patients, including 917 patients with brain metastasis. The iORR of immunomonotherapy was 26% (95% CI 19%-34%) and the sORR was 28% (95% CI 18%-40%). The iORR of first-line immunomonotherapy was 49% (95% CI 39%-58%). The iORR of symptomatic patients with hormone therapy and asymptomatic patients without hormone therapy was 26% (95% CI 20%-33%) and 19% (95% CI 16%-22%), respectively. The overall incidence of grade 3-4 adverse reactions was 14% (95% CI 11%-17%). Conclusions:The efficacy of ICI monotherapy in the first-line treatment of PD-L1-positive NSCLC patients with brain metastasis is better than that in the subsequent line therapy, and the application of hormone does not affect the efficacy of ICI. ICI monotherapy in the treatment of advanced NSCLC patients with brain metastasis is safe.
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Objective:To observe the diagnostic value of six classification intelligent auxiliary diagnosis lightweight model for common fundus diseases based on fundus color photography.Methods:A applied research. A dataset of 2 400 color fundus images from Nanjing Medical University Eye Hospital and Zhejiang Mathematical Medical Society Smart Eye Database was collected, which was desensitized and labeled by a fundus specialist. Of these, 400 each were for diabetic retinopathy, glaucoma, retinal vein occlusion, high myopia, age-related macular degeneration, and normal fundus. The parameters obtained from the classical classification models VGGNet16, ResNet50, DenseNet121 and lightweight classification models MobileNet3, ShuffleNet2, GhostNet trained on the ImageNet dataset were migrated to the six-classified common fundus disease intelligent aid diagnostic model using a migration learning approach during training as initialization parameters for training to obtain the latest model. 1 315 color fundus images of clinical patients were used as the test set. Evaluation metrics included sensitivity, specificity, accuracy, F1-Score and agreement of diagnostic tests (Kappa value); comparison of subject working characteristic curves as well as area under the curve values for different models.Result:Compared with the classical classification model, the storage size and number of parameters of the three lightweight classification models were significantly reduced, with ShuffleNetV2 having an average recognition time per sheet 438.08 ms faster than the classical classification model VGGNet16. All 3 lightweight classification models had Accuracy > 80.0%; Kappa values > 70.0% with significant agreement; sensitivity, specificity, and F1-Score for the diagnosis of normal fundus images were ≥ 98.0%; Macro-F1 was 78.2%, 79.4%, and 81.5%, respectively.Conclusion:The intelligent assisted diagnosis of common fundus diseases based on fundus color photography is a lightweight model with high recognition accuracy and speed; the storage size and number of parameters are significantly reduced compared with the classical classification model.
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Objective:To propose and evaluate the cycle-constraint adversarial network (CycleGAN) for enhancing the low-quality fundus images such as the blurred, underexposed and overexposed etc.Methods:A dataset including 700 high-quality and 700 low-quality fundus images selected from the EyePACS dataset was used to train the image enhancement network in this study.The selected images were cropped and uniformly scaled to 512×512 pixels.Two generative models and two discriminative models were used to establish CycleGAN.The generative model generated matching high/low-quality images according to the input low/high-quality fundus images, and the discriminative model determined whether the image was original or generated.The algorithm proposed in this study was compared with three image enhancement algorithms of contrast limited adaptive histogram equalization (CLAHE), dynamic histogram equalization (DHE), and multi-scale retinex with color restoration (MSRCR) to perform qualitative visual assessment with clarity, BRISQUE, hue and saturation as quantitative indicators.The original and enhanced images were applied to the diabetic retinopathy (DR) diagnostic network to diagnose, and the accuracy and specificity were compared.Results:CycleGAN achieved the optimal results on enhancing the three types of low-quality fundus images including the blurred, underexposed and overexposed.The enhanced fundus images were of high contrast, rich colors, and with clear optic disc and blood vessel structures.The clarity of the images enhanced by CycleGAN was second only to the CLAHE algorithm.The BRISQUE quality score of the images enhanced by CycleGAN was 0.571, which was 10.2%, 7.3%, and 10.0% higher than that of CLAHE, DHE and MSRCR algorithms, respectively.CycleGAN achieved 103.03 in hue and 123.24 in saturation, both higher than those of the other three algorithms.CycleGAN took only 35 seconds to enhance 100 images, only slower than CLAHE.The images enhanced by CycleGAN achieved accuracy of 96.75% and specificity of 99.60% in DR diagnosis, which were higher than those of oringinal images.Conclusions:CycleGAN can effectively enhance low-quality blurry, underexposed and overexposed fundus images and improve the accuracy of computer-aided DR diagnostic network.The enhanced fundus image is helpful for doctors to carry out pathological analysis and may have great application value in clinical diagnosis of ophthalmology.
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Objective:To study the characteristics of the genotype and phenotypic in a family with X-linked retinoschisis (XLRS) due to RS1 mutation. Methods:A retrospective clinical study. An XLRS family of 4 generations of 26 people were included in the study. Among them, 8 participants were males and 7 participants were females. Routine ophthalmologic examination was performed on 3 patients in the family including the proband and 12 patients with normal phenotype. Optical coherence tomography was performed in 2 of the 3 patients. Peripheral venous blood was extracted from all participants, whole-genome DNA was extracted, and potential pathogenic genes were screened by Panel sequencing. Conservative analysis, pathogenicity analysis and protein structure prediction were carried out by software tools. The pathogenicity of gene mutations was analyzed according to the American Society of Medical Genetics and Genomics (ACMG) guidelines.Results:The proband was 3 years old. Optical coherence tomography (OCT) examination showed that the retinal core layer in the macular area of both eyes had a cystic change, which was segmented by vertical or oblique bridging tissue. The proband's uncle was 32 years old. OCT examination showed atrophy in the macular area of the left eye. The macular area of the right eye was cystoid, segmented by vertical or oblique bridging tissue. No abnormality was found in the fundus examination of the proband's parents and 10 members of his family. Panel sequencing showed that c.361C>T/ p.Q121X hemizygous mutation was found in the fifth exon of RS1 gene in the proband (Ⅳ3) and 2 patients (Ⅱ1, Ⅲ8). The mother was a heterozygous mutation carrier of the gene, while the father had no mutation. The mutant gene causes premature termination of RS1, a truncated protein encoding 224 amino acids to 120 amino acids. Of the 10 patients with normal fundus examination, 6 participants were normal. The mutation was carried by four people, which were women. Homology analysis of the protein sequence showed that the mutant site was highly conserved in 12 mammals. Three-dimensional structural analysis of RS1 protein showed that the c-terminal amino acid sequence of the mutant protein was more than 50% missing. Analysis of ACMG guidelines indicated that the mutation was pathogenic. Conclusion:The RS1 mutation site c.361C>T/p.Q121X is a new mutation site of XLRS.
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With the development of biomolecular diagnostic technology and genetic analysis, it has been gradually discovered that some gene abnormalities can drive the occurrence and development of lung cancer. Among them, epidermal growth factor receptor (EGFR) is the most common mutant gene in non-small cell lung cancer (NSCLC). However, most of the current researches focus on the common mutations of EGFR, such as exon 19 deletion (19del) and exon 21 point mutation (L858R). There are few studies on rare EGFR mutations. This article reviews the progress of rare EGFR mutations in NSCLC.
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The SARS-CoV-2 virus first broke out in China in early 2020. The early symptoms of COVID-19 are similar to those of influenza. Therefore, during the epidemic, patients with similar symptoms will be tested for multiple pathogens at the same time. In order to control the spread of SARS-CoV-2, China has taken many measures. Under this special situation, have the types and epidemic characteristics of respiratory viruses changed? The nucleic acid test results of influenza A virus, influenza B virus and respiratory syncytial virus, as well as the antibody test results of 8 common respiratory viruses of Jinan Central Hospital were collected before and after the occurrence of SARS-CoV-2, and age distribution and time distribution characteristics were statisticed. Furthermore the epidemiological characteristics of this new virus before and after the SARS-CoV-2 epidemic was compared. In the early stage of the SARS-CoV-2 epidemic, influenza A, influenza B and respiratory syncytial virus nucleic acid test samples were large, and the positive rate of the three viruses was high. After that, the sample size and positive rate decreased significantly. No co-infection of SARS-CoV-2 and other viruses was found in our hospital. The sample size before the SARS-CoV-2 outbreak was larger than that after the outbreak, but the positive rate of the outbreak was lower than that after the outbreak. And the infection rate of children decreased in the middle and late stages of the epidemic. This is because since January 23, in order to prevent the spread of the new crown epidemic, my country has adopted measures such as wearing masks, not gathering together, and quarantining at home. This not only prevents the spread of the new crown virus, but also prevents the common respiratory tract. The spread of the virus has reduced the incidence of residents.
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An ongoing outbreak of pneumonia associated with SARS-CoV-2 has now been confirmed globally. In absence of effective vaccines, infection prevention and control through diagnostic testing and quarantine is critical. Early detection and differential diagnosis of respiratory infections increases the chances for successful control of COVID-19 disease. The nucleic acid RT-PCR test is regarded as the current standard for molecular diagnosis with high sensitivity. However, the highest specificity confirmation target ORF1ab gene is considered to be less sensitive than other targets in clinical application. In addition, a large amount of recent evidence indicates that the initial missed diagnosis of asymptomatic patients with SARS-CoV-2 and discharged patients with "re-examination positive" may be due to low viral load, and the ability of rapid mutation of coronavirus also increases the rate of false negative results. We aimed to evaluate the sensitivity of different nucleic acid detection kits so as to make recommendations for the selection of validation kit, and amplify the suspicious result to be reportable positive by means of simple continuous amplification, which is of great significance for the prevention and control of the current epidemic and the discharge criteria of low viral load patients.
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Corona Virus Disease 2019 (COVID-19) is a recently emerged life-threatening disease caused by SARS-CoV-2. Real-time fluorescent PCR (RT-PCR) is the clinical standard for SARS-CoV-2 nucleic acid detection. To detect SARS-CoV-2 early and control the disease spreading on time, a faster and more convenient method for SARS-CoV-2 nucleic acid detecting, RT-LAMP method (reverse transcription loop-mediated isothermal amplification) was developed. RNA reverse transcription and nucleic acid amplification were performed in one step at 63 {degrees}C isothermal conditions, and the results can be obtained within 30 minutes. ORF1ab gene, E gene and N gene were detected at the same time. ORF1ab gene was very specific and N gene was very sensitivity, so they can guarantee both sensitivity and specificity for SARS-CoV-2. The sensitivity of RT-LAMP assay is similar to RT-PCR, and specificity was 99% as detecting 208 clinical specimens. The RT-LAMP assay reported here has the advantages of rapid amplification, simple operation, and easy detection, which is useful for the rapid and reliable clinical diagnosis of SARS-CoV-2.
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In this study, Escherichia coli BL21 (DE3) was used as the host to construct 2 recombinant E. coli strains that co-expressed leucine dehydrogenase (LDH, Bacillus cereus)/formate dehydrogenase (FDH, Ancylobacter aquaticus), or leucine dehydrogenase (LDH, Bacillus cereus)/alcohol dehydrogenase (ADH, Rhodococcus), respectively. L-2-aminobutyric acid was then synthesized by L-threonine deaminase (L-TD) with LDH-FDH or LDH-ADH by coupling with two different NADH regeneration systems. LDH-FDH process and LDH-ADH process were optimized and compared with each other. The optimum reaction pH of LDH-FDH process was 7.5, and the optimum reaction temperature was 35 °C. After 28 h, the concentration of L-2-aminobutyric acid was 161.8 g/L with a yield of 97%, when adding L-threonine in batches for controlling 2-ketobutyric acid concentration less than 15 g/L and using 50 g/L ammonium formate, 0.3 g/L NAD+, 10% LDH-FDH crude enzyme solution (V/V) and 7 500 U/L L-TD. The optimum reaction pH of LDH-ADH process was 8.0, and the optimum reaction temperature was 35 °C. After 24 h, the concentration of L-2-aminobutyric acid was 119.6 g/L with a yield of 98%, when adding L-threonine and isopropanol (1.2 times of L-threonine) in batches for controlling 2-ketobutyric acid concentration less than 15 g/L, removing acetone in time and using 0.3 g/L NAD⁺, 10% LDH-ADH crude enzyme solution (V/V) and 7 500 U/L L-TD. The process and results used in this paper provide a reference for the industrialization of L-2-aminobutyric acid.
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Aminobutiratos , Metabolismo , Escherichia coli , Genética , Formiato Desidrogenases , Metabolismo , Leucina Desidrogenase , Metabolismo , NAD , MetabolismoRESUMO
Objective To propose a new evaluation system and evaluate the application value of diabetic retinopathy ( DR) intelligence assisted diagnostic technology based on fundus photography. Methods By using the diagnostic test method,an evaluation system of DR intelligent diagnostic technology based on fundus photography was established. The fundus photographs of 331 diabetic patients (662 eyes) with DR screening were collected in the First Affiliated Hospital of Huzhou University from January 2017 to October 2018. The results of experts ' diagnosis and intelligence assisted diagnosis were compared and evaluated. The evaluation system includes primary evaluation, intermediate evaluation and advanced evaluation. The primary evaluation is the consistency of non-DR ( NDR) in all diabetic patients receiving DR-assisted diagnostic techniques;the intermediate evaluation is the diagnosis consistency of DR lesion degree in patients diagnosed with DR (grade 1-4);the advanced evaluation is the diagnosis consistency of DR classification ( grade 0 -4 ) in all diabetic patients receiving DR-assisted diagnostic techniques. The intermediate evaluation includes two evaluation methods. The main evaluation indicators include sensitivity,specificity and Kappa value. Results Based on experts ' diagnosis, NDR accounted for 22. 7%;mild non-proliferative DR (NPDR),moderate NPDR,and severe NPDR accounted for 19. 9%,18. 7% and 25. 7%,respectively;proliferative DR( PDR) accounted for 13. 0%. Based on intelligence diagnostic system,NDR accounted for 25. 8%;mild NPDR, moderate NPDR and severe NPDR accounted for 19. 7%,19. 3% and 22. 8%,respectively;proliferative DR( PDR) accounted for 12. 4%. Based on evaluation system in the paper,the sensitivity,specificity and Kappa value in primary evaluation were 91. 4%, 84. 7% and 0. 72;the sensitivity, specificity and Kappa value in intermediate evaluation method one were 88. 4%,91. 1% and 0. 79;the sensitivity, specificity and Kappa value in intermediate evaluation method two were 80. 5%,93. 3% and 0. 75;the Kappa value in advanced evaluation was 0. 62. Conclusions The evaluation system can be applied to the evaluation of DR intelligent diagnostic technology,and the evaluation result can be used as the basis for the selection of DR intelligent diagnosis application scene.
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Lung cancer ranks first in the incidence of malignancies in China.It not only has a high mortality rate,but also has a high rate of brain metastases because of its special texture characteristics.With the development of imaging techniques and the improvement of diagnosis and treatment,the overall survival rate of lung cancer patients with brain metastases has been increased,however,the 5-year survival rate at each stage is still about 18%.This article reviews the current effective treatment strategies,including surgery,radiotherapy,chemotherapy,and targeted therapies for brain metastases of lung cancer.
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As a complex system, the topology of human's brain network has an important effect on further study of brain's structural and functional mechanism. Graph theory, a kind of sophisticated analytic strategies, is widely used for analyzing complex brain networks effectively and comparing difference of topological structure alteration in normal development and pathological condition. For the purpose of using this analysis methodology efficiently, it is necessary to develop graph-based visualization software. Thus, we developed VisConnectome, which displays analysis results of the brain network friendly and intuitively. It provides an original graphical user interface (GUI) including the tool window, tool bar and innovative double slider filter, brain region bar, runs in any Windows operating system and doesn't rely on any platform such as Matlab. When importing the user-defined script file that initializes the brain network, VisConnectome abstracts the brain network to the ball-and-stick model and render it. VisConnectome allows a series of visual operations, such as identifying nodes and connection, modifying properties of nodes and connection such as color and size with the color palette and size double slider, imaging the brain regions, filtering the brain network according to its size property in a specific domain as simplification and blending with the brain surface as a context of the brain network. Through experiment and analysis, we conclude that VisConnectome is an effective visualization software with high speed and quality, which helps researchers to visualize and compare the structural and functional brain networks flexibly.
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Humanos , Encéfalo , Fisiologia , Conectoma , SoftwareRESUMO
Objective To investigate the relationships of neuron-specific enolase (NSE) and progastrin-releasing peptide (ProGRP) with the initial chemotherapeutic effect and survival of patients with small-cell lung cancer (SCLC).Methods A total of 197 patients with SCLC diagnosed pathologically from January 2011 to September 2013 in Shanxi Provincial Cancer Hospital were selected.x 2 test and logistic regression analysis were used to analyze the factors affecting the initial chemotherapeutic response;KaplanMeier method,log-rank test and Cox regression analysis were used to analyze the factors affecting survival of patients.Results Among the 197 patients,NSE was negative in 64 cases and positive in 133 cases;ProGRP was negative in 51 cases and positive in 146 cases;41 cases with hyponatremia and 156 cases without hyponatremia.152 cases (77.2 %) had well response to initial treatment and 45 cases (22.8 %) had no reaction.Univariate analysis showed that stage of disease (x2 =4.456,P =0.033) and ProGRP (x2 =13.424,P < 0.001) were associated with initial therapeutic response.Logistic regression analysis showed that stage of disease (OR =0.404,95 % CI 0.197-0.828%,P =0.013) and ProGRP (OR =4.058,95 % CI 1.939-8.491,P =0.000) were the independent predictors of initial therapeutic response.Kaplan-Meier survival analysis showed that sex,age,smoking,with or without hyponatremia,stage of disease,NSE,ProGRP and number of chemotherapy cycles were all associated with 2-year survival rate (x2 values were 4.319,6.811,4.264,4.687,32.631,41.045,11.379,33.466,respectively,all P < 0.05).Multivariate analysis showed that stage of disease (RR =2.110,95 % CI 1.491-2.985,P < 0.001),number of chemotherapy cycles (RR =0.398,95 % CI 0.283-0.588,P < 0.001) and NSE (RR =1.422,95 % CI 1.113-1.784,P =0.002) were independent predictors of survival.However,ProGRP was not associated with survival of patients (RR =1.065,95 % CI 0.854-1.328,P =0.587).Conclusions ProGRP is associated with the initial chemotherapeutic response in patients with SCLC,and it has certain clinical significance in predicting the initial chemotherapeutic effect.NSE is associated with the survival prognosis of SCLC,and it is a prognostic factor of poor survival.
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Objective To observe the clinical efficacy of acupoint application plus modifiedZhi Sou powder in treating post-cold cough.Method A total of 120 patients with post-cold cough were randomized into group A, group B, and group C, 40 cases in each group. Group A was intervened by acupoint application plus modifiedZhi Sou powder, group B by oral administration ofZhi Sou powder, and group C by oral administration of compound Dextromethorphan syrup. The three groups were intervened once a day, 7 days as a treatment course. The clinical efficacies were compared after 2 treatment courses, and the adverse reactions during the study were observed.Result The total effective rate was 87.5% in group A, 67.5% in group B and 60.0% in group C. The total effective rate in group A was significantly different from that in group B and group C (P<0.05). The adverse reaction rate was 7.5% in group A, 5.0% in group B and 72.5% in group C. The adverse reaction rates in group A and B were significantly different from the rate in group C (P<0.01).Conclusion Acupoint application plusZhi Sou powder is an effective approach in treating post-cold cough, and it’s more effective than ordinary drug and produces less adverse reactions.
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Objective To establish a rapid, accurate and low-cost screening method for the detection of calreticulin (CALR) mutations in myeloproliferative neoplasms (MPN).Methods Seventy cases diagnosed with MPN were collected from 2012 to 2016. PCR combined with high resolution melting (HRM) analysis were used to screen the CALR mutations, and Sanger sequencing and T-A sequencing were applied to verify the HRM positive samples. CALR wild type DNA, type 1 and type 2 mutant DNA samples were selected and analyzed 4 times/day for 5 days to detected the CVs of Tm (melting temperature) respectively. JAK2 mutations were also analyzed in MPN patients to compare the association between JAK2 and CALR mutations.Results PCR-HRM analysis showed 7 cases (26.9%) and 5 cases (20.8%) patients with CALR mutations were screened out from 26 essential thrombocythaemia (ET) cases and 24 primary myelofibrosis (PMF) cases, but no CALR mutations were found in cases with polycythaemia vera (PV). All mutations were confirmed by direct sequencing or cloning sequencing. The CVs for HRM analysis of CALR wild type DNA, type 1 and type 2 mutant DNA samples were 1.91%,1.59% and 1.43%, respectively.There were 47 cases with JAK2 V617F and 1 case with exon12 mutation. No coexistence of JAK2 mutation and CALR mutations were found in a single sample.Conclusion PCR-HRM can be used for rapid screening of CALR mutation. Subsequent sequencing can be applied for rapid diagnosis of MPN patients in clinical practice.
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Objective To investigate the significance of resistant gene detection combined with adenosine triphosphate-tumor chemosensitivity assay (ATP-TCA) in the second-line chemotherapy of lung squamous cell cancer, and to provide a reference for clinical treatment. Methods 150 patients with lung squamous cell cancer diagnosed by histopathology or cytology and with the disease progressed after NP regime chemotherapy were enrolled. The mRNA expressions of excision repair cross complementation 1 (ERCC1) and ribonucleotide reductase M1 (RRM1) were detected by RT-PCR, and ATP-TCA was carried out. After detected by RT-PCR and ATP-TCA, the patients who were sensitive to gemcitabine plus cisplatin (GP) accepted the second-line systemic chemotherapy with GP regimen, and the others who were not sensitive to GP regimen or whose results of gene detection and ATP-TCA were on the contrary took the second-line chemotherapy regimens with docetaxel plus cisplatin (DP). Both groups accepted 2-4 cycles of systemic chemotherapy. The chest CT was followed up, and the response rate (RR), progression-free survival (PFS) and median survival time (MST) were investigated. Results The RR of GP group was 36.2 % (17/47), while the DP group was 28.1 % (26/92), and the difference was statistically significant (χ2= 4.274, P 0.05). Conclusion The resistance gene detection combined with ATP-TCA have certain guiding significance on the second-line chemotherapy for advanced lung squamous cell cancer.
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Objective To explore the clinical significance of platelet count increasing in patients with ovarian malignant tumor . Methods 80 cases of ovarian malignant tumor patients ,80 patients with ovarian benign tumor and 80 cases of healthy women were enrolled in the study as group A ,B ,C respectively .The group A was divided into FIGOⅠ group(n=30) ,and FIGOⅡ and above group(n=50) .Platelet count was detected by using fully automatic blood cell analyzer and the serum CA125 concentrations were also measured for all the groups .Results The platelet count and CA125 concentrations in group A were higher than group B and group C(P< 0 .05) .The positive rate of platelet increasing and serum CA125 were also higher than group B and group C(P<0 .05) .There were significant differences between FIGOⅠ group and FIGOⅡ and above group in platelet count and CA125 concen‐trations .Conclusion Ovarian malignant tumor complicated with increased platelet count is common in patients of advanced stage . The increased platelet count could indicate the malignant degree of ovarian malignant tumor .