Objective To compare the lipid-lowering efficacy and safety of fixed-dose combination and free combination of rosuvastatin and ezetimibe in hypercholesterolemia patients who fail to achieve low-density lipoprotein cholesterol(LDL-C)goal with statin monotherapy.Methods A total of 45 hypercholesterolemia patients who switched from statin monotherapy to fixed-dose combination of rosuvastatin and ezetimibe after failing to achieve target LDL-C goal admitted at cardiological departments of First Affiliated Hospital of Sun Yat-sen University,Nanhai Fourth People's Hospital,Foshan First People's Hospital,and Guangdong Provincial People's Hospital between March and June 2024 were enrolled and served as the study group.Another 120 hyper-cholesterolemia patients who treated with free combination of rosuvastatin and ezetimibe were se-lected from Xiamen Regional Health Medical Big Data Platform with propensity score matching and served as control group.The LDL-C level,LDL-C reduction,and changes in TC,HDL-C and TG levels in 4-6 weeks after the medication switch,as well as the safety indicators(AST,ALT,CK,Cre and eGFR)were compared between the two groups.Results In 4-6 weeks after the medication switch,the patients in the study group exhibited a significant decrease in LDL-C level(1.70±0.44 mmol/L vs 2.12±0.87 mmol/L,P＜0.01),obvious LDL-C reduction[(43.17±16.11)％vs(29.14±29.13)％,P＜0.01]when compared to those of the control group.The LDL-C goal attainment rate was significantly higher in the study group than the control group(71.11％vs 45.00％,P=0.003).In addition,there were no statistical differences in the levels of HDL-C and TG and the reductions of HDL-C and TG between the two groups in 4-6 weeks after treatment(P＞0.05).The study group obtained notably lower TC level and TC reduction than the control group in the time(P＜/0.05,P＜0.01).After treatment,no statistical differences were observed between the two groups in terms of AST,ALT,CK,Cre and eGFR(P＞0.05).Conclusion Com-pared to free combination of rosuvastatin and ezetimibe,fixed-dose combination can further reduce LDL-C level in hypercholesterolemia patients who have not achieved LDL-C goal with statin monotherapy,with higher LDL-C goal attainment rate and good safety.

Objective:To develop and validate the models based on mixed enhanced computed tomography (CT) radiomics and deep learning features, and evaluate the efficacy for differentiating pancreatic adenosquamous carcinoma (PASC) from pancreatic ductal adenocarcinoma (PDAC) before surgery.Methods:The clinical data of 201 patients with surgically resected and histopathologically confirmed PASC (PASC group) and 332 patients with surgically resected histopathologically confirmed PDAC (PDAC group) who underwent enhanced CT within 1 month before surgery in the First Affiliated Hospital of Naval Medical University from January 2011 to December 2020 were retrospectively collected. The patients were chronologically divided into a training set (treated between January 2011 and January 2018, 156 patients with PASC and 241 patients with PDAC) and a validation set (treated between February 2018 and December 2020, 45 patients with PASC and 91 patients with PDAC) according to the international consensus on the predictive model. The nnU-Net model was used for pancreatic tumor automatic segmentation, the clinical and CT images were evaluated, and radiomics features and deep learning features during portal vein phase were extracted; then the features were dimensionally reduced and screened. Binary logistic analysis was performed to develop the clinical, radiomics and deep learning models in the training set. The models' performances were determined by area under the ROC curve (AUC), sensitivity, specificity, accuracy, and decision curve analysis (DCA).Results:Significant differences were observed in tumor size, ring-enhancement, upstream pancreatic parenchymal atrophy and cystic degeneration of tumor both in PASC and PDAC group in the training and validation set (all P value <0.05). The multivariable logistic regression analysis showed the tumor size, ring-enhancement, dilation of the common bile duct and upstream pancreatic parenchymal atrophy were associated with PASC significantly in the clinical model. The ring-enhancement, dilation of the common bile duct, upstream pancreatic parenchymal atrophy and radiomics score were associated with PASC significantly in the radiomics model. The ring-enhancement, upstream pancreatic parenchymal atrophy and deep learning score were associated with PASC significantly in the deep learning model. The diagnostic efficacy of the deep learning model was highest, and the AUC, sensitivity, specificity, and accuracy of the deep learning model was 0.86 (95% CI 0.82-0.90), 75.00%, 84.23%, and 80.60% and those of clinical and radiomics models were 0.81 (95% CI 0.76-0.85), 62.18%, 85.89%, 76.57% and 0.84 (95% CI 0.80-0.88), 73.08%, 82.16%, 78.59% in the training set. In the validation set, the area AUC, sensitivity, specificity, and accuracy of deep learning model were 0.78 (95% CI 0.67-0.84), 68.89%, 78.02% and 75.00%, those of clinical and radiomics were 0.72 (95% CI 0.63-0.81), 77.78%, 59.34%, 65.44% and 0.75 (95% CI 0.66-0.84), 86.67%, 56.04%, 66.18%. The DCA in the training and validation sets showed that if the threshold probabilities were >0.05 and >0.1, respectively, using the deep learning model to distinguish PASC from PDAC was more beneficial for the patients than the treat-all-patients as having PDAC scheme or the treat-all-patients as having PASC scheme. Conclusions:The deep learning model based on CT automatic image segmentation of pancreatic neoplasm could effectively differentiate PASC from PDAC, and provide a new non-invasive method for confirming PASC before surgery.

Objective:To study the healthcare level (HCL) in China and its influencing factors.Methods:By using the data reported in the China statistical yearbook published by the National Bureau of Statistics and in other public literature, HCL was calculated in terms of the number of population and physicians in the whole country and various provinces. Multiple regression was used to analyze the relationship between HCL and regional population, area, number of administrative divisions and gross domestic product (GDP). Pearson correlation analysis was applied to analyze the relationship between healthcare level and medical radiation frequency. Results:Since 2015, Chinese HCL value was lower than 1 000, but there were two provinces with HCL value greater than 1 000 in 2019. Population and GDP were the influencing factors for the HCL, with correlation coefficients of 0.416 and -0.583, respectively. There was a correlation between HCL and medical exposure frequency of Chinese population( r= -0.620, P=0.028). Conclusions:Chinese HCL value was 542 in 2020, but there has been great differences between various provinces. HCL as an indicator of medical exposure assessment needs further research in China.

Objective:To explore the incidence, clinical characteristics and prognosis of invasive pulmonary fungal infection(IPFI)in recipients of lung transplantation(LT)in southern China.Methods:From January 2003 to August 2019, retrospective analysis was performed for 300 recipients of lung transplantation at three hospitals in southern China. There were 254 males and 46 females with an average age of (54.98±14.2)years. Clinical data were collected from medical records, including symptoms and signs, imaging studies, bronchoscopy examination, pathogen separation and culture from deep sputum and bronchoalveolar lavage fluid(BALF), fungal-related laboratory tests and tissue pathology.Results:Among 300 cases, 93(31.0%)had at least one episode of IPFI. The most common pathogen was aspergillosis(60.2%), followed by candida(15 cases, 16.1%)and Pneumocystis jeroveci (13 cases, 14.0%). Kaplan Meier analysis indicated that all-cause mortality was significantly higher in IPFI group than that in non-IPFI(nIPFI)group with one-year mortality of 45.2% vs. 26.7% in IPFI and nIPFI groups respectively( P<0.05). Conclusions:IPFI is prevalent after LT in southern China. And aspergillosis is the most common pathogen and Candida comes the next. The median occurring time for aspergillosis is 6 months after LT. Candida infection occurs earlier at airway anastomosis. A higher incidence of invasive fungal disease(IFD)associated with a lower survival indicates that IPFI has a substantial mortality among recipients after LT. Prophylactic agents should be optimized based upon an epidemiologically likely pathogen.

Objective:To investigate the clinical manifestation, genetic characteristics, treatment and prognosis of Crouzon-like syndrome.Methods:Clinical data of one case of Crouzon-like syndrome diagnosed in Children′s Hospital Affiliated to Zhengzhou University in May 2019 were collected, including clinical test, treatment plan, follow-up outcomes. The clinical characteristics and the mutation characteristics of IL11RA-related Crouzon-like syndrome were analyzed combined with the literature.Results:The male proband, five years and four months old, was admitted with the main clinical manifestations including headache, vomiting, exophthalmos, ocular hypertelorism, nasal root flat and scaphocephaly. CT showed that the cerebellar tonsil moved down slightly, the occipital magnum was full, the bilateral cranial plates were locally thinner, the bilateral cranial diameters were increased, and the cranial seams were closed. Magnetic resonance imaging showed ChiariⅠmalformation. The mutation c.40_63del and splice site mutation c.811-2A>G of the patient′s IL11RA gene were screened by whole exome sequencing. Sanger sequencing showed that the mutations are compound heterozygous and both are first reported. The mutation c.811-2A>G was derived from the patient′s mother, and the other one is de novo.Conclusions:The main clinical manifestations of Crouzon-like syndrome are craniosynostosis and midface hypoplasia and ocular deformity. The study identified two novel mutations in the Crouzon-like syndrome related IL11RA gene. Genetic sequencing is helpful for accurate diagnosis and timely surgical treatment.

Objective To explore the prevalence and influential factors of chronic respiratory system diseases among resi-dents over 1 5 years old in Hubei province and provide evidence for disease prevention.Methods During October to November in 2013,through stratified cluster sampling,we sampled 20 cities or counties.The survey included the the general condition of family, individual,chronic diseases.Results A total of 28 563 residents answered the questionnaire and 423 of them reported chronic re-spiratory system diseases by themselves.The prevalence rate was 14.8‰.These included 229 cases with COPD(54.1%),44 cases with asthma(10.4%),35 cases with chronic pharyngolaryngitis(8.3%)and 1 1 5 cases with other chronic respiratory system disea-ses(27.2%).In urban and rural area,the prevalence rate were 13.6‰ and 1 5.7‰ respectively.Multivariate logistic analysis showed that gender,age,economic status and medical insurance are influential factors of chronic respiratory system diseases.Conclusion Prevalence rate of chronic respiratory system diseases among residents over 1 5 years old in Hubei province was slightly increased and disease control measures should be brought out.

Objective To understand the prevalence and influential factors of allergic diseases among infants aged 6-24 months in Enshi prefecture to provide the basis for the prevention of the allergic disease in infants and young children .Methods 1 724 in-fants were extracted by using multi-stage stratified cluster sampling and the data including the demographic characteristics ,family condition ,caregiver condition and behavior ,and allergic disease information were collected by the questionnaire survey .The multiva-riate Logistic regression analysis was performed to analyze the influential factors of allergic diseases .Results Among the investiga-ted infants and young children ,the prevalence of allergic diseases was 11 .83% ,which was dominated by eczema with the prevalence of 7 .54% ,followed by allergic asthma (1 .97% ) .The univariate Logistic regression analysis showed that allergic diseases were as-sociated with the nationality (χ2 =17 .865 ,P=0 .000) ,month age(χ2 =9 .420 ,P=0 .009) ,feeding patterns(χ2 =6 .304 ,P=0 .043) and ,time for adding solid food(χ2 =12 .695 ,P=0 .002) and family income(χ2 =9 .259 ,P =0 .010) .The multivariate Logistic re-gression analysis showed that the ethnic minority [OR95% CI:1 .86(1 .27~2 .73) ,P=0 .001]and artificial feeding [OR95% CI:1 .17 (1 .01~2 .82) ,P=0 .045]had the higher risk for suffering from allergic diseases ,the month age between 18 to 24 months[OR95%CI:0 .57(0 .39~0 .84) ,P=0 .005]and the family income>30 000 yuan each year [OR95% CI:0 .64(0 .43~0 .96) ,P=0 .030]were negatively correlated with the allergic diseases in infants and young children .Conclusion The prevalence of allergic diseases among infants and young children aged 6-24 months in Enshi prefecture is relatively higher and the infants of ethnic minority ,low month age ,artificial feeding and lower family income have the higher risk of allergic diseases .

OBJECTIVETo study the treatment effects of cultured Cordyceps sinensis combined with glucocorticosteroid on experimental pulmonary fibrosis in rats induced by bleomycin.

METHODFifty rats were randomly divided into five groups, including control group, model group, cultured C. sinensis groups, prednisone group, cultured C. sinensis combined with prednisone group. On experimental day 0, the rats were respectively intratracheally instilled with bleomycin, and rats in the control group and model group with the same volume of normal saline. One day after the injection, cultured C. sinensis and glucocorticosteroid was respectively given to rats daily by gastric gavage, while the same volume of normal saline was given to those in the control group and model group. On 28th d, bronchoalveolar lavage fluid (BALF) and lung tissue were collected. Histological changes of the lungs were evaluated by HE stain, Masson's trichrome stain. Collagen content of the lung tissue was assessed by hydroxyprolin concentration. Lung expression of CTGF protein was assessed by immunohistochemistry. The level of TGF-beta1 protein was measured by ELISA.

RESULTCompared to model group, pulmonary fibrosis were alleviated in cultured C. sinensis and prednisone group, and CTGF expression, Hydroxyproline concentrations and protein TGF-beta1 were decreased. The combination effect of C. sinensis and prednisone group is augmented compared with using C. sinensis or prednisone group alone.

CONCLUSIONThe cultured C. sinensis and prednisone alleviates pulmonary fibrosis, and the combination use of both drugs has synergia effects in anti-fibrous degeneration.

Animals ; Bleomycin ; toxicity ; Connective Tissue Growth Factor ; analysis ; Cordyceps ; Drug Therapy, Combination ; Lung ; chemistry ; pathology ; Male ; Phytotherapy ; Prednisone ; administration & dosage ; Pulmonary Fibrosis ; chemically induced ; drug therapy ; pathology ; Rats ; Rats, Sprague-Dawley

Cordyceps sinensis is a medicinal fungus of Traditional Chinese Medicine. There are a wide range of reported uses of Cordycep sinensis in the literature. However, the production of Cordyceps sinensis is so limited that can not be widely used. Cultured Cordyceps sinensis (Bailing Capsule) and natural Cordyceps sinensis have similar chemical composition. Bailing Capsule possesses anti-inflammatory, anti-hypoxia, anti-tumor effect function and regulating the endocrine system, enhanced immune function, which has a protective effect on the kidney, lung, liver and other organs. Recently, Bailing capsule has some beneficial effects on pulmonary diseases, such as COPD, Pulmonary fibrosis, Asthma, which have been gradually applied to the clinical.
Animals ; Capsules ; Cordyceps ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Lung Diseases ; drug therapy ; Medicine, Chinese Traditional

To get information in the sexual and contraceptive behaviors in Chinese female college students, a randomized cluster sampling was conducted in colleges and universities in Wuhan Area, China, in terms of types of colleges, subjects (literature, sciences, medicines, art etc), and grades etc. A total number of 2450 questionnaires were distributed, with 2365 questionnaires returned being valid. The return rate of valid questionnaires was 96.6%. The questionnaire investigation was conducted on a multiple-choice and anonymous basis. Data were input into computer and SPSS12.0 software package was employed for statistical analysis. Among the female students, 1196 had the experiences of hugging and kissing (50.57%) and 423 (17.89%) had sexual experiences (sexual intercourse). The first sexual intercourse took place at the age of 19.23+/-1.74 y. There were significant differences in the sexual experiences among the majors of different subjects, with the rate of sexual experiences in art majors (43.17%) and high-grade students (34.31%) being the highest. The causes of the first sexual intercourse included sexual impulse, curiosity, intention to strengthen the relationship or to show loyalty to boyfriend and sometimes violence. While the motives of the sexual intercourse within the past one year before the investigation were to satisfy the sexual needs and to strengthen the relation with their boyfriends. With both first intercourse and sexual experiences within last one year, the partners of the sexual intercourse were mainly their boyfriends (95.7% and 97.3% respectively), but the partners also included acquaintances, "one night stand" partners and customers of sex trade. Some of them had multiple sexual partners, with the highest number of the sexual partners being 11. In the first sexual intercourse of the subjects, 44.0 % of them did not take any contraceptive measures; only 16.4% of them used condoms. In the sexual intercourse within the last one year, only 44.6% took contraceptive measures every time they had sexual intercourse. Among those who took contraceptive measures, 64.4% used condoms. Among those who had sexual intercourse, 101 persons got pregnant, with a rate of pregnancy being 4.3%, accounting for 23.9% of all who had sexual intercourse. Among those who got pregnant, 78 persons got pregnant once; the others became pregnant more than two times, the highest being 5 times. There were 122 persons who had inflammation of reproductive system, mostly vaginitis. Other conditions included venereal warts and herpes genitalis. It is concluded that the rate of sexual behaviors is high in female college students and there exist promiscuity, unexpected pregnancy and transmission of STD in the students.