1.Enhancing Disciplinary Development Through Journal Columns: Taking the "Clinical Practice Guidelines"Column in Medical Journal of Peking Union Medical College Hospital as an Example
Meihua WU ; Hui LIU ; Qi ZHOU ; Qianling SHI ; Na LI ; Yule LI ; Xiaoqing LIU ; Kehu YANG ; Jinhui TIAN ; Long GE ; Bin MA ; Xiuxia LI ; Xuping SONG ; Xiaohui WANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1315-1324
To explore the role of the "Clinical Practice Guidelines" column and others in the We collected papers published by the Lanzhou University Evidence-Based Medicine Center team in the "Clinical Practice Guidelines" column and others from 2018 to 2025. These publications were analyzed across multiple dimensions, including authorship and institutional affiliations, citation metrics, and research themes and content. A total of 59 papers were included in the analysis, with authors representing 70 domestie and international research institutions. The cumulative citation count was 639, with the highest single-paper citation frequency reaching 101. The average citation per paper was 10.8, and total downloads exceeded 30 000. The content focused on key themes such as guideline terminology, development methodology, guideline evaluation, and dissemination and implementation. The evolution of research topics progressed from critiques of common misconceptions and hot topies in the field to multidimensional evaluations of thecurrent state of Chinese guidelines, culminating in the fommulation of industry standards for guidelines. These contributions have provided critical references for translating guideline theory into practice in China and have garnered widespread attention and discussion among scholars in the field. The "Clinical Practice Guidelines" column and others in the
2.Diagnostic value of the vesical imaging-reporting and data system in bladder urothelial carcinoma with variant histology
Linjing JIANG ; Xiao YANG ; Lingkai CAI ; Qiang CAO ; Wei TIAN ; Xiaotong LIU ; Bo LIANG ; Meihua JIANG ; Gongcheng WANG ; Qiang SHAO ; Hongliang QUE ; Xuping JIANG ; Qiang LYU
Chinese Journal of Urology 2025;46(10):751-758
Objective:To evaluate the diagnostic value of the vesical imaging-reporting and data system(VI-RADS)for determining muscle invasion in variant histology urothelial carcinoma(VUC)of the bladder.Methods:A retrospective analysis was performed on the pathological and imaging data of 518 bladder cancer patients admitted to Jiangsu Province Hospital between January 2013 and January 2023. Patients were stratified into pure urothelial carcinoma(PUC)group( n = 457)and variant urothelial carcinoma(VUC)group( n = 61)based on the presence of histological variants. In the PUC group,there were 390 males(85.3%)and 67 females(14.7%),with a mean age of(66.9 ± 11.2)years. Tumor characteristics included maximum diameter ≥ 30 mm in 149(32.6%),< 30 mm in 308(67.4%),multiple tumors in 147(32.2%),solitary in 310(67.8%),pedunculated morphology in 143(31.3%)and non-pedunculated in 314(68.7%). Histological grading identified high-grade tumors in 319 patients(69.8%)and low-grade tumors in 138(30.2%). Pathological stage distribution included 191 of T a(41.8%),127 of T 1(27.8%),76 of T 2(16.6%),47 of T 3(10.3%),and 16 of T 4(3.5%)patients. The VUC group included 61 patients,comprising 51 males(83.6%)and 10 females(16.4%),with a mean age of(65.8 ± 11.4)years. Tumor characteristics were maximum diameter ≥ 30 mm in 38(62.3%),< 30 mm in 23(37.7%),multiple tumors in 16(26.2%),solitary in 45(73.8%),pedunculated morphology in 11(18.0%)and non-pedunculated in 50(82.0%). Histological grading identified high-grade tumors in 59 patients(96.7%)and low-grade tumors in 2(3.3%). Pathological stage distribution included 3 of T a(4.9%),15 of T 1(24.6%),15 of T 2(24.6%),20 of T 3(32.8%),and 8 of T 4(13.1%)patients. No statistically significant differences were found between the two groups in gender,age,or tumor multiplicity( P > 0.05). Statistically significant differences were found in pathological grade,pathological stage,maximum tumor diameter,and pedunculated morphology( P < 0.05). Furthermore,an external validation cohort of 278 bladder cancer patients treated between February 2023 and February 2024 from multiple centers(Jiangsu Provincial People’s Hospital,The First Affiliated Hospital of Zhengzhou University,Union Hospital Tongji Medical College Huazhong University of Science and Technology,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Suzhou Municipal Hospital,Huaian First People’s Hospital,Yixing People’s Hospital)was retrospectively analyzed to externally validate the performance of VI-RADS scoring in predicting muscle invasion of VUC. This cohort included a PUC subgroup of 241 patients,comprising 196 males(81.3%)and 45 females(18.7%),with a mean age of(68.0 ± 10.7)years. Tumor characteristics were maximum diameter ≥ 30 mm in 85(35.3%),< 30 mm in 156(64.7%),multiple tumors in 65(27.0%),solitary in 176(73.0%),pedunculated morphology in 76(31.5%)and non-pedunculated in 165(68.5%). Histological grading identified high-grade tumors in 175 patients(72.6%)and low-grade tumors in 66(27.4%). Pathological staging comprised 107 patients of T a(44.4%),78 of T 1(32.4%),22 of T 2(9.1%),22 of T 3(9.1%),and 12 of T 4(5.0%). The VUC subgroup consisted of 37 patients,comprising 29 males(78.4%)and 8 females(21.6%),with a mean age of(70.5 ± 9.5)years. Tumor characteristics were maximum diameter ≥ 30 mm in 23(62.2%),< 30 mm in 14(37.8%),multiple tumors in 9(24.3%),solitary in 28(75.7%),pedunculated morphology in 7(18.9%)and non-pedunculated in 30(81.1%). Histological grading identified high-grade tumors in 36 patients(97.3%)and low-grade tumors in 1(2.7%). Pathological staging comprised 1 patient of T a(2.7%),9 of T 1(24.3%),7 of T 2(18.9%),19 of T 3(51.4%),and 1 of T 4(2.7%). In this validation cohort,no significant differences were found in gender,age,tumor multiplicity,or pedunculated morphology between the PUC and VUC subgroups( P > 0.05). Significant differences were observed in pathological grade,pathological stage,and maximum tumor diameter( P < 0.05). Three radiologists independently reviewed and scored the multiparametric MRI(mp-MRI)in a blinded manner. Inter-reader agreement was assessed using the weighted kappa statistic. Differences in variables between the two groups were compared using t-tests,chi-square tests,or Fisher’s exact test. The diagnostic performance of VI-RADS for muscle invasion in VUC and PUC was comprehensively evaluated using receiver operating characteristic(ROC)curves,the area under the curve(AUC),and cut-off values determined by the Youden’s index. The DeLong test was used to assess whether the diagnostic performance of VI-RADS differed between VUC and PUC. Results:In the retrospective single-center cohort,the AUC of VI-RADS for assessing muscle invasion was 0.895(95% CI 0.864?0.922)in the PUC group,with a cut-off value of > 3,and the AUC was 0.896(95% CI 0.791-0.960)in the VUC group,with a cut-off value of > 3. The difference between the two groups was not statistically significant( P = 0.986). Using a VI-RADS score > 3 as the cut-off value,the accuracy,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)for diagnosing muscle invasion status in the PUC group were 85.8%(392/457),70.5%(98/139),92.5%(294/318),80.3%(98/122),and 87.8%(294/335),respectively. The corresponding values for the VUC group were 82.0%(50/61),76.7%(33/43),94.4%(17/18),97.1%(33/34),and 63.0%(17/27).In the retrospective multicenter cohort,the AUC of VI-RADS for assessing muscle invasion was 0.891(95% CI 0.845?0.927)in the PUC group,with a cut-off value of > 2,and the AUC was 0.898(95% CI 0.754?0.973)in the VUC group,with a cut-off value of > 3. The difference between the two groups was not statistically significant( P = 0.897). Using a VI-RADS score > 3 as the cut-off value,the accuracy,sensitivity,specificity,PPV,and NPV for diagnosing muscle invasion status in the PUC group were 85.9%(207/241),58.9%(33/56),94.1%(174/185),75.0%(33/44),and 88.3%(174/197),respectively. The corresponding values for the VUC group were 81.1%(30/37),77.8%(21/27),90.0%(9/10),95.5%(21/22),and 60.0%(9/15).In the single-center cohort,the Kappa values for inter-reader agreement in assessing muscle invasion status using VI-RADS were 0.881( P < 0.01)for the PUC group and 0.941( P < 0.01)for the VUC group among the three readers. In the multicenter cohort,the Kappa values were 0.858( P < 0.01)for the PUC group and 0.838( P < 0.01)for the VUC group. Conclusions:VI-RADS demonstrates similarly high diagnostic performance for assessing muscle invasion in both PUC and VUC,which is applicable for diagnosing muscle invasion status in VUC,and shows good inter-reader agreement.
3.Efficacy observation of endovascular treatment for acute large-vessel occlusion ischemic stroke over 24 h after onset
Meihua HUYAN ; Zhaochen LIU ; Hongjian SHEN ; Pengfei XING ; Lei ZHANG ; Zifu LI ; Pengfei YANG ; Yongwei ZHANG ; Jianmin LIU
Academic Journal of Naval Medical University 2025;46(9):1116-1120
Objective To investigate the safety and effectiveness of endovascular treatment in patients with acute ischemic stroke due to large vessel occlusion(AIS-LVO)over 24 h after onset.Methods The clinical data of AIS-LVO patients who received endovascular treatment in Neurovascular Center of The First Affiliated Hospital of Naval Medical University from Jan.2018 to Dec.2022 were retrospectively analyzed,including baseline characteristics,imaging findings,treatment,degree of vascular recanalization(modified thrombolysis in cerebral infarction grade 2b and 3 for successful recanalization)and prognosis.Results A total of 57 patients were included,including 42 males and 15 females,aged from 30 to 84 years old.The most common risk factors were hypertension(39 cases,68.4%),followed by smoking history(24 cases,42.1%),diabetes mellitus(17 cases,29.8%),previous stroke history(16 cases,28.1%),and atrial fibrillation(9 cases,15.8%).Before treatment,the National Institutes of Health stroke scale score was 12.84±7.04,and the Alberta Stroke Program early computed tomography score was 9.00(7.00,10.00).Vascular occlusion sites included middle cerebral artery occlusion in 27(47.4%)cases,internal carotid artery occlusion in 24(42.1%)cases,and tandem lesions in 6(10.5%)cases.The time from onset to femoral artery puncture was 38.30(28.17,53.71)h,and the time from femoral artery puncture to vascular recanalization was 52.00(38.50,92.50)min.General anesthesia was the main anesthesia method,accounting for 64.9%(37/57).The etiological types of stroke were mainly large artery atherosclerosis(38 cases,66.7%),cardiogenic embolism(9 cases,15.8%),unknown causes(6 cases,10.5%),and other clear causes(4 cases,7.0%).Mechanical thrombectomy was the first choice in 41(71.9%)cases,balloon dilatation/stenting was used in 35(61.4%)cases,of which 15(26.3%)cases were the first choice.Finally,53(93.0%)cases were recanalized successfully.In terms of complications,1(1.8%)case had symptomatic intracranial hemorrhage.The 90-d prognosis rate was 59.6%(34/57),and 3(5.3%)cases died.Conclusion Endovascular treatment for AIS-LVO patients over 24 h after onset has high recanalization rate and good safety,but it still needs to be further verified by randomized controlled trials.
4.Interpretation of "Guidelines for prevention of respiratory syncytial virus infections in mothers and infants (2025 Edition)"
Pengxiang ZHOU ; Wei ZHOU ; Huixia YANG ; Meihua PIAO ; Yangyu ZHAO ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2025;28(12):1029-1034
The "Guidelines for prevention of respiratory syncytial virus (RSV) infection in mothers and infants (2025 Edition)" were developed by the Society of Perinatal Medicine, Chinese Medical Association. This guideline focuses on preventing RSV infections in maternal and neonatal populations, providing 15 evidence-based recommendations addressing eight clinical questions that integrate current best evidence with clinical expertise and patient preferences. The recommendations encompass non-pharmacological prevention, pharmacological prophylaxis, and vaccine strategies. This article provides a comprehensive interpretation of the guidelines, summarizes the current evidence status and practical limitations, and aims to facilitate better understanding and application of the recommendations among healthcare providers, thereby enhancing RSV infection prevention and control for maternal and neonatal populations in China.
5.Diagnostic value of the vesical imaging-reporting and data system in bladder urothelial carcinoma with variant histology
Linjing JIANG ; Xiao YANG ; Lingkai CAI ; Qiang CAO ; Wei TIAN ; Xiaotong LIU ; Bo LIANG ; Meihua JIANG ; Gongcheng WANG ; Qiang SHAO ; Hongliang QUE ; Xuping JIANG ; Qiang LYU
Chinese Journal of Urology 2025;46(10):751-758
Objective:To evaluate the diagnostic value of the vesical imaging-reporting and data system(VI-RADS)for determining muscle invasion in variant histology urothelial carcinoma(VUC)of the bladder.Methods:A retrospective analysis was performed on the pathological and imaging data of 518 bladder cancer patients admitted to Jiangsu Province Hospital between January 2013 and January 2023. Patients were stratified into pure urothelial carcinoma(PUC)group( n = 457)and variant urothelial carcinoma(VUC)group( n = 61)based on the presence of histological variants. In the PUC group,there were 390 males(85.3%)and 67 females(14.7%),with a mean age of(66.9 ± 11.2)years. Tumor characteristics included maximum diameter ≥ 30 mm in 149(32.6%),< 30 mm in 308(67.4%),multiple tumors in 147(32.2%),solitary in 310(67.8%),pedunculated morphology in 143(31.3%)and non-pedunculated in 314(68.7%). Histological grading identified high-grade tumors in 319 patients(69.8%)and low-grade tumors in 138(30.2%). Pathological stage distribution included 191 of T a(41.8%),127 of T 1(27.8%),76 of T 2(16.6%),47 of T 3(10.3%),and 16 of T 4(3.5%)patients. The VUC group included 61 patients,comprising 51 males(83.6%)and 10 females(16.4%),with a mean age of(65.8 ± 11.4)years. Tumor characteristics were maximum diameter ≥ 30 mm in 38(62.3%),< 30 mm in 23(37.7%),multiple tumors in 16(26.2%),solitary in 45(73.8%),pedunculated morphology in 11(18.0%)and non-pedunculated in 50(82.0%). Histological grading identified high-grade tumors in 59 patients(96.7%)and low-grade tumors in 2(3.3%). Pathological stage distribution included 3 of T a(4.9%),15 of T 1(24.6%),15 of T 2(24.6%),20 of T 3(32.8%),and 8 of T 4(13.1%)patients. No statistically significant differences were found between the two groups in gender,age,or tumor multiplicity( P > 0.05). Statistically significant differences were found in pathological grade,pathological stage,maximum tumor diameter,and pedunculated morphology( P < 0.05). Furthermore,an external validation cohort of 278 bladder cancer patients treated between February 2023 and February 2024 from multiple centers(Jiangsu Provincial People’s Hospital,The First Affiliated Hospital of Zhengzhou University,Union Hospital Tongji Medical College Huazhong University of Science and Technology,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Suzhou Municipal Hospital,Huaian First People’s Hospital,Yixing People’s Hospital)was retrospectively analyzed to externally validate the performance of VI-RADS scoring in predicting muscle invasion of VUC. This cohort included a PUC subgroup of 241 patients,comprising 196 males(81.3%)and 45 females(18.7%),with a mean age of(68.0 ± 10.7)years. Tumor characteristics were maximum diameter ≥ 30 mm in 85(35.3%),< 30 mm in 156(64.7%),multiple tumors in 65(27.0%),solitary in 176(73.0%),pedunculated morphology in 76(31.5%)and non-pedunculated in 165(68.5%). Histological grading identified high-grade tumors in 175 patients(72.6%)and low-grade tumors in 66(27.4%). Pathological staging comprised 107 patients of T a(44.4%),78 of T 1(32.4%),22 of T 2(9.1%),22 of T 3(9.1%),and 12 of T 4(5.0%). The VUC subgroup consisted of 37 patients,comprising 29 males(78.4%)and 8 females(21.6%),with a mean age of(70.5 ± 9.5)years. Tumor characteristics were maximum diameter ≥ 30 mm in 23(62.2%),< 30 mm in 14(37.8%),multiple tumors in 9(24.3%),solitary in 28(75.7%),pedunculated morphology in 7(18.9%)and non-pedunculated in 30(81.1%). Histological grading identified high-grade tumors in 36 patients(97.3%)and low-grade tumors in 1(2.7%). Pathological staging comprised 1 patient of T a(2.7%),9 of T 1(24.3%),7 of T 2(18.9%),19 of T 3(51.4%),and 1 of T 4(2.7%). In this validation cohort,no significant differences were found in gender,age,tumor multiplicity,or pedunculated morphology between the PUC and VUC subgroups( P > 0.05). Significant differences were observed in pathological grade,pathological stage,and maximum tumor diameter( P < 0.05). Three radiologists independently reviewed and scored the multiparametric MRI(mp-MRI)in a blinded manner. Inter-reader agreement was assessed using the weighted kappa statistic. Differences in variables between the two groups were compared using t-tests,chi-square tests,or Fisher’s exact test. The diagnostic performance of VI-RADS for muscle invasion in VUC and PUC was comprehensively evaluated using receiver operating characteristic(ROC)curves,the area under the curve(AUC),and cut-off values determined by the Youden’s index. The DeLong test was used to assess whether the diagnostic performance of VI-RADS differed between VUC and PUC. Results:In the retrospective single-center cohort,the AUC of VI-RADS for assessing muscle invasion was 0.895(95% CI 0.864?0.922)in the PUC group,with a cut-off value of > 3,and the AUC was 0.896(95% CI 0.791-0.960)in the VUC group,with a cut-off value of > 3. The difference between the two groups was not statistically significant( P = 0.986). Using a VI-RADS score > 3 as the cut-off value,the accuracy,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)for diagnosing muscle invasion status in the PUC group were 85.8%(392/457),70.5%(98/139),92.5%(294/318),80.3%(98/122),and 87.8%(294/335),respectively. The corresponding values for the VUC group were 82.0%(50/61),76.7%(33/43),94.4%(17/18),97.1%(33/34),and 63.0%(17/27).In the retrospective multicenter cohort,the AUC of VI-RADS for assessing muscle invasion was 0.891(95% CI 0.845?0.927)in the PUC group,with a cut-off value of > 2,and the AUC was 0.898(95% CI 0.754?0.973)in the VUC group,with a cut-off value of > 3. The difference between the two groups was not statistically significant( P = 0.897). Using a VI-RADS score > 3 as the cut-off value,the accuracy,sensitivity,specificity,PPV,and NPV for diagnosing muscle invasion status in the PUC group were 85.9%(207/241),58.9%(33/56),94.1%(174/185),75.0%(33/44),and 88.3%(174/197),respectively. The corresponding values for the VUC group were 81.1%(30/37),77.8%(21/27),90.0%(9/10),95.5%(21/22),and 60.0%(9/15).In the single-center cohort,the Kappa values for inter-reader agreement in assessing muscle invasion status using VI-RADS were 0.881( P < 0.01)for the PUC group and 0.941( P < 0.01)for the VUC group among the three readers. In the multicenter cohort,the Kappa values were 0.858( P < 0.01)for the PUC group and 0.838( P < 0.01)for the VUC group. Conclusions:VI-RADS demonstrates similarly high diagnostic performance for assessing muscle invasion in both PUC and VUC,which is applicable for diagnosing muscle invasion status in VUC,and shows good inter-reader agreement.
6.Interpretation of "Guidelines for prevention of respiratory syncytial virus infections in mothers and infants (2025 Edition)"
Pengxiang ZHOU ; Wei ZHOU ; Huixia YANG ; Meihua PIAO ; Yangyu ZHAO ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2025;28(12):1029-1034
The "Guidelines for prevention of respiratory syncytial virus (RSV) infection in mothers and infants (2025 Edition)" were developed by the Society of Perinatal Medicine, Chinese Medical Association. This guideline focuses on preventing RSV infections in maternal and neonatal populations, providing 15 evidence-based recommendations addressing eight clinical questions that integrate current best evidence with clinical expertise and patient preferences. The recommendations encompass non-pharmacological prevention, pharmacological prophylaxis, and vaccine strategies. This article provides a comprehensive interpretation of the guidelines, summarizes the current evidence status and practical limitations, and aims to facilitate better understanding and application of the recommendations among healthcare providers, thereby enhancing RSV infection prevention and control for maternal and neonatal populations in China.
7.27-Hydroxycholesterol/liver X receptor/apolipoprotein E mediates zearalenone-induced intestinal immunosuppression:A key target potentially linking zearalenone and cancer
Ruan HAONAN ; Zhang JING ; Wang YUNYUN ; Huang YING ; Wu JIASHUO ; He CHUNJIAO ; Ke TONGWEI ; Luo JIAOYANG ; Yang MEIHUA
Journal of Pharmaceutical Analysis 2024;14(3):371-388
Zearalenone(ZEN)is a mycotoxin that extensively contaminates food and feed,posing a significant threat to public health.However,the mechanisms behind ZEN-induced intestinal immunotoxicity remain unclear.In this study,Sprague-Dawley(SD)rats were exposed to ZEN at a dosage of 5 mg/kg/day b.w.for a duration of 14 days.The results demonstrated that ZEN exposure led to notable pathological alterations and immunosup-pression within the intestine.Furthermore,ZEN exposure caused a significant reduction in the levels of apolipoprotein E(ApoE)and liver X receptor(LXR)(P<0.05).Conversely,it upregulated the levels of myeloid-derived suppressor cells(MDSCs)markers(P<0.05)and decreased the presence of 27-hydroxycholesterol(27-HC)in the intestine(P<0.05).It was observed that ApoE or LXR agonists were able to mitigate the immunosuppressive effects induced by ZEN.Additionally,a bioinformatics analysis highlighted that the downregulation of ApoE might elevate the susceptibility to colorectal,breast,and lung cancers.These find-ings underscore the crucial role of the 27-HC/LXR/ApoE axis disruption in ZEN-induced MDSCs proliferation and subsequent inhibition of T lymphocyte activation within the rat intestine.Notably,ApoE may emerge as a pivotal target linking ZEN exposure to cancer development.
8.Clinical efficacy and safety of amlodipine besylate and benazepril hydrochloride tablets (II) in the treatment of primary hypertension
Min ZHANG ; Na ZHOU ; Xiufeng LIU ; Qunqun YU ; Guangping CHEN ; Meiling XIE ; Meihua LIU ; Xiang YANG ; Yali CHEN
Chinese Journal of Primary Medicine and Pharmacy 2024;31(5):691-695
Objective:To investigate the clinical efficacy and safety of amlodipine besylate and benazepril hydrochloride tablets (II) in the treatment of primary hypertension.Methods:A total of 280 patients with primary hypertension who were treated at Shougang Shuigang Hospital between June 2022 and June 2023 were selected as study subjects. A clinical case-control study was conducted, and the RAND function method was utilized to randomly allocate the subjects into four groups, each receiving a different treatment: amlodipine besylate group (Group A, n = 70), benazepril hydrochloride group (Group B, n = 70), compound formulation amlodipine besylate and benazepril hydrochloride tablets group (Group C, n = 71), and amlodipine besylate plus benazepril hydrochloride group (Group D, n = 69). Relevant therapeutic indicators (blood pressure compliance rate, changes in blood pressure values) and safety indicators (adverse reactions, medication adherence) were observed. Results:The blood pressure compliance rates of Group C and Group D were 91.5% (65/71) and 89.9% (62/69), respectively. There was no statistically significant difference between the two groups ( χ2 = 1.24, P = 0.143), but both were higher than the rates of 77.1% (54/70) and 74.3% (52/70) in Group A and Group B, respectively ( χ2 = 5.68, 4.86, P = 0.004, 0.012). Before treatment, there was no statistically significant difference in systolic and diastolic blood pressure among the four groups of patients (all P > 0.05). After treatment, there was a statistically significant decrease in both systolic and diastolic blood pressure among the four groups compared with their pre-treatment levels (all P < 0.05). Specifically, Group C and Group D exhibited significant reductions in blood pressure following treatment ( t = 4.35, 5.12, 7.25, 5.86, all P < 0.05). Meanwhile, there was no statistically significant difference in systolic blood pressure between Group C and Group D after treatment ( P > 0.05), while diastolic blood pressure was lower in Group C than Group D after treatment ( t = 6.01, P < 0.05). There was a significant downward trend observed in total cholesterol, triglycerides, and low-density lipoprotein cholesterol levels (all P < 0.05). Notably, Group B and Group D reported higher incidences of dry cough, with 15 and 10 cases, respectively, compared with Group A and Group C, which had 1 and 3 cases, respectively. These differences were statistically significant ( χ2 = 4.25, 5.04, both P < 0.05). Furthermore, the treatment compliance rates for Group A, Group B, and Group C were 72.9% (51/70), 71.4% (50/70), and 74.6% (53/71), respectively, all exceeding the 46.4% (32/69) compliance rate of Group D. These differences were also statistically significant ( χ2 = 4.68, 5.24, 4.98, all P < 0.05). Conclusion:The clinical efficacy and safety of the compound formulation amlodipine besylate and benazepril hydrochloride tablets (II) in the treatment of primary hypertension are superior to those of single tablets and combination therapy.
9.A retrospective study on clinicopathological features and prognostic factors of 179 cases of laryngeal squamous cell carcinoma
Zhipeng MI ; Yongchun LI ; Wulin WEN ; Xueliang SHEN ; Fengxia YANG ; Meihua YANG ; Yuqiao ZHANG ; Baoli CHEN ; Ruixia MA
Chinese Archives of Otolaryngology-Head and Neck Surgery 2024;31(11):686-691
OBJECTIVE To analyze the clinicopathological features of laryngeal squamous carcinoma tumors and their correlation with prognosis in order to improve the understanding and diagnosis of laryngeal squamous cell carcinoma.METHODS The clinical and pathological data(including gender,age,stage,differentiation,immunohistochemistry,etc.)of 179 patients with laryngeal squamous cell carcinoma[171 males,8 females,aged 30-84(61.53±8.02)years]who were treated in Department of Otolaryngology Head and Neck Surgery,The First and Second Clinical Medical Schools of Ningxia Medical University from January 2015 to December 2022 were retrospectively studied,and the effects of various factors on prognosis were analyzed.RESULTS Among the 179 patients with laryngeal squamous cell carcinoma,the male-to-female ratio was 21.4:1,and the incidence was high in the age group of 60-79 years old(58.7%),and the youngest age of onset was 30 years old.The main clinical manifestations were hoarseness 138 cases(77.1%),sore throat 16 cases(8.9%)and pharyngeal foreign body sensation 13 cases(7.3%).Glottic type was more common in the primary site 135 cases(75.4%),and 31 cases were accompanied by cervical lymph node metastasis(17.3%).The degree of differentiation was more common in the moderately differentiated type 80 cases(44.7%).The positive rates of immunohistochemistry markers p16,EGFR(epidermal growth factor receptor),PD-1/PD-L1 and VEGF(vascular endothelial growth factor)were 20.3%,96.4%,36.4%and 77.3%,respectively.Univariate Kaplan-Meier survival analysis showed that the site of disease,lymph node metastasis,and tumor stage were significantly correlated with disease recurrence.Multivariate Cox regression analysis showed that the clinical stage of the tumor was an independent risk factor for the prognosis of the disease(HR=3.715,95%CI:1.519-9.088,P=0.04).CONCLUSION The stage of laryngeal squamous cell carcinoma,the site of the disease,and the metastasis of the lymph nodes are the main factors affecting the prognosis.The high positive expression rate of immunohistochemistry markers EGFR and VEGF is worth paying attention to Targeted therapy for patients with positive PD-1/PD-L1 testing is a promising research direction.
10.Effect of buccal needle therapy on perioperative analgesic effects in patients undergoing laparoscopic radical colon cancer surgery
Yihui ZHOU ; Meihua ZHU ; Haiqing HU ; Cong NIU ; Xiaoliang YANG ; Jiamin ZHANG ; Zhiyong CHEN
The Journal of Clinical Anesthesiology 2024;40(7):704-708
Objective To observe the effect of buccal needle therapy on perioperative analgesia in patients undergoing laparoscopic radical colon cancer surgery.Methods Sixty patients underwent dective laparoscopic radical of colon cancer surgery were selected,32 males and 28 females,aged 45-74 years,BMI 18.5-25.0 kg/m2 and ASA physical status Ⅱ or Ⅲ.The patients were divided into two groups using the randomized numerical table method:buccal needle group and control group,30 patients in each group.Before the induction of anesthesia,the buccal needle group was given buccal needle therapy once,and buc-cal needle therapy was performed once a day at 9 a.m.in the postoperative period,leaving the needle in place for 30 minutes each time,for 3 consecutive days of treatment,and the control group was not treated with buccal needle therapy.The amount of intraoperative propofol,remifentanil,sufentanil used in the 48 hours postoperative period and recorded.VAS pain scores were recorded at 1 hour,4,24,and 48 hours postoperatively.Venous blood was collected at the time of admission to the hand room and at 1 day,2,and 3 days postoperatively,respectively,and the concentrations of plasma C-reactive protein(CRP),interleu-kin-6(IL-6),and tumor necrosis factor-alpha(TNF-α)were measured.The occurrence of adverse reactions within 48 hours after operation was recorded.Results Compared with the control group,intraop-erative propofol,remifentanil,the amount of sufentanil used and the number of analgesic pump presses with-in 48 hours after operation in the buccal needle group were significantly reduced in the buccal needle group(P<0.05),VAS pain scores were significantly lower at 1 hour,4,24,and 48 hours postoperatively(P<0.05),CRP,IL-6,and TNF-α concentrations were significantly lower at 1 day,2,and 3 days postopera-tively(P<0.05),and nausea and vomiting,incidence of laryngospasm and laryngeal discomfort were sig-nificantly reduced(P<0.05).Conclusion The perioperative use of buccal needle therapy in patients un-dergoing laparoscopic radical colon cancer surgery can effectively reduce pain,inhibit inflammatory respon-ses,and decrease the incidence of postoperative adverse reactions.

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