Objective To observe the efficacy and safety of Buyi Pishen Prescription combined with alisartan ester tablets in patients with primary chronic kidney disease stage 3(CKD3)with spleen-kidney qi deficiency syndrome.Methods Totally 80 patients were divided into treatment group and control group using a random number table method,with 40 cases in each group.Both groups received basic treatment and alisartan ester tablets(1 tablet/day,once daily,orally).The treatment group additionally received the Buyi Pishen Prescription(1 dosage/day,twice daily,orally).Both groups were treated for 24 weeks.TCM syndrome efficacy and clinical efficacy were evaluated.At 8,16 and 24 weeks,24-hour urinary protein(24 hUpro),serum creatinine(SCr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR)and TCM syndrome scores were measured.Serum oxidative stress markers(SOD,GSH-Px,MDA)were assessed before and after treatment.Blood potassium and liver function were monitored throughout.Results The total effective rate for TCM syndrome efficacy was 82.50%(33/40)in the treatment group and 60.00%(24/40)in the control group(P<0.05),and the treatment group was better than the control group.The total clinical efficacy rate was 77.50%(31/40)in the treatment group and 50.00%(20/40)in the control group,and the treatment group was better than the control group(P<0.05).Compared with before treatment,the treatment group showed a significant decrease in 24 hUpro and SCr at weeks 8,16 and 24,a significant decrease in BUN at weeks 16 and 24,and a significant increase in eGFR at weeks 8,16 and 24(P<0.01);the control group showed a decrease in 24 hUpro at weeks 8,16 and 24 of treatment(P<0.05),a decrease in SCr at weeks 16 and 24 of treatment(P<0.05),and an increase in eGFR at weeks 16 and 24 of treatment(P<0.05).In addition,the treatment group had lower 24 hUpro and SCr at weeks 16 and 24 of treatment than the control group(P<0.05,P<0.01),and higher eGFR than the control group(P<0.05,P<0.01).Compared with before treatment,the total scores of both the treatment group and control group significantly decreased at 16 and 24 weeks of treatment(P<0.01).The total scores of the treatment group were significantly lower than those of the control group at 8,16 and 24 weeks of treatment(P<0.01).Compared with before treatment,both groups showed a significant increase in serum SOD levels(P<0.05,P<0.01)and a significant decrease in MDA levels after treatment(P<0.05,P<0.01).The improvement in the treatment group was more significant than that in the control group(P<0.05).Both groups showed no abnormalities in blood potassium and liver function.Conclusion Buyi Pishen Prescription combined with alisartan ester tablets can reduce the levels of 24 hUpro,BUN and SCr,improve eGFR,alleviate TCM symptoms,and delay CKD progression in CKD3 patients with spleen-kidney qi deficiency syndrome,which can effectively reduce the serum MDA level and increase the antioxidant enzyme SOD level in patients,and its mechanism may be related to improving oxidative stress levels.

ObjectiveTo investigate the therapeutic effects of direct-acting antiviral agents (DAAs) combined regimens for hepatitis C virus (HCV) patients in Dehong Prefecture, Yunnan Province from 2022 to 2024, to analyze the characteristics of treatment failure patients, so as to provide a basis for discovering more effective treatment regimens in the future. MethodsData on HCV prevention and treatment in Dehong Prefecture was extracted from the China Disease Control and Prevention Information System. A total of 617 patients with HCV antiviral therapy were included, and the differences in variable characteristics among patients with different genotypes were analyzed using comparative statistical tests, including basic socio-demographic characteristics, biochemical testing indicators, and information on previous treatment and current treatment. In addition, the cure rate of HCV patients with diverse characteristics was compared, and the potential causes of treatment failure were explored simultaneously. ResultsThe cure rate of HCV was 96.8%, and statistically significant differences were observed in aspartate transaminase (AST) and alanine transaminase (ALT) levels, previous antiviral therapy history and initial treatment regimens among patients with different HCV genotypes (all P<0.05). Among the multi-type combination regimens, the cure rate of sofosbuvir (SOF)-containing regimens was 97.00%, that of velpatasvir (VEL)-containing regimens was 95.45%, and the cure rate of other treatment regimens, including the regimens with ribavirin (RIB) intervention, was 93.10%. Among the patients with treatment failure, 45.00% had genotype 3, 40.00% had abnormal abdominal ultrasound results, and all presented with elevated baseline AST test levels. ConclusionThe clinical treatment of HCV patients should consider the differences in genotype and biochemical test results. DAAs combined regimens for HCV have achieved a high cure rate in Dehong Prefecture and are applicable to HCV patients with diverse clinical characteristics, providing research evidence for wider application.

Objective To observe the efficacy and safety of Buyi Pishen Prescription combined with alisartan ester tablets in patients with primary chronic kidney disease stage 3(CKD3)with spleen-kidney qi deficiency syndrome.Methods Totally 80 patients were divided into treatment group and control group using a random number table method,with 40 cases in each group.Both groups received basic treatment and alisartan ester tablets(1 tablet/day,once daily,orally).The treatment group additionally received the Buyi Pishen Prescription(1 dosage/day,twice daily,orally).Both groups were treated for 24 weeks.TCM syndrome efficacy and clinical efficacy were evaluated.At 8,16 and 24 weeks,24-hour urinary protein(24 hUpro),serum creatinine(SCr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR)and TCM syndrome scores were measured.Serum oxidative stress markers(SOD,GSH-Px,MDA)were assessed before and after treatment.Blood potassium and liver function were monitored throughout.Results The total effective rate for TCM syndrome efficacy was 82.50%(33/40)in the treatment group and 60.00%(24/40)in the control group(P<0.05),and the treatment group was better than the control group.The total clinical efficacy rate was 77.50%(31/40)in the treatment group and 50.00%(20/40)in the control group,and the treatment group was better than the control group(P<0.05).Compared with before treatment,the treatment group showed a significant decrease in 24 hUpro and SCr at weeks 8,16 and 24,a significant decrease in BUN at weeks 16 and 24,and a significant increase in eGFR at weeks 8,16 and 24(P<0.01);the control group showed a decrease in 24 hUpro at weeks 8,16 and 24 of treatment(P<0.05),a decrease in SCr at weeks 16 and 24 of treatment(P<0.05),and an increase in eGFR at weeks 16 and 24 of treatment(P<0.05).In addition,the treatment group had lower 24 hUpro and SCr at weeks 16 and 24 of treatment than the control group(P<0.05,P<0.01),and higher eGFR than the control group(P<0.05,P<0.01).Compared with before treatment,the total scores of both the treatment group and control group significantly decreased at 16 and 24 weeks of treatment(P<0.01).The total scores of the treatment group were significantly lower than those of the control group at 8,16 and 24 weeks of treatment(P<0.01).Compared with before treatment,both groups showed a significant increase in serum SOD levels(P<0.05,P<0.01)and a significant decrease in MDA levels after treatment(P<0.05,P<0.01).The improvement in the treatment group was more significant than that in the control group(P<0.05).Both groups showed no abnormalities in blood potassium and liver function.Conclusion Buyi Pishen Prescription combined with alisartan ester tablets can reduce the levels of 24 hUpro,BUN and SCr,improve eGFR,alleviate TCM symptoms,and delay CKD progression in CKD3 patients with spleen-kidney qi deficiency syndrome,which can effectively reduce the serum MDA level and increase the antioxidant enzyme SOD level in patients,and its mechanism may be related to improving oxidative stress levels.

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

【Objective】 To investigate the practice and benefit of national standardized management of type 2 diabetes in Yulin City. 【Methods】 We recruited the adult type 2 diabetes patients who sought medical help at our hospital from May 2020 to October 2022 as subjects. We collected their basic information (sex and age); measured height, weight, waist and hip circumference, and blood pressure; calculated body mass index (BMI); and detected blood glucose, c-peptide, HbA1c, biomarkers, urinary microalbumin, sensory nerve conduction velocity of lower limbs, ABI, and subcutaneous and visceral fat at the time of MMC recruited and the end of six months. T test and Mann-Whitney U rank sum test were used for measurement data and χ² test or Fisher’s exact probability method for counting data to analyze the data. 【Results】 After 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, and visceral and subcutaneous fat in all the patients decreased, but the level of fasting c-peptide increased compared with the baseline (all P<0.05). Secondly, compared with the baseline, the control rate of HbA1c (35.21% vs. 13.71% ) and the comprehensive control rate (13.97% vs. 7.26% ) were both significantly increased at six months (P<0.05). Thirdly, after 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, TG, TC, and UA were decreased more, while the fasting c-peptide and postprandial c-peptide were increased more in the patients of the HbA1c standard group (HbA1c<7% ) than those of the non-standard group. 【Conclusion】 The multiple benefits of blood glucose, blood lipid, uric acid and islet function can be achieved by taking type 2 diabetes patients into MMC. Meanwhile, the rates of HbA1c control and comprehensively reaching the standard are significantly increased. Therefore, MMC can explore a new way for the management of type 2 diabetic patients in this area.

Chimeric antigen receptor T (CAR-T) cell therapy is a novel cellular immunotherapy that is widely used to treat hematological malignancies, including acute leukemia, lymphoma, and multiple myeloma. Despite its remarkable clinical effects, this therapy has side effects that cannot be underestimated. Cytokine release syndrome (CRS) is one of the most clinically important and potentially life-threatening toxicities. This syndrome is a systemic immune storm that involves the mass cytokines releasing by activated immune cells. This phenomenon causes multisystem damages and sometimes even death. In this study, we reported the management of a patient with recurrent and refractory multiple myeloma and three patients with acute lymphocytic leukemia who suffered CRS during CAR-T treatment. The early application of tocilizumab, an anti-IL-6 receptor antibody, according to toxicity grading and clinical manifestation is recommended especially for patients who suffer continuous hyperpyrexia, hypotensive shock, acute respiratory failure, and whose CRS toxicities deteriorated rapidly. Moreover, low doses of dexamethasone (5-10 mg/day) were used for refractory CRS not responding to tocilizumab. The effective management of the toxicities associated with CRS will bring additional survival opportunities and improve the quality of life for patients with cancer.

Objective To investigate the expression level and clinical significance of WT1 gene in acute luekemia (AL) patients.Methods WT1 gene level was detected by real time quantitative-polymerase chain reaction in acute myelogenous leukemia (AML) and in acute lymphocytic leukemia (ALL) patients.Then the expression levels of WT1 gene in different subtypes of AML were compared,and the correlation between gene expression and disease courses and prognosis were observed.Moreover,the relationship between disease courses and WT1 expression in patiens after receiving haemopoietic stem cell transplantation were analyzed.Results Among 66 cases,WT1 expression positive rate was 87.5 ％ (14/16) in AML and 76.0 ％ (38/50) in ALL.In AML,the expression level in M3 showed the lowest than that in any other subtypes (compared with M1,M2,M4,M5,P value was 0.040,0.007,0.006 and 0.01,respectively).The expression level of WT1 was closely correlated with leukemia disease courses.The expression level in complete remission (CR) group showed a significant lower expression level than that in non-remission group (P =0.018) and relapse group (P =0.003),and the re-increase of WT1 expression level could predict relapse as early as 1.5 months.Moreover,WT1 expression also showed an close relationship with prognosis of patients receiving haemopoietic stem cell transplantation.Patients whose WT1 was undetectable had a better prognosis than those with persistent expression,and increase again after becoming undetectable.Conclusion WT1 has a high expression level in AL,which can represent minimal residual disease.The expression level in M3 was lowest than that in different AML subtypes,and its expression level has a close correlation with clinical disease course and prognosis of AL.

[Objective]To discuss the clinical effect of fludarabine and busulfan (Bu+Flu) as a low toxicity myeloablative conditioning regimen for allogeneic peripheral blood stem cell transplantation (allo-HSCT)in leukemia patients.[Methods]Clinical data of 13 patients with hematological malignancies receiving conditioning regimen with Bu+Flu for allo-HSCT were analyzed retrospectively.Conditioning regimen was Bu+Flu,compalriot mismatched and unrelated transplantation combined with rabbit anti-human thymocytes immune globulin (ATG).CsA+short course of methotrexate or CsA + mycophenolate mofetil were used to prevent graft-versus-host disease (GVHD).DNA sequencing of short tandem repeat (STR)polymorphism analysis method was performed for identification of donor stem cells implantation.[Results]13 patients all tolerated with this conditioning regimen well,no serious complications occurred.Neutrophil engraftment was at 9-15 days (median 11 days),platelet engraftment at 8-25 days (median 13 days).10 patients achieved hematopoiesis reconstitution with their full donor chimerisms confirmed by STR-DNA analysis.Acute GVHD occurred in 5 cases,accounting for 38.5％.Chronic GVHD occurred in 4 cases of 10 patients could be assessed,accounting for 40.0％.Severe GVHD more than Ⅱ degree did not happen.1-39 months (median time 11 months)of follow-up revealed the overall survival rate of 76.9％(10/13),disease-free survival of 61.5％ (8/13).The causes for death were relapse in all.[Conclusion]The conditioning regimen with Bu+Flu has low toxicity,well tolerance and better effect.

Objective To study the clinic effect and safety of MEAD chemotherapy regimen for adult patients with relapsed or refractory acute lymphocyte leukemia. Methods Between July 2006 and July 2009,twenty-two adult patients with relapsed or refractory acute lymphocyte leukemia received MEAD regimen (mitoxantrone 6 mg/d dl-3 iv drip,cytarabine 100 mg/d dl-5 iv drip,etoposide 100 mg/d dl-5 iv drip,dexmethasone 10 mg/d dl-8 iv drip). Results The complete remission (CR) rate of adult patients with relapsed or refractory acute lymphocyte leukemia was 31.8 %,the partial remission(PR) rate was 22.7 % and the overall response (OR) rate 54.5 %. The cumulitive CR rate was 50.0 %,and the PR rate 40.9 % after two times MEAD chemotherapy regimen. The main adverse effect was different level of myelosuppression,and other toxicity of vital organ was mild. Conclusion MEAD regimen is effective and can be tolerated for adult patients with relapsed or refractory acute lymphocyte leukemia,and its side effect is mild.

Objective To study the curative effects and adverse effects of the thalidomide combined with COMP chemotherapy in treating multiple myeloma(MM).Methods 42 patients were initially diagnosed as MM and 27 patients were refractory and relapsed MM.The small dose of thalidomide combined with COMP management and COMP management alone were used.The effective rate and adverse effects were analyzed.Changes of M-protein in serum,percentage of plasma cells in bone marrow and the level of hemoglobin were also analyzed in both pre-treatment and post-treatment periods.Results In 42 patients who were initially diagnosed as MM,the effective rate was 40.9% for 22 patients treated by chemotherapy alone and 70.0% for 20 patients treated by the thalidomide combined with chemotherapy.Statistic difference was observed between those two group.As to the 27 patients who were refractory and relapsed MM,the effective rate was 42.9% for 13 patients treated by chemotherapy alone and 84.6% for 14 patients treated by the thalidomide combined with chemotherapy.Statistic significance was present between them.Adverse effects were less and tolerated.Conclusion Treatment of small dose of thalidomide combined with COMP chemotherapy could significantly improve the effective rate with less adverse effects.