Cost effectiveness analysis of CAR-T cell therapy for patients with relapsed/refractory multiple myeloma in China.

BACKGROUND: The landscape of treatment strategies for relapsed/refractory multiple myeloma (RRMM) has dramatically changed due to the emergence of chimeric antigen receptor T (CAR-T) cell therapy. The aim of this study was to evaluate the cost-effectiveness of two CAR-T cell treatments for RRMM patients from the perspective of the Chinese healthcare system. METHODS: A Markov model was used to compare currently available salvage chemotherapy with Idecabtagene vicleucel (Ide-cel) and Ciltacabtagene autoleucel (Cilta-cel) for treatment of patients with RRMM. The model was developed based on data from three studies: CARTITUDE-1, KarMMa, and MAMMOTH. The healthcare cost and utility of RRMM patients were collected from a provincial clinical center in China. RESULTS: In the base case analysis, 3.4% and 36.6% of RRMM patients were expected to be long-term survivors after 5 years of Ide-cel and Cilta-cel treatment, respectively. Compared to salvage chemotherapy, Ide-cel and Cilta-cel were associated with incremental QALYs of 1.19 and 3.31, and incremental costs of US$140,693 and $119,806, leading to ICERs of $118,229 and $36,195 per QALY, respectively. At an ICER threshold of $37,653/QALY gained, the probability that Ide-cel and Cilta-cel are cost-effective were estimated to be 0% and 72%, respectively. With younger target people entering the model, and a partitioned survival model in scenario analysis, the ICERs of Cilta-cel and Ide-cel changed rather mildly and their cost-effectiveness results were the same as base analysis. CONCLUSIONS: Based on the willingness-to-pay of 3-times China's per capita GDP in 2021, Cilta-cel was considered to be a more cost-effective option compared to salvage chemotherapy for RRMM in China, while Ide-cel was not.

Visual analysis of the treatment of non-alcoholic fatty liver disease based on Web of Science / 中国药房

OBJECTIVE To analyze the current status， hotspots and development trends of research on the treatment of non-alcoholic fatty liver disease （NAFLD）， providing reference for subsequent research. METHODS Searching the Web of Science database， the literature related to the treatment of NAFLD from the establishment of the database to December 31， 2022 were collected. CiteSpace 6.1.R6 was used to construct a visual atlas， perform collaborative network analysis on authors， countries and institutions， and conduct keyword co-occurrence， clustering and emergence analysis to explore its research status and hotspots. RESULTS A total of 3 882 articles were included， and the number of publications had been increasing year by year. The top three countries in terms of publication volume were China， the United States， and Japan. The author with the highest volume of publications was Sanyal from the United States （37 articles）， while the institution with the highest volume of publications was the University of California， San Diego （75 articles）. A closely connected research team abroad mainly conducted large-scale randomized controlled trials （RCT） to evaluate the effectiveness and safety of various interventions， including medication and lifestyle， in treating NAFLD. However， domestic researches mainly focused on basic researches about the treatment of NAFLD with effective medicinal ingredients， and were characterized by traditional Chinese medicine. There were relatively few high-quality large-scale RCT studies related to it. Keyword analysis showed that researches in various countries mainly focused on regulating liver oxidative stress and inflammation， improving the overall balance of glucose and lipid metabolism. Except for hypoglycemic drugs， drugs that act on various comprehensive metabolic homeostasis targets in the body had entered clinical research， and had enormous therapeutic potential. CONCLUSIONS The research on NAFLD treatment continues to grow in popularity and tends to research targets and drugs for regulating systemic metabolic homeostasis. As the main force of research， China should strengthen communication with the international community， grasp the trends and directions of basic research， attach importance to clinical research， and continuously tap the therapeutic potential of traditional Chinese medicine.

Diagnosis of a patient with Spinocerebellar ataxia type 29 due to a novel variant of ITPR1 gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical and genetic characteristics of a child with spinocerebellar ataxia type 29 (SCA29) due to novel variant of the inositol 1,4,5-trisphosphate receptor type 1 (ITPR1) gene.@*METHODS@#The child was subjected high-throughput sequencing, and candidate variant was verified by Sanger sequencing of his family members.@*RESULTS@#The child was found to harbor a c.800C>T (p.T267M) variant of the ITPR1 gene, which was not found in his parents and their fetus. The variant has occurred in a hotspot of the ITPR1 gene variants and was unreported before in China. Based on his clinical and genetic characteristics, the child was diagnosed with SCA29.@*CONCLUSION@#The novel heterozygous c.800C>T (p.T267M) of the ITPR1 gene probably underlay the SCA29 in this child.

Clinical effect of cosmetic reconstruction for partial defect of distal segment of thumb and finger / 中华显微外科杂志

Objective:To explore the clinical effect of cosmetic reconstruction for partial defect of distal segment of digits.Methods:Form January 2018 to January 2021, the Department of Hand Surgery of Institute for Hygiene of Ordnance Industry(The 521 Hospital of Weapon Industry) admitted 129 patients with partial defect of distal segment of thumb or fingers with phalange or tendon exposure. The patients were 111 males and 18 females with an average age of 34(17-59) years old. The sizes of nailbed defect were 0.4 cm×1.1 cm-1.8 cm×2.0 cm, the length of phalange defect was 0.4-1.8 cm, and the sizes of the soft tissue defect were 1.6 cm×1.8 cm-3.2 cm×4.8 cm. Great toe tissue flaps were used to reconstruct the partial defect of distal segment of thumb or fingers after debridement. Wounds of fibular flap of great toe in 77 cases were directly sutured in 17 patients. The donor sites in rest 60 great toes were narrowed first and then repaired with skin grafts in 10 cases, with artificial dermis in 28 cases and with transverse V-Y advancement flaps of ipsilateral great toes for 22 cases. Forty-nine of 52 donor site wounds for hallux toenail flap were repaired with artificial dermis and 3 with free peroneal artery perforator flaps. The method was outpatient follow-up. Postoperative follow-up lasted until July 2022. The check-items for follow-up included: occurrence of necrosis, appearance, shape and texture of the flap, appearance of the reconstructed nails, TPD of the reconstructed digit pulps, tolerance to cold on the scars of flaps, flexion and extension of the reconstructed digits. The healing time of phalanges of the reconstructed digits was evaluated by X-rays. The appearance, sensation, the tolerance to cold of great toe and the movement of donor foot were also assessed.Results:Postoperative follow-up lasted for 18 to 24 months, with an average of 21 months. A total of 128 flaps survived. Necrosis occurred in 1 fibular hallux flap, the necrosis was cured with a reverse digital proper artery island flap. Thereafter, all flaps healed well. The appearance, shape, texture and nails of reconstructed digits were close to the contralateral digits. The reconstructed thumb and finger were evaluated according to Zook, 127 cases were excellent and 2 cases were good.TPD of the pulps of the reconstructed digits was 4-10 mm. The mean score of the Vancouver scar scale(VSS) was 0.6 for scars of the reconstructed digits. The mean score of the Visual analog scale(VAS) was 0.3 for the tolerance to cold. Flexion and extension function recovered well in all the reconstructed digits. According to the Evaluation Criteria of Upper limb Function Hand Surgery Society of Chinese Medical Association, the function of hand was excellent in 127 cases and 1 in each of good and fair. X-rays of all digits showed the phalange healing of the reconstructed digits, with an average healing time of 2 months after surgery, without phalange resorption, infection, nonunion nor stress fracture. There was no difference between the length of the donor great toe and the contralateral toe, except the donor site of the great toe nail root. There was no significant visual difference between the appearance of the donor great toe and the contralateral toe. TPD of the pulps of donor great toe was 4-8 mm. The mean score of the VSS was 1.4 for scars in the donor great toe. The mean score of the VAS was 0.7 for the tolerance to cold of the donor great toe. There was no stress fracture at donor site, and the functions of donor foot were not affected when walking, running, jumping and tiptoeing in all patients.Conclusion:It is an ideal method for reconstructing a partial defect of distal segment of digit by great toe flap. It can not only reconstruct the partial defect of distal segment of the digit, but also results in a good appearance and satisfactory functions of the reconstructed digit. Damage to the donor site is minimum. The length of the donor great toe is unchanged, and it has little impact on sensation and appearance of the donor great toe. Meanwhile, there is no adverse effect on walking, running and jumping with the donor foot.

An epidemiological analysis of 536 older adult patients with chronic wounds / 中国基层医药

Objective:To investigate the clinical characteristics of older adult patients with chronic wounds and perform an epidemiological analysis.Methods:The general data, wound information, treatment information, and health economics information of 536 older adult patients with chronic wounds who received treatment in Yancheng No. 1 People's Hospital from January 2016 to December 2020 were retrospectively analyzed. All collected data were analyzed using SPSS 25.0 software.Results:Among older adult patients with chronic wounds, there were more men ( n = 316, 59.0%) than women ( n = 220, 41.0%). The number of patients aged 60-70 years ( n = 252, 47.0%) was the highest, and the number of patients aged > 80 years ( n = 98, 18.3%) among all age brackets. All patients had underlying diseases. The main wound types were diabetic wounds ( n = 134, 25.0%), venous wounds ( n = 94, 17.5%), and arterial wounds ( n = 81, 15.1%). There was a significant difference in the distribution of wound types among patients at different ages ( χ2 = 90.63, P < 0.001). The wounds were mainly located in the lower limbs ( n = 510, 74.0%) and sacral and sacrococcygeal regions ( n = 117, 17.0%). The results of wound pathogen detection showed that the proportion of gram-negative bacteria was the highest. There were no significant differences in treatment efficiency, length of hospital stay, and hospital cost among patients receiving different treatments ( χ2 = 82.46, H = 104.84, 202.01, all P < 0.001). There was a significant difference in outcome among patients at different ages ( χ2 = 15.12, P = 0.012). There was no significant difference in treatment efficiency among patients with different types of wounds ( χ2 = 12.01, P = 0.100). There were significant differences in the length of hospital stay and hospital cost among patients with different types of wounds ( H = 82.17, 49.84, both P < 0.001). There were no significant differences in the length of hospital stay and hospital cost among patients of different ages ( H = 1.42, 3.09, P = 0.492, 0.214). Conclusion:The older adult patients with chronic wounds are mainly male, and the majority of them had underlying diseases. Diabetic wounds were the main wound type. Chronic wounds mainly occur in the sacral and sacrococcygeal regions. The rate of gram-negative bacteria is high. Surgical efficiency for chronic wounds is very good.

Study on regulation mechanism of glaucocalyxin A on the autophagy and apoptosis of HCCLM 3 hepatocellular carcinoma cells through Bcl- 2/Beclin1 target / 中国药房

OBJECTIVE To study the regulator y mech anism of glaucocalyxin A （GLA） on autophagy and apoptosis of HCCLM3 hepatocellular carcinoma cells. METHODS HCCLM3 cells were taken ，and control group ，GLA 2.5 μg/mL group，GLA 5 μg/mL group and GLA 10 μg/mL group were mainly set according to different experimental purposes. In control group，only complete medium was added ；in each administration group ，complete medium containing the corresponding final concentration of GLA was added. Cell cycle distribution and apoptosis were detected by flow cytometry ；mitochondrial morphology and autophagy were observed by transmission electron microscope （only control group ，GLA 5 μg/mL group）；JC-1 staining and fluorescence inverted microscope were used to observe and detect the mitochondrial membrane potential of the cells ；Western blot assay was used to detect the protein expression of Bcl- 2， Bax， Beclin1 and cleaved caspase- 3 proteins in the cells ； the co-immunoprecipitation method was used to detect the binding and dissociation of Bcl- 2 and Beclin 1（only GLA 5 μg/mL group， GLA 10 μg/mL group）. RESULTS Compared with control group ，GLA 5 μg/mL and GLA 10 μg/mL could induce a significant arrest of the cell cycle in the G 2-M phase for HCCLM 3，a significant decrease in mitochondrial membrane potential ，an increase in apoptosis as well as significant promotion of the protein expression of Bax ，cleaved caspase- 3 and Beclin 1，and significant inhibition of the protein expression of Bcl- 2（P＜0.01）. GLA 5 μg/mL also significantly changed mitochondrial morphology and increased autophagosomes. The results of co-immunoprecipitation showed that compared with GLA 5 μg/mL，GLA 10 μg/mL could enhance the binding of Bcl- 2 and Beclin 1. CONCLUSIONS GLA can regulate the autophagy and apoptosis of HCCLM 3 cells by Bcl-2/Beclin1 target. The effect is closely related to the dose of GLA.

Genetic studies of primary biliary cholangitis in the post-GWAS era / 临床肝胆病杂志

With the constant increase in the awareness of primary biliary cholangitis (PBC) and the continuous improvement in related diagnostic methods in the past two decades, the incidence and prevalence rates of PBC tend to increase and PBC is now the most common autoimmune liver disease worldwide. A series of family-based studies in the early stage have shown that PBC has strong genetic tendency, and subsequent genomic analyses have been performed for PBC in different populations and have obtained a large amount of genetic data. Future genetic studies of PBC will focus on translating these results into clinical practice.

Influencing factors and strategies of enhancing nanoparticles into tumors

The administration of nanoparticles (NPs) first faces the challenges of evading renal filtration and clearance of reticuloendothelial system (RES). After that, NPs infiltrate through the expanded endothelial space and penetrated the dense stroma of tumor microenvironment to tumor cells. As long as possible to prolong the time of NPs remaining in tumor tissue, NPs release active agent and induce pharmacological action. This review provides a comprehensive summary of the physical and chemical properties of NPs and the influence of various biological factors in tumor microenvironment, and discusses how to improve the final efficacy through adjusting the characteristics and structure of NPs. Perspectives and future directions are also provided.

Baicalin induces ferroptosis in bladder cancer cells by downregulating FTH1

Ferroptosis is a non-apoptotic regulated cell death caused by iron accumulation and subsequent lipid peroxidation. Currently, the therapeutic role of ferroptosis on cancer is gaining increasing interest. Baicalin an active component in

A preliminary study on the change and clinical significance of peptidylarginine deiminase 4 expression on the neutrophils in the peripheral blood from the patients with anti-neutrophil cytoplasmic myeloperoxidase antibody-associated vasculitis / 中华风湿病学杂志

Objective:To investigate the change of peptidylarginine deiminase 4 (PAD4) expression in the neutrophils of peripheral blood of patients with anti-neutrophil cytoplasmic myeloperoxidase antibody-associated vasculitis (MPO-AAV), and to analyze the relationship between the change and disease activity.Methods:Thirty-nine untreated patients with active MPO-AAV (patient group) and thirty-nine healthy volunteers (control group) were enrolled into this study. The PAD4 expressed on neutrophils was detected by flow cytometry (FCM). The serum neutrophil extracellular traps (NETs), fragments from the activated complement C5 (C5a) and anti-neutrophil cytoplasmic myeloperoxidase antibody (MPO-ANCA) were measured by enzyme-linked immuno sorbent assay (ELISA). Their disease activity was evaluated by Birmingham vasculitis activity score (BVAS). All the detected results were compared between the 2 groups by t test, Spearman correlation analysis and multivariate linear regression analysis were employed to analyze the relationship between BVAS and the Lab test results in patient group. Results:The proportion of neutrophil expressing PAD4, the mean fluorescence intensity (MIF) of PAD4, the levels of NETs and C5a in patient group were significantly higher than those in the control group [(71±11)% vs (26±6)%, t=22.456, P<0.01; (33±4) vs (14±4), t=18.668, P<0.01; (0.62±0.22) vs (0.26±0.15), t=8.466, P<0.01 and (4.6±1.0) vs (2.9±1.0), t=7.697, P<0.01, respectively]. In patient group, BVAS was positively associated with the proportion of PAD4 + neutrophil, MFI of PAD4, the serum level of NETs, C5a and MPO-ANCA ( r=0.843, P<0.01; r=0.821, P<0.01; r=0.411 1, P<0.01; r=0.613, P<0.01 and P=0.790, P<0.01, respectively), however, the results of multiple linear regression analysis showed only the percentage of PAD4 + neutrophils and the level of MPO-ANCA were independent influencing factors on BVAS ( β=0.324 6, P<0.01 and β=0.796, P<0.01, respectively). Conclusion:The percentage of neutrophils expressed PAD4 in the peripheral blood of patient with active MPO-AAV is significantly increased, and it is an independent factor affecting the disease activity. Intervention on this expression might be a potential new pathway for MPO-AAV treatment.

Analysis of early predictive factors for invalidity of high flow nasal catheter oxygen therapy / 中国实用护理杂志

Objective:High-flow nasal cannula (HFNC) is a new method to treat adult respiratory distress. This study aims to explore the early predictors of the inefficiency of HFNC in patients with respiratory distress.Methods:A total of 162 patients with respiratory distress were treated with HFNC oxygen therapy in the Department of Respiratory and Critical Care Medicine, Emergency and Critical Care Medicine. The age, sex, weight, history, diagnosis, vital signs, blood oxygen saturation/inhaled oxygen concentration (SpO 2/FiO 2, SF) ratio, and modified respiratory distress score (mRDAI) , duration of HFNC oxygen therapy, replacement of advanced oxygen therapy support time, adverse reactions and other data were extracted from the medical electronic medical records. Results:A total of 154 valid samples were included, with a median age of 55 (inter-quartile range 47-72), including 59 patients (38.3%) with acute bronchiolitis, 64 patients (41.6%) with bacterial pneumonia, 31 patients (20.1%) with atypical or viral pneumonia; 129 patients (83.8%) with effective HFNC oxygen therapy and 25 patients (16.2%) with ineffective HFNC oxygen therapy. SF ratio in ineffective HFNC oxygen therapy patients at admission was lower, pH value was lower, partial pressure of carbon dioxide was higher ( P values were 0.008, 0.012, 0.001). RR, mRDAI score and SF ratio in the first hour of effective HFNC oxygen therapy patients improved significantly ( t values were 1.732, 9.783, 37.591, P<0.05 or 0.01). SF ratio in the first hour of HFNC was lower than 195 (area under curve 0.842, 95% CI 0.743-0.942, P<0.01). It was the critical value for the ineffectiveness of oxygen therapy. Conclusions:When patients with respiratory distress are supported by HFNC oxygen therapy, the lower initial fingertip oxygen saturation, higher blood gas arterial partial pressure of carbon dioxide and lower SF ratio are the early predictors of failure of HFNC oxygen therapy.

Global research hotspots on oncology-bibliometric analysis based on the ESI hot papers / 生物医学工程学杂志

With the increasing global burden of various cancer, an abundance of papers emerged every year in the research hotspots of oncology, covering a wide range of research types and topics. In order to facilitate interested readers to quickly grasp the frontier and hotspots of cancer research, it would be helpful to sort out and summarize the research topic in a timely manner. According to the classification of disciplines, we screened the Essential Science Indicators (ESI) hot papers released in 2019 for the ones in the oncology field, utilized methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation to further reveal the context and characteristics of research in the field of oncology, summarized the latest progresses and future directions in the field, and provided information and hints for the trajectory of future research. A total of 549 papers were included, which were mainly from the field of clinical medicine; the country with the most publications was the United States, while China ranked the fourth in terms of contribution; the research institution with the highest number of published papers was University of Texas system;

Global research hot points on cardiovascular disease--bibliometric analysis based on the ESI hot papers / 生物医学工程学杂志

With the heavier burden of cardiovascular disease, an abundance of papers emerge every year in the research hotspots, which cover a wide range of types and content. In order to let readers interested in the cardiovascular field quickly understand the research hotspots and research frontier, it is necessary to sort out and summarize the research topic in time. According to the discipline classification, we screened papers in cardiovascular field from the Essential Science Indicators (ESI) hot papers published in 2019. Methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation were used a step further to reveal the context and characteristics of research in the field of cardiovascular diseases, summarize the latest progress and development direction in this field, and provide information and hints for the expansion of future research directions. A total of 297 papers were finally included, which were mainly in the field of clinical medicine; The country with the most publications was the United States, while China ranked the fifth in terms of contribution; the research institution with the highest number of published papers was Harvard University;

Effect of flow rate and temperature of high flow nasal catheter on comfort of patients with acute hypoxic respiratory failure / 中国实用护理杂志

Objective@#To investigate the effect of high flow nasal catheter (HFNC) respiratory support flow and temperature on the comfort of patients with acute hypoxemic respiratory failure (AHRF), and the AHRF subgroup with severe hypoxemia (FiO2 ≥ 45%), improve HNFC flow to improve patient comfort.@*Methods@#A prospective, randomized, crossover study of 40 patients with AHRF who underwent HFNC respiratory support (PaO2/FiO2 ≤ 300 + pulmonary infiltration + exclusion of cardiogenic pulmonary edema) was performed to assess patient comfort changes in HFNC flow and temperature changes.@*Results@#When the HFNC flow rate was 30 L/min and 60 L/min, the patient′s comfort at 31 °C was significantly improved (P < 0.01), and the change in flow was not related to patient comfort. In the subgroup of patients with FiO2 ≥ 45%, lower temperature (31 °C) and higher HFNC flow (60 L/min) improved patient comfort (P < 0.01).@*Conclusion@#The temperature of HFNC respiratory support significantly affects the comfort of patients with AHFP. Patients with lower temperature are more comfortable, and comfort is not related to flow. For patients with severe hypoxemia (FiO2 ≥ 45%), high flow rates provide better comfort.

Effect evaluation of six-character exercise breathing assisted long-term home oxygen therapy in patients with chronic obstructive pulmonary disease / 中国实用护理杂志

Objective@#To evaluate the effect of six-character formula breathing exercises combined with long-term home oxygen therapy in the rehabilitation of patients with chronic obstructive pulmonary disease (COPD).@*Methods@#A total of 200 COPD patients in Shanghai First People′s Hospital were divided into control group and observation group by odd and even numbers with 100 cases each. The patients in control group received routine long-term home oxygen therapy and the patients in observation group received six-character formula breathing exercises as an adjunct to long-term home oxygen therapy. The patients completed the Modified Medical Research Council (mMRC) score at 1 month, 3 months and 9 months respectively. At 6 months and 12 months, the patients completed the mMRC score, the frequency of acute exacerbation of chronic obstructive pulmonary disease (AECOPD), the number of re-admissions, the partial pressure of carbon dioxide in arterial blood (PaCO2) and St. George′s Respiratory Disease Questionnaire (SGRQ) scores. At 12 months, the patients were evaluated for the six-minute walking test.@*Results@#The duration of oxygen in observation group was (6.3 ± 1.7) h/d, was shorter than control group (7.5 ± 2.1) h/d (t=2.040, P=0.043). The frequency of AECOPD in observation group at 12 months was (3.12 ± 0.49) times/case, was lower than control group (4.95±0.65) times/case (t= 22.482, P <0.01). The frequency of re-admission in observation group was (1.09 ± 0.41) times/case, was lower than control group (1.22 ± 0.39) times/case (t= 2.215, P=0.028). The mMRC scores in observation group at 3 months and 9 months was (2.733±0.750), (2.749 ± 0.938), was lower than control group (3.186 ± 0.734), (3.197 ± 0.848) (t=4.317, 3.543, P<0.01). The SGRQ scores in observation group at 6 months and 12 months was (54.678 ± 9.318), (56.656 ± 7.294), was lower than control group (61.603 ± 8.989), (63.006 ± 7.387) (t=5.349, 6.117, P<0.01). PaCO2 in observation group at 12 months was (6.422 ± 0.864) kPa, was better than control group (6.856 ± 0.904) kPa (t=3.471, P=0.01). The walking distance of 6 minutes in observation group was (265.483 ± 19.277) meters, was longer than control group (232.966 ± 18.883) meters (t= 12.050, P < 0.01).@*Conclusions@#Six-character formula breathing exercises assisted with long-term home oxygen therapy can reduce the use of oxygen, reduce the frequency of AECOPD and readmission, improve the symptoms of COPD patients, and delay the pathological process of COPD.

Etiology and clinical analysis of 232 hospitalized children with hypertension / 中华实用儿科临床杂志

Objective@#To analyze the etiology and clinical characteristics of hypertension in children; to analyze the risk factors for primary hypertension with target organ damage, and to provide evidence for clinical diagnosis of hypertension in children.@*Methods@#Two hundred and thirty-two hospitalized children with hypertension at Children′s Hospital Institute of Pediatrics from April 2013 to December 2017 were retrospectively analyzed, including general situation, clinical manifestation, laboratory examination, auxiliary examination and damage assessment of target organs.@*Results@#(1)There were totally 232 eligible cases, consisting of 184 males(79.3%) and 48 females(20.7%). Among these children: 38 cases(16.4%), 126 cases(54.3%), and 68 cases(29.3%) were diagnosed as prehypertension, hypertension in stage Ⅰ, and hypertension in stage Ⅱ, respectively.(2)The etiological composition of hypertension: there were 181 cases(78%) diagnosed as primary hypertension and 51 cases(22%) diagnosed as secondary hypertension, respectively; the proportion of the primary hypertension children during the period of preschool, school-age, and adolescent was 1.6%(3 cases), 21.0%(38 cases) and 77.4%(140 cases), respectively.The etiology of secondary hypertension was mostly of the renal parenchymal hypertension and renal vascular hypertension(43.1%). (3) The clinical manifestations of primary hypertension were mostly of asymptomatic or mild symptoms, totally 148 cases(64%), and then dizziness, headache, chest pain, chest tightness, palpitation, blurred vision, and other clinical symptoms.(4) The high risk factors for primary hypertension with target-organ damage included cesarean section, glucose metabolism disturbance and body mass index >24 kg/m2.@*Conclusions@#In recent years, the proportion of primary hypertension among hospitalized children has increased.The changes in the etiology of secondary hypertension are not found.Primary hypertension children are often accompanied with target organ damage.It is of great significance to make blood pressure monitoring as a routine physical examination for primary and middle school students, so as to detect hypertension in children earlier, and make active intervention and improve the prognosis of hypertension in children.

The disorder of emotional audiovisual integration of addiction / 中华行为医学与脑科学杂志

The drug cues of multi-sensory have higher reliability and ecological validity,and play a key role in the substance and behavioral addiction. However,the comprehensive discussion on the relation-ship of addiction and the disorder of emotional audiovisual integration was very limited so far. Reviewing re-cent studies on multi-sensory integration of substance and behavioral addictions,it had been found that both two addiction groups had disorders of audiovisual integration,especially the negative emotion. Neuroimaging studies found that the abnormal activation on prefrontal cortical during emotional audiovisual integration com-monly tended to live in substance and behavioral addictions,suggesting that the disorder of emotional audiovi-sual integration for addictions might be related to the weakening of cognitive control. Further improvements of the neural mechanism of emotional audiovisual integration disorder of addictions,as well as the more ecologi-cally predictive indicators and clinical diagnosis criteria are needed.

Effect evaluation of six-character exercise breathing assisted long-term home oxygen therapy in patients with chronic obstructive pulmonary disease / 中国实用护理杂志

Objective To evaluate the effect of six-character formula breathing exercises combined with long-term home oxygen therapy in the rehabilitation of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 200 COPD patients in Shanghai First People′s Hospital were divided into control group and observation group by odd and even numbers with 100 cases each. The patients in control group received routine long-term home oxygen therapy and the patients in observation group received six-character formula breathing exercises as an adjunct to long-term home oxygen therapy. The patients completed the Modified Medical Research Council (mMRC) score at 1 month, 3 months and 9 months respectively. At 6 months and 12 months, the patients completed the mMRC score, the frequency of acute exacerbation of chronic obstructive pulmonary disease (AECOPD), the number of re-admissions, the partial pressure of carbon dioxide in arterial blood (PaCO2) and St. George′s Respiratory Disease Questionnaire (SGRQ) scores. At 12 months, the patients were evaluated for the six-minute walking test. Results The duration of oxygen in observation group was (6.3 ± 1.7) h/d, was shorter than control group (7.5 ± 2.1) h/d (t =2.040, P =0.043). The frequency of AECOPD in observation group at 12 months was (3.12 ± 0.49) times/case, was lower than control group (4.95±0.65) times/case (t=22.482, P<0.01). The frequency of re-admission in observation group was (1.09 ± 0.41) times/case, was lower than control group (1.22 ± 0.39) times/case (t=2.215, P=0.028). The mMRC scores in observation group at 3 months and 9 months was (2.733±0.750), (2.749 ± 0.938), was lower than control group (3.186 ± 0.734), (3.197 ± 0.848) (t=4.317, 3.543, P<0.01). The SGRQ scores in observation group at 6 months and 12 months was (54.678 ± 9.318), (56.656 ± 7.294) , was lower than control group (61.603 ± 8.989), (63.006 ± 7.387) (t=5.349, 6.117, P<0.01). PaCO2 in observation group at 12 months was (6.422 ± 0.864) kPa, was better than control group (6.856 ± 0.904) kPa (t=3.471, P=0.01). The walking distance of 6 minutes in observation group was (265.483 ± 19.277) meters, was longer than control group (232.966 ± 18.883) meters (t = 12.050, P <0.01). Conclusions Six-character formula breathing exercises assisted with long-term home oxygen therapy can reduce the use of oxygen, reduce the frequency of AECOPD and readmission, improve the symptoms of COPD patients, and delay the pathological process of COPD.

Etiology and clinical analysis of 232 hospitalized children with hypertension / 中华实用儿科临床杂志

Objective To analyze the etiology and clinical characteristics of hypertension in children;to ana-lyze the risk factors for primary hypertension with target organ damage,and to provide evidence for clinical diagnosis of hypertension in children. Methods Two hundred and thirty-two hospitalized children with hypertension at Children＇s Hospital Institute of Pediatrics from April 2013 to December 2017 were retrospectively analyzed,including general situa-tion,clinical manifestation,laboratory examination,auxiliary examination and damage assessment of target organs. Results (1)There were totally 232 eligible cases,consisting of 184 males(79. 3%)and 48 females(20. 7%). Among these children:38 cases(16. 4%),126 cases(54. 3%),and 68 cases(29. 3%)were diagnosed as prehypertension,hy-pertension in stageⅠ,and hypertension in stageⅡ,respectively.(2)The etiological composition of hypertension:there were 181 cases(78%)diagnosed as primary hypertension and 51 cases(22%)diagnosed as secondary hypertension, respectively;the proportion of the primary hypertension children during the period of preschool,school-age,and ado-lescent was 1. 6%(3 cases),21. 0%(38 cases)and 77. 4%(140 cases),respectively. The etiology of secondary hy-pertension was mostly of the renal parenchymal hypertension and renal vascular hypertension(43. 1%).(3)The clinical manifestations of primary hypertension were mostly of asymptomatic or mild symptoms,totally 148 cases(64%),and then dizziness,headache,chest pain,chest tightness,palpitation,blurred vision,and other clinical symptoms.(4)The high risk factors for primary hypertension with target-organ damage included cesarean section,glucose metabolism dis-turbance and body mass index >24 kg/m2 . Conclusions In recent years,the proportion of primary hypertension among hospitalized children has increased. The changes in the etiology of secondary hypertension are not found. Primary hypertension children are often accompanied with target organ damage. It is of great significance to make blood pressure monitoring as a routine physical examination for primary and middle school students,so as to detect hypertension in children earlier,and make active intervention and improve the prognosis of hypertension in children.

Value of indocyanine green clearance test in assessing liver reserve function / 临床肝胆病杂志

Basic liver functions can guarantee substance metabolism necessary for the body, and the liver itself has the ability of self-healing and self-regeneration. Routine liver function tests cannot fully reflect the potential of liver parenchyma, i.e., the actual status of liver reserve function. Indocyanine green clearance test is considered an ideal index for liver reserve function. This article reviews the value of indocyanine green clearance test in clinical practice, in order to improve the awareness of the importance of liver reserve function assessment among clinicians.