Objective To investigate the expression o f telomerase activity in pheochromacytoma and to assess its utility as a prognos tic marker. Methods Telomerase activity was estimated in 23 samples of pheohromocytoma tissue and 6 samples of normal adrenal medullae by autoradiography-based telomeric repeat amplification protocol. The reaults w ere analized with follow-up findings. Results Of the 2 3 pheochromocytoma samples, 2 had telomerase activity and both the telomerase-p ositive pheochromocytomas apparently arose from extraadrenal tissues. All normal adrenal medullae samples were negative for telomerase activity. During follow- up, we found both of the telomerase positive patients developed mutiple metastat ic lesions after surgery. Only one of 21 telomerase negative patients clinically developed bilateral lung metastases and a local recurrence after surgery. Conclusions Telomerase activity may be used as an important i ndicator of potentially malignant pheochromocytoma and may serve as a prognosti c marker.

Objective:To investigate the difference of clinical characteristics of children and adults with brucellosis osteoarthritis in Yinchuan, Ningxia.Methods:The clinical data of patients with brucellosis osteoarthritis who were diagnosed in General Hospital of Ningxia Medical University from January 2009 to September 2019 were collected retrospectively. According to age, the patients were divided into two groups: children (0-14 years old, 50 cases) and adults (≥15 years old, 236 cases). Epidemiological characteristics, clinical manifestations and laboratory examination results of the two groups were compared and analyzed.Results:Among children, 39 were males and 11 were females, school age children (8-14 years old, 25 cases) were more common; among adults, 179 were males and 57 were females, middle-aged and elderly people (46-65 years old, 128 cases) were more common. The peak incidence of both groups was from March to August (39 children and 142 adults). In the two groups, a total of 266 patients (40 children and 226 adults) were recorded with a history of exposure, of which 226 patients (28 children and 198 adults) had contacted with cattle, sheep and other live animals. In clinical manifestations, compared with children, adults had higher incidences of low back pain [38.00% (19/50) vs 63.98% (151/236)], hyperhidrosis [6.00% (3/50) vs 30.08% (71/236)] and fatigue [8.00% (4/50) vs 34.75% (82/236)], and lower incidences of single joint pain [70.00% (35/50) vs 19.49% (46/236)], fever [72.00% (36/50) vs 49.15% (116/236)], and lymph node enlargement [30.00% (15/50) vs 2.54% (6/236)], and the differences were statistically significant ( P < 0.05). Among children, the knee joint involvement (62.00%, 31/50) and hip joint involvement (42.00%, 21/50) were more common, but spinal involvement was not found; while among adults, spinal involvement (55.51%, 131/236) was the most common. The incidences of elevated white blood cell count [18.00% (9/50) vs 6.36% (15/236)], elevated percentage of lymphocytes [82.00% (41/50) vs 27.12% (64/236)], elevated platelet [24.00% (12/50) vs 8.90% (21/236)], elevated aspartate aminotransferase [64.00% (32/50) vs 30.08% (71/236)], elevated alanine aminotransferase [38.00% (19/50) vs 20.76% (49/236)] and anemia [42.00% (21/50) vs 16.53% (39/236)] in children were higher than those in adults; the incidences of elevated percentage of neutrophils [0 (0/50) vs 9.75% (23/236)], hypoalbuminemia [2.00% (1/50) vs 14.41% (34/236)], low sodium [2.00% (1/50) vs 10.17% (24/236)], elevated C-reactive protein [50.00% (25/50) vs 77.12% (182/236)] in children were lower than those in adults, and the differences were statistically significant ( P < 0.05). The positive rate of blood culture in children (65.22%, 30/46) was higher than that in adults (40.54%, 60/148), and the difference was statistically significant ( P < 0.05). Conclusions:There are differences in clinical characteristics between children and adults with brucellosis osteoarthritis in Yinchuan, Ningxia. In particular, there is a significant difference between children and adults in the location of bone and joint involvement.

10.3969/j.issn.2095-4344.2013.24.016

This study was aimed to evaluate the clinical effect and safety of Chinese medicine treatment of lumbar disc herniation with qi-tonifying, stasis-resolving and kidney-tonifying method. The randomized con-trolled trial (RCT) was applied in the study to evaluate the clinical effect of qi-tonifying, stasis-resolving and kidney-tonifying method in the treatment of lumbar disc herniation . A total of 122 lumbar disc herniation pa-tients were randomly divided into the treatment group ( n = 61 ) and the control group ( n = 61 ) . Chinese medicine treatment with the qi-tonifying, stasis-resolving and kidney-tonifying method was applied in the treatment group . And Celecoxib and Methycobal were orally administered in the control group . Then , the VAS scores, JOA scores, Oswestry disability index (ODI) were recorded and analyzed pre-treatment, four weeks af-ter treatment and the twelfth week of follow-up in order to evaluate the clinical effect . Adverse reactions were also observed and recorded at the same time to give a comprehensive evaluation on its safety . The results showed that there were no significant differences between the treatment group and control group in the baseline data before treatment . Hence , data from two groups were comparable . Compared with pre-treatment , the VAS scores and ODI scores were obviously reduced in both groups after four-week treatment . The JOA scores were increased obviously ( P < 0 . 05 ) . There were no statistical differences on ODI scores and JOA scores between two groups . The VAS scores of the treatment group were obviously higher than the control group ( P < 0 . 05 ) . In the twelfth week of follow-up , the VAS scores , ODI scores and JOA scores had increasing tendency in
both groups . There were no statistical differences between two groups . There were no statistical differences on the total effective rate between two groups . In the treatment group , four patients received surgery , four cases lost to follow-up , and four cases with mild adverse event . In the control group , six patients received surgery , three cases lost to follow-up , and two cases with mild adverse event . It was concluded that the RCT of Chi-nese medicine treatment of lumbar disc herniation with q i-tonifying , stasis-resolving and kidney-tonifying method received same clinical effect as the combination of Celecoxib and Methycobal . The Chinese medicine treatment can effectively relieve pain degree of lumbar disc herniation , improve function of the lumbar vertebrae and improve the daily life and social activity ability of patients. The short-term follow-up effects were con-firmed . However , the long-term efficacy still requires further study .

Objective To evaluate clinical efficacy and safety of Bizheng Granules combined with basic therapy in the treatment of liver and kidney insufficiency and phlegm-dampness cross-blocking syndrome of nerve root type cervical spondylosis radiculopathy.Methods Totally 108 patients with nerve root type cervical spondylosis radiculopathy were selected and divided into Bizheng Granules group,Jingfukang Granules group,and Bizheng Granules placebo group according to random number table method,with 36 cases in each group.The three groups were treated with the basic treatment(oral methylcobalamin tablets of 0.5 mg,three times a day,and cervical spine intermittent traction once a day,each time for 15 min),and Bizheng Granules were given in the Bizheng Granules group,and Jingfukang Granules in the Jingfukang Granules group,and Bizheng Granules placebo in the Bizheng Granules placebo group,twice a day after meals.All three groups were treated continuously for 2 weeks and followed up at 4 and 12 weeks after treatment.Visual analog scale(VAS),cervical dysfunction index(NDI),and 36-items short form survey(SF-36)score were recorded in the 3 groups before and after treatment and 4 and 12 weeks after treatment,respectively.Adverse reactions during treatment and follow-up were recorded in the 3 groups.Results 3 cases lost in the Bizheng Granules group,3 cases in the Jingfukang Granules group,and 1 case in the Bizheng Granules placebo group.Compared with the pre-treatment period,the differences in VAS score,NDI score,and SF-36 score among the three groups of patients at all time points of treatment and follow-up were statistically significant(P<0.05).At 12 weeks after treatment,the VAS score and NDI score of the Bizheng Granules group and the Jingfukang Granules group were lower than those of the Bizheng Granules placebo group,but the differences in VAS score and NDI score between Bizheng Granules group and Jingfukang Granules group were not statistically significant(P>0.05).12 weeks after treatment,the SF-36 score of Bizheng Granules group were higher than those of Bizheng Granules placebo group,but the difference in SF-36 score between Bizheng Granules group and Jingfukang Granules group was not statistically significant(P>0.05).The total effective rate of Bizheng Granules group was better than that of the Jingfukang Granules group and Bizheng Granules placebo group(P<0.05).The incidence of adverse reactions in the three groups was not statistically significant(P>0.05).There were no serious adverse events in the three groups.Conclusion Bizheng Granules combined with basic therapy has a definite therapeutic effect in improving pain,restoring cervical dysfunction,and improving quality of life in the treatment of liver and kidney insufficiency and phlegm-dampness cross-blocking syndrome of nerve root type cervical spondylosis radiculopathy,with good safety.

Objective To systematically analyze and identify key risk factors for postoperative pulmonary hemorrhage u-sing a combination of the random forest(RF)model and traditional logistic regression analysis,so as to provide data support for clinical practice.Methods This study included patients who underwent needle biopsy of lung masses from January 2020 to December 2023 in the Department of Interventional Therapy,Cancer Hospital,Tianjin Medical University.There were 844 cases,including 387 males and 457 females,ranging in age from 39 to 82 years.Clinical data and puncture-related characteristics were collected,including tumor size,puncture depth,puncture angle,presence of emphysema,lesion loca-tion in the lung,body position during puncture,whether the puncture passed through the interlobar fissure,and the number of punctures.The RF model was used to rank the importance of all variables,identifying those with the highest predictive value.Subsequently,a multivariate logistic regression model was applied to the top-ranked important variables to further e-valuate their independent impact on postoperative pulmonary hemorrhage.Results The RF model results showed that tumor size and puncture depth had the highest importance in predicting the risk of postoperative pulmonary hemorrhage.Multivari-ate logistic regression analysis further confirmed that smaller tumor size(HR:0.980,95％CI:0.971-0.989,P＜0.05)was significantly associated with a lower risk of hemorrhage,while greater puncture depth(HR:1.146,95％CI:1.063-1.235,P＜0.05)was closely related to a higher risk of hemorrhage.Additionally,other factors such as puncture angle,age,lesion location in the lung and presence of emphysema showed some influence but did not reach statistical significance in the multi-variate analysis.Conclusion This study successfully identified tumor size and puncture depth as independent risk factors for postoperative pulmonary hemorrhage by combining the RF model with multivariate logistic regression analysis.The appli-cation of the RF model improved the accuracy of feature selection,allowing us to focus on the most contributory predictive variables.These findings provide important support for preoperative risk assessment,suggesting that clinicians should priori-tize these key factors in preoperative evaluations to develop safer and more effective surgical plans,thereby reducing the risk of postoperative hemorrhage and other complications.