Objective To investigate the effect of Elvitegravir,Cobicistat,Emtricitabine and Tenofovir Alafenamide single tablet alone versus tenofovir(TDF)+lamivudine(3TC)+efavirenz(EFV)scheme in the treatment of patients with acquired immunodeficiency syndrome(AIDS).Methods A total of 100 patients with AIDS who visited the hospital from January 2022 to October 2022 were selected and divided into two groups by random number table method,50 cases in each group.Group A was treated with Elvitegravir,Cobi-cistat,Emtricitabine and Tenofovir Alafenamide single tablet monotherapy and Group B was treated with TDF+3TC+EFV scheme.The human immunodeficiency virus(HIV)load,body immunity(CD4+,CD8+,CD4+CD38+cell ratio,CD8+CD38+cell ratio),lipid metabolism indexes[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],glucose metabolism indexes[fasting blood glucose(FPG),glycated hemoglobin(HbA1c)],glycoprotein 130(gp130),interleukin-35(IL-35)and its receptor IL-12Rβ2 levels were observed before and after treatment in the two groups,and the drug safety in the two groups was counted.Results After 3 months of treatment,HIV load,CD8+count,CD4+CD38+cell ratio,and CD8+CD38+cell ratio in both groups were lower than those before treatment,and CD4+count was higher than that before treatment(P＜0.05),but the difference was not statistically significant when compared between A and B groups(P＞0.05).After 3 months of treat-ment,the levels of IL-12Rβ2,gp130,IL-35,TC,TG,and LDL-C in both groups were higher than those before treatment,and HDL-C level was lower than that before treatment,and the change in group B was greater than that in group A(P＜0.05).FPG and HbAlc levels were higher in group B after 1 month and 3 months of treatment,and were higher than those in group A(P＜0.05).Drug safety analysis showed that the incidence rates of adverse reactions were 12.00％(6/50)in group A and 26.00％(13/50)in group B,and there was no statistically significant difference between the two groups(P＞0.05).The incidence rates of liver and kidney injury in group A was 10.00％(5/50),and that in group B was 12.00％(6/50),and there was no statistically significant difference between two groups(P＞0.05).Conclusion Elvitegravir,Cobicistat,Emtricitabine and Tenofovir Alafenamide single tablet monotherapy and the TDF+3TC+EFV scheme could significantly re-duce the HIV load of AIDS patients and improve their immune level,but the former has less effect on pa-tients'glycolipid metabolism and inflammatory factors,and the monotherapy scheme is superior based on the comprehensive consideration of safety and efficacy.

Objective To investigate the effect of teaching method using students as standardized patients on clinical practice teaching of neurology.Methods We randomly assigned 80 undergraduate majoring in clinical medicine into two groups:a control group where students were instructed with traditional clinical teaching methods,and an experimental group where students acted as standardized patients.Following the clinical placement,we administered an Objective Structured Clinical Exam-ination(OSCE)and a satisfaction survey to all participants.Results The experimental group performed significantly better than the control group in history taking and neurological examination in the OSCE(P＜0.05).The results of the questionnaire showed that the experimental group scored significantly higher than the control group in improving clinical thinking,stimulating learning interest,and improving communication skills(P＜0.05).Conclusion The teaching methods using student as standardized pa-tients in the process of clinical practice in neurology helps to improve the history taking and neurological physical examination skills of clinical students,yielding good educational outcomes.

Perimenopausal syndrome （MPS）， a common endocrine system disease， is one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in endocrinology， gynecology， and interdisciplinary fields of both Western and Chinese medicine to discuss the advantages and challenges of diagnosing and treating MPS with Western medicine， TCM， and integrative medicine. Experts at the conference believe that MPS is initiated by estrogen decline and rooted in deficiency， with the pathogenesis being imbalance between Yin and Yang in the kidney. The hormone replacement therapy in Western medicine for menopause can rapidly alleviate related symptoms by quickly restoring the estrogen level and timely detect and delay complications of menopause， whereas such a therapy has certain risks， necessitating close monitoring of adverse reactions. Moreover， the various contraindications and precautions limit the clinical application of the hormone replacement therapy. TCM has advantages in synergistically alleviating symptoms such as hot flashes， sweating， sleep disorders， and emotional abnormalities of MPS without causing obvious adverse reactions. However， its efficacy is slower than the hormone replacement therapy， and the TCM evidence for preventing and treating complications of menopause remains unclear. Three suggestions were proposed for the future development of both Western and TCM for ameliorating MPS. First， an integrated diagnosis and treatment system for MPS with both Western and Chinese medicine should be established. Second， high-quality evidence-based interventions for MPS should be developed with TCM alone or in combination with Western medicine. Third， efforts should be made to promote the new TCM drug development and the interdisciplinary cooperation for treating MPS.

Objective To evaluate the efficacy and safety of Elvitegravir, Cobicistat, Emtricitabine and Tenofovir Alafenamide Fumarate Tablets in initial treatment of acquired immune deficiency syndrome (AIDS) patients. Methods A total of 80 treatment-naive AIDS patients were selected as research subjects and randomly divided into control group and observation group, with 40 patients in each group. The control group was treated with free antiviral drugs (tenofovir + lamivudine + efavirenz), while the observation group was treated with Elvitegravir, Cobicistat, Emtricitabine and Tenofovir Alafenamide Fumarate Tablets. The CD4⁺ count, human immunodeficiency virus (HIV) viral load, and biochemical indicators were compared between the two groups before treatment and at 3, 6, 9, and 12 months after treatment. The adherence, adverse reactions, and quality of life were also compared between the two groups. Results During the treatment, six patients in the observation group and 9 patients in the control group had no compliance. With the extension of treatment time, the CD4⁺ level in both groups gradually increased, and the HIV viral load gradually decreased (P < 0.05). After 3, 6, 9, and 12 months of treatment, the CD4⁺ levels in the observation group were higher than those in the control group, and the HIV viral loads were lower than those in the control group (P < 0.05). With the extension of treatment time, the levels of alanine aminotransferase, aspartate aminotransferase, urea, creatinine, and uric acid in the control group gradually increased, and the random blood glucose levels after 3, 6, 9, and 12 months of treatment in the control group were higher than those before treatment (P < 0.05). After 3, 6, 9, and 12 months of treatment, the levels of alanine aminotransferase, aspartate aminotransferase, urea, creatinine, uric acid, and random blood glucose in the observation group were lower than those in the control group (P < 0.05). The incidence of adverse reactions in the observation group was 2.94% (1/34), which was lower than 90.00% (36/40) in the control group (corrected χ²=55.718, P < 0.001). With the extension of treatment time, the scores of various dimensions of quality of life in both groups gradually increased, and the scores of various dimensions of quality of life after treatment in the observation group were higher than those in the control group (P < 0.05). Conclusion Compared with the free antiviral drug regimen, Elvitegravir, Cobicistat, Emtricitabine and Tenofovir Alafenamide Fumarate Tablets shows better efficacy in the treatment of AIDS-naive patients, which can significantly increase the CD4⁺ level, and reduce the HIV viral load. Besides, it has high safety, and can significantly improve their quality of life.

OBJECTIVES: To investigate the difference in intestinal microbiota between preterm infants with neurodevelopmental impairment (NDI) and those without NDI. METHODS: In this prospective cohort study, the preterm infants who were admitted to the neonatal intensive care unit of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from September 1, 2019 to September 30, 2021 were enrolled as subjects. According to the assessment results of Gesell Developmental Scale at the corrected gestational age of 1.5-2 years, they were divided into two groups: normal (n=115) and NDI (n=100). Fecal samples were collected one day before discharge, one day before introducing solid food, and at the corrected gestational age of 1 year. High-throughput sequencing was used to compare the composition of intestinal microbiota between groups. RESULTS: Compared with the normal group, the NDI group had a significantly higher Shannon diversity index at the corrected gestational age of 1 year (P<0.05). The principal coordinate analysis showed a significant difference in the composition of intestinal microbiota between the two groups one day before introducing solid food and at the corrected gestational age of 1 year (P<0.05). Compared with the normal group, the NDI group had a significantly higher abundance of Bifidobacterium in the intestine at all three time points, a significantly higher abundance of Enterococcus one day before introducing solid food and at the corrected gestational age of 1 year, and a significantly lower abundance of Akkermansia one day before introducing solid food (P<0.05). CONCLUSIONS There are significant differences in the composition of intestinal microbiota between preterm infants with NDI and those without NDI. This study enriches the data on the characteristics of intestinal microbiota in preterm infants with NDI and provides reference for the microbiota therapy and intervention for NDI in preterm infants.
Infant ; Child ; Infant, Newborn ; Humans ; Child, Preschool ; Infant, Premature ; Prospective Studies ; Gastrointestinal Microbiome ; China ; Infant, Premature, Diseases ; Gestational Age

OBJECTIVE: To investigate the role of multiple serological methods in the identification of complex antibodies. METHODS: The blood group antigens were detected by saline and microcolumn agglutination methods. The saline method was used to screen and identify IgM-type antibodies in the patient's serum, while the polybrene, anti-globulin, microcolumn agglutination, enzymic and absorption-elution methods were used to screen and identify IgG-type antibodies. RESULTS: The patient was B/CCDee/Jk(a-b+)/Fy(a-b+) blood type. The serum reacted with panel cells, and the reaction presented anti-E pattern in the saline medium. It was fully positive in the microcolumn agglutination card, except 2 negative ones after using papain to treat the panel cells. Referring to the pattern table, it was concluded that there existed anti-c, anti-E, and anti-Jk^a antibodies, and one antibody corresponding to an antigen that was easily destroyed by papain. The red blood cells with specific phenotype were selected for absorption-elution to identify IgG-type anti-c, anti-E, anti-Jk^a and anti-Fy^a antibodies. CONCLUSION It is confirmed that IgM-type anti-E, and IgG-type anti-c, anti-E, anti-Jk^a and anti-Fy^a antibodies exist in the patient's serum by multiple serological methods.
Humans ; Papain ; Blood Group Antigens ; Erythrocytes ; Immunoglobulin G ; Immunoglobulin M

OBJECTIVE: To analyze the intellectual landscape and emerging research trends of Chinese medicine (CM) in the management of pediatric asthma through a scientometric study. METHODS: Publications related to CM in the management of pediatric asthma were retrieved from the Web of Science Core Collection using relevant keywords. A scientometric study was performed using CiteSpace and VOSviewer. RESULTS: A total of 1,673 original articles and reviews from 1991 to 2019 were included in the analysis. The amount of annual publications had a gradual increase with time. USA was the major contributor both in country and institution analyses. Based on the co-citation, the published journals were grouped into 4 clusters. Keyword analysis indicated that the main hotspots were: (1) comprehensive management; (2) risk factors, mechanism, and prevalence; (3) prevention and treatment; (4) inflammation; and (5) environmental research. Lastly, we predicted that three emerging trends were quality of life promotion, immune response, and combination therapy. CONCLUSIONS CM research in the management of pediatric asthma will maintain the current trend of steady growth. This scientometric analysis may help scientists to identify the areas of interests and future directions in the field.
Asthma/drug therapy* ; Bibliometrics ; Child ; Humans ; Medicine, Chinese Traditional ; Publications ; Quality of Life

Objective:To investigate the characteristics of functional limitation and associated factors in patients with rheumatoid arthritis (RA).Methods:Consecutive patients with RA were recruited from August 2015 to June 2019 at Department of Rheumatology, Sun Yat-Sen Memorial Hospital. Demographic and clinical characteristics including age, gender, erythrocyte sedimentation rate (ESR), visual analogue scale (VAS) of pain, clinical disease activity index (CDAI), modified total Sharp score were collected. Physical function was assessed by the Stanford health assessment questionnaire disability index (HAQ-DI).Ordered logistic regression was used to analyze the related factors of HAQ-DI.Results:A total of 643 RA patients were finally recruited including 114 males and 529 females with mean age (49.7±12.9) years. There were 399 (62.1%) patients having different degrees of functional limitation, who were classified as mild (293, 45.6%), moderate (73, 11.4%) and severe (33, 5.1%). The prevalence of functional limitation was positively correlated with age and disease activity. The most restricted activity was walking [43.5% (280/643)], followed by gripping [36.1% (232/643)], reaching [35.5% (228/643)], daily activities [33.4% (215/643)], hygiene [33.0% (212/643)], dressing and grooming [29.7% (191/643)] and arising [29.1% (187/643)], and the last eating [18.4% (118/643)]. Multivariate ordered logistic regression analysis showed that age ( OR=1.019, 95% CI 1.004-1.035),pain VAS ( OR=1.820, 95% CI 1.616-2.050), ESR ( OR=1.009, 95% CI 1.001-1.017), CDAI ( OR=1.080, 95% CI 1.059-1.102) and modified total Sharp score ( OR=1.010, 95% CI 1.004-1.015) were associated factors of functional limitation. Conclusion:The majority RA patients have functional limitation. Age, pain and active disease are independent associated factors. Therefore, target treatment and control of pain should be emphasized in RA patients.

Objective:To evaluate the safety and feasibility of endovascular recanalization for non-acute internal carotid artery occlusion (NA-ICAO), and to propose a new angiographic classification.Methods:From April 2015 to October 2019, 95 consecutive patients with symptomatic NA-ICAO who received endovascular recanalization were retrospectively analyzed in Beijing Tiantan Hospital, Capital Medical University. All the patients were divided into four groups according to DSA: type Ⅰ, petrous segments were distally reconstituted by collateral vessels; type Ⅱ, cavernous segments were distally reconstituted by collateral vessels; type Ⅲ, ophthalmic segments were distally reconstituted by collateral vessels; type Ⅳ, communicating segments were distally reconstituted by collateral vessels. Study data including clinical characteristics, surgical details, lesion classification, recanalization rate and perioperative complications. For the counting data, the χ 2 test was used to compare between groups. For the quantitative data, the ANOVA was used for the normal distribution data, otherwise the Kruskal-Wallis H test was used. The primary safety outcome was any stroke or death within 30 days. Results:Among the 95 patients, 67 (70.53%) had successful recanalization. The recanalization rates of type Ⅰ－Ⅳ were 92.31% (36/39), 81.82% (18/22), 47.83% (11/23) and 18.18% (2/11) respectively (χ2=29.557, P<0.001). And the complication rates of the four types were 5.13% (2/39), 13.64% (3/22), 21.74% (5/23) and 9.10% (1/11) respectively. The incidence of perioperative ischemic stroke was 2.11% (2/95). No other serious stroke and death occurred. Conclusions:Endovascular recanalization may be feasible and safe for carefully selected patients with NA-ICAO and therefore represents an alternative treatment. The patients with type Ⅰ and Ⅱ lesions had higher recanalization rates, while the patients with type Ⅳ lesions had significantly lower recalculation rate. The new angiographic classification is conducive to the selection of suitable patients and difficulty in grading.

Objective:To investigate the clinical effect of spousal kidney transplantation , and to explore the significance in today's society.Methods:We retrospectively collected the relevant clinical data from the transplantation department of the first hospital of jilin university, from October 2009 to December 2018. Receptors who accepted spousal, parental and compatriot donor kidney is respectively obtained.Then the postoperative efficacy of the three groups were compared.Results:The graft survival rates of spousal kidney transplantation were 94.1% at 3 years and 83.7% at 5 years, which were not significantly different from other types of living kidney transplantation ( P=0.260). There was no significant difference in creatinine at each time point within 3 years after operation between three groups. At 3 years and 5 years after operation, there was no significant difference in creatinine between spouse group and sibling group.But the creatinine of spouse group was lower compared with parent group ( P=0.014, 0.038). The incidence of rejection within 1 years after spousal renal transplantation was 25%, which was significantly higher than parent group and sibling group ( P=0.029). Age of donor, gender of recipient, D/R BMI and incidence of AR or not in recipient were independent predictors for 1-year creatinine in living kidney transplantation (correlation coefficient: 0.048、-26.03、-15.95、10.23; P=0.003、<0.001、0.021、0.013). Conclusions:Spousal kidney transplantation has same clinical efficacy compared with other types of living kidney transplantation, which can greatly improve the donor kidney resource.So it worth being further promotion, but compared with other types of living kidney transplantation, we should be more alert to the incidence of rejection reaction, so as to obtain better curative effect.