OBJECTIVE: To evaluate the clinical efficacy and safety of Yangxue Qingnao Pills (YXQNP) combined with amlodipine in treating patients with grade 1 hypertension. METHODS: This is a multicenter, randomized, double-blind, and placebo-controlled study. Adult patients with grade 1 hypertension of blood deficiency and Gan (Liver)-yang hyperactivity syndrome were randomly divided into the treatment or the control groups at a 1:1 ratio. The treatment group received YXQNP and amlodipine besylate, while the control group received YXQNP's placebo and amlodipine besylate. The treatment duration lasted for 180 days. Outcomes assessed included changes in blood pressure, Chinese medicine (CM) syndrome scores, symptoms and target organ functions before and after treatment in both groups. Additionally, adverse events, such as nausea, vomiting, rash, itching, and diarrhea, were recorded in both groups. RESULTS: A total of 662 subjects were enrolled, of whom 608 (91.8%) completed the trial (306 in the treatment and 302 in the control groups). After 180 days of treatment, the standard deviations and coefficients of variation of systolic and diastolic blood pressure levels were lower in the treatment group compared with the control group. The improvement rates of dizziness, headache, insomnia, and waist soreness were significantly higher in the treatment group compared with the control group (P<0.05). After 30 days of treatment, the overall therapeutic effects on CM clinical syndromes were significantly increased in the treatment group as compared with the control group (P<0.05). After 180 days of treatment, brachial-ankle pulse wave velocity, ankle brachial index and albumin-to-creatinine ratio were improved in both groups, with no statistically significant differences (P>0.05). No serious treatment-related adverse events occurred during the study period. CONCLUSIONS Combination therapy of YXQNP with amlodipine significantly improved symptoms such as dizziness and headache, reduced blood pressure variability, and showed a trend toward lowering urinary microalbumin in hypertensive patients. These findings suggest that this regimen has good clinical efficacy and safety. (Registration No. ChiCTR1900022470).
Humans ; Amlodipine/adverse effects* ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Hypertension/complications* ; Middle Aged ; Treatment Outcome ; Drug Therapy, Combination ; Adult ; Blood Pressure/drug effects* ; Double-Blind Method ; Aged ; Antihypertensive Agents/adverse effects*

OBJECTIVE: To analyze the clinical effect of decompression and bone grafting on osteonecrosis of the femoral head(ONFH) at different sites of necrotic lesions. METHODS: A total of 105 patients with ARCOⅡstage ONFH admitted from January 2017 to December 2018 were retrospectively analyzed. There were 71 males and 34 females, with an average age of (55.20±10.98) years old. The mean course of all patients was(15.91±9.85) months. According to Japanese Inveatigation Committee (JIC) classification, all patients were divided into 4 types:17 cases of type A, 26 cases of type B, 33 cases of type C1 and 29 cases of type C2. All four groups were treated with decompression of the pulp core and bone grafting. Visual analogue scale(VAS) and Harris hip joint score were used before and at 3, 6, 12, and 24 months after the operation, and the collapse of the femoral head was observed by X-ray examination within 2 years. RESULTS: All 105 patients were successful on operation without complications, and the mean follow-up duration was (24.45±2.75) months. Harris score showed that there was no statistical difference among four groups before surgery and 3, 6 months after surgery (P>0.05);at 12 and 24 months after surgery, there were significant differences among all groups (P<0.01). There were significant differences in intragroup Harris scores at preoperative and postoperative time points among four groups (P<0.01). VAS showed that there was no statistical difference among four groups before and 3, 6 months after surgery (P>0.05);at 12 and 24 months after surgery, there were significant differences among all groups (P<0.01). There were significant differences in VAS at preoperative and postoperative time points among four groups (P<0.01). None of the patients in four groups had femoral head collapse before and 3, 6 months after surgery. At 12 months after operation, there were 3 cases of femoral head collapse in group C and 4 cases in group C2(P>0.05);At 24 months after operation, 1 case of femoral head collapse occurred in group B, 6 cases in group C1 and 8 cases in group C2(P<0.05). CONCLUSION Core decompression and bone grafting can improve the effect of ONFH and hip preservation. The effect of hip preservation for ONFH is closely related to the location of the osteonecrosis lesion, so the influence of the location of lesion on the effect of hip preservation should be considered in clinical treatment, so as to make better preoperative hip preservation plan.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Retrospective Studies ; Femur Head Necrosis/diagnosis* ; Femur Head/surgery* ; Treatment Outcome ; Decompression, Surgical ; Bone Transplantation

OBJECTIVE: To evaluate the consistency and reproducibility of aortic root measurements by Anythink, a semi-automated preoperative CT analysis software, with those of 3mensio. METHODS: Sixty-seven patients undergoing transcatheter aortic valve replacement (TAVR) in the First Medical Center of Chinese PLA General Hospital from December, 2016 to February, 2022 were retrospectively enrolled in this study. A cardiology resident who completed his professional training used both the software Anythink and 3mensio (as the gold standard) to reconstruct the aortic root model and analyze the parameters of the aortic annulus and the surrounding structures. The correlation and consistency of the measurement results of two software were analyzed. Two independent residents also used Anythink software to repeat the measurements for the same patient for assessment of the reproducibility of Anythink measurements. The valve models were selected based on the measurements by Anythink and 3mensio, and similarities and differences of the two software in clinical valve selection were assessed. RESULTS: The measurements of the distances from the anulus plane to the left and right coronary ostium, average diameter of the anulus, anulus area, anulus perimeter, and the angle between the annulus and horizontal plane did not differ significantly between the two software (P > 0.05), and their measurements showed positive correlations (r= 0.884-0.981, P < 0.01). The intra-group and inter-group correlation coefficients of the anulus parameters measured by Anythink ranged from 0.894 to 0.992 and from 0.651 to 0.954, respectively. The Kappa-test values of valve models selected by Anythink and 3mensio based on the average diameter, area diameter and perimeter diameter were 0.886, 0.796 and 0.775, respectively. The intra-group Kappa values for the valve models selected based on Anythink measurements were 0.819, 0.841, and 0.795, and the inter-group Kappa values were 0.812, 0.812, and 0.768, respectively. Compared with the measurements by 3mensio, the recommended area diameter measured by Anythink was slightly greater in patients with postoperative paravalvular leakage, but slightly smaller in patients with postoperative new-onset conduction block. CONCLUSION Anythink has excellent measurement consistency and high reproducibility for aortic root measurements, and trained cardiologists can use Anythink to obtain accurate aortic root parameters before TAVR.
Humans ; Transcatheter Aortic Valve Replacement ; Reproducibility of Results ; Retrospective Studies ; Aorta ; Tomography, X-Ray Computed

Objective:To investigate the clinical efficacy of 3D printed guide plate-assisted hematoma puncture and catheter drainage in the treatment of a moderate volume of hypertensive intracerebral hemorrhage in the basal ganglia.Methods:The clinical data of 42 patients with a moderate volume of hypertensive intracerebral hemorrhage in the basal ganglia who received treatment with 3D printed guide plate-assisted hematoma puncture and catheter drainage in Dazhu Hospital of North Sichuan Medical College from January 2016 to January 2021 were retrospectively analyzed. In the traditional puncture group, there were 19 patients who received traditional punctures according to preoperative cranial CT findings (traditional puncture group). In the 3D printed guide plate puncture group, there were 23 patients who received hematoma puncture and catheter drainage assisted by a 3D printed guide plate. Preoperative preparation time (from admission to operation), operative time, the number of hematoma punctures, hematoma clearance rate, postoperative indwelling time of drainage tube, residual hematoma rate, the occurrence of puncture canal bleeding, intracranial infection, Glasgow Coma Scale score measured at 3 and 7 days after surgery, and Glasgow Outcome Scale score measured at 1, 3 and 6 months after surgery were compared between the two groups.Results:There were no significant differences in preoperative preparation time and operative time between the two groups ( t = 0.25, 0.40, both P > 0.05). 3D-printed guide plate-assisted hematoma puncture reduced the probability of reveiving one more hematoma puncture during the surgery. There was no significant difference in the number of hematoma puncture between the two groups ( χ2= 0.48, P > 0.05). There were no significant differences in the probabilities of puncture canal bleeding and intracranial infection between the two groups ( χ2 = 0.05, 0.03, both P > 0.05). Postoperative indwelling time of the drainage tube in the 3D printed guide plate puncture group was significantly shorter than that in the traditional puncture group [(3.10 ± 0.38) vs. (3.46 ± 0.52) days, t = 2.65, P < 0.05]. The residual hematoma rate in the 3D printed guide plate puncture group was significantly lower than that in the traditional puncture group [(32.04 ± 5.33)% vs. (37.37 ± 5.51)%, χ2 = 3.20, P < 0.05]. There were significant differences in Glasgow Coma Scale score measured at 3 and 7 days after surgery between the two groups [(12.04 ± 1.19) points vs. (11.26 ± 0.93) points, (13.65 ± 0.88) points vs. (12.94 ± 0.97) points, t = 2.33, 2.46, both P < 0.05]. Glasgow Outcome Scale score measured at 1, 3, and 6 months after surgery in the 3D printed guide plate puncture group was 18, 21, and 22 points, respectively, which was significantly higher than 9, 11, and 12 points in the traditional puncture group ( χ2 = 4.34, 4.69, 5.17, all P < 0.05). Conclusion:3D printed guide plate assisted hematoma puncture and catheter drainage for treatment of a moderate volume of hypertensive intracerebral hemorrhage in the basal ganglia can increase the accuracy of puncture, decrease hematoma residual rate, improve short- and long-term prognosis, does not prolong preoperative preparation time. Moreover, it costs low, is safe, and is easy to learn.

In China, the incidence of liver cancer remains high. Approximately 80% of diagnosed patients are in the intermediate and advanced stages, with a high recurrence rate and poor prognosis after surgery. Therefore, substantially reducing the incidence and mortality has always been a major clinical challenge for liver cancer. In recent years, immune checkpoint inhibitor therapy represented by programmed death protein 1 (PD-1) antibody is gradually innovating the traditional paradigm of tumor treatment, but the beneficiary population in liver cancer patients is relatively limited. With the rapid development of high-throughput sequencing, proteomics and immunomics and other fields, the demand for precision medicine continues to increase. Tumor vaccines, especially derived from neoantigens, have shown promising therapeutic effects in malignant solid tumors such as melanoma and non-small cell lung cancer due to their immunogenicity. Combining the latest research reports at home and abroad, this paper emphasis on whether tumor vaccines can effectively treat or even cure liver cancer.
Humans ; Cancer Vaccines/therapeutic use* ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Programmed Cell Death 1 Receptor ; Immunotherapy ; Lung Neoplasms/drug therapy* ; Immune Checkpoint Inhibitors ; Liver Neoplasms/drug therapy*

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

Objective To investigate the oral health status and awareness of urban children in Lhasa,aiming to provide a data basis for the prevention and treatment of children's caries and the promotion of oral health education. Methods A total of 504 Tibetan students were selected by cluster sampling from 2 primary schools in Chengguan District of Lhasa.All the participants were required to take oral health examination and complete a questionnaire about oral health awareness and behavior. Results The caries prevalence rate and mean decayed-missing-filled tooth(DMFT)of permanent teeth were 75.00% and 2.18±1.91,respectively.The rates of pit and fissure sealant and filling of permanent teeth were 3.77% and 6.81%,respectively.The caries prevalence rate of first permanent molars was 47.62%.The mean DMFT of permanent teeth and caries prevalence rate of first permanent molar were significantly higher in female group(
Child ; DMF Index ; Dental Caries/epidemiology* ; Female ; Humans ; Oral Health ; Oral Hygiene ; Prevalence ; Schools ; Students ; Surveys and Questionnaires

Objective: To discuss the techniques and repairing methods of various degree of compound tissue defects in the auriculotemporal region. Methods: Retrospective analysis was conducted on three cases of different repairing methods for huge compound tissue defects in different degrees in the auriculotemporal region after the resection of the malignant tumor or sinus tract due to repeated infection in our hospital. Results: Following total removal of the tumors or sinus tract in all patients, we applied retroauricular lingual flap transfer repairing, latissimus dorsi flap free transfer repairing and vascular anastomosis, scalp tissue expansion in stage Ⅰ, then repairing the lesion with expanded scalp and filling the huge mastoid cavity with abdominal fat in stage Ⅱ, respectively, according to the characteristics of compound tissue defects in the auriculotemporal region. All free flaps survived well. Conclusions: The anatomy of the auricular-temporal area is complex and involves important vascular and neural structures of head and neck and lateral skull base. The huge composite tissue defect following auriculotemporal region surgery, which is composed of skin, muscle and bone tissue, needs to be repaired in one stage. Therefore, flexible repairing methods should be chosen based on different situations, for attaining the goal of completely removing tumor and lesions, and then, covering the operation cavity.
Humans ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin Transplantation ; Temporal Lobe ; Treatment Outcome