1.Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients (version 2024)
Yao LU ; Yang LI ; Leiying ZHANG ; Hao TANG ; Huidan JING ; Yaoli WANG ; Xiangzhi JIA ; Li BA ; Maohong BIAN ; Dan CAI ; Hui CAI ; Xiaohong CAI ; Zhanshan ZHA ; Bingyu CHEN ; Daqing CHEN ; Feng CHEN ; Guoan CHEN ; Haiming CHEN ; Jing CHEN ; Min CHEN ; Qing CHEN ; Shu CHEN ; Xi CHEN ; Jinfeng CHENG ; Xiaoling CHU ; Hongwang CUI ; Xin CUI ; Zhen DA ; Ying DAI ; Surong DENG ; Weiqun DONG ; Weimin FAN ; Ke FENG ; Danhui FU ; Yongshui FU ; Qi FU ; Xuemei FU ; Jia GAN ; Xinyu GAN ; Wei GAO ; Huaizheng GONG ; Rong GUI ; Geng GUO ; Ning HAN ; Yiwen HAO ; Wubing HE ; Qiang HONG ; Ruiqin HOU ; Wei HOU ; Jie HU ; Peiyang HU ; Xi HU ; Xiaoyu HU ; Guangbin HUANG ; Jie HUANG ; Xiangyan HUANG ; Yuanshuai HUANG ; Shouyong HUN ; Xuebing JIANG ; Ping JIN ; Dong LAI ; Aiping LE ; Hongmei LI ; Bijuan LI ; Cuiying LI ; Daihong LI ; Haihong LI ; He LI ; Hui LI ; Jianping LI ; Ning LI ; Xiying LI ; Xiangmin LI ; Xiaofei LI ; Xiaojuan LI ; Zhiqiang LI ; Zhongjun LI ; Zunyan LI ; Huaqin LIANG ; Xiaohua LIANG ; Dongfa LIAO ; Qun LIAO ; Yan LIAO ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Peixian LIU ; Tiemei LIU ; Xiaoxin LIU ; Zhiwei LIU ; Zhongdi LIU ; Hua LU ; Jianfeng LUAN ; Jianjun LUO ; Qun LUO ; Dingfeng LYU ; Qi LYU ; Xianping LYU ; Aijun MA ; Liqiang MA ; Shuxuan MA ; Xainjun MA ; Xiaogang MA ; Xiaoli MA ; Guoqing MAO ; Shijie MU ; Shaolin NIE ; Shujuan OUYANG ; Xilin OUYANG ; Chunqiu PAN ; Jian PAN ; Xiaohua PAN ; Lei PENG ; Tao PENG ; Baohua QIAN ; Shu QIAO ; Li QIN ; Ying REN ; Zhaoqi REN ; Ruiming RONG ; Changshan SU ; Mingwei SUN ; Wenwu SUN ; Zhenwei SUN ; Haiping TANG ; Xiaofeng TANG ; Changjiu TANG ; Cuihua TAO ; Zhibin TIAN ; Juan WANG ; Baoyan WANG ; Chunyan WANG ; Gefei WANG ; Haiyan WANG ; Hongjie WANG ; Peng WANG ; Pengli WANG ; Qiushi WANG ; Xiaoning WANG ; Xinhua WANG ; Xuefeng WANG ; Yong WANG ; Yongjun WANG ; Yuanjie WANG ; Zhihua WANG ; Shaojun WEI ; Yaming WEI ; Jianbo WEN ; Jun WEN ; Jiang WU ; Jufeng WU ; Aijun XIA ; Fei XIA ; Rong XIA ; Jue XIE ; Yanchao XING ; Yan XIONG ; Feng XU ; Yongzhu XU ; Yongan XU ; Yonghe YAN ; Beizhan YAN ; Jiang YANG ; Jiangcun YANG ; Jun YANG ; Xinwen YANG ; Yongyi YANG ; Chunyan YAO ; Mingliang YE ; Changlin YIN ; Ming YIN ; Wen YIN ; Lianling YU ; Shuhong YU ; Zebo YU ; Yigang YU ; Anyong YU ; Hong YUAN ; Yi YUAN ; Chan ZHANG ; Jinjun ZHANG ; Jun ZHANG ; Kai ZHANG ; Leibing ZHANG ; Quan ZHANG ; Rongjiang ZHANG ; Sanming ZHANG ; Shengji ZHANG ; Shuo ZHANG ; Wei ZHANG ; Weidong ZHANG ; Xi ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Xiaojun ZHANG ; Guoqing ZHAO ; Jianpeng ZHAO ; Shuming ZHAO ; Beibei ZHENG ; Shangen ZHENG ; Huayou ZHOU ; Jicheng ZHOU ; Lihong ZHOU ; Mou ZHOU ; Xiaoyu ZHOU ; Xuelian ZHOU ; Yuan ZHOU ; Zheng ZHOU ; Zuhuang ZHOU ; Haiyan ZHU ; Peiyuan ZHU ; Changju ZHU ; Lili ZHU ; Zhengguo WANG ; Jianxin JIANG ; Deqing WANG ; Jiongcai LAN ; Quanli WANG ; Yang YU ; Lianyang ZHANG ; Aiqing WEN
Chinese Journal of Trauma 2024;40(10):865-881
Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.
2.Application of molecular markers in the research of genetic diversity in medical helminths
XU Fang-fang ; SU Xiao-yi ; LONG Shao-rong ; LIU Ruo-dan ; JIANG Peng ; GUI Jing ; WANG Zhong-quan ; ZHANG Xi
China Tropical Medicine 2023;23(1):83-
Human-animal parasitic diseases caused by medical helminths are hazardous to human health. Genetic polymorphism studies on medical helminth populations can not only understand the biological characteristics and genetic structure of their populations, but also help reveal how they adapt to their parasitic environment, thus contributing to deepen our understanding of the epidemiological patterns of parasitic diseases and improve our understanding of accurate prevention and control of parasitic diseases. With the development of molecular biology, molecular markers such as DNA barcodes, simple sequence repeats, and single nucleotide polymorphism markers have been widely used to study the genetic relationships among parasite populations and individuals, and to reveal the genetic variation of parasite populations and the evolution of species origins. In this paper, we systematically review the application of three molecular markers commonly used in the study of genetic polymorphism in medical helminths, with a view to laying the foundation for related research.
3.Effect of panlong needling at Jiaji (EX-B 2) on motor dysfunction in patients with Parkinson's disease of liver and kidney deficiency: a randomized controlled trial.
Lin HAN ; Xiu-Zhen SU ; Zhong-Yuan ZHANG ; Ying LIU ; Zhong-Xiang WEI ; Qing-Lan ZHANG ; Jun-Ping ZHANG ; Chen-Xi WANG ; Quan-de SU
Chinese Acupuncture & Moxibustion 2022;42(5):493-497
OBJECTIVE:
To compare the curative effect of panlong needling at Jiaji (EX-B 2) combined with western medication and western medication alone on motor dysfunction in patients with Parkinson's disease (PD) of liver and kidney deficiency.
METHODS:
A total of 98 patients with PD were randomly divided into an acupuncture and medication group (49 cases, 1 case dropped off) and a western medication group (49 cases,1 case was removed). The patients in the western medication group were given oral of levodopa and benserazide hydrochloride tablets, 125 mg each time, three times a day in the 1st week, and the dose was increased according to the needs of the patients' condition from the 2nd week until 250 mg each time, three times a day, for 16 consecutive weeks. On the basis of the same western medication treatment as the western medication group, panlong needling was applied at Jiaji (EX-B 2) from C2 to L5 in the acupuncture and medication group, once a day, 20 times as a course of treatment, for 4 consecutive courses. The scores of unified Parkinson's disease rating scale (UPDRS-Ⅲ, UPDRS-Ⅳ), TCM symptoms score, and 39-item Parkinson's disease questionnaire (PDQ-39) score were evaluated before treatment, after treatment and during follow-up of 1 month after treatment, respectively. The safety of the two groups was compared.
RESULTS:
After treatment and during follow-up, except the PDQ-39 score of the western medication group, the scores of UPDRS-Ⅲ, UPDRS-Ⅳ, TCM syndrome and PDQ-39 were lower than those before treatment in the two groups (P<0.05), and the scores of above indexes in the acupuncture and medication group were lower than those of the western medication group (P<0.05). The total incidence of adverse reactions in the acupuncture and medication group was 10.4% (5/48), which was lower than 29.2% (14/48) in the western medication group (P<0.05).
CONCLUSION
Panlong needling at Jiaji (EX-B 2) combined with western medication could significantly improve the motor dysfunction and clinical symptoms, improve the quality of life and has high safety, and the efficacy is superior to western medication alone.
Acupuncture Points
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Acupuncture Therapy
;
Chlorophenols
;
Humans
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Kidney
;
Liver
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Parkinson Disease/therapy*
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Quality of Life
;
Treatment Outcome
4.Preliminary audiological evaluation of the SoundBite bone conduction devices in adults with single-sided deafness.
Xin XI ; Hui ZHAO ; An Ran PANG ; Xian Hua ZHANG ; Long Hao WANG ; Qian WANG ; Yu SU ; Yong Yi YUAN ; Li Dong ZHAO ; Quan SHI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2021;56(5):478-486
Objective: The auditory deficits of single-sided deafness (SSD) can be treated with a novel intra-oral device, SoundBite, which delivers sound by applying vibratory signal to the teeth. The purpose of this study was to evaluate the efficacy and benefit of the bone conduction device for Chinese adults with SSD. Methods: Eighteen patients aged 19-66 yrs with acquired, permanent sensorineural SSD and no current treatment by any other devices for SSD, were recruited in a prospective controlled, nonrandomized, unblinded study. They were requested the continually daily wear of the new device over a 30-day free trial period. The intra-oral hearing device was placed around two maxillary teeth and was similar to a small partial denture or retainer. The audiological tests included pure tone air conduction thresholds, monosyllable word recognition score (WRS) in quiet and sentence reception thresholds in noise (via CMNmatrix test). The benefit was determined with the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire. Results: The monosyllable WRS and the 50% threshold of signal-to-noise ratio (SNR50) were significantly better in all aided conditions. The head shadow effect, assessed by the SNR50 via CMNmatrix test improved an average of 2.6 dB after 30 days' wearing compared with unaided condition (P<0.001). The APHAB scores improved (P<0.05) for all subjects for the Global and Ease of Communication, Reverberation, Background Noise subscales. The SSQ scores improved (P<0.05) for all subjects for Speech, Spatial and Qualities of Hearing subscales. Conclusion: The SoundBite is a good alternative to the well-established implantable bone conduction devices in patients with SSD. An improvement in listening ability in noise and quiet as well as a decrease of the head shadow effect is validated as the expected.
Adult
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Aged
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Bone Conduction
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Deafness
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Hearing Aids
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Hearing Loss, Unilateral
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Humans
;
Middle Aged
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Prospective Studies
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Speech Perception
;
Treatment Outcome
;
Young Adult
5.Comparative imaging study of two positron emission computed tomography tracers of 18F-FEA-Erlotinib and 11C-Erlotinib in HCC827 tumor-bearing nude mice
Shun HUANG ; Yan-Jiang HAN ; Kong-Zhen HU ; Li CHEN ; Peng-Hui SUN ; Hu-Bing WU ; Quan-Shi WANG ; Su-Qing ZHAO ; Xi ZHENG
The Chinese Journal of Clinical Pharmacology 2018;34(5):535-538
Objective To evaluate the imaging study of two positron emission computed tomography (PET) tracers of 18 F-fluoroethyl (FEA)-Erlotinib and 11C-Erlotinib in HCC827 tumor-bearing nude mice.Methods The 18F-FEA-Erlotinib and 11C-Erlotinib were synthesized by nucleophile substitution reactions.The dynamic micro-PET/CT imaging of 18F-FEA-Erlotinib for 1 h was performed in HCC827 tumor -bearing mice to evaluate the in vivo biological distribution and determine the best imaging time.Static scan of 18 F-FEA-Erlotinib and 11C-Erlotinib were performed after 1 h injection.The regions of interest (ROIs) were sketched and the semi-quantitative analysis was conducted by the percentage activity of injection dose per gram of tissue (% ID/g).Results Dynamic micro-PET/CT imaging analysis revealed that the best static imaging time was 1 h.The resolution and contrast were good and the tumor boundaries were clear in the 18F-FEA-Erlotinib static images.In the semi-quantitative analysis,the ratios of tumor/brain,tumor/lung,tumor/bone and tumor/muscle ratios were 5.87 ± 1.21,2.97 ± 0.58,3.33 ± 0.60 and 3.80 ± 0.72 respectively for 18F-FEA-Erlotinib.Meanwhile,the ratios of the same tissues were 5.48 ± 1.45,1.10 ± 0.34,2.63 ± 0.54 and 2.10 ± 0.63respectively for 11C-Erlotinib.The resolution of 18F-FEA-Erlotinib imaging was better than 11C-Erlotinib images.Conclusion The uptake of 18F-FEA-Erlotinib in HCC827 tumor was visual obviously.The image resolution and the target/non-target ratio of 18F-FEA-Erlotinib was higher than 11C-Erlotinib.
6.Expressions of SLC22A14 and SPAG6 proteins in the ejaculated sperm of idiopathic asthenozoospermia patients.
Fang-Yuan HUO ; Yu-Shan LI ; Xi-Yang YANG ; Quan-Xian WANG ; Jun-Jie LIU ; Lin-Kai WANG ; Yan-Hua SU ; Lin SUN
National Journal of Andrology 2017;23(8):703-707
Objective:
To investigate the expressions of solute carrier family 22 member 14 (SLC22A14) and sperm-associated antigen 6 (SPAG6) in the sperm of idiopathic asthenospermia men.
METHODS:
We collected semen samples from 50 idiopathic asthenozoospermia patients and another 50 normal sperm donors, purified the sperm by discontinuous density centrifugation on Percoll gradients, and then determined the mRNA and protein expressions of SLC22A14 and SPAG6 by RT-PCR and Western blot, respectively.
RESULTS:
Compared with the normal controls, the idiopathic asthenozoospermia patients showed significantly decreased mRNA expressions of SLC22A14 (0.77 ± 0.08 vs 0.53 ± 0.10, P<0.01) and SPAG6 (0.78 ± 0.09 vs0.52 ± 0.10 , P<0.01) and protein expressions of SLC22A14 (0.80 ± 0.09 vs 0.55 ± 0.10 , P<0.01) and SPAG6 (0.78 ± 0.09 vs 0.56 ± 0.09, P<0.01).
CONCLUSIONS
T The expressions of SLC22A14 and SPAG6 are reduced in the sperm of the patients with idiopathic asthenospermia, which may be one of the important causes of asthenospermia.
Asthenozoospermia
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metabolism
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Blotting, Western
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Ejaculation
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Humans
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Male
;
Microtubule Proteins
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genetics
;
metabolism
;
Organic Cation Transport Proteins
;
genetics
;
metabolism
;
Proteomics
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RNA, Messenger
;
metabolism
;
Sperm Motility
;
Spermatozoa
;
metabolism
7. Preoperative application of combination of portal venous injection of donor spleen cells and intraperitoneal injection of rapamycin prolongs the survival of cardiac allografts in mice
Wen-lin GONG ; Gang DU ; Su-fang ZHOU ; Nuo YANG ; Yong-xiang ZHAO ; Chuang SHA ; Zhong-gui SHAN ; Zhong-quan QI ; Nuo YANG ; Yong-xiang ZHAO
Asian Pacific Journal of Tropical Medicine 2017;10(5):454-460
Objective To investigate the effects of preoperative portal venous injection of donor spleen cells (PVIDSC) and intraperitoneal injection of rapamycin in the acute rejection of cardiac allograft in mice and the underlying mechanisms. Methods Homogenous female B6 mice and BALB/c mice were used as recipients and donors of heart transplantation. These mice were randomly divided into different groups and received PVIDSC alone, rapamycin alone, or PVIDSC and rapamycin combined therapy. In addition, the underlying mechanism was studied by measuring a number of cytokines. Results Preoperative combination of PVIDSC and intraperitoneal injection of rapamycin significantly prolonged the survival of heterotopic cardiac allograft in mice, but had no effects on the survival time of cardiac allografts in mice pre-sensitized by skin grafting. Preoperative combination of PVIDSC and intraperitoneal injection of rapamycin increased the expression of IL-10 and Foxp3 and reduced the expression of INF-. Short-term preoperative administration of rapamycin promotes the expression of CD4
8.Detection and Analysis of EGFR and KRAS Mutations in the Patients with Lung Squamous Cell Carcinomas
ZHANG HUI ; YANG XINJIE ; QIN NA ; LI XI ; YANG HUIYI ; NONG JINGYING ; LV JIALIN ; WU YUHUA ; ZHANG QUAN ; ZHANG XINYONG ; WANG JINGHUI ; SU DAN ; ZHANG SHUCAI
Chinese Journal of Lung Cancer 2015;(10):621-625
Background and objective Activating mutations in epidermal growth factor receptor (EGFR) and KARS are important markers in non-small cell lung cancer. However, EGFR and KARS gene mutations in lung squamous cell carcinoma are rarely reported. hTe aim of this study was to analyze EGFR and KARS gene mutation rate and their relationship with clinical features in patients with lung squamous cell carcinomas. Methods A total of 139 patients undergoing treatment for na?ve lung squamous cell carcinomas with tumor tissue samples available for testing were recruited. EGFR and KARS mutation statuses of the tumor samples were detected using a mutant enriched liquid chip. Results Of the 139 cases of lung squamous cell carcinoma, EGFR mutations were detected in 25 cases (18%), KARS mutations were detected in 7 cases (5%), and the pres-ence of both EGFR and KARS mutations was detected in 1 case (0.7%). EGFR mutations occurred more otfen in females than in males (33.3%vs 16.5%) and in patients that never smoked than in those who smoke (29.6%vs 16.1%). However, the differ-ence did not reach statistical signiifcance (P>0.05). No signiifcant differences were observed in age, stage, and different biopsy type. KARS mutations occurred more otfen in males than in females (5.5%vs 0%), but the difference did not reach statistical signiifcance (P>0.05). No signiifcant differences were observed in age, stage, different biopsy type, and smoking status (P>0.05). Conclusion EGFR and KARS mutations were low in lung squamous cell carcinomas, and had no signiifcant correlation with clinical features. Before using tyrosine kinase inhibitor targeted therapy, EGFR and KARS mutations should be detected in pa-tients with lung squamous cell carcinomas.
9.Analysis of chronergy for treatment of spinal cord injury with the allogeneic bone mesenchymal stem cells (BMscs) transplantation in rats.
Da-peng DUAN ; Quan SU ; Wei HU ; Wu-Lin YOU ; Xiao-Qian DANG ; Kun-Zheng WANG
China Journal of Orthopaedics and Traumatology 2013;26(10):845-849
OBJECTIVETo observe the change of behavior, pathological change of the spinal cord,and expression of brain-derived neurotrophic factor (BDNF) and brain-derived neurotrophic factor (NGF) on rats with spinal cord injury in order to explore the optimal time of BMSCs transplantation.
METHODSEighty health SD rats were randomly divided into 8 groups (group A,B,C,D,E,F,G,H), 10 rats in each group. According to the modified Allen method,the rat model of spinal cord injury was built. Group A as non-injured group only exposed the spinal cord but not result in blast injury. BMSCs of vitro culture were respectively infunded the region of spinal cord injury in group C, D, E, F, G, H (as transplantation groups) at the 0 h, 6 h, 24 h,3 d,5 d,7 d after model made. Group B as single model group was infunded the equal cell culture fluid. BBB score was used to evaluate the function of spinal cord at the 1st,2nd and 4th weeks after injury. The morphological changes of the tissue of spinal cord injury were observed by HE stain and the expression of BDNF and NGF were detected by Elisa method at the 4th weeks after BMSCs transplantation.
RESULTSIn non-injured group,BBB score was highest than that of other 7 groups at the 1st, 2nd and 4th weeks after injury (P<0.01). There was no significant difference in BBB score between single model group and transplantation groups at the 1st week after BMSCs transplantation (P>0.05). BBB score in transplantation groups were higher than that of single model group at the 2nd and 4th weeks after BMSCs transplantation (P<0.05). At the 2nd week after injury, BBB score from high to low was group F,E,G,D,H,C,but there was no significant difference among the groups (P>0.05). At the 4th week after injury,there was significant differences in BBB score between group F and other transplantation groups (group C,D,E,G,H)(P
CONCLUSIONAllogeneic BMSCs transplantation is effective to stimulate the recovery of spinal cord function in rats with spinal cord injury,and the optimal time of BMSCs transplantation maybe at the 3 d after injury.
Animals ; Behavior, Animal ; Brain-Derived Neurotrophic Factor ; genetics ; Female ; Male ; Mesenchymal Stem Cell Transplantation ; Nerve Growth Factor ; genetics ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; metabolism ; pathology ; therapy ; Transplantation, Homologous
10.Asthma at acute attack stage treated with "Shao's five needling therapy": a multi-central randomized controlled study.
Su-Ju SHAO ; Chun-Fen QUAN ; Su-Xia SHAO ; Miao ZHOU ; Xin-Jian JING ; Yu-Xiao ZHAO ; Zhi-Xin REN ; Pei-Yu WANG ; Xi-Yan GAO ; Jie YANG ; Zhong REN ; Li KONG
Chinese Acupuncture & Moxibustion 2013;33(9):774-778
OBJECTIVETo evaluate the clinical efficacy of asthma at acute attack stage treated with "Shao's five needling therapy".
METHODSThe randomized controlled method was applied to divide 210 cases into an observation group and a control group, 105 cases in each one. In the observation group, "Shao's five needling therapy" [Feishu (BL 13), Dazhui (GV 14), Fengmen (BL 12)] and the combined therapy were adopted, including oxygen uptake, aerosol inhalation and oral administration of prednisone. In the control group, the oral administration of theophylline sustained release tablet and the combined therapy were applied. The treatment was continued for 7 days. The clinical symptoms and physical signs such as wheezing, cough, expectoration, chest stuffiness, wheezing rale and shortness of breath, as well as lung function indices such as forced expiratory volume one second (FEV1) and peak expiratory flow (PEF) were observed before and after treatment in the two groups.
METHODSIn the observation group, 69 cases were cured clinically, 20 cases effective remarkably, 7 cases effective and 0 case failed. In the control group, 49 cases were cured clinically, 31 cases effective remarkably, 15 cases effective and 0 case failed. The difference in the efficacy was significant in comparison of the two groups (P < 0.05). The therapeutic effect in the observation group was better than that in the control group. The total score of the symptoms and physical signs, FEV1 and PEF after treatment were all improved significantly in the two groups (all P < 0.01). And the results in the observation group were better than those in the control group (all P < 0.01).
CONCLUSION"Shao's five needling therapy" achieves the significant efficacy on asthma at acute attack stage. It significantly relieves the symptoms and physical signs of the patients and improves lung functions. The effect is better than that of theophylline sustained release tablet.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Asthma ; physiopathology ; therapy ; Female ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

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