Objective:To explore the impact of marital status on the prognosis of adult patients with primary intrahepatic cholangiocarcinoma.Methods:3283 patients with primary intrahepatic single tube carcinoma from 1998 to 2018 were collected.They were divided into married group(n=1999)and unmarried group(n=1284)based on marital status.The clinical data of adult patients with primary intrahepatic cholangiocarcinoma of different marital statuses were compared.Kaplan Meier survival curves were used to analyze the survival status of adult patients with primary intrahepatic cholangiocarcinoma in different marital statuses.Univariate and multivariate Cox regression analysis were used to investigate the factors affecting the survival of adult patients with primary intrahepatic cholangiocarcinoma.Kaplan Meier survival curves were used to analyze the survival status of adult patients with primary intrahepatic cholangiocarcinoma in different marital statuses,including whether they received surgical treatment,radiotherapy treatment,and gender differences.Results:The proportion of male patients,the proportion of white patients,the proportion of patients over 60 years old,the proportion of patients receiving surgical treatment,the proportion of patients receiving radiotherapy,and the proportion of patients receiving chemotherapy in the married group were higher than those in the unmarried group(P＜0.05).Kaplan Meier survival curve analysis results showed that,the 3-month and 5-year survival rates between married and unmarried groups were Log-rank test P＜0.05.Multivariate Cox regression analysis showed that,age over 60 years old,later tumor stage,surgical treatment,radiotherapy,and chemotherapy were risk factors for survival in adult patients with primary intrahepatic cholangiocarcinoma(P＜0.05).Kalplan Meier survival curve results showed that,there was no significant difference in 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who received surgical treatment(Log-Rank test P=0.381).There was a significant difference in the 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who have not received surgical treatment(Log-Rank test P=0.015).There was no significant difference in 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who received radiotherapy(Log-Rank test P=0.073).There was a significant difference in the 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who have not received radiotherapy(Log-Rank test P＜0.001).There was no significant difference in 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who received chemotherapy(Log-Rank test P=0.337).There was a significant difference in the 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who have not received chemotherapy(Log-Rank test P＜0.001).There was no significant difference in the survival status of male patients with primary intrahepatic cholangiocarcinoma in adults of different marital statuses(Log-Rank test P=0.136).There were differences in the survival status of female patients with primary intrahepatic cholangiocarcinoma in adults of different marital statuses(Log-Rank test P＜0.001).Conclusion:Male,white,and over 60 years old are risk factors for the occurrence of primary intrahepatic cholangiocarcinoma in adults.Among them,more than half of the patients did not receive surgery or radiotherapy treatment,and about half of the patients did not receive chemotherapy.Married individuals are more likely than unmarried individuals to undergo anti-tumor treatments such as surgery,radiotherapy and chemotherapy.The staging of intrahepatic cholangiocarcinoma and whether surgery or chemotherapy is received are independent predictors of long-term survival.Marital status is not an independent predictor and can indirectly affect long-term survival.Male marital status has no significant survival benefits for this disease,while female marital status has survival benefits for this disease.The marital status of patients with intrahepatic cholangiocarcinoma who have not undergone radiotherapy,chemotherapy,or surgical intervention has a significant impact on their survival outcomes.

Objective:To explore the impact of marital status on the prognosis of adult patients with primary intrahepatic cholangiocarcinoma.Methods:3283 patients with primary intrahepatic single tube carcinoma from 1998 to 2018 were collected.They were divided into married group(n=1999)and unmarried group(n=1284)based on marital status.The clinical data of adult patients with primary intrahepatic cholangiocarcinoma of different marital statuses were compared.Kaplan Meier survival curves were used to analyze the survival status of adult patients with primary intrahepatic cholangiocarcinoma in different marital statuses.Univariate and multivariate Cox regression analysis were used to investigate the factors affecting the survival of adult patients with primary intrahepatic cholangiocarcinoma.Kaplan Meier survival curves were used to analyze the survival status of adult patients with primary intrahepatic cholangiocarcinoma in different marital statuses,including whether they received surgical treatment,radiotherapy treatment,and gender differences.Results:The proportion of male patients,the proportion of white patients,the proportion of patients over 60 years old,the proportion of patients receiving surgical treatment,the proportion of patients receiving radiotherapy,and the proportion of patients receiving chemotherapy in the married group were higher than those in the unmarried group(P＜0.05).Kaplan Meier survival curve analysis results showed that,the 3-month and 5-year survival rates between married and unmarried groups were Log-rank test P＜0.05.Multivariate Cox regression analysis showed that,age over 60 years old,later tumor stage,surgical treatment,radiotherapy,and chemotherapy were risk factors for survival in adult patients with primary intrahepatic cholangiocarcinoma(P＜0.05).Kalplan Meier survival curve results showed that,there was no significant difference in 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who received surgical treatment(Log-Rank test P=0.381).There was a significant difference in the 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who have not received surgical treatment(Log-Rank test P=0.015).There was no significant difference in 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who received radiotherapy(Log-Rank test P=0.073).There was a significant difference in the 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who have not received radiotherapy(Log-Rank test P＜0.001).There was no significant difference in 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who received chemotherapy(Log-Rank test P=0.337).There was a significant difference in the 5-year survival rate between married and unmarried adult patients with primary intrahepatic cholangiocarcinoma who have not received chemotherapy(Log-Rank test P＜0.001).There was no significant difference in the survival status of male patients with primary intrahepatic cholangiocarcinoma in adults of different marital statuses(Log-Rank test P=0.136).There were differences in the survival status of female patients with primary intrahepatic cholangiocarcinoma in adults of different marital statuses(Log-Rank test P＜0.001).Conclusion:Male,white,and over 60 years old are risk factors for the occurrence of primary intrahepatic cholangiocarcinoma in adults.Among them,more than half of the patients did not receive surgery or radiotherapy treatment,and about half of the patients did not receive chemotherapy.Married individuals are more likely than unmarried individuals to undergo anti-tumor treatments such as surgery,radiotherapy and chemotherapy.The staging of intrahepatic cholangiocarcinoma and whether surgery or chemotherapy is received are independent predictors of long-term survival.Marital status is not an independent predictor and can indirectly affect long-term survival.Male marital status has no significant survival benefits for this disease,while female marital status has survival benefits for this disease.The marital status of patients with intrahepatic cholangiocarcinoma who have not undergone radiotherapy,chemotherapy,or surgical intervention has a significant impact on their survival outcomes.

Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R² of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.
Pregnancy ; Child ; Humans ; Female ; Glycated Hemoglobin ; Cohort Studies ; Diabetes Mellitus/diagnosis* ; Sensitivity and Specificity ; ROC Curve

An imported case of acute schistosomiasis was reported in Wuhan City in 2020. The case was infected with Schistosoma by contact with the infested water due to playing water in the Yangtze River when working out of Hubei Province. The patient visited four medical institutions and the duration from onset to definitive diagnosis was 20 days. The patient’s low awareness of schistosomiasis prevention and control knowledge and lack of diagnosis and treatment awareness for schistosomiasis among medical institutions were considered as main causes of the development of acute schistosomiasis and progression to severe case. Intensifying schistosomiasis health education among mobile populations and improving the awareness and capability of early diagnosis of schistosomiasis among clinicians are recommended.

Aim To investigate the effect of dihydromyricetin (DHM) on lipid accumulation in liver of obese mice induced by high fat diet and its mechanism. Methods Sixty C57BL/6J mices were randomly divided into six groups (n = 10); (1)ND group; normal diet, (2)ND + L-DHM group; normal diet and treatment with low-dose DHM (125 mg • kg

Objective To study the single nucleotide polymorphisms (SNPs)that predict a patient's risk of grade 2-3 paclitaxel-induced peripheral sensory neuropathy (PSN) in Chinese Han populations.Methods Totally 216 patients received paclitaxel in Peking Union Medical College Hospital from May 2014 to December 2016 were enrolled.DNA was isolated from peripheral blood.Genotyping for eight candidate SNPs was performed on Sequenom-MassARRARYiPLEX platform.Patients were followed up and PSN was assessed by trained physicians according to National Cancer Institute-Common Terminology Criteria for Adverse Events v4.03.Results A total of 209 patients entered the final analysis.Among the candidate SNPs,only rs4141404:A>C(LIMK2) was significantly associated with grade 2/3 PSN (OR:4.32,95%CI:2.37-7.89,P<0.0001).In multivariate logistic regression analysis,both rs4141404:A>C(LIMK2) and history of receiving platinum compound (OR:2.70,95%CI:1.32-5.51,P=0.007) were associated with grade 2/3 PSN.Conclusion rs4141404:A>C(LIMK2) may be the markers of risk of grade 2/3 PSN.

OBJECTIVETo evaluate the clinical efficacy and safety of treatment of chronic primary glomerulopathy (CPG) patients of Shen deficiency and dampness heat syndrome (SDDHS) by Yishen Qingli Granule (YQG) combined with low-dose Tripterygium Wilfordii multiglycoside Tablet (TWT).

METHODSTotally 231 CPG patients of SDDHS were enrolled in this study (including 60 patients from First Affiliated Hospital of Nanjing University of Chinese Medicine, 58 from First Affiliated Hospital of Nanjing Medical University, 46 from Xinqiao Hospital of Third Military Medical University, 35 from First Affiliated Hospital of Guangzhou University of Chinese Medicine, 14 from First Affiliated Hospital of Soochow University, and 18 from Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine). They were randomly assigned to the control group (116 cases) and the trial group (115 cases) according to block group method. There were 217 cases in the safety analysis set (109 cases in the trial group vs 108 cases in the control group), and 203 cases in the full analysis set (99 cases in the trial group vs 104 cases in the control group). All patients received basic treatment such as ACEI/ARB. Furthermore, YQG (consisting of raw astragalus 10 g, prepared Polygonum Multiflorum 10 g, Pyrrosia 10 g, 1.5 g each package, containing 10 g of crude drugs) was additionally given to patients in the trial group, each package, twice daily. The TWT (10 mg) was given, twice a day. The TWT dose was adjusted according to 24 h urinary total protein (UTP). The placebos of YQG and TWT were administered to those in the control group. The treatment course consisted of 24 weeks and the follow-up visit lasted for 24 weeks. The biochemical indices were observed before and after treatment including 24 h UTP, urine red cell count (U(RBC)), renal functions (BUN, SCr), blood routine test (WBC), and liver functions (SGPT, SGOT). Reverse reactions such as gastrointestinal discomfort, skin rash, and irregular menstruation were also observed.

RESULTSCompared with the control group, the total effective rate was better in the trial group (82.83% vs 61.54%, P < 0.01). Results of stratified comparison of UTP showed better efficacy in the trial group (0.8-3.0 g/24 h, P < 0.01). The UTP decline occurred in the trial group after 8 weeks of treatment, with stable action, showing statistical difference when compared with the control group (P < 0.01). In the trial group, U(RBC) level decreased after treatment but changed more significantly. But there was no statistical difference in the changes when compared with the control group (P > 0.05). After treatment, there were no statistical difference in safety indicators such as WBC, SGPT, and SGOT between the two groups after treatment (P > 0.05).

CONCLUSIONOn the basis of basic treatment such as ACEI/ARB, application of YQG combined with low-dose TWT had better effect in controlling proteinuria of CPG patients, and could help stabilizing their conditions with less adverse reactions.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Kidney Diseases ; diagnosis ; drug therapy ; Kidney Glomerulus ; pathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; methods ; Treatment Outcome ; Tripterygium

Objective To investigate the effects of IL-21,IL-23 and IL-4 in the pathogenesis of Guillain-Barré syndrome(GBS) of children,and to analyze the influence of intravenous immunoglobulin(IVIG) on the serum levels of IL-21,IL-23 and IL-4 in GBS patients.Methods Forty-one pediatric patients with GBS hospitalized in our department from Jan.2005 to Sep.2012 were studied.According to the time of IVIG administration,patients were divided into group A and group B,given IVIG respectively within the 7th day and the 8th-12th day.According to Hughes score,patients were divided into mild group and severe group.The serum levels of IL-21,IL-23 and IL-4 were detected by means of ELISA before and after treatment.Results Before treatment,the serum levels of IL-21,IL-23 and IL-4 had no signifiant difference between group A and group B.After treatment,the serum levels of IL-21,IL-23 in group A and group B were significantly decreased than those before treatment (all P ＜ 0.05),with no significant difference in IL-4 levels.There was no signifiant difference in group A and group B in the serum levels of IL-21,IL-23 and IL-4 after treatment (all P ＞0.05).In the severe group,the serum levels of IL-21,IL-23 were significantly higher than those in the mild group before and after treatment (all P ＜ 0.05),with no significant difference in IL-4 levels.After treatment,the serum levels of IL-21,IL-23 were significantly decreased than those before treatment in the mild group and the severe group (all P ＜ 0.05),with no significant difference in IL-4 levels.Conclusions The serum levels of IL-21,IL-23 are significantly increased in GBS children,indicating they play an important role in the pathogenesis of GBS.Levels of IL-21 and IL-23 are significantly decreased after administration of IVIG,which showed that IVIG could inhibit the secretion of IL21 and IL-23,reduce cellular inflammatory response,and eventually prevent the development of GBS.IL-4 secretion is not obviously affected with IVIG,it might have a role in the recovery of GBS.

OBJECTIVEHuman growth hormone (hGH) is an essential therapeutic drug for the treatment of growth hormone (GH) deficiency (GHD). However, the process of dissolving hGH of the powder form is complicated and potentially hazardous. In the present study, we evaluated the efficacy and safety of preparation in the replacement therapy for children with GH deficiency.

METHODSA 12-month randomized, open-label, multicenter trial was conducted in 31 previously untreated children with growth failure secondary to GH deficiency [20 boys and 11 girls, mean age (10.5 +/- 4.1) years]. An recombined human growth hormone (rhGH) solution (Iintropin AQ) was given via subcutaneous injection daily in every evening at a weekly dose of 0.25 mg/kg. The patients were followed up at 3, 6, 9, and 12 months of the treatment, and the course of treatment was 12 months. Body height was measured 3-monthly and height velocity (HV) and mean height standard deviation score (HT SDS) were calculated. Serum Insulin-like growth factor I (IGF-1), Insulin-like growth factor binding protein 3 (IGFBP-3), GH antibodies and safety parameters were assessed at the baseline and at 3-month intervals. Bone age (BA) was assessed at the baseline and the rate of skeletal maturation (DeltaBA/DeltaCA) was calculated after 6 and 12 months of rhGH treatment by a central bone age reader. Moreover, the safety of rhGH solution treatment was assessed.

RESULTSAfter 12 months of liquid rhGH therapy, growth parameters were significantly increased over baseline. (1) The mean (+/- SD) height increment DeltaHT (cm) was 4.0 +/- 1.3, 7.0 +/- 2.0, 10.3 +/- 2.6 and 12.9 +/- 3.3 after 3, 6, 9, and 12 months of treatment, respectively (P < 0.01), which indicated linear growth after treatment. The GV (cm/years) was 2.7 +/- 0.9 before treatment and increased to 16.0 +/- 5.1, 14.1 +/- 4.0, 13.7 +/- 3.5, and 12.9 +/- 3.3 after treatment, suggesting that catch-up growth was significant after treatment as compared to the pre-treatment status (P < 0.01). Accordingly, post-treatment catch-up growth was obvious, significant differences were observed in HT SDS, which was -4.62 +/- 1.46 at the onset of therapy and increased significantly after the treatment to -3.80 +/- 1.53, -3.28 +/- 1.60, -2.86 +/- 1.75 and -2.47 +/- 1.86, respectively (P < 0.01). The height difference between GH deficient children and unimpaired children of the same age and gender gradually decreased after treatment, which was significantly different from that seen before treatment (P < 0.01). (2) The levels of serum IGF-1 and IGFBP-3 were increased comparably for the treatment. IGF-1 level (microg/L) was 41 +/- 64 at baseline and increased to 179 +/- 155, 202 +/- 141, 156 +/- 155 and 159 +/- 167 after 3, 6, 9, 12 months of treatment. IGFBP-3 level (mg/L) was 1540 +/- 1325 at baseline, and increased to 3891 +/- 1815, 4051 +/- 1308, 3408 +/- 1435 and 3533 +/- 1413, respectively, suggesting that with the increases in height, IGF-1, and IGFBP-3 were significantly activated to relatively high levels by the medication and reached peak values between 3 and 6 months of treatment. The levels of IGF-1 and IGFBP-3 were significantly different before and after treatment (P < 0.01). The IGF-1/IGFBP-3 molar ratio significantly increased during GH therapy (0.143 +/- 0.013 pre-therapy up to 0.240 +/- 0.055 post-therapy, P < 0.01). The IGF-1/IGFBP-3 molar ratio tended to stabilize after 3-month GH therapy. (3) The bone age assessment carried out 6 and 12 months after treatment showed that the bone maturity (DeltaBA/DeltaCA) was 1.01 +/- 0.57 and 1.07 +/- 0.75, respectively, suggesting that there was no speed-up development in the bone age. No severe adverse events were observed during the trial and the most frequent accompanying event was mild hypothyroidism.

CONCLUSIONSrhGH solution (Iintropin AQ) is a safe and effective preparation in the replacement therapy for children with GH deficiency.

Child ; China ; Dwarfism, Pituitary ; blood ; drug therapy ; Female ; Growth Disorders ; blood ; drug therapy ; Human Growth Hormone ; deficiency ; therapeutic use ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; blood ; Insulin-Like Growth Factor I ; metabolism ; Male ; Prospective Studies ; Recombinant Proteins ; therapeutic use

OBJECTIVETo study the protective effect of lidocaine against lung injury after hemorrhagic shock in rabbits.

METHODSEighteen healthy rabbits were randomly divided into 3 groups (n=6), namely lidocaine group (group L), hemorrhagic shock group (group H) and control group (group C). Hemorrhagic shock model was established in rabbits in groups L and H, and the venous blood samples were collected for measurement of plasma malondialdehyde (MDA) and superoxidedismutase (SOD) before phlebotomy (T0), 2 h after hemorrhagic shock (T1) and 2 h after resuscitation (T2). Blood samples were also taken for measurement of MDA and SOD at the same time points in group C. The wet to dry weight ratio of the lung (W/D) was measured at T2.

RESULTSMDA level was significantly lower while SOD level significantly higher in group L than in group H (P<0.05). The W/D ratio in group L was reduced significantly as compared with that in group H (P<0.05).

CONCLUSIONLidocaine can remarkably alleviate lung injury after hemorrhagic shock by inhibiting MDA production and increasing SOD content.

Animals ; Disease Models, Animal ; Lidocaine ; pharmacology ; Lung ; drug effects ; metabolism ; Lung Injury ; prevention & control ; Malondialdehyde ; blood ; Rabbits ; Shock, Hemorrhagic ; drug therapy ; Superoxide Dismutase ; blood