Objective:To evaluate the outcomes of intensive conservative treatment compared to conventional conservative treatment in patients with acute aortic syndrome(AAS).Methods:The study prospectively enrolled consecutive patients with AAS who were admitted to Beijing Anzhen Hospital, affiliated with Capital Medical University, and Beijing Dawanglu Emergency Rescue Hospital from January 2024 to December 2024. These patients with surgical contraindications or refused surgery for various reasons opted for conservative treatment. A total of 282 patients were included, and 15 patients with missing data or those who died without any treatment were excluded. Finally, 267 patients were enrolled, of whom 94 received intensive conservative treatment, and 173 received conventional conservative treatment, the inverse probability of treatment weighting (IPTW) was used to reduce the influence of confoundings. After adjusting of baseline datas via IPTW, the survival outcomes of the two groups were compared at 14 days, 30 days, and at the end of follow-up.Results:The results showed significant differences in acute phase survival rates between the enhanced conservative treatment group and the conventional conservative treatment group at 14 days(82.40%vs.53.20%, P<0.0001). Significant survival differences were also observed at 30 days and at 276-day mid-term follow-up (96.29% vs.51.60%, P<0.0001; 78.50% vs.48.50%, P<0.0001). In the subgroup analysis, for type A aortic dissection, the enhanced conservative treatment group had higher survival rates compared to the conventional conservative treatment group at 14, 30 and 276 days (63.46% vs.41.35%, P<0.05; 52.17% vs.37.90%, P<0.05; 50.00% vs. 31.97%, P<0.05). However, for type B aortic dissection, although the enhanced conservative treatment group had higher survival rates than the conventional conservative treatment group, no statistically significant differences were observed (96.29% vs. 80.00%, P=0.054; 95.65% vs.78.37%, P=0.067; 94.12% vs.74.20%, P=0.088). Conclusion:For patients diagnosed with AAS are forced to choose conservative treatment if emergency surgery is not possible in the first place, intensive conservative treatment strategies can significantly reduce the mortality in the acute phase compared with conventional conservative treatment. Mid-term follow-up, intensive conservative treatment still has a significant survival advantage.

Objective:To explore the clinical efficacy of olapalib in the treatment of platinum-sensitive recurrent breast cancer susceptibility gene (BRCA)-mutated ovarian cancer.Methods:The clinical data of 105 patients with platinum-sensitive recurrent BRCA-mutated ovarian cancer confirmed by pathology/imaging from October 2020 to March 2023 in Baoding Second Central Hospital were selected retrospectively, and they were divided into the control group (52 cases) and the experimental group (53 cases) according to the treatment methods. The control group was treated with a platinum-containing regimen, followed by olaparib at the end of the treatment. The experimental group was treated with olaparib. The recent clinical outcomes, tumour marker levels, ovarian cancer functional assessment of treatment questionnaire (FACT-O) score, cancer fatigue scale (CFS) score, and adverse reaction were compared between the two groups. The survival curve was drawn by Kaplan-Meier, and the prognosis was compared.Results:The overall response rate clinical in the experimental group was higher than that in the control group: 64.15%(34/53) vs.44.23%(23/52), there was a statistical difference ( χ2 = 4.20, P<0.05). After treatment, the levels of serum glycoantigen (CA) 125, CA153, human epithelial protein 4 (HE4), and vascular endothelial growth factor (VEGF) in the experimental group were lower than those in the control group: (42.35 ± 6.85) kU/L vs. (46.64 ± 7.11) kU/L, (24.26 ± 4.58) kU/L vs. (26.74 ± 5.20) kU/L, (144.25 ± 19.85) pmol/L vs. (155.64 ± 21.26) pmol/L, (335.32 ± 38.41) μg/L vs. (359.47 ± 41.24) μg/L; the FACT-O scores in the experimental group was higher than that in the control group: (55.24 ± 6.85)scores vs. (51.26 ± 7.19) scores; the CFS scores in the experimental group was lower than that in the control group: (38.51 ± 6.11) scores vs. (44.94 ± 8.38) scores, there were statistical differences ( P<0.05).After treatment, the rate of dizziness, nausea, leukopenia, neutropenia, thrombocytopenia, and anemia in the experimental group were lower than those in the control group ( P<0.05). The results of the survival curve showed that the median progression-free survival in the experimental group was longer than that in the control group ( P<0.05). Conclusions:Single-agent olaparib is effective in treating platinum-sensitive recurrent BRCA-mutated ovarian cancer, and can improve quality of life, reduce anemia and adverse reaction, and prolong patients′ median survival.

Objective:To explore the clinical efficacy of olapalib in the treatment of platinum-sensitive recurrent breast cancer susceptibility gene (BRCA)-mutated ovarian cancer.Methods:The clinical data of 105 patients with platinum-sensitive recurrent BRCA-mutated ovarian cancer confirmed by pathology/imaging from October 2020 to March 2023 in Baoding Second Central Hospital were selected retrospectively, and they were divided into the control group (52 cases) and the experimental group (53 cases) according to the treatment methods. The control group was treated with a platinum-containing regimen, followed by olaparib at the end of the treatment. The experimental group was treated with olaparib. The recent clinical outcomes, tumour marker levels, ovarian cancer functional assessment of treatment questionnaire (FACT-O) score, cancer fatigue scale (CFS) score, and adverse reaction were compared between the two groups. The survival curve was drawn by Kaplan-Meier, and the prognosis was compared.Results:The overall response rate clinical in the experimental group was higher than that in the control group: 64.15%(34/53) vs.44.23%(23/52), there was a statistical difference ( χ2 = 4.20, P<0.05). After treatment, the levels of serum glycoantigen (CA) 125, CA153, human epithelial protein 4 (HE4), and vascular endothelial growth factor (VEGF) in the experimental group were lower than those in the control group: (42.35 ± 6.85) kU/L vs. (46.64 ± 7.11) kU/L, (24.26 ± 4.58) kU/L vs. (26.74 ± 5.20) kU/L, (144.25 ± 19.85) pmol/L vs. (155.64 ± 21.26) pmol/L, (335.32 ± 38.41) μg/L vs. (359.47 ± 41.24) μg/L; the FACT-O scores in the experimental group was higher than that in the control group: (55.24 ± 6.85)scores vs. (51.26 ± 7.19) scores; the CFS scores in the experimental group was lower than that in the control group: (38.51 ± 6.11) scores vs. (44.94 ± 8.38) scores, there were statistical differences ( P<0.05).After treatment, the rate of dizziness, nausea, leukopenia, neutropenia, thrombocytopenia, and anemia in the experimental group were lower than those in the control group ( P<0.05). The results of the survival curve showed that the median progression-free survival in the experimental group was longer than that in the control group ( P<0.05). Conclusions:Single-agent olaparib is effective in treating platinum-sensitive recurrent BRCA-mutated ovarian cancer, and can improve quality of life, reduce anemia and adverse reaction, and prolong patients′ median survival.

Objective:To evaluate the outcomes of intensive conservative treatment compared to conventional conservative treatment in patients with acute aortic syndrome(AAS).Methods:The study prospectively enrolled consecutive patients with AAS who were admitted to Beijing Anzhen Hospital, affiliated with Capital Medical University, and Beijing Dawanglu Emergency Rescue Hospital from January 2024 to December 2024. These patients with surgical contraindications or refused surgery for various reasons opted for conservative treatment. A total of 282 patients were included, and 15 patients with missing data or those who died without any treatment were excluded. Finally, 267 patients were enrolled, of whom 94 received intensive conservative treatment, and 173 received conventional conservative treatment, the inverse probability of treatment weighting (IPTW) was used to reduce the influence of confoundings. After adjusting of baseline datas via IPTW, the survival outcomes of the two groups were compared at 14 days, 30 days, and at the end of follow-up.Results:The results showed significant differences in acute phase survival rates between the enhanced conservative treatment group and the conventional conservative treatment group at 14 days(82.40%vs.53.20%, P<0.0001). Significant survival differences were also observed at 30 days and at 276-day mid-term follow-up (96.29% vs.51.60%, P<0.0001; 78.50% vs.48.50%, P<0.0001). In the subgroup analysis, for type A aortic dissection, the enhanced conservative treatment group had higher survival rates compared to the conventional conservative treatment group at 14, 30 and 276 days (63.46% vs.41.35%, P<0.05; 52.17% vs.37.90%, P<0.05; 50.00% vs. 31.97%, P<0.05). However, for type B aortic dissection, although the enhanced conservative treatment group had higher survival rates than the conventional conservative treatment group, no statistically significant differences were observed (96.29% vs. 80.00%, P=0.054; 95.65% vs.78.37%, P=0.067; 94.12% vs.74.20%, P=0.088). Conclusion:For patients diagnosed with AAS are forced to choose conservative treatment if emergency surgery is not possible in the first place, intensive conservative treatment strategies can significantly reduce the mortality in the acute phase compared with conventional conservative treatment. Mid-term follow-up, intensive conservative treatment still has a significant survival advantage.

Objective:To analyze the optical coherence tomography (OCT) imaging characteristics in patients with Coats disease and their value in predicting macular fibrosis.Methods:A nested case-control study was performed.A total of 43 patients (43 eyes) diagnosed with Coats disease through color fundus photography, ocular B-scan ultrasonography, fundus fluorescein angiography, and spectral-domain OCT examination were enrolled from January 2008 to October 2021 at the Xijing Hospital.Among them, there were 40 males and 3 females, aged from 2 to 60 years old, with a median age of 13 years.Macular fibrosis was used as an indicator of poor prognosis, and patients were divided into two groups based on whether macular fibrosis occurred at the end of follow-up.The differences in OCT characteristics between two groups were compared and logistic regression analysis was used to identify the risk factors for macular fibrosis.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Xijing Hospital of Fourth Military Medical University (No.KY20202009-C-1).Results:The OCT clinical features of 43 cases of Coats disease included intraretinal hard exudates in 43 eyes (100%), subretinal fluid in 21 eyes (48.8%), macular cysts in 17 eyes (27.9%), subretinal exudates in 9 eyes (20.9%), anterior retinal hyperreflective dots in 7 eyes (16.3%), epiretinal membrane in 21 eyes (48.8%), and intraretinal fluid in 22 eyes (51.2%).In color fundus photos of 41 eyes, 38 eyes (93.0%) had hard exudates distributed in the posterior pole and 27 eyes (65.9%) had the mid-peripheral region.OCT examination showed that hard exudates were distributed in the inner nuclear layer in 35 eyes (81.4%) and the outer nuclear layer in 33 eyes (76.7%).Among 21 eyes with exudative retinal detachment detected by OCT, 9 eyes (42.9%) were detected by fundus photography and 18 eyes (85.7%) were detected by B-scan ultrasonography.The proportions of eyes with subretinal fluid and subretinal exudates were higher in the macular fibrosis group than in the non-macular fibrosis group, and the differences were statistically significant ( χ2=20.755, P<0.001; χ2=6.133, P=0.013).Logistic regression analysis showed that the presence of subretinal fluid was a risk factor for macular fibrosis (odds ratio=48.345, 95% confidence interval: 4.272-547.066, P=0.002). Conclusions:OCT examination can detect subretinal fluid, subretinal exudates, macular cysts, macular exudates, and hyperreflective spots in the retina of patients with Coats disease.Subretinal fluid is a risk factor for macular fibrosis.

OBJECTIVE To establish the quality standard of Triadica cochinchinensis and to perform the acute toxicity study. METHODS Appearance properties, powder microscopic identification, and thin-layer chromatography(TLC) identification were researched. The specific chromatogram was established by HPLC. The content of cadmium(Cd), lead(Pb), arsenic(As), copper(Cu), and mercury(Hg) was determined by inductively coupled plasma-mass spectrometry(ICP-MS). Acute toxicity was studied by maximum dose. RESULTS The outer skin of herbs was dark brown, and the inner surface was light yellow brown and fibrous. Besides, crystal sheath fiber was common, and calcium oxalate clusters arranges in rows. In the TLC diagram of the test product, the fluorescent spots of the same color were displayed at the corresponding position of the control product(scopoletin, isofraxidin). Five common peaks were calibrated in the characteristic map and the three characteristic peaks(scopoletin, isofraxidin, dimethylfraxetin) were recognized. The content of the measured heavy metal elements was lower than the national limit standard. The linear correlation coefficient was R2 > 0.999. The precision, stability, repetitive RSD were < 10%. The average recovery rate of the added sample was 80%−120%, and the RSD was < 10%. The maximum dose of the acute toxicity test was 184.09 g·kg−1. The 14 d internal body mass, food intake, organ-body ratios, the serum glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, blood urea nitrogen, and creatinine were not significantly different by comparing with the normal controls. Therefore, no significant toxicity was observed. CONCLUSION The established standard can provide a reference for evaluating the quality of Triadica cochinchinensis. The heavy metal content of ten batches of medicinal materials is within the safe range. Acute toxicity test show that there is no obvious significant adverse teactions after oral administration, and the safe dose range is large, which can provide a reference for the subsequent development and utilization.

Objective To explore the effect of robot-assisted therapy combined with motor imagery therapy on upper limb motor function of patients with stroke.Methods A total of 75 patients with incipient stroke(course of disease＜3 months),who met the inclusion and exclusion criteria and were admitted to our center from Match 2019 to October 2022,were randomly divided into three groups(n=25)by random number table method.Besides conventional rehabilitation of upper limbs,group A received motor imagery therapy,group B received robot-assisted therapy and group C received robot-assisted therapy combined with motor imagery therapy for 8 weeks.The function of upper limbs and activities of daily living were evaluated by motion range of Armeo? Spring upper limb rehabilitation robot,simple Fugl-Meyer assessment-upper extremities(FMA-UE),and modified Barthel index(MBI)before treatment,after 4 weeks of treatment and 8 weeks of treatment.Results All the scores were significantly increased in the three groups after 4 weeks and 8 weeks of treatment(P＜0.001).All the scores of group B and C were higher than those of group A after 4 weeks and 8 weeks of treatment(P＜0.05).All the scores of group C were higher than those of group B after 8 weeks of treatment(P＜0.05).Conclusion Robot-assisted therapy combined with motor imagery therapy can further improve the upper limb motor function and activities of daily living for stroke patients.

ObjectiveTo investigate the effect and mechanism of osthole on the proliferation and apoptosis in human intrahepatic cholangiocarcinoma HuCCT1 cells. MethodThe effect of 10， 20， 40， 80， and 120 μmol·L^-1 osthole on the proliferation of HuCCT1 cells was detected by the cell counting kit-8 （CCK-8）. A blank group， and low-， medium-， and high-dose osthole groups （16， 32， and 64 μmol·L^-1） were set up. The effect of osthole on cell clone formation rate was detected by colony formation assay. The effect of osthole on cell cycle and apoptosis was detected by flow cytometry. The effect of osthole on cell apoptotic morphology was detected by Hoechst 33342 fluorescent staining. The effect of osthole on cell cycle protein cyclin B₁， proliferating cell nuclear antigen （PCNA）， cysteine-aspartic acid protease （Caspase）-9， Caspase-3， cleaved Caspase-9， cleaved Caspase-3， cleaved poly（ADP-ribose） polymerase （cleaved PARP）， B-cell lymphoma-2 （Bcl-2）， phosphorylated protein kinase B （p-Akt）， phosphorylated mammalian target of rapamycin （p-mTOR）， and phosphorylated ribosomal protein S6 （p-RPS6） was detected by Western blot. ResultThe cell viability in the osthole group（40，80，120 μmol·L^-1） decreased （P<0.05，P<0.01）， with the half maximal inhibitory concentration （IC₅₀） of 63.8 μmol·L^-1 as compared with that in the blank group. Compared with the blank group， the osthole groups（32，64 μmol·L^-1）showed reduced clone formation rate （P<0.01）， increased number of cells in the G₂ phase （P<0.05，P<0.01）， decreased number of cells， increased pyknosis and fragmentation， increased apoptosis rate （P<0.05，P<0.01）， down-regulated expression of cyclin B₁， PCNA， Bcl-2， Caspase-3， Caspase-9， p-Akt， p-mTOR， and p-RPS6 （P<0.05，P<0.01）， and up-regulated expression of cleaved Caspase-3， cleaved Caspase-9， and cleaved PARP （P<0.05，P<0.01）. ConclusionOsthole can inhibit the proliferation and promote the apoptosis of HuCCT1 cells， and its mechanism may be related to the Akt/mTOR signaling pathway.

Objective To discuss the proper operation time of patients with encapsulated empyema secondary to tubercu-lous pleurisy by review the clinical characteristics and duration of these patients.Methods From December 1995 to May 2017, 235 patients with encapsulated empyema and pleural decortication were operated.The course of disease and preopera-tional data were collected.Patients were divided into three groups according to the duration of disease(group A with 113 cases,≤12 months; group B with 53 cases, 12 -24 months; group C with 69 cases, >24 months).Propensity score matching (PSM) was used to decrease the baseline difference among three groups.Preoperational features, such as operation time, bleeding, complications were compared between groups.Results PSM were conducted between group A and group B (45 paired patients), group B and group C(29 paired patients), respectively.The length of operation, amount of bleeding and blood transfusion in group B were significantly higher than those in group A and group C .The days with tube and hospitalization in group B were significantly longer than group A, but they were insignificantly different compared with group C(P>0.05). Postoperative complications were similar between the three groups(P>0.05).Conclusion Encapsulated empyema in early stage(within 1 year of onset) or after the maturation of the fibrous plate(over 2 years) is less difficult for surgical intervention, and try to avoid surgical treatment at high risk(1 to 2 years).