Objective:To explore the prevalence and independent associated factors of vascular calcification (VC) in non-dialysis chronic kidney disease (CKD) patients of stage 3-5.Methods:It was a single-center cross-sectional observational study. Non-dialysis stage 3-5 CKD patients ≥18 years old who were admitted to the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University from May 1, 2022 to December 31, 2022 with VC evaluation were enrolled. The patients' general information, laboratory examination and imaging data were collected. Coronary artery calcification (CAC), thoracic aorta calcification (TAC), abdominal aorta calcification (AAC), carotid artery calcification and aortic valve calcification (AVC) were evaluated by cardiac-gated electron-beam CT (EBCT) scans, lateral lumbar x-ray, cervical macrovascular ultrasound and echocardiography, respectively. The differences in clinical data and the prevalence of VC at different sites of patients with different CKD stages were compared, and the prevalence of VC at different sites of patients in different age groups [youth group (18-44 years old), middle-aged group (45-64 years old) and elderly group (≥65 years old)] and patients with or without diabetes were compared. Multivariate logistic regression analysis was used to analyse the independent associated factors of VC for different areas.Results:A total of 206 patients aged (51±14) years were included, including 129 (62.6%) males. There were 44 patients with CKD stage 3 (21.4%), 51 patients with CKD stage 4 (24.8%), and 111 patients with CKD stage 5 (53.9%). CKD was caused by chronic glomerulonephritis [104 cases (50.5%)], diabetic kidney damage [35 cases (17.0%)], hypertensive kidney damage [29 cases (14.1%)] and others [38 cases (18.4%)]. Among 206 patients, 131 (63.6%) exhibited cardiovascular calcification, and the prevalence of CAC, TAC, AAC, carotid artery calcification, and AVC was 37.9%, 43.7%, 37.9%, 35.9% and 9.7%, respectively. The overall prevalence of VC in young, middle-aged and elderly patients was 24.6%, 73.6% and 97.4%, respectively. With the increase of age, the prevalence of VC in each site gradually increased, and the increasing trend was statistically significant (all P<0.001). The overall prevalence of VC in CKD patients with diabetes was 92.5% (62/67), and the prevalence of VC at each site in the patients with diabetes was significantly higher than that in the patients without diabetes (all P<0.001). Multivariate logistic regression analysis revealed that age (every 10 years increase, OR=2.51, 95% CI 1.77-3.56, P<0.001), hypertension ( OR=5.88, 95% CI 1.57-22.10, P=0.009), and diabetes ( OR=4.66, 95% CI 2.10-10.35, P<0.001) were independently correlated with CAC; Age (every 10 years increase, OR=6.43, 95% CI 3.64-11.36, P<0.001) and hypertension ( OR=6.09, 95% CI 1.33-27.84, P=0.020) were independently correlated with TAC; Female ( OR=0.23, 95% CI 0.07-0.72, P=0.011), age (every 10 years increase, OR=3.90, 95% CI 2.42-6.29, P<0.001), diabetes ( OR=5.37, 95% CI 2.19-13.19, P<0.001) and serum magnesium ( OR=0.01,95% CI 0-0.35, P=0.014) were independently correlated with AAC. Moreover, age and diabetes were independently correlated with carotid artery calcification, AVC and overall VC Conclusions:The prevalence of VC in non-dialysis CKD patients of stage 3-5 is 63.59%, of which CAC reaches 37.9%, TAC is the most common one (43.7%), while AVC is the least one (9.7%). Age and diabetes are the independent associated factors for VC of all sites except TAC, while hypertension is an independent associated factor for both CAC and TAC.

Objective:To investigate the characteristics and relationship between the location of lower extremity deep vein thrombosis (DVT) and the site of pulmonary embolism in hospitalized patients.Methods:The data of patients with lower extremity DVT diagnosed by ultrasound examination and pulmonary embolism diagnosed by CT pulmonary angiography from December 2017 to December 2021 were analyzed retrospectively. According to the location of lower extremity DVT, the patients were divided into mixed DVT, proximal DVT, and distal DVT which was further divided into anterior/posterior tibial vein or peroneal vein thrombosis and calf muscular venous thrombosis. Mixed DVT was referred to the presence of both proximal and distal DVT. According to the involved site of pulmonary artery, pulmonary embolism was divided into three types: main pulmonary artery, left or right pulmonary artery trunk embolism, lobar pulmonary artery embolism and segmental pulmonary artery embolism. The location of lower extremity DVT, the site of pulmonary embolism, the clinical manifestation (shortness of breath, chest tightness, chest pain, hemoptysis, cough, lower limb swelling, lower limb pain, syncope, fever) and risk factors (fracture/trauma, tumor, diabetes, hypertension, atrial fibrillation, infection, surgery, autoimmune diseases, paralysis, pregnancy) of venous thromboembolism (VTE), and the level of D-dimer were analyzed.Results:A total of 209 patients were enrolled finally, including 127 patients with left lower extremity DVT (60.8%) and 82 with right lower extremity DVT (39.2%). Mixed DVT accounted for 39.2%, proximal DVT accounted for 17.3%, and distal DVT accounted for 43.5% (anterior/posterior tibial vein and peroneal vein thrombosis accounted for 14.8%, calf muscular venous thrombosis accounted for 28.7%). The incidences of main pulmonary artery embolism, left or right pulmonary artery trunk embolism in the mixed DVT and proximal DVT were significantly higher than those in the anterior/posterior tibial vein or peroneal vein thrombosis and calf muscular venous thrombosis [41.5% (34/82), 38.8% (14/36) vs. 16.2% (5/31), 10.0% (6/60)], with statistically significant differences (all P < 0.05). The incidences of pulmonary segmental artery embolism in the anterior/posterior tibial vein or peroneal vein thrombosis were higher than those in the mixed DVT and proximal DVT [41.9% (13/31) vs. 26.8% (22/82), 30.6% (11/36)], but the difference was not statistically significant (both P > 0.05). The incidences of pulmonary segmental artery embolism in the calf muscular venous thrombosis were significantly higher than those in the mixed DVT and the proximal DVT [66.7% (40/60) vs. 26.8% (22/82), 30.6% (11/36)], and the difference was statistically significant (both P < 0.05). The levels of D-dimer in patients with calf muscular venous thrombosis combined with main pulmonary artery embolism, left or right pulmonary artery trunk embolism were significantly higher than those in patients with calf muscular venous thrombosis combined pulmonary segmental artery embolism (mg/L: 6.08±3.12 vs. 3.66±2.66, P < 0.05). There were no significant differences in D-dimer levels in other patients with DVT combined with pulmonary embolism in different sites. In terms of the clinical manifestations of VTE, the incidences of lower limb swelling in the mixed DVT and proximal DVT were significantly higher than those in the anterior/posterior tibial vein or peroneal vein thrombosis and calf muscular venous thrombosis [54.9% (45/82), vs. 29.0% (9/31), 15.0% (9/60), both P < 0.05], the incidences of lower limb swelling in the proximal DVT were significantly higher than those in the calf muscular venous thrombosis [41.7% (15/63) vs. 15.0% (9/60), P < 0.05], there were no significant difference in the other clinical manifestations among the DVT groups. There was no significant difference in the incidence of VTE risk factors among the groups. Conclusions:The DVT of inpatients mostly occurred in the left lower limb, and the incidence of distal DVT was higher than that of proximal DVT. Mixed DVT and proximal DVT combined with pulmonary embolism mostly occurred in the main pulmonary artery, left or right pulmonary artery trunk, while distal DVT combined with pulmonary embolism mostly occurred in the pulmonary segmental artery. The levels of D-dimer in patients with lower extremity DVT combined with main pulmonary artery or left and right pulmonary artery trunk embolism were higher than those in patients with pulmonary lobe and segmental artery embolism. The incidence of lower extremity swelling in patients with mixed DVT and proximal DVT was higher than that in patients with distal DVT.

Objective:To evaluate the efficacy of Qingpeng ointment in the treatment of early herpes zoster neuralgia.Methods:From January to June 2019, sixty patients with herpes zoster (34 males and 26 females, aged 12 to 48 years, onset time of 1 to 7 days) were randomly divided into experimental group and control group. Both groups were given the same antiviral and neurotrophic therapy after admission. The experimental group was treated with Qingpeng ointment for external use in addition. The numerical rating scale (NRS), sleep score (AIS) and adverse reactions of the two groups were evaluated at pre-treatment, 3, 5, 7, 15 and 30 days after treatment.Results:Compared with pre-treatment, the NRS and AIS scores of the experimental group were significantly reduced at each time from day 3, and the difference was statistically significant. The NRS and AIS scores of the control group were reduced at each time from day 7, and the difference was statistically significant. Compared with control group, the NRS scores of the experimental group on the 3rd, 5th, and 7th days and the AIS scores on the 3rd and 5th days after treatment were lower than those of the control group, and the difference was statistically significant. There were no serious adverse reactions in the two groups.Conclusions:External application of Qingpeng ointment can quickly relieve early neuralgia in patients with herpes zoster, improve the patients＇ sleep, and there is no obvious adverse reaction.

OBJECTIVE： To provide reference for pharmaceutical enterprises to enhance the R&D capability and improve the R&D investment strategy. METHODS： The annual report data of 13 listed pharmaceutical enterprises in southwest China were collcted. Taking fixed assets， operating costs， the number of employees in service and the amount of R&D investment as input indicators， net profit， operating income and earnings per share as output indicators， the efficiency values were calculated by using MyDEA 1.0 software based on super-efficiency DEA model. The operating efficiency of enterprises with or without R&D input were compared； the contribution rate of R&D investment to enterprises were calculated. Finally， Wilcoxon symbolic rank test was carried out by using SPSS 20.0 software to compare the difference. RESULTS： From 2013 to 2015， 10 of the 13 listed pharmaceutical enterprises had increased their R&D investment， which indicated that listed pharmaceutical enterprises in southwest China paid more attention to R&D investment. For three consecutive years， the efficiency value of R&D investment of the 13 listed pharmaceutical enterprises was significantly higher than that of the enterprises without R&D investment， and the number of the former reaching DEA efficiency was more， indicating that R&D investment was positively correlated with the operational efficiency of pharmaceutical enterprises. The Wilcoxon symbol rank test also confirmed that R&D investment was an effect input. After three enterprises joined the R&D input index， their operational efficiency was improved， and their R&D contribution was greater. Five enterprises had zero R&D contribution， their efficiency value remained unchanged whether or not they joined R&D input. The R&D contribution of other listed pharmaceutical enterprises varied greatly in each year. CONCLUSIONS： At the overall level of the industry， enterprises should increase their R&D investment and pay attention to improving R&D efficiency， establish a sound R&D innovation system and R&D personnel training mechanism， establish an integrated training mode of production， learning and research； the government should create an environment to support R&D activities of pharmaceutical enterprises. For individual enterprises， different strategies should be adopted based on practical situation in order to improve the pulling effect of R&D input on the operational efficiency of enterprises.

Aiming at comparing the pre-operative and post-operative gait characteristics and therefore establishing post-operative rehabilitation guidance for patients with end-stage knee osteoarthritis (KOA) merged with varus deformity, this study captured the level walking and sit-to-stand trials of 9 patients with 3-dimensional motion analysis system and after which musculoskeletal multi-body dynamic analysis was conducted. The study indicated that the average range of motion (ROM) of the proposed-surgical knee was 24.4°-57.6° and that of the non-surgical knee was 22.5°-71.5°. The knee ROM of control group during level walking was 7.2°-62.4°. When the unilateral KOA patients stood up from chair to complete the sit-to-stand movement, the ground reaction forces (GRFs) symmetry was 0.72-0.85, which means that the non-surgical limb bear the majority of body weight. The GRFs of the bilateral KOA patients were smallest during the sit-to-stand movement. The strategy that the non-surgical limb dominates in loading bearing taken by the unilateral KOA patients to cover most post-operative daily activities could increase the risk of KOA among non-surgical side joints as a result of long-term excessive loading-bearing. The study, on kinematics and biomechanical characteristics of patients with KOA merged with varus deformity, could help to understand the pathogenesis of KOA merged with varus deformity from the perspective of biomechanics and to provide strong clinic guidance for the pre-operative evaluation, prevention and post-operative recovery for patients.

OBJECTIVE:To provide reference for the sustainable development of pharmaceutical industry in Guizhou province.METHODS:By literature review,personal interview and questionnaire survey,the current situation about the development of pharmaceutical industry in Guizhou province were investigated and analyzed,and the corresponding countermeasures and suggestions were put forward.RESULTS:The literatures were obtained from network literature by Baidu search engine,published data by government portal website of administrative department,documents by CNKI and VIE Five personal interviews involved the relevant management personnel in Policies and Regulations Department,Medicine and Cosmetics Production Supervision Department,Medical Device Supervision Department of Guizhou Province Food and Drug Administration.A total of 70 questionnaires (drug production enterprises as object) were sent out,and 57 valid questionnaires were collected with the effective recovery rate of 81.4％.In the present,there were a total of 175 pharmaceutical production enterprises (56.5％ in Guiyang city) and 106 medical device manufacturers in Guizhou province.Of 57 pharmaceutical manufacturing enterprises investigated,87.8％ of them were certified by the 2010 edition of Good Manufacturing Practice (GMP).The number of varieties of Chinese herbal medicines in Guizhou province ranked second in the whole country;total area of Chinese herbal medicine planting,wild protection and tending ranked third in the whole country in 2015;the industrial output value of Chinese patent medicine accounted for 85.1％ of the total output value of the pharmaceutical industry;but no approved new medicines were class 1 and 2 new medicines;R&D personnel with high education levels took small proportion significantly.The output capacity of chemical medicine industry was far lower than the average national level;the chemical industry output value accounted for only about 10％ of the total output value of the pharmaceutical industry in the province;the rate of success approval was almost zero for new drugs declared by drug manufacturers in recent years.Biological products industry was an emerging industry,currently there were only 3 biological products production enterprises.Of 341 products in medical device industry,there were 146 class Ⅰ products,190 class Ⅱ products and 5 classⅢproducts,manifesting as narrow coverage,few production type,relatively backward level.Seven percent of pharmaceutical production enterprise involved in the derivatives industry,and the development of TCM health care industry attracted more and more attention.CONCLUSIONS:The Chinese and national medicine industry has been the dominant force,the development of chemical medicine,biological products and medical device indusmy has lagged behind,and medicine derivatives industry needs to promote the integration of TCM and health-and-fitness.Thewhole industry strategic consciousness is comparatively backward,high-end R&D personnel is lack,and independent innovation ability is weak.It is suggested to done the top design,guide enterprises mergers and restructuring;develop characteristic medicine,support small molecule chemical medicines and biological products enterprises deeply;deepen the understanding of industrial policy,and increase investment in independent innovation;develop new medicine derivatives,and expand the pharmaceutical e-commerce sales channel;broaden the industry chain depth,breadth and width,and excavate medical big data.

OBJECTIVE:To provide reference for the sustainable development of pharmaceutical enterprises in Guizhou prov-ince. METHODS:A questionnaire was conducted for 55 pharmaceutical enterprises in Guizhou province,the basic situation of en-terprises,familiarity of related directors to Good Manufacture Practice of Drugs(GMP)and relevant policy,the current situation of implementing the new version GMP were investigated and statistically analyzed,problems were found,and corresponding coun-termeasures were put forward. RESULTS & CONCLUSIONS:Totally 55 questionnaires were sent out,49 valid ones were received with effectively recovery of 85.1%. The results showed 43 enterprises(87.8%)had passed the GMP authentication;only 13 enter-prises(26.5%)directors were very familiar with the new version GMP. In terms of personnel management,the head of production management and quality management and the authorized person of quality and personnel had not yet met related requirements of the new version GMP fully;in terms of equipment and production management,production area transformation(clean areas,lounges, warehouses,water use) and air purification system design in most enterprises met related requirements of the new version GMP, 23 enterprises (46.9%) still can not conduct fully inspection to products and materials;in terms of document management,there were still some enterprises not meeting the new version GMP standards fully,enterprises'documents(health area layout,air purifi-cation layout,management procedures,operating procedures,etc.) of production site were imperfect. According to the investiga-tion,the main existing problems included lack of funds in implementing the new version GMP reform,not enough understanding or familiarity with the new version GMP,relevant personnel management not reaching the designated position,equipment and pro-duction management needing to be strengthened,document management systemic being poor,risk management being not sound, etc. It is suggested that government should give all forms of capital policy and strengthen the training of the new version GMP;en-terprises should attach great importance to the relevant personnel management,strengthen the equipment and production manage-ment,set up perfect document management system and a sound system of risk management.

The inverse cancer comorbidity in schizophrenia patients may be related to the genetic factors ,involving the regu‐lation of apoptosis .The tumour suppressor gene TP53 ,involved in neural apoptosis ,is one of the potential candidate genes associat‐ed with schizophrenia which might reduce colorectal cancer risk .We recruited 270 schizophrenia patients and 312 colorectal cancer patients without schizophrenia .To examine the genetic association between schizophrenia and colorectal cancer ,we analysed eight SNPs (rs12951053 ,rs1625895 ,rs2909430 ,rs9895829 ,rs1042522 ,rs8079544 ,rs8064946 ,rs17806770) covering 14 .35 kb in the re‐gion of TP53 .We observed that one of the eight genetic polymorphisms showed statistically significant differences between the colo‐rectal cancer subjects and the schizophrenia subjects (rs12951053 ,P=0 .000 1 ,OR 1 .70 ,95% CI 1 .30-2 .23) .In addition ,the hap‐lotype of A‐G (rs12951053‐rs8064946) ,giving a global P=0 .001 8 ,was the most significant .Our data indicate that the polymor‐phisms of rs12951053 in TP53 confer reduced susceptibility to colorectal cancer and suggest a potential protective mechanism a‐gainst colorectal cancer in the schizophrenia patients of Han Chinese origin .

BACKGROUNDWe evaluated the impact of the number of metastatic lymph nodes and the metastatic lymph nodes ratio (the ratio between metastatic lymph nodes and total dissected lymph nodes, MLNR) in patients with gastric adenocarcinoma following curative gastrectomy and also analyzed the relationship between the number of removed lymph nodes and prognosis in node-negative gastric cancer.

METHODSFrom January 2005 to December 2010, 1 390 patients who were diagnosed with gastric adenocarcinoma and underwent curative gastrectomy were included. In particular, lymph node metastasis was not present in 515 patients. The number of metastatic lymph nodes and the metastatic lymph nodes ratio were selected for univariate and multivariate analyses to evaluate their influences on the disease outcome. The survival curve was presented according to the number of removed lymph nodes in node-negative gastric cancer using Kaplan-Meier plots.

RESULTSThe overall 5-year survival rate was 54% in this group. Univariate analysis revealed that age category, macroscopic appearance, histological grade, tumor size, depth of primary tumor invasion, number of metastatic lymph nodes, metastatic lymph nodes ratio, tumor, nodes, metastasis-classification (TNM) stage and status of lymphovascular, and vessel invasion have significant impact on survival. The number of metastatic lymph nodes and the metastatic lymph nodes ratio both have significant impact on survival (P < 0.001). However, in multivariate analyses, only the metastatic lymph nodes ratio was identified to be an independent prognostic factor (P < 0.001). The number of removed lymph nodes in node-negative was a strong prognostic factor of survival, the more lymph nodes dissected, the better the survival.

CONCLUSIONSThe metastatic lymph nodes ratio has more significant prognostic value for survival in patients with gastric cancer following curative gastrectomy than the number of metastatic lymph nodes. The number of removed lymph nodes might be an important prognostic factor for gastric cancer without lymph node metastasis.

Adenocarcinoma ; mortality ; surgery ; Aged ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms ; mortality ; surgery

We searched and retrieved literature on the topic of medical image processing published on SCI journals in the past 10 years. We then imported the retrieved literature into TDA for data cleanup before data analysis and pro cessing by EXCLE and UCINET to generate tables and figures that could indicate disciplinary correlation and research hotspots from the perspective of bibliometrics. The results indicated that people in Europe and USA were leading researchers on medical image processing with close international cooperation. Many disciplines contributed to the fast development of medical image processing with intense interdisciplinary researches. The papers that we found show recent research hotspots of the algorithm, system, model, image and segmentation in the field of medical image processing. Cluster analysis on key words of high frequency demonstrated complicated clustering relationship.
Algorithms ; Bibliometrics ; Cluster Analysis ; Diagnostic Imaging ; trends ; Humans ; Image Processing, Computer-Assisted ; trends ; International Cooperation