OBJECTIVES: To investigate the changes in blood levels of calcium and bone metabolism biochemical markers in patients with primary osteoporosis receiving treatment with denosumab. METHODS: Seventy-three patients with primary osteoporosis treated in our Department between December, 2021 and December 2023 were enrolled. All the patients were treated with calcium supplements, vitamin D and calcitriol in addition to regular denosumab treatment every 6 months. Blood calcium, parathyroid hormone (PTH), osteocalcin (OC), type I procollagen amino-terminal propeptide (PINP), and type I collagen carboxy-terminal telopeptide β special sequence (β‑CTX) data before and at 3, 6, 9, and 12 months after the first treatment were collected from each patient. RESULTS: Three months after the first denosumab treatment, the bone turnover markers (BTMs) OC, PINP, and β-CTX were significantly decreased compared to their baseline levels by 39.5% (P<0.001), 56.2% (P<0.001), and 81.8% (P<0.001), respectively. At 6, 9, and 12 months of treatment, OC, PINP, and β-CTX remained significantly lower than their baseline levels (P<0.001). Blood calcium level was decreased (P<0.05) and PTH level increased (P<0.05) significantly in these patients at months of denosumab treatment, but their levels were comparable to the baseline levels at 6, 9, and 12 months of the treatment (P>0.05). CONCLUSIONS Denosumab can suppress BTMs and has a good therapeutic effect in patients with primary osteoporosis, but reduction of blood calcium and elevation of PTH levels can occur during the first 3 months in spite of calcium supplementation. Blood calcium and PTH levels can recover the baseline levels as the treatment extended, suggesting the importance of monitoring blood calcium and PTH levels during denosumab treatment.
Humans ; Denosumab/therapeutic use* ; Calcium/blood* ; Parathyroid Hormone/blood* ; Biomarkers/blood* ; Osteoporosis/blood* ; Osteocalcin/blood* ; Procollagen/blood* ; Female ; Collagen Type I/blood* ; Peptide Fragments/blood* ; Bone Density Conservation Agents/therapeutic use* ; Bone and Bones/metabolism* ; Male ; Middle Aged ; Vitamin D ; Peptides/blood* ; Aged

Repetitive transcranial magnetic stimulation (rTMS) is a rapid and effective therapy for major depressive disorder; however, there is significant variability in therapeutic outcomes both within and across individuals, with approximately 50% of patients showing no response to rTMS treatment. Many studies have personalized the stimulation parameters of rTMS (e.g., location and intensity of stimulation) according to the anatomical and functional structure of the brain. In addition to these parameters, the internal states of the individual, such as circadian rhythm, behavior/cognition, neural oscillation, and neuroplasticity, also contribute to the variation in rTMS effects. In this review, we summarize the current literature on the interaction between rTMS and internal states. We propose two possible methods, multimodal treatment, and adaptive closed-loop treatment, to integrate patients' internal states to achieve better rTMS treatment for depression.
Humans ; Transcranial Magnetic Stimulation/methods* ; Depressive Disorder, Major/physiopathology* ; Neuronal Plasticity/physiology* ; Brain/physiopathology*

Objective:To study the application value of analytic hierarchy process(AHP)-risk analysis management strategy in management for medical equipment of hospital,so as to improve utilization efficiency of equipment.Methods:A decision model of managing equipment was established by adopting AHP-risk analysis management strategy,and Entropy method was used to optimize and improve the combined weight of AHP algorithm,so as to obtain the comprehensive weight of classification decision for medical equipment.The equipment was classified into high risk,second highest risk,medium risk,second lowest risk and low risk to receive different management strategy.A total of 103 medical equipment in clinical use at People's Hospital of Xinjiang Uygur Autonomous Region from January 2023 to February 2024 were selected,and the conventional management method was adopted to manage these equipment during January 2023 and July 2024,and AHP-risk analysis management strategy was adopted to manage them during August 2023 and February 2024.The differences of the management effects of medical equipment in clinical use,and technical support for equipment between two management methods were compared.Results:The average use rate,rate of growth amplitude of cost-effectiveness,and rate of growth amplitude of social benefit of equipment of using the AHP risk analysis management method were respectively(95.34±3.75)%,(7.65±2.18)%,and(10.81±2.42)%,all of which were higher than those of the conventional management method.However,the average relative operating rate and relative turnover rate of using the AHP risk analysis management method were respectively(9.26±2.46)%and(10.63±2.07)%,all of which were lower than those of the conventional management method,and the differences were statistically significant(t=9.223,24.681,17.813,15.764,18.873,P<0.05).The average self-repair rate,upgrade efficiency,and coincidence rate of scrapping equipment of using the AHP-risk analysis management method were respectively(91.54±4.25)%,(94.52±3.77)%,and(93.53±4.72)%,all of which were higher than those of the conventional management method.However,the average failure rate of that was(0.74±0.38)%,which was lower than the average failure rate of the conventional management method,and the differences of them were statistically significant(t=8.445,9.624,14.046,22.794,P<0.05).Conclusion:The AHP-risk analysis management strategy can improve the management effect of clinical use of medical equipment,and the technical support for medical equipment,and enhance usage and maintenance efficiency of equipment,and achieve refined management for medical equipment.

Objective To investigate the changes of anti-Müllerian hormone(AMH),inhibin-B(INHB)and inhibin-A(INHA)levels in boys with cryptorchidism,analyze their clinical application value,and provide labo-ratory data for the diagnosis and treatment of cryptorchidism.Methods A total of 1 310 boys with cryp-torchidism who were hospitalized or visited the outpatient department in the hospital from July 2020 to July 2023 were included in the case group.Another 50 boys who underwent physical examination at the hospital and had no abnormalities in reproductive system development such as testicles were selected as the control group.Venous blood was collected from all the research subjects in a fasting state and placed into biochemical tubes.After centrifuging the serum,the changes in the levels of anti-Müllerian hormone(AMH),Inhibin B(INHB),and Inhibin A(INHA)in the two groups were detected by the chemiluminescence method.The differences between the two groups were analyzed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of AMH,INHB,and INHA for cryptorchidism.Results The AMH lev-els in boys with cryptorchidism were significantly higher than those in the control group(P＜0.01),while the INHB and INHA levels were significantly lower than those in the control group(P＜0.01).ROC curve analy-sis showed that the area under the curve(AUC)of AMH was 0.65(95％CI:0.56-0.74,P＜0.01).When the Youden index was 26.85％and the cut off value was 37.19 ng/mL,it had relatively good sensitivity(88.85％)but relatively low specificity(38.00％).The AUC of INHB was 0.63(95％CI:0.57-0.70,P＜0.01).When the Youden index was 24.17％and the cut off value was 77.17 pg/mL,it had relatively poor sensitivity(38.17％)but relatively good specificity(86.00％).Both AMH and INHB have certain clinical val-ue in the differential diagnosis of boys with cryptorchidism.The AUC of INHA was 0.81(95％CI:0.79-0.84,P＜0.01).When the Youden index was 75.86％and the cut off value was 5.165 pg/mL,it had a rela-tively good sensitivity(77.86％)and specificity(98.00％).Conclusion The changes in the levels of serum AMH and INHB have certain diagnostic value for boys with cryptorchidism,while INHA has a good diagnos-tic value and can be used as an auxiliary diagnostic indicator for boys with cryptorchidism.

Objective:To explore the real experience of patients with diffuse large B-cell lymphoma in clinical trials of chimeric antigen receptor T (CAR-T) cell therapy, providing reference for clinical practice.Methods:This study was descriptive qualitative research. From January to December 2024, 15 patients with diffuse large B-cell lymphoma who completed a clinical trial of CAR-T cell therapy in Ward of Biological Immunotherapy of the First Affiliated Hospital of Zhengzhou University were selected by purposive sampling method for semi-structured interviews. The data was analyzed by content analysis method.Results:The experience of patients with diffuse large B-cell lymphoma participating in the clinical trial of CAR-T cell therapy were summarized into three themes and 12 sub-themes, namely, the pre-enrollment situation and attitude towards the clinical trial: survival from adversity (caught in the dilemma of treatment, grasping the last hope, survival desire overcoming fear, active psychological construction), social support and power source in the clinical trial: support network (unnoticeable personal strength, multi-dimensional family support system, professional medical support system, weak peer support system), and experience and feeling after CAR-T cell therapy: positive experience driven by efficacy (satisfaction with treatment effectiveness and clinical trials, pleased with reduced adverse reactions, increased confidence in treating diseases, adverse reactions were not scary) .Conclusions:Patients with diffuse large B-cell lymphoma have an overall positive experience during clinical trials of CAR-T cell therapy, but the negatives should not be ignored. Healthcare professionals should strengthen the health education of clinical trials, assist patients to improve the social support network, make up for the short board of patient support, alleviate the adverse reactions of patients, and then increase the enthusiasm of patients to participate in clinical trials.

Objective:To study the application value of analytic hierarchy process(AHP)-risk analysis management strategy in management for medical equipment of hospital,so as to improve utilization efficiency of equipment.Methods:A decision model of managing equipment was established by adopting AHP-risk analysis management strategy,and Entropy method was used to optimize and improve the combined weight of AHP algorithm,so as to obtain the comprehensive weight of classification decision for medical equipment.The equipment was classified into high risk,second highest risk,medium risk,second lowest risk and low risk to receive different management strategy.A total of 103 medical equipment in clinical use at People's Hospital of Xinjiang Uygur Autonomous Region from January 2023 to February 2024 were selected,and the conventional management method was adopted to manage these equipment during January 2023 and July 2024,and AHP-risk analysis management strategy was adopted to manage them during August 2023 and February 2024.The differences of the management effects of medical equipment in clinical use,and technical support for equipment between two management methods were compared.Results:The average use rate,rate of growth amplitude of cost-effectiveness,and rate of growth amplitude of social benefit of equipment of using the AHP risk analysis management method were respectively(95.34±3.75)%,(7.65±2.18)%,and(10.81±2.42)%,all of which were higher than those of the conventional management method.However,the average relative operating rate and relative turnover rate of using the AHP risk analysis management method were respectively(9.26±2.46)%and(10.63±2.07)%,all of which were lower than those of the conventional management method,and the differences were statistically significant(t=9.223,24.681,17.813,15.764,18.873,P<0.05).The average self-repair rate,upgrade efficiency,and coincidence rate of scrapping equipment of using the AHP-risk analysis management method were respectively(91.54±4.25)%,(94.52±3.77)%,and(93.53±4.72)%,all of which were higher than those of the conventional management method.However,the average failure rate of that was(0.74±0.38)%,which was lower than the average failure rate of the conventional management method,and the differences of them were statistically significant(t=8.445,9.624,14.046,22.794,P<0.05).Conclusion:The AHP-risk analysis management strategy can improve the management effect of clinical use of medical equipment,and the technical support for medical equipment,and enhance usage and maintenance efficiency of equipment,and achieve refined management for medical equipment.

Objective:To explore the real experience of patients with diffuse large B-cell lymphoma in clinical trials of chimeric antigen receptor T (CAR-T) cell therapy, providing reference for clinical practice.Methods:This study was descriptive qualitative research. From January to December 2024, 15 patients with diffuse large B-cell lymphoma who completed a clinical trial of CAR-T cell therapy in Ward of Biological Immunotherapy of the First Affiliated Hospital of Zhengzhou University were selected by purposive sampling method for semi-structured interviews. The data was analyzed by content analysis method.Results:The experience of patients with diffuse large B-cell lymphoma participating in the clinical trial of CAR-T cell therapy were summarized into three themes and 12 sub-themes, namely, the pre-enrollment situation and attitude towards the clinical trial: survival from adversity (caught in the dilemma of treatment, grasping the last hope, survival desire overcoming fear, active psychological construction), social support and power source in the clinical trial: support network (unnoticeable personal strength, multi-dimensional family support system, professional medical support system, weak peer support system), and experience and feeling after CAR-T cell therapy: positive experience driven by efficacy (satisfaction with treatment effectiveness and clinical trials, pleased with reduced adverse reactions, increased confidence in treating diseases, adverse reactions were not scary) .Conclusions:Patients with diffuse large B-cell lymphoma have an overall positive experience during clinical trials of CAR-T cell therapy, but the negatives should not be ignored. Healthcare professionals should strengthen the health education of clinical trials, assist patients to improve the social support network, make up for the short board of patient support, alleviate the adverse reactions of patients, and then increase the enthusiasm of patients to participate in clinical trials.

Arsenic compounds are widely used for the therapeutic intervention of multiple diseases.Ancient pharmacologists discovered the medicinal utility of these highly toxic substances,and modern phar-macologists have further recognized the specific active ingredients in human diseases.In particular,Arsenic trioxide(ATO),as a main component,has therapeutic effects on various tumors(including leukemia,hepatocellular carcinoma,lung cancer,etc.).However,its toxicity limits its efficacy,and con-trolling the toxicity has been an important issue.Interestingly,recent evidence has pointed out the pivotal roles of arsenic compounds in phase separation and membraneless organelles formation,which may determine their toxicity and therapeutic efficacy.Here,we summarize the arsenic compounds-regulating phase separation and membraneless organelles formation.We further hypothesize their potential involvement in the therapy and toxicity of arsenic compounds,highlighting potential mecha-nisms underlying the clinical application of arsenic compounds.

Objective·To investigate the expression of miR-146a in peripheral blood CD4+T lymphocytes of patients with rheumatoid arthritis(RA)and its correlation with inflammatory cytokines such as tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6).Methods·A total of 30 active RA patients who received medical treatment and 30 healthy controls who underwent physical examinations at the People's Hospital of Longhua,Shenzhen from August 2019 to July 2021 were selected.Peripheral blood mononuclear cells(PBMCs)and CD4+T lymphocytes were isolated from venous blood extracted from RA patients and healthy controls,respectively.Quantitative real-time PCR(qPCR)was used to detect the expression of miR-146a in peripheral blood CD4+T lymphocytes,and enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of TNF-α and IL-6.After transfection of the peripheral blood CD4+T lymphocytes of RA patients with miR-146a mimic,the expression of miR-146a,TNF-α and IL-6 was detected again.The correlations between miR-146a expression and TNF-α and IL-6 expression in RA patients,both before and after transfection,were analyzed by using Pearson correlation coefficient.Results·Before transfection with miR-146a mimic,the expression levels of miR-146a,TNF-α and IL-6 in peripheral blood CD4+T lymphocytes of RA patients were significantly higher than those of healthy controls(all P＜0.001).After transfection,the expression of miR-146a in peripheral blood CD4+T lymphocytes of RA patients was significantly higher,and the expression of TNF-α and IL-6 was significantly lower(all P＜0.001).The results of Pearson correlation analysis showed that the expression of miR-146a in peripheral blood CD4+T lymphocytes of RA patients,both before and after transfection,was positively correlated with the expression of TNF-α and IL-6,respectively(r=0.959,P＜0.001;r=0.916,P＜0.001;r=0.971,P＜0.001;r=0.861,P＜0.001).Conclusion·miR-146a can regulate the levels of TNF-α and IL-6 in peripheral blood CD4+T lymphocytes of RA patients,indicating that miR-146a may play a role in the pathogenesis of RA.

Objective To develop a training curriculum for specialist nurses in oral implantology and to provide a theoretical basis for professional development.Methods In September 2022,based on literature reviews,interviews and group discussions were conducted to formulate an preliminary draft of the"Training Curriculum for Nursing Specialists in Oral Implantology",which included 6 primary domains and 23 secondary items.Between October and November 2022,Delphi method was employed to conduct 2 rounds of expert consultations with 17 dentists and nursing specialists in oral implantology.The initial draft was improved based on the results of consultation and a final version of the curriculum was concluded.Results The response rate of the two rounds of expert consultation was both of 100%with an expert authority coefficient at 0.873.The importance scores for the items in the two rounds of expert correspondence ranged from 4.31 to 5.00 and 4.47 to 5.00,respectively,with the coefficients of variation ranged from 0 to 0.16 and 0 to 0.14,respectively.The proportion of maximum scores in the two rounds of expert consultation ranged from 43.75%to 100.00%and 47.10%to100.00%,respectively,with Kendall W coefficients of 0.196 and 0.310,respectively,indicating statistically significant differences(all P<0.001).The finalised curriculum encompassed 6 primary domains and 30 secondary items.The primary domains included basic knowledge about oral implantation,perioperative care of oral implantation,care during restoration period of oral implantation,infection management of oral implantation,emergency management of oral implantation,and nursing management in oral implantation.Conclusion The curriculum developed for training of specialist nurses in oral implantology is scientifically valid and reliable.It is in line with the training requirements for the specialists in oral implantology and provides guidance for the professional training.