OBJECTIVE:To observe clinical efficacy and safety of Xianlinggubao combined with alendronate sodium in the treatment of osteoporosis. METHODS:112 patients with osteoporosis were randomly divided into treatment group and control group with 56 cases in each group. Both group were given routine treatment as calcium carbonate,vitamin D and life style. Control group were given alendronate sodium 10 mg orally,qd;treatment group was additionally given Xianlinggubao capsule 1.5 g,bid, on the basis of control group. Both groups received 12 weeks of treatment. The levels of S-Ca,S-P,24 h urinary calcium(U-Ca), alkaline phosphatase(ALP),osteocalcin,IL-6,bone mineral density(BMD)of L2-4 lumbar spine and femoral neck were observed in 2 groups before and after treatment. Clinical efficacy and toxic reaction were compared. RESULTS:There was no statistical sig-nificance in the levels of S-P and S-Ca between 2 groups after treatment(P>0.05);the level of ALP、osteocalcin、BMD increased in treatment group after treatment,the level of U-Ca and IL-6 decreased compared to before treatment,and the treatment group was better than the control group,with statistical significance(P<0.05). Total effective rate of treatment group(92.86%)was sig-nificantly higher than that of control group (73.21%),with statistical significance (P<0.05). No obvious toxic side effects was found in 2 groups. CONCLUSIONS:Xianlinggubao combined with alendronate sodium shows significant therapeutic efficacy for patients with osteoporosis with good safety.

Objective To study the value of CT scan in diagnosis and clinical therapy of thyroid diseases.Methods CT findings in 61 cases with various thyroid diseases confirmed pathologically were analyzed retrospectively.Results ① 9 patients were Hashimoto’s thyroiditis.Of them,5 cases were diffuse lesions and 4 localized at one enlarged lobe and 1 with calcification.② 28 cases with hyperplasia included 2 Graves disease of diffuse lesions with enlargement and 26 nodular hyperplasia.There were calcification in 8 and cystic change in 13.③ 24 cases of thyroid tumor included 14 thyroid adenomas with complete circumscribed enhanced ring around the lesion,10 of them were in company with cystic change and 4 with calcification.13 cases were single lesion and one case was mattiple lesions.10 thyroid carcinoma,3 cases were in company with cystic change and 7 with calcification.Metastasis of cervical lymph nodus was found by CT in 7 cases.Metastatic lymph nodes presented marked enhancement,cystic change and calcification.Conclusion CT scan both plain and contrast-enhanced are beneficial for the detection of thyroid diseases,and is also important for planning the management and predicting the prognosis of this disease.

Objective To explore the necessity of colonoscopy in young patients with chronic constipation.Methods Data of patients aged 18-50 underwent colonoscopy at Tianjin Medical University General Hospital with chronic constipation as the sole indication between April 2003 and May 2014 were analyzed.Endoscopic and pathologic reports were analyzed.Results During the study period,a total of 563 patients were included,who were aged 18-50 with chronic constipation as the sole indication,of which 260 patients were aged 18-35,and 303 patients were aged 36-50.No lesion was found during colonoscopy in 167 (29.7％) patients,whereas in other 396 (70.3 ％) patients positive findings were reported,including polyps in 45 patients (of which 13 were with multiple polyps),adenomas in 20(17 in distal colon,3 in proximal colon).In patients aged 18-35,3 cases of adenomas(3/260,1.2％) were found,of which 1 patient (1/260,0.4％)had advanced adenoma.In patients aged 36-50,17 cases of adenomas(17/303,5.6％) were found,of which 4 (4/303,1.3％) were advanced ones.Colorectal cancers were found in 2 patients (0.7％,2/303),both in patients aged 36-50.The detection rate for colorectal neoplasms (including adenoma and cancer) in patients with chronic constipation aged 18-35 was significantly lower than that in patients aged 36-50[1.2％(3/260) VS 6.3％(19/303),P=0.002,95％CI:0.05-0.60].Conclusion The detection rate for colorectal neoplasms in patients aged 18-35 years with chronic constipation is relatively low,and colonoscopy is not recommended for them.

Objective To explore the common causes and associated risk factors for unintentional injuries among inpatient children from Yuying Children's Hospital of Wenzhou Medical College during 2007～2008.Methods This retrospective study involved 2 672 children of 0～18 years of age treated for unintentional injuries in Yuying Children's Hospital of Wenzhou Medical Collge from 2007 to 2008.Statistical evluation included x2 analysis and computation of relative risk(RR)with a 95％ confidence interval(CI).Results The top five types of unintentional injury were falls from one level to another(e.g.from playground equipment,chair,bed,stationary vehicle,and so on.)or falls on same level(e.g.from slipping,tripping,stumbling,collision,and so on)(30.84％),traffic accident(25.15％),falls from height(e.g.from balcony,bridge,building,window,and so on)(11.56％),foreign body ingestion/inhalations(6.89％),open wounds including cut,lacerarion and puncture wound(6.51％).The types of unintentional injury were not uniform among different age groups(x2 =602.12,P ＜0.01).Boys had a higher incidence of injury than did girls with a ratio of 2.34∶ 1.Unintentional injury rates varied considerably by age(x2 =583.90,P ＜0.01).The most prevalent age group was 1～4 years old.The most common body part injuried was the extremity region(54.00％).20.40％ of cases had injuried to the neck and head,15.27％ had thorax and abdomen injuries,3.78％ had vertebral column injuries and 1.87％ had pelvis injuries.Significant differences existed in injuried body site among different age children(x2 =315.21,P ＜0.01).The discharge departments were traumatic department(42.07％),hand surgery and spinal department(22.16％),department of otorhinolaryngology(6.89％),orthopaedic department(6.32％),neurosurgical department(5.84％),and the other discharge departments included pediatric surgical department,chest surgery department,stomatology department,ophthalmic department,pediatric intensive care unit and pediatric internal department.The number and rate of unintentional injury were the highest in summer(July-September),accounting for 28.63％.The estimated days and cost of unintentional injuries were 1 1.72 d and 9 617.96 yuan RMB each child,respectively.Conclusion Injury prevention efforts should include consideration of the substantial differences in the leading causes of unintentional injuries,in regard to sex,age and type of injury.Unintentional injuries lead to a threat to health and well-being and waste a majory source of medical spending in China for children and youth 0 to 18 years age.Making efforts to prevent child injury and establishing a complete emergency medical system are very important.

A method of high performance liquid chromatography coupled with time-of-flight mass spectrometry was used to detect the endogenous metabolites changes in plasma of normal rats, rats of dampness stagnancy due to spleen deficiency and Astragalus flavone component intervention rats. Metabolism map of rat plasma was obtained and the mechanism of Astragalus flavonoids on dampness stagnancy due to spleen deficiency was studied. Rat model with dampness stagnancy due to spleen deficiency was established by high fat and low protein diet plus load swimming. Liquid chromatography tandem mass spectrometry was used for the analysis of rat plasma sample, and 0.05％ formic acid water with 0.05％ formic acid acetonitrile as the mobile phase was applied in gradient elution with Halo C18 chromatographic column. In this study, partial least squares discriminant analysis and variance analysis were used to screen the potential biomarkers, it was found that the metabolic profile of the Astragalus flavonoids was different from that of the model group, which was close to that of the normal group. A total of 11 potential biomarkers were identified, including glycerol phospholipids, sphingolipids, amino acids, and so on. The metabolic pathways of biomarkers including three tricarboxylic acid cycle, glycerol phospholipid metabolism, fatty acid metabolism, amino acid metabolism and so on, which mainly related to energy metabolism and fat metabolism in the body. Related indexes of rats with syndrome of spleen deficiency of water and dampness were significantly callback after Astragalus flavone intervention, including macro indicators such as body weight, independent activities and micro indicators such as metabolic markers, blood lipids and others. The result showed that Astragalus flavonoids played the role of strengthening the spleen and draining the water mainly through regulating the energy metabolism, fat metabolism and so on.

Non-small cell lung cancer is a prevalent and rapidly-expanding challenge to modern medicine. While generalized medicine with traditional chemotherapy yielded comparatively poor response rates and treatment results, the cornerstone of personalized medicine using genetic profiling to direct treatment has exalted the successes seen in the field and raised the standard for patient treatment in lung and other cancers. Here, we discuss the current state and advances in the field of personalized medicine for lung cancer, reviewing several of the mutation-targeting strategies that are approved for clinical use and how they are guided by patient genetic information. These classes include inhibitors of tyrosine kinase (TKI), anaplastic lymphoma kinase (ALK), and monoclonal antibodies. Selecting from these treatment plans and determining the optimal dosage requires in-depth genetic guidance with consideration towards not only the underlying target genes but also other factors such as individual metabolic capability and presence of resistance-conferring mutations both directly on the target gene and along its cascade(s). Finally, we provide our viewpoints on the future of personalized medicine in lung cancer, including target-based drug combination, mutation-guided drug design and the necessity for data of population genetics, to provide rough guidance on treating patients who are unable to get genetic testing.

ObjectiveTo observe the clinical effectiveness and safety of She medicine （畲药） Diren Zishen Formula（地稔滋肾方） combined with acupuncture as adjunctive treatment for primary biliary cholangitis with liver and kidney yin deficiency syndrome. MethodsSeventy patients of primary biliary cholangitis with liver and kidney yin deficiency syndrome were randomly divided into a control group and a treatment group， with 35 patients in each group. The control group received oral ursodeoxycholic acid capsules （250 mg per dose， three times daily）. The treatment group received She medicine Diren Zishen Formula oral decoction （one dose daily， 200 ml per dose in the morning and evening， served warm） and acupuncture ［bilateral Sanyingjiao （SP6）， Taichong （LR3）， Ganshu （BL18）， Zusanli （ST36）， Fenglong （ST17）， once daily， 5 consecutive days per week］ in addition to the same treatment as the control group. The treatment duration was three months for both groups. Comparisons were made between the two groups before and after treatment for the following parameters， which were four traditional Chinese medicine （TCM） symptoms scores （skin itching， fatigue， jaundice， and flank pain）， TCM syndrome scores， liver function indicators including aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， alkaline phosphatase （ALP）， gamma-glutamyl transferase （GGT） and total bilirubin （TBiL）， liver fibrosis markers including serum laminin （LN）， serum hyaluronic acid （HA）， serum type Ⅳ collagen （Ⅳ-C） and serum type Ⅲ procollagen （PC-Ⅲ）， and inflammatory factor indicators including serum interleukin-6 （IL-6） and tumor necrosis factor-alpha （TNF-α）. The effectiveness of TCM syndrome between the two groups was compared and safety evaluations were also conducted after treatment. ResultsA total of 32 cases were finally analyzed in the treatment group， while the control group had 31 cases. The total effective rate of TCM syndrome in the treatment group （87.50%， 28/32） was higher than that in the control group （67.74%， 20/31） （P＜0.05）. After treatment， the TCM symptom scores， syndrome scores， liver function， and liver fibrosis markers in both groups signi-ficantly decreased， while in the treatment group， the inflammatory factor indicators decreased after treatment， and more decreases were found than those in the control group （P＜0.05 or P＜0.01）. Both groups had good safety， and no adverse reactions were observed. ConclusionThe combination of She medicine Diren Zishen Formula and acupuncture as an adjunctive treatment for primary biliary cholangitis can significantly improve the clinical effectiveness， improve liver function， reduce inflammatory response， and alleviate liver fibrosis， with good safety.

Non-small cell lung cancer is recognized as the deadliest cancer across the globe. In some areas, it is more common in women than even breast and cervical cancer. Its rise, vaulted by smoking habits and increasing air pollution, has garnered much attention and resource in the medical field. The first lung cancer treatments were developed more than half a century ago. Unfortunately, many of the earlier chemotherapies often did more harm than good, especially when they were used to treat genetically unsuitable patients. With the introduction of personalized medicine, physicians are increasingly aware of when, how, and in whom, to use certain anti-cancer agents. Drugs such as tyrosine kinase inhibitors, anaplastic lymphoma kinase inhibitors, and monoclonal antibodies possess limited utility because they target specific oncogenic mutations, but other drugs that target mechanisms universal to all cancers do not. In this review, we discuss many of these non-oncogene-targeting anti-cancer agents including DNA replication inhibitors (

Lung cancer remains the leading cause of cancer deaths worldwide and is the most common cancer in males. Immune-checkpoint inhibitors (ICIs) that target programmed cell death protein-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) have achieved impressive efficacy in the treatment of non-small-cell lung cancer (NSCLC) (Pardoll, 2012; Champiat et al., 2016; Gao et al., 2022). Although ICIs are usually well tolerated, they are often accompanied by immune-related adverse events (irAEs) (Doroshow et al., 2019). Non-specific activation of the immune system produces off-target immune and inflammatory responses that can affect virtually any organ or system (O'Kane et al., 2017; Puzanov et al., 2017). Compared with adverse events caused by chemotherapy, irAEs are often characterized by delayed onset and prolonged duration and can occur in any organ at any stage of treatment, including after cessation of treatment (Puzanov et al., 2017; von Itzstein et al., 2020). They range from rash, pneumonitis, hypothyroidism, enterocolitis, and autoimmune hepatitis to cardiovascular, hematological, renal, neurological, and ophthalmic irAEs (Nishino et al., 2016; Kumar et al., 2017; Song et al., 2020). Hence, we conducted a retrospective study to identify validated factors that could predict the magnitude of the risk of irAEs in patients receiving PD-1/PD-L1 inhibitors; our approach was to analyze the correlation between the clinical characteristics of patients at the start of treatment and relevant indicators such as hematological indices and the risk of developing irAEs. Then, we developed an economical, practical, rapid, and simple model to assess the risk of irAEs in patients receiving ICI treatment, as early as possible.
Male ; Humans ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Lung Neoplasms/drug therapy* ; Immune Checkpoint Inhibitors/adverse effects* ; Programmed Cell Death 1 Receptor ; Retrospective Studies ; Apoptosis