Objective To evaluate the prevalence rate of pulmonary malignant disease in people at high risk of lung cancer through low-dose multi-slice spiral CT. Methods 1 200 symptom-free volunteers were under low-dose spiral CT scans in an on-going screening study. The people tested aged 40 or older regardless of their gender or smoking history. Low-dose CT scans were performed with Iightspeed Plus multi-slice scanner using spiral mode, 120 kV,30 mAs. Results Calcified nodules were detected in 32 participants and non-calcified nodules were detected in 18 participants by low-dose CT,in which 3 were vicious ones,including 1 non-solid lesion and 2 solid lesions. The detection rate of lung cancer was 0. 25%. Conclusion Low-dose multi-slice spiral CT was effective in detecting, classifying and defining lung nodules,and furthermore would make it possible to find lung cancer at earlier stage.

To evaluate the efficacy and safety of compound Decumbent Corydalis Rhizome (DCR) in treating patients with knee osteoarthritis (OA). Totally 79 patients with knee osteoarthritis were selected from out-patient and inpatient departments of West China Hospital and randomly divided into the test group and the control group. The test group (n = 41) was given Compound DCR with the dosage of 1.8 g · d(-1), while the control group (n = 38) was administered with diclofenac sodium with the dosage of 75 mg · d(-1). After 12 weeks of treatment, the total efficacy rates based on patients/physicians evaluation for experimental and control groups were 68.29%, 63.41% and 71.05%, 63.16%, respectively, without significant difference between the two groups. Both of the two groups showed significant improvements in the main efficacy indexes (pain on walking 20 m) and minor indexes (tenderness on palpation, Western Ontario and McMaster Universities OA index (WOMAC) and Short-Form Health Survey (SF-36 ), but without significant difference in efficacy between them. The incidence of related adverse events was 24.39% in the test group and 47.37% in the control group, respectively, with significant differences between the two groups (P < 0.05). In the controlled study, compound DCR is as efficient as diclofenac sodium but more tolerable, with a good clinical application prospect.
Adult ; Aged ; Corydalis ; chemistry ; Diclofenac ; administration & dosage ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; Rhizome ; chemistry ; Treatment Outcome

Objective To observe the clinical efficacy of Weixuening granule combined with prednisone for treatment of patients with primary immune thrombocytopenia (ITP) and its impact on platelet-associated antibodies(PAIgG, PAIgM, PAIgA). Methods Sixty patients with ITP were randomly divided into a observation group (30 cases, Weixuening granule combined with prednisone) and a control group (30 cases, prednisone therapy alone), 3 months constituting a therapeutic course. The clinical effects, platelet count (PLT) and PAIgG, PAIgM, PAIgA of two groups were observed after two courses of treatment. The time of withdrawing prednisone, relapse rate in 1 year and adverse reactions were also monitored. Results The total effective rate of the observation group was higher than that of the control group [90.00%(27/30) vs. 73.33%(22/30), P<0.05]. The time of withdrawing prednisone was significantly shorter in the observation group than that in the control group(days:39.8±7.8 vs. 55.3±6.5, P<0.05). The relapse rate in 1 year in the observation group was obviously lower than that of the control group [23.3%(7/30) vs. 50.0%(15/30), P < 0.05]. The PLT levels were markedly increased after treatment in the two groups, the levels of platelet-associated antibodies PAIgM and PAIgA after treatment in the two groups were lower than those before treatment, and the degree of improvement in observation group was superior to that of the control group [PLT (×109/L):113.25±15.47 vs. 84.79±20.37, PAIgM:(28.91±10.42)%vs. (30.75±9.37)%, PAIgA:(19.32±11.54)%vs. (21.15±15.16)%]. The level of PAIgG in the observation group was decreased obviously after treatment, while in the control group, it did not have significant change before and after treatment, and in the comparison of the level of PAIgG after treatment between the two groups, there was statistical significant difference [(15.29±9.02)%vs (32.41±9.34)%, P<0.05]. There were adverse reactions in the two groups, including centrality obesity, polytrichosis, acne, and hyperglycemia;the incidence of the above side effects in observation group was lower than that of the control group [73.3%(22/30) vs. 86.7%(26/30)], but the difference was not statistically significant (P>0.05). Conclusions The combined use of Weixuening granule and prednisone for treatment of patients with primary ITP is more effective than administration of prednisone alone;the adverse reactions are less in combined therapy group. Possibly, the better therapeutic effect of combined therapy is related to the decrease of platelet-associated antibodies and increase of the platelet generation.

Objective To explore the prevalence of sialorrhea and its clinical correlation with dysphagia in Chinese patients with Parkinson′s disease ( PD ).Methods One hundred and sixteen consecutive patients with a clinical diagnosis of PD were selected.Demographic data included sex , age, years of education, age at onset of PD, clinical genotype, disease duration, treatment, Hoehn and Yahr (H&Y) stage.Sialorrhea was assessed using the Unified Parkinson′s Disease Rating Scale (UPDRS) Ⅱitem number 6.All patients were studied with videofluoroscopic study of swallowing ( VFSS).Results The prevalence rate of sialorrhea in PD was 59.5% (69/116, 95% CI 50.6%-68.4%).Males were more likely to develop sialorrhea than females (47/70 vs 22/46,χ2 =4.298, P=0.038).PD patients′sialorrhea correlated with oral dysphagia:with food leaking from the mouth ( liquid r=0.229, P=0.014; juice r=0.197, P=0.034;pudding viscosities r=0.231, P=0.013;solid food r=0.255, P=0.006), with more than 1 ml of oral food residues (liquid r=0.319, P<0.01;solid food r=0.185, P=0.047), with delay in food transfer to the root of the tongue (liquid r=0.279, P=0.002; juice r=0.209, P=0.024), and delayed swallow transfer ( pudding viscosities r=0.257, P=0.005).Sialorrhea score was not related to H&Y stage, clinical course and levodopa equivalent doses (LED).The prevalence rate of dysphagia in PD was 87.1%(95% CI 81.0% -93.2%).Liquid was more likely to cause pharyngeal dysphagia ( P=0.03).With the increase in H&Y stage , so did the oral and pharyngeal stages of dysphagia.Late and mid-course was more likely to develop oral and pharyngeal dysphagia than those with early clinical course .Conclusions Sialorrhea and dysphagia are common non-motor symptoms in PD patients.Sialorrhea is more prevalent in males and correlates with oral phase of dysphagia.Liquid is more likely to cause pharyngeal dysphagia.With increase in H&Y stage , so did oral and pharyngeal dysphagia.Even though late clinical course is more likely to develop oral and pharyngeal dysphagia than early clinical course , the comparison between late and intermediate clinical courses does not reach statistical significance .

Objective To investigate the therapeutic effect of low-dose and long-course homoharringtonine and cytarbine (HA) in treating atypical chronic myeloid leukaemia (aCML).Methods Twenty-seven patients diagnosed atypical chronic myeloid leukaemia(aCML) from Oct.2003 to May 2014.in the Affiliated Hospital of Logistics University of People's Armed Police Force were divided into treatment and control groups.Fourteen cases in the treatment group were given the chemotherapy of HA (H:1.5 mg/(m2 · d),A:100 mg/(m2· d) for two weeks,and 13 cases in the control group were given the combined therapy of Hydroxycarbamide(1-3 g/d) and recombined human interferon α-2b(3×106U by intramuscular injection every other day) for four weeks.The haemoglobin (Hb) level,the numbers of white blood cell count (WBC) and platelet count(PLT) were measured.Moreover,the clinical effects were evaluated through measured hemogram and myelogram at 4 weeks after treatment.Results The levels of Hb,the numbers of WBC and PLT at before and 1 and 2 weeks in treatment group were as same as those in control group(P＞0.05).While,the numbers of WBC and PLT at 2 weeks,as well as Hb and the numbers of WBC and PLT in 3 weeks,4 weeks in treatment group were significantly different from those in control group (P ＜ 0.05).Furthermore,repeated measurement ANOVA showed that the levels of WBC,Hb,PLT between two groups were significant (F between groups =833.16,145.59,143.11;P＜0.05),and there were significant differences at different time (F between groups =443.92,17.41,149.11;P ＜ 0.05),meanwhile with interaction (F across group =69.77,43.26,75.25;P ＜0.05).In treatment group,there was 8 cases were complete remission,2 cases were partial remission and 4 cases were not released,and the total effective rate 71.4％.While in control group,there were no one was complete remission,2 cases were partial remission and 4 cases were not released,and the total effective rate was 15.4％.And the different was significant (x2 =11.25,P＜ 0.05).Conclusion The therapeutic effect of lowdose and long-course HA in treating atypical chronic myeloid leukaemia is more efficient and practical than traditional treatment.And its side effects are tolerable.

Objective:To investigate the effects of sperm DNA fragmentation index(DFI)on embryonic development and live birth outcomes of in vitro fertilization-fresh embryo transfer(IVF-ET).Methods:We selected 947 cases of IVF-ET due to female factors from June 2015 to December 2020 and,according to the DFI,divided them into a low-(DFI＜15％),a medium-(15≤DFI≤30％)and a high-DFI(30％＜DFI)group.We obtained the female factors(including age,body mass index[BMI],and base-line levels of sexual hormones and anti-Müllerian hormone[AMH]),male factors(including age,BMI,and semen parameters),pa-rameters of superovulation induction,semen parameters before and after IVF treatment,outcome of ovulation induction,embryo quality and pregnancy outcome,and compared them among the three groups.Results:The patients in the medium-and high-DFI groups had a significantly older age than those in the low-DFI group.There were statistically significant differences among the three groups in the baseline percentages of progressively motile sperm,non-progressively motile sperm and immotile sperm,and total sperm motility and progressive sperm motility before IVF(P＜0.01).The baseline percentage of morphologically normal sperm,sperm concentration and total sperm count before IVF treatment,and sperm concentration after IVF treatment were significantly lower in the medium-and high-DFI groups than in the low-DFI group,and so was the total sperm count in the high-DFI than in the low-and medium-DFI groups either before or after semen treatment(P＜0.01).The fertilization rate was also markedly lower in the medium-and high-DFI than in the low-DFI group,but no statistically significant differences were observed in ovulation induction parameters,embryo quality and pregnan-cy outcome among the three groups.Conclusion:High DFI significantly affects sperm motility.The DFI level after semen treatment is negatively correlated with sperm concentration,total sperm count and fertilization rate,but does not affect embryo quality and preg-nancy outcome.

With the increasingly more serious environmental pollution in China in recent years, effective intervention with PM25-induced health risks has become a major scientific issue to be addressed urgently in medical research field in China. NOD-like receptors (NLRs) are a family of cytoplasmic pattern-recognition receptors that have critical roles in innate immunity. On the basis of study progresses in international cardiovascular disease research "Fine particulate matter exposure is a modifiable risk factor for the morbidity and mortality of cardiovascular diseases", and with reference to the current understanding of pulmonary inflammation and oxidative stress in PM2.5-induced acute coronary syndrome, this study intended to investigate whether intracellular pattern recognition NL-RP3 plays a important role in the inital event of PM2.5 induced vessel inflammation as a foreign matter in the process of plaque destabilization and to thoroughly explore the underlying mechanisms responsible for PM2.5-induced acute cardiovascular events. On the other hand, it also studies the feasibility of using traditional Chinese medicine to treat plaque destabilization cause by PM2.5 exposure and discuss it's pathogenesis and intervention strategy based on TCM theory. This paper in order to provide scientific basis for social focal issues in public health proactively and offers the references for relevant research.
Air Pollutants ; toxicity ; Animals ; Environmental Exposure ; adverse effects ; Humans ; Medicine, Chinese Traditional ; methods ; Particulate Matter ; toxicity ; Plaque, Atherosclerotic ; chemically induced ; drug therapy ; mortality

Histologic transformation (HT) is a frequent event in the clinical course of patients with indolent lymphoma with dismal outcome. The diagnosis of HT is based on clinical manifestation, PET-CT and pathologic biopsy, and the latter is a golden standard for HT. There are contradictory data about the impact of initial management on the risk of transformation. Patients who present with HT did not receive R-CHOP or chemotherapy-naive, should receive this regimen. For the subset of patients received R-CHOP prior to HT, the second line chemotherapy for DLBCL should be adopted. Consolidation with HDT-ASCT should be considered for the suitable young patients. The radio-immunotherapy and novel drugs showed a bright perspective for the patients with HT.
Antineoplastic Combined Chemotherapy Protocols ; Humans ; Lymphoma, Non-Hodgkin

OBJECTIVETo compare effects of integrated treatment traditional Chinese medicine and Western medicine (TCM-WM) and simple western medicine on TCM clincal symptoms in the patient of AIDS with pulmonary inflammation.

METHODA multicenter randomized controlled trials of 164 subjects evaluated the effects of clinical symptoms of AIDS with pulmonary inflammation of TWO regimens: the TCM-WM group (n = 111) and western medicine treatment group (n = 53), while incidence of TCM symptoms in different time points in two groups were analyzed.

RESULTTwenty eight days after treatment, the cured and markedly effective rate of TCM symptoms in the TCM-WM group significantly exceeding that in the western medicine treatment group (cured and markedly effective rate significant efficiency 44.55% vs 20.00%), while the incidence rate for the TCM symptoms of fever and headache in the TCM-WM group was significantly lower than that in western medicine group.

CONCLUSIONThe integrated treatment of traditional Chinese medicine and Western medicine helps to alleviate the TCM clinical symptoms of AIDS with pulmonary inflammation.

Acquired Immunodeficiency Syndrome ; complications ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Multivariate Analysis ; Pneumonia ; complications ; drug therapy ; Treatment Outcome

Objective:To explore the risk factors for in-hospital mortality in patients with severe trauma and their predictive predictive value.Methods:A retrospective case-control study was used to analyze the data of 509 patients with severe trauma in the trauma database of the Trauma Center of the Second Affiliated Hospital of Soochow University from January 2017 to December 2021, including 377 males and 132 females, aged 18-94 years [53(42, 65)years]. Injury severity score (ISS) was 16-75 points [22(18, 29)points]. Injured parts included the head and neck in 409 patients (80.35%), the chest in 328(64.44%), the abdomen in 193(37.91%), the pelvis in 142(27.90%), the spine in 79(15.52%), and the limb in 247(48.53%). According to the clinical outcome during the hospital stay, the patients were divided into survival group ( n=390) and non-survival group ( n=119). Baseline and clinical data of the two groups were compared, including gender, age, cause of injury (traffic injury, fall from height, sharp instrument injury, etc.), injury site (head and neck, chest, abdomen, pelvis, spine, limb), vital signs on admission (temperature, systolic blood pressure, heart rate, respiratory rate), blood tests on admission [hemoglobin, platelets, prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), fibrinogen (FIB)], Glasgow coma scale (GCS) upon admission to the emergency room, revised trauma score (RTS) upon admission to the emergency room, ISS after whole-body CT examination, quick sequential organ failure assessment (qSOFA) score upon admission to the emergency room, and INR combined with qSOFA score. The baseline and clinical data of the survival group and the non-survival group were first compared with univariate analysis. Then, the independent risk factors of in-hospital mortality in patients with severe trauma were determined by multivariate Logistic stepwise regression (forward and backward). Based on the above data, receiver operating characteristic (ROC) curves were generated with Medcalc statistical software to analyze the efficacy of each risk factor in assessing in-hospital mortality in patients with severe trauma. Results:Univariate analysis showed that there were significant differences in age, injury site, temperature, systolic blood pressure, hemoglobin, platelet, PT, APTT, INR, FIB, GCS, RTS, ISS, qSOFA score, and INR combined with qSOFA score between the two groups ( P<0.05 or 0.01), while there were no significant differences in gender, cause of injury, heart rate, and respiratory rate between the two groups ( P>0.05). Multivariate Logistic stepwise regression analysis showed that age, systolic blood pressure, APTT, ISS, and INR combined with qSOFA score were significantly correlated with in-hospital mortality in patients with severe trauma ( P<0.01). ROC curve analysis results showed that the area under the curve (AUC) of in-hospital mortality in patients with severe trauma predicted by age, systolic blood pressure, APTT, ISS, and INR combined with qSOFA score were 0.63(95% CI 0.59, 0.68) and 0.60(95% CI 0.55, 0.64), 0.66(95% CI 0.62, 0.70), 0.73(95% CI 0.69, 0.77), and 0.75(95% CI 0.72, 0.80), respectively. Conclusions:Age, systolic blood pressure, APTT, ISS, and INR combined with qSOFA score are the independent risk factors for in-hospital mortality in patients with severe trauma. ISS and INR combined qSOFA score can better predict in-hospital mortality of patients with severe trauma than age, systolic blood pressure and APTT.