Biochemical indexes and blood composition in early lactation health,ketosis and hypocalcemia dairy cows were analyzed to make sure the milk composition characteristics with related diseases,the correlation analysis between early lactating dairy milk composition and blood biochemical were also make in order to provide support for the cattle health assessment.According to theblood index,72 Holstein cows 7-21 d postpartum,were divided into group subclinical hypocalcemia,ketosis test group and control group,24 heads each group.The blood and milk of cows were collected and used to analyze the correlation between blood biochemical indexes and milk composition.The results showed that ketosis and hypocalcemia induced the level of milk protein and non fat milk solids decreased,while the content of citric acid in milk increased.The correlation equation between citric acid in milk and serum NEFA,BHBA and GLU was y=3.192x-0.802,(R2 =0.363),y=4.594x-0.793,(R2 =0.320),y=1.228x+0.775,(R2 =0.261),in which x was the content of citric acid in milk.The results showed that the content of citric acid in milk had positively related to blood NEFA,which could be used as an early marker for the diagnosis of negative energy balance.The levels of BUN and ALB in blood can be used to evaluate the levels of milk protein and urea.

AIM:To evaluate the clinical effective-ness and safety of generic and branded dienogest in the treatment of endometriosis.so as to provide the basis for clinical use of dienogest.MEHTODS:The data of patients admitted to Third Affiliated Hospital of Zhengzhou University from August 2022 to August 2023 who received dienogest(2 mg/d,orally,for 6 months)for treatment of endometrio-sis were collected.The clinical efficacy and adverse reactions of generic drugs and original drugs in the treatment of endometriosis-related pain were com-pared through follow-up surveys of the two groups of patients at 3 months and 6 months respectively.RESULTS:There was highly significant reduction in pelvic pain in both groups with mean of similar in generic group(34.0±3.0)mm and branded group(34.5±3.9)mm.The most frequent drug-related ad-verse effects in generic dienogest was vaginal bleeding(93%)which was no statistical difference with branded dienogest(90%).CONCLUSION:The generic and branded dienogest have the same clini-cal effectiveness and similar safety.

Objective To evaluate the safety and efficacy of irreversible electroporation (IRE) combined with neoadjuvant chemotherapy in patients with locally advanced pancreatic cancer. Methods We searched PubMed, Embase, Cochrane Library, Web of Science, China Biomedical Literature Database, CNKI, Wanfang, and VIP databases for articles dated from the establishment of each database to March 2022. Meta-analysis was performed using RevMan5.4 software. Results A total of 3970 patients with locally advanced pancreatic cancer were enrolled in eight studies, including one randomized controlled trial, four retrospective studies, and three prospective studies. The patients were divided into the combined therapy group with 344 patients and the chemotherapy-only group with 3626 patients. Meta-analysis showed that the overall survival of patients in the combined therapy group was significantly higher than that in the chemotherapy-only group (OR=4.52; 95%CI: 2.63-7.77; P < 0.00001). However, no significant difference existed in the disease control rate between the combined therapy group and the chemotherapy-only group (OR=0.58; 95%CI: 0.02-18.74; P=0.76). Moreover, no significant difference existed in the disease progression between the two groups (OR=0.49; 95%CI: 0.23-1.02; P=0.06). The combination of neoadjuvant chemotherapy and IRE had no significant effect on the incidence of adverse reactions of gastrointestinal reaction (OR=0.37; 95%CI: 0.10-1.34; P=0.13) and bone marrow suppression (OR=0.61; 95%CI: 0.26-1.40; P=0.24). Conclusion IRE combined with neoadjuvant chemotherapy can remarkably improve the prognosis of patients with locally advanced pancreatic cancer, and significantly prolong the overall survival.

AIM:To perform a multidimensional analysis of the clinical study characteristics of endo-metriosis based on the ClinicalTrials.gov,providing comprehensive and objective information for re-searchers,clinicians,and clinical pharmacists.METHODS:A thorough investigation was conduct-ed on clinical trials related to endometriosis,regis-tered on the ClinicalTrials.gov from its inception to October 20,2023.Relevant trial data were extract-ed and statistically analyzed using bibliometrics and comparative research methods.RESULTS:A to-tal of 667 endometriosis clinical studies were regis-tered globally,showing an annual increase.The United States(127 trials),France(70 trials),and Ita-ly(57 trials)had the highest number of registered trials.Interventional studies were predominant(416 trials,62.4%),followed by observational stud-ies(251 trials,37.6%).Within interventional stud-ies,drug therapy was the primary intervention(223 trials,53.6%).Despite endometriosis being a female condition,male subjects were also consid-ered,with 6 trials specifically requiring male partici-pants and 37 trials not restricting gender.Compa-nies/corporations were the main funding sources,while public and governmental organizations pro-vided relatively less funding.CONCLUSION:Clinical trial research on endometriosis is in a phase of growth,with drug therapy being the main treat-ment approach.However,there is a relative lack of investment and attention from public funds and governmental organizations.

Objective To conduct reevaluation of systematic review/Meta-analysis on the efficacy and safety of transcatheter arteri-al chemoembolization(TACE)combined with sorafenib in the treatment of unresectable hepatocellular carcinoma(HCC).Methods The systematic reviews and Meta-analysis of TACE combined with sorafenib in the treatment of HCC were collected through computer searches on PubMed,Embase,the CochraneLibrary,CNKI and Wanfang data knowledge service platform.The time limit was from data-base inception to August 2022.The experimental group received TACE combined with sorafenib,and the control group received other con-ventional treatments.After screening the literature and extracting the data,PRISMA statement was adopted to evaluate the quality of the included reports,AMSTAR 2scale was used for methodological quality evaluation,and GRADE tool was used for outcome indicator and evidence quality evaluation.Results A total of 9 literatures were included,including 43 outcome indicators.The PRISMA score was 20.5-25.5,including 7 articles of high quality and 2 articles of moderate quality.The results of AMSTAR 2 quality evaluation show that all the literatures were of extremely low quality,and the key items with the most problems were item 2 and item 7.The results of GRADE evaluation showed that there were 4 high quality indicators,15medium quality indicators,21 low quality indicators and 3 unevaluable indi-cators.The main factor leading to degradation was bias risk,followed by inconsistency.In terms of curative effect,compared with the con-trol group,the 1-year survival rate,time to progression,objective response rate and disease control rate of patients in the experimental group were significantly improved.However,the incidence of adverse reactions(diarrhea,hand and foot syndrome,hypertension)in the control group was significantly better than those in the experimental group.Conclusion The methodology quality and evidence quality of systematic review/Meta-analysis related to TACE combined with sorafenib in the treatment of HCC is poor,and the standardization still needs to be further improved.

In recent years, monotherapy and combination therapy with immune checkpoint inhibitors (ICIs) have achieved good efficacy in a variety of malignancies from solid tumors to lymphomas and have become a standardized and systematic treatment modality for many cancers. However, there is still a lack of studies on the safety of ICIs in hepatitis B virus (HBV)-infected patients with malignancies, and early studies have reported HBV reactivation due to ICI antitumor therapy in clinical practice. With reference to related literature, this article reviews the recent clinical trials and application of ICIs in cancer patients with chronic viral infection and clarifies the efficacy and safety of ICIs in this special population, in order to provide a reference for clinical medication.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.