Objective To explore the relationship between hormone therapy (HT) in women withovarian malignancy and prognosis. Methods HT was used in 31 patients with ovarian cancer after surgery,and 44 eases with ovarian eaneer served as controL The expression of estrogen receptor (ER)α, ERβ andprogesterone receptor (PR) was detected by immunohistoehemieal staining respectively. The level of serumealeitonin and transforming growth factor α (TGFα) was detected by radio-immune and enzyme-linkedimmunosorbent assay pre- or post-surgery, as well as half a year to one year later post-surgery respectively inthese eases. The survival curve of Kaplan-Meier and log-rank test as well as scale risk of Cox model wereused to analyze the relationship between HT and prognosis of ovarian cancer. Results ( 1 ) The results oflog-rank test showed that there was no difference in survival curve of patients with or without HT [ (1108±52), (1086±43) d; P=0.940] ; the results of scale risk of Cox model also showed that HT was not anindependent prognosis factor for patients with HT. (2) There was no relationship with HT and theaccumulated survival in patients with either positive or negative expression of ERa, ERβ and PR in tissue;as well as between HT and the level of serum TGFα pre-, post-surgery, or half a year to one year aftersurgery. (3) The level of serum caleitonin in patients without HT post-surgery half a year to one year laterwas higher than that pre-surgery [ (141±13), (95±11) μg/; P<0.05], but there was no significantdifference between patients with HT half a year to one year later past-surgery and pre-surgery [ (90±18)μg/L, (93±14) μ/L; P>0.05]. (4) There was a significant difference in body and emotion function between HT and without HT groups [(1.84±1.50), (1.45±0.82); (12.69±10.20), (12.90±11.61); P<0.05], as well as in sex quality and autonomic nerve maladjustment and in the special listmade [(1.05±0.74), (1.77±1.08); (10.10±3.21), (13.09±4.30); P<0.05]. ConclusionsThere is no adverse influence on prognosis in using of HT for patients with ovarian cancer after surgery. HTfor patients with ovarian cancer post-surgery can help keep a stable level of scmm calcitonin as well asimprove the quality of life.

Although medical damage risks really exist, an effective medical risk sharing system is still not available in China right now. By analyzing the status quo of Chinese medical damage risks sharing system, the authors put forward the following suggestions to improve the current system: Upgrading the preventive strategy for medical disputes, establishing multi-level and multi-channel comprehensive medical damage risks sharing system, promoting the effective cooperation between insurance relief systems and mediation system for medical disputes, and constructing highly effective pathways to resolve the medical disputes.
China ; Dissent and Disputes ; Humans ; Insurance, Liability ; Malpractice ; Negotiating ; Risk Sharing, Financial

Objective:Hepatic fibrosis is a common pathological basis for many chronic liver diseases and can progress to cirrhosis,a leading cause of mortality in liver diseases.Early identification and reversal of hepatic fibrosis are key in the treatment of chronic liver disease.This study aims to compare the expression levels of serum core fucosylated low molecular weight kininogen(LMWK-Fc)and alpha-galactosylated(α-Gal)antibodies in patients with hepatic fibrosis at different stages,and to evaluate their diagnostic efficacy for hepatic fibrosis. Methods:A retrospective analysis was conducted on 275 patients with chronic liver disease who visited the Department of Infectious Diseases at the Second Xiangya Hospital of Central South University between June 2022 and March 2023.Among these,115 patients underwent liver biopsy.Based on the extent of collagen deposition and its impact on liver structure and microcirculation,patients were staged from 0 to 4:S0(no significant collagen deposition in liver tissues;liver structure and microcirculation are normal),S1(mild collagen deposition in liver tissues,with partial disruption of lobule structure,but microcirculation remains largely normal),S2(moderate collagen deposition in liver tissues,with partial disruption of lobule structure and microcirculation),S3(extensive collagen deposition in liver tissues,with substantial disruption of lobule structure and microcirculation),and S4(development of cirrhosis,with heavy collagen deposition,complete disruption of lobule structure,and severe impairment of microcirculation).Patients were grouped as no fibrosis(S0),fibrosis(S1-S2),and significant fibrosis(S3-S4).For the 160 patients without liver biopsy,they were categorized based on liver stiffness measurement(LSM)value:no fibrosis(F0:LSM＜7.3 kPa),fibrosis(F1-F2:LSM 7.3-12.4 kPa),and significant fibrosis(F3-F4:LSM＞12.4 kPa).Demographic data(age,gender)and laboratory indicators(alanine transaminase,aspartate transaminase,gamma-glutamyl transferase,alkaline phosphatase,alpha-fetoprotein,platelet count)were collected to calculate the fibrosis-4 index(FIB-4)and aspartate aminotransferase-to-platelet ratio index(APRI).Serum LMWK-Fc and α-Gal antibodies were measured and compared across the groups,and their correlation with fibrosis severity was analyzed.The receiver operating characteristic(ROC)curve was used to assess the predictive value of serum LMWK-Fc and α-Gal antibody levels for hepatic fibrosis. Results:Among the 160 patients without complete liver biopsy,serum α-Gal antibody and LMWK-Fc levels increased progressively from the no fibrosis group to the significant fibrosis group,with statistically significant differences(P＜0.05).Among the 115 patients with liver biopsy,serum LMWK-Fc levels were significantly higher in the fibrosis group and the significant fibrosis groups compared with the no fibrosis group,and α-Gal antibody levels were significantly higher in the significant fibrosis group compared with the no fibrosis group and the fibrosis group(P＜0.001,P=0.032,respectively).Univariate and multivariate linear regression analyses showed that hepatic fibrosis was correlated with gender and LMWK-Fc levels(both P＜0.05),but not with age,α-Gal antibody levels,FIB-4,or APRI(all P＞0.05). Conclusion:The expression levels of serum LMWK-Fc and α-Gal antibodies vary across different stages of hepatic fibrosis,suggesting a potential association with fibrosis progression.LMWK-Fc levels have a certain predictive value for the diagnosis of hepatic fibrosis.

Background: Previous studies showed controversial findings for correlation of periodontal disease and cognitive deficits. Methods: We searched systematically for studies pertaining to correlation of periodontal disease and cognitive deficits published between August 1980 and December 2019 on Web of Science and PubMed. We combined the data extracted from the included studies to determine the correlation between periodontal disease and cognitive deficits. Results: Our analysis indicated a higher risk of cognitive deficits in those with moderate to severe periodontal disease when compared to those with mild or no periodontal disease (odds ratio (OR) = 1.38 (95% confidence intervals (CI): 1.28-1.48). Subgroup analysis showed significant correlations in only case-control and cohort studies (case-control studies: OR = 1.49 (95% CI: 1.24-1.80); cohort studies: relative risk (RR) = 1.33 (95% CI: 1.22-1.45)). Subgroup analysis also indicated that moderate to severe periodontal disease was correlated to increased dementia and Alzheimer disease risks, whereas no significant correlation was found between periodontal disease and mild cognitive impairment (dementia: OR/RRs = 1.32 (95% CI: 1.22-1.44); Alzheimer disease: OR/RRs = 1.51 (95% CI: 1.20-1.90); Mild cognitive impairment: OR/RRs = 1.31 (95% CI: 0.89-1.94)). Furthermore, subgroup analysis showed significant correlations between cognitive deficits and tooth loss, periodontitis, whereas no significant correlation was found between deep periodontal pockets and cognitive deficits (tooth loss: OR/RRs = 1.57 (95% CI: 1.39- 1.77); periodontitis: OR/RRs = 1.43 (95% CI: 1.03-2.00); deep periodontal pockets: OR/RRs = 1.24 (95% CI: 0.77-2.00)). Conclusions: This review suggests a significant correlation between periodontal disease and cognitive deficits. Interventional studies for periodontal disease may be beneficial for patients with cognitive deficits