PURPOSE:To investigate the differences in gut microbial characteristics between two traditional Chinese syndromes of premature ovarian insufficiency(POI).METHODS:Forty women with POI were recruited from the Department...PURPOSE:To investigate the differences in gut microbial characteristics between two traditional Chinese syndromes of premature ovarian insufficiency(POI).METHODS:Forty women with POI were recruited from the Department of Traditional Chinese Medicine at Shenzhen Maternity and Child Healthcare Hospital between June and December 2020.Women with POI were divided into the kidney deficiency and blood stasis syndrome(SDBS)and Qi and blood deficiency syndrome(QBDS)groups.Gut microbial community profiles were analyzed by 16S rRNA gene sequencing using an Illumina Mi Seq system.A retrospective study comparing hormone levels and gut microbiota information was performed between the SDBS and QBDS groups.RESULTS:Compared with the QBDS group,the serum levels of estradiol(E2)and anti-Müllerian hormone(AMH)were significantly decreased in the SDBS group.The quantities of Adlercreutzia,Eggerthella,Klebsiella,and Paraprevotella significantly increased in the SDBS group,whereas Lactobacillus decreased significantly.Moreover,alterations in the microbiome in the SDBS and QBDS groups were closely related to the levels of E2 and AMH.The area under the receiver operating characteristic curve for the classification of the two syndromes by the gut microbiome was 0.71.CONCLUSIONS:There were significant differences in the dominant microbiota between the SDBS and QBDS groups,and the change in Proteobacteria in the QBDS group was more significant.The characteristics of gut microbiota help us differentiate between the SDBS and QBDS groups,which may provide a basis for the objectification of TCM syndrome types.展开更多
OBJECTIVE:To illustrate the effect of add-on therapy of Traditional Chinese Medicine(TCM)on the long-term survival of anemic lower-risk myelodysplastic syndromes(LR-MDS)patients.METHODS:In this study,we conducted a re...OBJECTIVE:To illustrate the effect of add-on therapy of Traditional Chinese Medicine(TCM)on the long-term survival of anemic lower-risk myelodysplastic syndromes(LR-MDS)patients.METHODS:In this study,we conducted a retrospective analysis of the data of patients with LR-MDS who were identified from Shuguang Hospital between January 2006 and June 2020.The Kaplan-Meier method was used to calculate overall survival(OS),while the Cox model was employed to analyze prognostic factors of long-term survival.A total of 162 patients who met the inclusion criteria were divided into two groups:the TCM group(n=78)or the non-TCM group(n=84).RESULTS:There were no significant differences in baseline characteristics.The cumulative survival rate of the TCM group was significantly higher than that of the non-TCM group[log-rank P=0.029,hazard ratio(HR)=0.484,95%confidence interval(CI)(0.249,0.942),P<0.05].Patients with longer TCM treatment appeared to have better OS(≥12 months vs<12 months);[HR,0.16695%CI(0.055,0.508),P<0.001].According to the Cox model analysis,the combination of TCM and conventional Western Medicine may be a protective factor affecting the long-term survival of LR-MDS patients[HR=0.509,95%CI,(0.261,0.993),P=0.048].The hematologic improvement erythroid response(HI-E)rate of the TCM group was significantly higher than that of the non-TCM group(69.23%vs 52.38%;P=0.028).However,the duration of HI-E and cases of disease progression after HI-E did not significantly differ from the non-TCM group(P>0.05).CONCLUSIONS:The integration of TCM and Western Medicine has the potential to extend the OS of LR-MDS patients when compared to the use of Western Medicine alone.展开更多
Objective This study aims to explore the correlation between traditional Chinese medicine(TCM)syndromes and the expression status of estrogen receptor(ER)and progesterone receptor(PR)in breast cancer patients before a...Objective This study aims to explore the correlation between traditional Chinese medicine(TCM)syndromes and the expression status of estrogen receptor(ER)and progesterone receptor(PR)in breast cancer patients before and after adjuvant chemotherapy.Methods A total of 222 breast cancer patients with consistent ER and PR expression scheduled to undergo adjuvant chemotherapy were classified according to TCM syndrome differentiation before and after chemotherapy.The data were analyzed using chi-square tests and binary logistic regression with SPSS 26.0 software,and compared with ER/PR expression results.Results(i)In the ER-positive/PR-positive group,compared with prechemotherapy,syndromes of spleen qi deficiency,spleen deficiency with dampness-phlegm,and spleen–kidney deficiency significantly increased during mid-chemotherapy and after chemotherapy.Compared with mid-chemotherapy,spleen yang deficiency syndrome significantly increased after chemotherapy,with statistical significance(p<0.05).(ii)In the ER-negative/PR-negative group,compared with prechemotherapy,syndromes of spleen qi deficiency and spleen deficiency with dampness-phlegm significantly increased during mid-chemotherapy,while spleen qi deficiency,spleen yang deficiency,and spleen–kidney deficiency significantly increased after chemotherapy.Compared with mid-chemotherapy,spleen–kidney deficiency and spleen yang deficiency syndromes significantly increased after chemotherapy,with statistical significance(p<0.05).(iii)The distribution of spleen qi deficiency syndrome during mid-chemotherapy and after chemotherapy was significantly higher in the ER-positive/PR-positive group than in the ER-negative/PR-negative group,with statistical significance(p<0.05).(iv)ER and PR were not independent influencing factors for the various syndrome types before and after adjuvant chemotherapy(p>0.05).Conclusion After chemotherapy initiation,syndromes of spleen qi deficiency,spleen yang deficiency,and spleen–kidney deficiency significantly increased in both ER-positive/PR-positive and ER-negative/PR-negative groups.The distribution of spleen qi deficiency during mid-chemotherapy and after chemotherapy was significantly higher in the ER-positive/PR-positive group than in the ER-negative/PR-negative group.ER and PR were not independent influencing factors for the syndrome types before and after adjuvant chemotherapy.展开更多
Recently,Jayabalan et al published an important study.The authors defined the liver outcome score as a novel biomarker for predicting liver-related mortality in patients with autoimmune hepatitis-primary biliary chola...Recently,Jayabalan et al published an important study.The authors defined the liver outcome score as a novel biomarker for predicting liver-related mortality in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome.After thoroughly reviewing their work,we offer insights that primarily relate to their study design to enhance the medical community’s understanding of this complex disease.展开更多
This letter addresses the study by Jayabalan et al,which underscores the liver outcome score(LOS)and hemoglobin(Hb)as key prognostic markers for patients with autoimmune liver disease overlap syndromes(AILDOS),with pa...This letter addresses the study by Jayabalan et al,which underscores the liver outcome score(LOS)and hemoglobin(Hb)as key prognostic markers for patients with autoimmune liver disease overlap syndromes(AILDOS),with particular relevance to the autoimmune hepatitis-primary biliary cholangitis(AIH-PBC)subgroup.The findings indicate that an LOS threshold of 6 achieves high sensitivity and specificity in predicting liver-related mortality among AIH-PBC patients.Moreover,low Hb levels emerge as a significant mortality predictor across all AILDOS cases.These results contribute valuable perspectives on risk stratification in AILDOS,highlighting the promise of non-invasive prognostic tools.Future studies with larger cohorts are needed to substantiate LOS and Hb as robust markers for clinical application.展开更多
Traditional Chinese medicine(TCM)auscultation has a long history,and with advancements in equipment and analytical methods,the quantitative analysis of auscultation parameters has determined.However,the complexity and...Traditional Chinese medicine(TCM)auscultation has a long history,and with advancements in equipment and analytical methods,the quantitative analysis of auscultation parameters has determined.However,the complexity and diversity of auscultation,along with variations in devices,analytical methods,and applications,bring challenges to its standardization and deeper application.This review presents the advancements in auscultation equipment and systems,auscultation characteristic parameters,and their application in the diagnosis of pulmonary diseases and syndromes over the past 10 years,while also exploring the progress and challenges of current digital research of auscultation.This review also proposes the establishment of standardized protocols for the collection and analysis of auscultation data,the incorporation of advanced artificial intelligence(AI)auscultation analysis methods,and an exploration of the diagnostic utility of auscultatory features in pulmonary diseases and syndromes,so as to provide more precise decision support for intelligent diagnosis of pulmonary diseases and syndromes.展开更多
BACKGROUND Kidney transplantation is the most effective means to treat patients with renal failure,but its postoperative problems such as rejection reactions,immunosuppressant poisoning,chronic transplant kidney nephr...BACKGROUND Kidney transplantation is the most effective means to treat patients with renal failure,but its postoperative problems such as rejection reactions,immunosuppressant poisoning,chronic transplant kidney nephropathy,etc.still have not been effectively solved.This study searched for literature on traditional Chinese medicine(TCM)syndromes after kidney transplantation in China,conducted statistical analysis of the results,and sought to identify the underlying patterns.AIM To understand the TCM syndromes after renal transplantation and associated rules and provide a theoretical basis for further clinical research.METHODS The literature pertaining to TCM syndromes in renal transplantation,published in the China National Knowledge Infrastructure,Wanfang database,and WIP database from 1970 to 2021,was meticulously searched and comprehensively and statistically analyzed.RESULTS Following the established inclusion and exclusion criteria,13 studies were selected for analysis.Post-renal transplantation,no significant discrepancy was noted among the groups based on the location of TCM viscera.However,when categorized according to TCM pathogenic factors,the groups with spleen and kidney yang deficiency,as well as liver and kidney yin deficiency,exhibited a statistically significant difference in the frequency.CONCLUSION Currently,the research on TCM syndromes pertaining to renal transplantation is in its nascent phase.It is imperative to conduct a multicentric,large-scale survey of TCM syndromes subsequent to renal transplantation in the ensuing years.展开更多
Traditional Chinese medicine(TCM)has played a significant role in the prevention and treatment of chronic heart failure(CHF).To study TCM diagnosis of CHF,a total of 278 Chinese clinical research articles on the study...Traditional Chinese medicine(TCM)has played a significant role in the prevention and treatment of chronic heart failure(CHF).To study TCM diagnosis of CHF,a total of 278 Chinese clinical research articles on the study of CHF syndromes in recent 40 years retrieved from Web of Science,Scopus,Pub Med,Embase,CNKI,Wanfang Data,Cq VIP,and Sino Med.According to cumulative frequency analysis,network analysis,and hierarchical cluster analysis,the study found the distribution of CHF syndromes was syndrome of qi deficiency with blood stasis,syndrome of qi and yin deficiency,syndrome of yang deficiency with water flooding,syndrome of heart blood stasis obstruction,syndrome of turbid phlegm,and syndrome of collapse due to primordial yang deficiency.The syndrome elements on location of illness were heart,kidney,lung,and spleen.The syndrome elements on nature of illness were qi deficiency,blood stasis,yang deficiency,yin deficiency,water retention,and turbid phlegm.These findings can provide reference to the research on diagnosis and treatment of CHF,and contribute to the study on syndrome standardization and objective research of TCM diagnosis.展开更多
Objective Great obstetrical syndrome(GOS)represents a group of pregnancy-related diseases that result in inadequate placentation.Most GOS cases end in preterm,either spontaneously or indicatively,and the use of antena...Objective Great obstetrical syndrome(GOS)represents a group of pregnancy-related diseases that result in inadequate placentation.Most GOS cases end in preterm,either spontaneously or indicatively,and the use of antenatal corticosteroids(ACS)is inevitably discussed.The placenta is an important,transient fetal-derived organ and is the embodiment of maternal or fetal well-being.However,few studies provide histological evidence of the placenta in GOS.This study aims to address these issues.Methods A total of 831 pregnant women were prospectively recruited.Placenta tissue was collected immediately and fixed with 4%paraformaldehyde solution for future H&E analysis.A novel checklist was devised to evaluate maternal vascular malperfusion sections on the basis of the commonly accepted Amsterdam placental workshop group consensus statement.Results A total of 131 patients were classified as having GOS.Comparisons between those with and without GOS revealed significant differences,including higher levels of distal villous hypoplasia,increased syncytial knots,accelerated villous maturation,and higher total scores in GOS.We found significant negative associations between GOS and neonatal weight,neonatal height,head circumference,placental surface area,placental volume,and placenta gross examination score.GOS neonates were 1.25 times more likely to have hyperbilirubinemia.Regarding the effect of ACS,a significant reduction in birthweight,height,and head circumference was observed,along with an increased risk of hyperbilirubinemia.Conclusion This study provides histological evidence of the GOS that supports the defective deep placentation hypothesis.Our research also contributes to benefit-risk consultation in the GOS,such as in cases of PE and FGR,where a balance between fetal lung maturation and short-term neonatal outcomes is crucial.展开更多
Paraneoplastic neurological syndrome refers to certain malignant tumors that have affected the distant nervous system and caused corresponding dysfunction in the absence of tumor metastasis.Patients with this syndrome...Paraneoplastic neurological syndrome refers to certain malignant tumors that have affected the distant nervous system and caused corresponding dysfunction in the absence of tumor metastasis.Patients with this syndrome produce multiple antibodies,each targeting a different antigen and causing different symptoms and signs.The CV2/collapsin response mediator protein 5(CRMP5)antibody is a major antibody of this type.It damages the nervous system,which often manifests as limbic encephalitis,chorea,ocular manifestation,cerebellar ataxia,myelopathy,and peripheral neuropathy.Detecting CV2/CRMP5 antibody is crucial for the clinical diagnosis of paraneoplastic neurological syndrome,and anti-tumor and immunological therapies can help to alleviate symptoms and improve prognosis.However,because of the low incidence of this disease,few repo rts and no reviews have been published about it so far.This article intends to review the research on CV2/CRMP5antibody-associated paraneoplastic neurological syndrome and summarize its clinical features to help clinicians comprehensively understand the disease.Additionally,this review discusses the curre nt challenges that this disease poses,and the application prospects of new detection and diagnostic techniques in the field of paraneoplastic neurological syndrom e,including CV2/CRMP5-associated paraneoplastic neurological syndrome,in recent years.展开更多
Objective To investigate the relationship among serum vitamin D levels, physical performance impairment, and geriatric syndromes in elders with hypertension. Methods According to the concentration of vitamin D levels,...Objective To investigate the relationship among serum vitamin D levels, physical performance impairment, and geriatric syndromes in elders with hypertension. Methods According to the concentration of vitamin D levels, a total of 143 elderly patients with hypertension were classified into vitamin D deficient group （vitamin D 〈 20 ng/mL, n = 94） and vitamin D appropriate group （vitamin D 〉 20 ng/rnL, n = 49）. Geriatric syndromes and physical performance were assessed by using comprehensive geriatric assessment （CGA）. Correlation among vitamin D levels, geriatric syndromes and physical performance was analyzed. Results No statistical differences were found in various aspects of geriatric syndromes between the two groups （P 〉 0.05）. While correlation analysis indicated that vitamin D levels had a positive association with ADL score （r = 0.235, P 〈 0.01） and a negative association with Morse fall scale score （r = 0.238, P 〈 0.01）. Patients with deficient vitamin D level had longer time both in the Five Time Sit to Stand Test （5tSTS）, （15.765 ± 5.593） and the four-meter walk test [7.440 （5.620, 9.200）], a weaker hand-grip in the grip strength test （28.049 ± 9.522）, and a lower Tinetti performance-oriented mobility assessment （Tinetti POMA） [26 （22, 27）] and Balance subscale of the Tinetti performance-oriented mobility assessment （B-POMA） score [ 14 （12, 16）], compared with appropriate vitamin D level [（13.275 ± 3.692）; 5.810 （4.728, 7.325）]; （31.989 ± 10.217）; [26.5 （25, 28）]; [15 （14, 16）, respectively, all P 〈 0.05]. Furthermore, results of logistic regression indicated that vitamin D was significantly associated with 5tSTS （OR = 1.2, 95% CI = 1.050-1.331, P 〈 0.01）, Tinetti POMA （OR = 3.7, 95% CI：1.284-10.830, P 〈 0.05） and B-POMA （OR = 0.8, 95% CI：0.643-0.973, P 〈 0.05）. Conclusions In elderly hypertensive patients, serum vitamin D deficient level is associated with physical performance impairment. However, no statistical significance was found between vitamin D and geriatric syndromes. Further study is required to investigate possible mechanisms for the association between vitamin D and physical performance.展开更多
Objective:The clinical symptoms of diarrhea-predominant irritable bowel syndrome(IBS-D)can be effectively improved by traditional Chinese medicine(TCM)treatment,based on the usage of specific therapies for different T...Objective:The clinical symptoms of diarrhea-predominant irritable bowel syndrome(IBS-D)can be effectively improved by traditional Chinese medicine(TCM)treatment,based on the usage of specific therapies for different TCM syndromes.However,in the stage of diagnosis,the standard criteria for the classification of TCM syndrome were still deficient.Through serum metabolic profiling,this study aimed to explore potential biomarkers in IBS-D patients with different TCM syndromes,which can assist in diagnosis of the disease.Methods:Serum samples were collected from healthy controls(30 cases),IBS-D patients with LiverStagnation and Spleen-Deficiency syndrome(LSSD,30 cases),Yang Deficiency of Spleen and Kidney syndrome(YDSK,11 cases)and Damp Abundance due to Spleen-Deficiency syndrome(DASD,22 cases).Serum metabolic profiling was conducted by ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry.The potential biomarkers were screened by orthogonal partial least square-discriminate analysis,while metabolic pathways undergoing alterations were identified by pathway enrichment analysis in Metabo Analyst 4.0.Results:Overall,34 potential biomarkers were identified in LSSD group,36 in YDSK group and 31 in DASD group.And the 13 metabolites shared by three groups were determined as the potential biomarkers of IBS-D.Glycerophospholipid metabolism was disturbed significantly in IBS-D patients,which may play a role in IBS-D through inflammation.What’s more,three TCM syndromes have the specific potential biomarkers in glycerophospholipid metabolism.Conclusion:The serum metabolomics revealed that different TCM syndrome types in IBS-D may have different metabolic patterns during disease progression and glycerophospholipid metabolism was one of the pathways,whose metabolism was disturbed differently among three TCM syndromes in IBS-D.Therefore,the specific potential biomarkers in glycerophospholipid metabolism of three TCM syndromes in IBS-D can serve as the objective indicators,which can facilitate the TCM-syndrome objective classification of IBS-D.展开更多
OBJECTIVE: To investigate neuropsychological features of post-stroke cognitive impairment with no dementia(PSCIND) patients with different Traditional Chinese Medicine(TCM) syndromes.METHODS: We recruited 50 patients ...OBJECTIVE: To investigate neuropsychological features of post-stroke cognitive impairment with no dementia(PSCIND) patients with different Traditional Chinese Medicine(TCM) syndromes.METHODS: We recruited 50 patients with PSCIND between April 2012 and March 2013. Patients were divided into different groups according to TCM classifications. Patients were assessed using neuropsychological tests, including cognitive screening(mini-mental state examination), memory testing (auditory verbal learning test), executive/attention[shape trails test, stroop color-word test(SCWT),reading the mind in the eyes test, the digit ordering test-A(DOT-A), and symbol digit modalities test], language(action naming test, Boston naming test, famous face test, similarity test, and verbal fluency test), and visuospatial functioning [complex figure test(CFT)].RESULTS: We found no significant differences between patients with and without a diagnosis of turbid phlegm blocking the upper orifices on neuropsychological test performance. Patients diagnosed with upper hyperactivity of liver Yang syndrome scored significantly lower on the SCWT-C executive test and the CFT-delayed recall memory test. Patients with excess syndrome scored significantly lower on the SCWT-C executive test, and significantly higher on the DOT-A executive test.CONCLUSION: Neuropsychological characteristics differ between PSCIND patients with different TCM classifications.展开更多
There is an increasing interest and popularity of Chinese herbal medicine worldwide, which is accompanied by increasing concerns about its effectiveness and potential toxicity. Several ingredients, such as polyphenoli...There is an increasing interest and popularity of Chinese herbal medicine worldwide, which is accompanied by increasing concerns about its effectiveness and potential toxicity. Several ingredients, such as polyphenolic compounds berberine, flavonoids, and curcumin, have been studied extensively by using various animal models. Effectiveness of treatment and amelioration of metabolic syndromes, including insulin resistance and dyslipidemia, has been demonstrated. This review summarizes the major checkpoints and contributing factors in regulation of exogenous and endogenous lipid metabolism, with particular emphasis centered on triglyceride-rich and cholesterol-rich lipoproteins. Available experimental evidence demonstrating the lipid-lowering effect of berberine, flavonoids and curcumin in cell culture and animal models is compiled, and the strengths and shortcomings of experimental designs in these studies are discussed.展开更多
The myelodysplastic/myeloproliferative neoplasms(MDS/MPNs) are a unique group of hematologic malignancies characterized by concomitant myelodysplastic and myeloproliferative features. According to the 2008 WHO classif...The myelodysplastic/myeloproliferative neoplasms(MDS/MPNs) are a unique group of hematologic malignancies characterized by concomitant myelodysplastic and myeloproliferative features. According to the 2008 WHO classification, the category includes atypical chronic myeloid leukemia(a CML), chronic myelomonocytic leukemia(CMML), juvenile myelomonocytic leukemia(JMML), MDS/MPN-unclassifiable(MDS/MPN-U), and the provisional entity refractory anemia with ring sideroblasts and thrombocytosis(RARS-T). Although diagnosis currently remains based on clinicopathologic features, the incorporation of nextgeneration platforms has allowed for the recent molecular characterization of these diseases which has revealed unique and complex mutational profiles that support their distinct biology and is anticipated to soon play an integral role in diagnosis,prognostication, and treatment. Future goals of research should include the development of disease-modifying therapies, and further genetic understanding of the category will likely form the foundation of these efforts.展开更多
Because of the rarity of familial gastrointestinal cancerpredisposing syndromes,their exploration in literature is not extensive.In this review,an update of the clinicopathological and molecular criteria of gastrointe...Because of the rarity of familial gastrointestinal cancerpredisposing syndromes,their exploration in literature is not extensive.In this review,an update of the clinicopathological and molecular criteria of gastrointestinal familial polyposis syndromes with potential malignant transformation is performed.In addition,a guide for screening and surveillance was synthesized and a distribution of gene mutations according to the specific syndromes and geographic distribution was included.The following inherited polyposes syndromes were analyzed: familial adenomatous polyposis,the hamartomatous familial polyposes(Juvenile polyposis,Peutz-Jeghers syndrome,Cowden syndrome,BannayanRiley-Ruvalcaba syndrome,hereditary mixed polyposis syndrome,Gorlin syndrome,Birt-Hogg-Dube syndrome,neurofibromatosis type Ⅰand multiple endocrine neoplasia syndrome 2B),Li-Fraumeni syndrome,and MUTYHassociated adenomatous polyposis.For proper medical care,subspecialization of gastroenterologists,pathologists,and genticists in the field of familial diseases should be introduced in the medical curriculum.展开更多
Background Elderly patients with non-ST-segment elevation acute coronary syndromes(NSTE-ACS)may present delirium but its clinical relevance is unknown.This study aimed at detennining the clinical associated factors,an...Background Elderly patients with non-ST-segment elevation acute coronary syndromes(NSTE-ACS)may present delirium but its clinical relevance is unknown.This study aimed at detennining the clinical associated factors,and prognostic implications of delirium in old-aged patients admitted for NSTE-ACS.Methods LONGEVO-SCA is a prospective multicenter registry including unselected patients with NSTE-ACS aged>80 years.Clinical variables and a complete geriatric evaluation were assessed during hospitalization.The association between delirium and 6-month mortality was assessed by a Cox regression model weighted for a propensity score including the potential confounding variables.We also analysed its association with 6-month bleeding and cognitive or functional decline.Results Among 527 patients included,thirty-seven(7%)patients presented delirium during the hospitalization.Delirium was more frequent in patients with dementia or depression and in those from nursing homes(27.0%vs.3.1%,24.3%vs.11.6%,and 11.1%V5.2.2%,respectively;all P<0.05).Delirium was significantly associated with in-hospital infections(27.0%vs.5.3%,P<0.001)and usage of diuretics(70.3%vs.49.8%,P=0.02).Patients with delirium had longer hospitalizations[median 8.5(5.5-14)vs.6.0(4.0-10)days,P=0.02]and higher incidence of 6-month bleeding and mortality(32.3%vs.10.0%and 24.3%vs.10.8%,respectively;both P<0.05)but similar cognitive or functional decline.Delirium was independently associated with 6-month mortality(HR=1.47,95%CI:1.02-2.13,P=0.04)and 6-month bleeding events(OR=2.87;95%CI:1.98-4」6,P<0.01).Conclusions In-hospital delirium in elderly patients with NSTE-ACS is associated with some preventable risk factors and it is an independent predictor of 6-month mortality.展开更多
OBJECTIVE:To explore the relationship between the efficacy of realgar for the treatment of myelodysplastic syndromes with multilineage dysplasia(MDS-MLD)and arsenic concentration in the peripheral blood of patients.ME...OBJECTIVE:To explore the relationship between the efficacy of realgar for the treatment of myelodysplastic syndromes with multilineage dysplasia(MDS-MLD)and arsenic concentration in the peripheral blood of patients.METHODS:In this prospective study,a total of 50 MDS-MLD patients were treated with traditional Chinese drugs containing realgar for 3 months in Xiyuan Hospital from March 2018 to January 2019.Routine blood examination as well as liver and kidney function were monitored before and after treatment.The concentration of arsenic in the peripheral blood was measured using an atomic fluorescence spectrometer after treatment.The correlation between clinical effect and arsenic concentration was analyzed by Spearman’s method.RESULTS:The treatment response rate was 54%.Two patients(4%)achieved complete remission,50%(25 of 50)showed hematologic improvement,and 23 patients had stable disease(23%).No disease progression was observed.Arsenic concentration in the peripheral blood ranged from 14.60 to 85.96μg/L.Clinical efficacy was positively correlated with arsenic concentration(P<0.05).The incidence of mild adverse reactions was 16%.CONCLUSION:A relatively high concentration of arsenic in the peripheral blood may improve the clinical efficacy of realgar in MDS-MLD patients.展开更多
BACKGROUND:The complications of systemic inflammatory response syndrome(SIRS)include acute lung injury,acute kidney injury,shock,and multiple organ dysfunction syndrome(MODS).In recent years,how to clear inflammatory ...BACKGROUND:The complications of systemic inflammatory response syndrome(SIRS)include acute lung injury,acute kidney injury,shock,and multiple organ dysfunction syndrome(MODS).In recent years,how to clear inflammatory mediators has become a hot topic in critical care medicine.Researchers hypothesize that continuous blood purification(CBP) can effectively eliminate a variety of inflammatory mediators which participate in the occurrence of MODS and adjust the immune imbalance.This study aimed to observe the effects of CBP in MODS patients.METHODS:In this retrospective clinical study,a total of 38 MODS patients,18 males and 20 females,were enrolled.After conventional therapy,all the patients received CBP.Biochemistry,blood gas analysis,oxygenation index,mean arterial blood pressure(MAP),acute physiology and chronic health evaluation(APACHE) II scores were monitored.RESULTS:After CBP,the vital signs of patients were rapidly stable,and electrolyte disorders and acid-base imbalance were corrected.Renal function,blood gas,oxygenation index were all improved.MAP was increased,and APACHE II score was significantly decreased.All patients had good tolerance,stable hemodynamics,and no obvious adverse reaction on CBP compared with pre-CBP.CONCLUSION:CBP can effectively clean toxins,correct electrolyte acid-base balance,and improve systemic inflammatory response syndrome and the organ function of MODS patients.展开更多
基金Sanming Project of Medicine in Shenzhen:the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Luo Songping National Famous Chinese Medicine Practitioner Female Reproductive Disorders Prevention and Treatment Team(SZZYSM202311010)Guangdong Provincial Administration of Traditional Chinese Medicine:Investigation of the Mechanism of Regulating Ren-Tong-Du Acupuncture on Ovarian Granulosa Cells in Polycystic Ovary Syndrome based on Activin A/Smads Signalling Pathway(No.20181229)+1 种基金Guangdong Provincial Administration of Traditional Chinese Medicine:Evaluation of the Efficacy of Menstrual Regulation and Pregnancy Promotion by Acupuncture in the Treatment of Premature Ovarian Insufficiency(No.20201294)Shenzhen Science and Innovation Commission:Investigating the Mechanism of Action of Acupuncture in Regulating the Gut Microbiome to Inhibit Apoptosis of Ovarian Granulosa Cells in Premature Ovarian Insufficiency Mice based on the Rictor/Torepamycin Target Protein C2 Pathway(No.JCYJ20210324130001004)。
文摘PURPOSE:To investigate the differences in gut microbial characteristics between two traditional Chinese syndromes of premature ovarian insufficiency(POI).METHODS:Forty women with POI were recruited from the Department of Traditional Chinese Medicine at Shenzhen Maternity and Child Healthcare Hospital between June and December 2020.Women with POI were divided into the kidney deficiency and blood stasis syndrome(SDBS)and Qi and blood deficiency syndrome(QBDS)groups.Gut microbial community profiles were analyzed by 16S rRNA gene sequencing using an Illumina Mi Seq system.A retrospective study comparing hormone levels and gut microbiota information was performed between the SDBS and QBDS groups.RESULTS:Compared with the QBDS group,the serum levels of estradiol(E2)and anti-Müllerian hormone(AMH)were significantly decreased in the SDBS group.The quantities of Adlercreutzia,Eggerthella,Klebsiella,and Paraprevotella significantly increased in the SDBS group,whereas Lactobacillus decreased significantly.Moreover,alterations in the microbiome in the SDBS and QBDS groups were closely related to the levels of E2 and AMH.The area under the receiver operating characteristic curve for the classification of the two syndromes by the gut microbiome was 0.71.CONCLUSIONS:There were significant differences in the dominant microbiota between the SDBS and QBDS groups,and the change in Proteobacteria in the QBDS group was more significant.The characteristics of gut microbiota help us differentiate between the SDBS and QBDS groups,which may provide a basis for the objectification of TCM syndrome types.
基金China Academy of Chinese Medical Sciences Innovation Fund:Precise Positioning Decision-making Platform for Clinical Trials of Traditional Chinese Medicine Based on Predicition Model(CI2021A04707)The Fundamental Research Funds for the Central Public Welfare Research Institutes:Research on Traditional Chinese Medicine Syndrome Differentiation-based a Bayesian Decision Model of Basket Trial(ZZ13-YQ-076)+1 种基金The Fifth Batch of National TCM Clinical Outstanding Talent Training ProgramThe Fund of National Natural Science Foundation of China(Youth Science):Effect of Compound Shenlu Granule on Apoptosis of CD34+Cells in Lower-risk Myelodysplastic Syndromes Bone Marrow based on p38 Mitogen-activated Protein Kinase Pathway(81403233)。
文摘OBJECTIVE:To illustrate the effect of add-on therapy of Traditional Chinese Medicine(TCM)on the long-term survival of anemic lower-risk myelodysplastic syndromes(LR-MDS)patients.METHODS:In this study,we conducted a retrospective analysis of the data of patients with LR-MDS who were identified from Shuguang Hospital between January 2006 and June 2020.The Kaplan-Meier method was used to calculate overall survival(OS),while the Cox model was employed to analyze prognostic factors of long-term survival.A total of 162 patients who met the inclusion criteria were divided into two groups:the TCM group(n=78)or the non-TCM group(n=84).RESULTS:There were no significant differences in baseline characteristics.The cumulative survival rate of the TCM group was significantly higher than that of the non-TCM group[log-rank P=0.029,hazard ratio(HR)=0.484,95%confidence interval(CI)(0.249,0.942),P<0.05].Patients with longer TCM treatment appeared to have better OS(≥12 months vs<12 months);[HR,0.16695%CI(0.055,0.508),P<0.001].According to the Cox model analysis,the combination of TCM and conventional Western Medicine may be a protective factor affecting the long-term survival of LR-MDS patients[HR=0.509,95%CI,(0.261,0.993),P=0.048].The hematologic improvement erythroid response(HI-E)rate of the TCM group was significantly higher than that of the non-TCM group(69.23%vs 52.38%;P=0.028).However,the duration of HI-E and cases of disease progression after HI-E did not significantly differ from the non-TCM group(P>0.05).CONCLUSIONS:The integration of TCM and Western Medicine has the potential to extend the OS of LR-MDS patients when compared to the use of Western Medicine alone.
基金supported by the 2022 Traditional Chinese Medicine Scientific Research Special Project of Henan Province,China(2022ZY1048)2023 Traditional Chinese Medicine Scientific Research Special Project of Henan Province,China(2023YZ2043)General Program of Natural Science Foundation of Henan Province,China(232300421183).
文摘Objective This study aims to explore the correlation between traditional Chinese medicine(TCM)syndromes and the expression status of estrogen receptor(ER)and progesterone receptor(PR)in breast cancer patients before and after adjuvant chemotherapy.Methods A total of 222 breast cancer patients with consistent ER and PR expression scheduled to undergo adjuvant chemotherapy were classified according to TCM syndrome differentiation before and after chemotherapy.The data were analyzed using chi-square tests and binary logistic regression with SPSS 26.0 software,and compared with ER/PR expression results.Results(i)In the ER-positive/PR-positive group,compared with prechemotherapy,syndromes of spleen qi deficiency,spleen deficiency with dampness-phlegm,and spleen–kidney deficiency significantly increased during mid-chemotherapy and after chemotherapy.Compared with mid-chemotherapy,spleen yang deficiency syndrome significantly increased after chemotherapy,with statistical significance(p<0.05).(ii)In the ER-negative/PR-negative group,compared with prechemotherapy,syndromes of spleen qi deficiency and spleen deficiency with dampness-phlegm significantly increased during mid-chemotherapy,while spleen qi deficiency,spleen yang deficiency,and spleen–kidney deficiency significantly increased after chemotherapy.Compared with mid-chemotherapy,spleen–kidney deficiency and spleen yang deficiency syndromes significantly increased after chemotherapy,with statistical significance(p<0.05).(iii)The distribution of spleen qi deficiency syndrome during mid-chemotherapy and after chemotherapy was significantly higher in the ER-positive/PR-positive group than in the ER-negative/PR-negative group,with statistical significance(p<0.05).(iv)ER and PR were not independent influencing factors for the various syndrome types before and after adjuvant chemotherapy(p>0.05).Conclusion After chemotherapy initiation,syndromes of spleen qi deficiency,spleen yang deficiency,and spleen–kidney deficiency significantly increased in both ER-positive/PR-positive and ER-negative/PR-negative groups.The distribution of spleen qi deficiency during mid-chemotherapy and after chemotherapy was significantly higher in the ER-positive/PR-positive group than in the ER-negative/PR-negative group.ER and PR were not independent influencing factors for the syndrome types before and after adjuvant chemotherapy.
基金Supported by The Key Research and Development Project of the Science and Technology Department of Sichuan Province,China,No.2023YFS0280The High-Level Research Initiation Fund of The First Affiliated Hospital of Chengdu Medical College,China,No.CYFY-GQ43.
文摘Recently,Jayabalan et al published an important study.The authors defined the liver outcome score as a novel biomarker for predicting liver-related mortality in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome.After thoroughly reviewing their work,we offer insights that primarily relate to their study design to enhance the medical community’s understanding of this complex disease.
文摘This letter addresses the study by Jayabalan et al,which underscores the liver outcome score(LOS)and hemoglobin(Hb)as key prognostic markers for patients with autoimmune liver disease overlap syndromes(AILDOS),with particular relevance to the autoimmune hepatitis-primary biliary cholangitis(AIH-PBC)subgroup.The findings indicate that an LOS threshold of 6 achieves high sensitivity and specificity in predicting liver-related mortality among AIH-PBC patients.Moreover,low Hb levels emerge as a significant mortality predictor across all AILDOS cases.These results contribute valuable perspectives on risk stratification in AILDOS,highlighting the promise of non-invasive prognostic tools.Future studies with larger cohorts are needed to substantiate LOS and Hb as robust markers for clinical application.
基金National Natural Science Foundation of China(82104738)National Administration of Traditional Chinese Medicine(TCM)High-level Key Discipline Construction Project:TCM Diagnostics(ZYYZDXK-2023069).
文摘Traditional Chinese medicine(TCM)auscultation has a long history,and with advancements in equipment and analytical methods,the quantitative analysis of auscultation parameters has determined.However,the complexity and diversity of auscultation,along with variations in devices,analytical methods,and applications,bring challenges to its standardization and deeper application.This review presents the advancements in auscultation equipment and systems,auscultation characteristic parameters,and their application in the diagnosis of pulmonary diseases and syndromes over the past 10 years,while also exploring the progress and challenges of current digital research of auscultation.This review also proposes the establishment of standardized protocols for the collection and analysis of auscultation data,the incorporation of advanced artificial intelligence(AI)auscultation analysis methods,and an exploration of the diagnostic utility of auscultatory features in pulmonary diseases and syndromes,so as to provide more precise decision support for intelligent diagnosis of pulmonary diseases and syndromes.
文摘BACKGROUND Kidney transplantation is the most effective means to treat patients with renal failure,but its postoperative problems such as rejection reactions,immunosuppressant poisoning,chronic transplant kidney nephropathy,etc.still have not been effectively solved.This study searched for literature on traditional Chinese medicine(TCM)syndromes after kidney transplantation in China,conducted statistical analysis of the results,and sought to identify the underlying patterns.AIM To understand the TCM syndromes after renal transplantation and associated rules and provide a theoretical basis for further clinical research.METHODS The literature pertaining to TCM syndromes in renal transplantation,published in the China National Knowledge Infrastructure,Wanfang database,and WIP database from 1970 to 2021,was meticulously searched and comprehensively and statistically analyzed.RESULTS Following the established inclusion and exclusion criteria,13 studies were selected for analysis.Post-renal transplantation,no significant discrepancy was noted among the groups based on the location of TCM viscera.However,when categorized according to TCM pathogenic factors,the groups with spleen and kidney yang deficiency,as well as liver and kidney yin deficiency,exhibited a statistically significant difference in the frequency.CONCLUSION Currently,the research on TCM syndromes pertaining to renal transplantation is in its nascent phase.It is imperative to conduct a multicentric,large-scale survey of TCM syndromes subsequent to renal transplantation in the ensuing years.
基金financed by the grants from the National Natural Science Foundation of China(No.81803996)Shanghai Key Laboratory of Health Identification and Assessment(No.21DZ2271000)。
文摘Traditional Chinese medicine(TCM)has played a significant role in the prevention and treatment of chronic heart failure(CHF).To study TCM diagnosis of CHF,a total of 278 Chinese clinical research articles on the study of CHF syndromes in recent 40 years retrieved from Web of Science,Scopus,Pub Med,Embase,CNKI,Wanfang Data,Cq VIP,and Sino Med.According to cumulative frequency analysis,network analysis,and hierarchical cluster analysis,the study found the distribution of CHF syndromes was syndrome of qi deficiency with blood stasis,syndrome of qi and yin deficiency,syndrome of yang deficiency with water flooding,syndrome of heart blood stasis obstruction,syndrome of turbid phlegm,and syndrome of collapse due to primordial yang deficiency.The syndrome elements on location of illness were heart,kidney,lung,and spleen.The syndrome elements on nature of illness were qi deficiency,blood stasis,yang deficiency,yin deficiency,water retention,and turbid phlegm.These findings can provide reference to the research on diagnosis and treatment of CHF,and contribute to the study on syndrome standardization and objective research of TCM diagnosis.
基金supported by the National Science Foundation of China(No.81873843)the National Science and Technology Pillar Program of China during the Twelfth Five-Year Plan Period(No.2014BA105B05)the Fundamental Research Funds for the Central Universities(No.2017 KFYXJJ102 and No.2019 KFYXKJC053).
文摘Objective Great obstetrical syndrome(GOS)represents a group of pregnancy-related diseases that result in inadequate placentation.Most GOS cases end in preterm,either spontaneously or indicatively,and the use of antenatal corticosteroids(ACS)is inevitably discussed.The placenta is an important,transient fetal-derived organ and is the embodiment of maternal or fetal well-being.However,few studies provide histological evidence of the placenta in GOS.This study aims to address these issues.Methods A total of 831 pregnant women were prospectively recruited.Placenta tissue was collected immediately and fixed with 4%paraformaldehyde solution for future H&E analysis.A novel checklist was devised to evaluate maternal vascular malperfusion sections on the basis of the commonly accepted Amsterdam placental workshop group consensus statement.Results A total of 131 patients were classified as having GOS.Comparisons between those with and without GOS revealed significant differences,including higher levels of distal villous hypoplasia,increased syncytial knots,accelerated villous maturation,and higher total scores in GOS.We found significant negative associations between GOS and neonatal weight,neonatal height,head circumference,placental surface area,placental volume,and placenta gross examination score.GOS neonates were 1.25 times more likely to have hyperbilirubinemia.Regarding the effect of ACS,a significant reduction in birthweight,height,and head circumference was observed,along with an increased risk of hyperbilirubinemia.Conclusion This study provides histological evidence of the GOS that supports the defective deep placentation hypothesis.Our research also contributes to benefit-risk consultation in the GOS,such as in cases of PE and FGR,where a balance between fetal lung maturation and short-term neonatal outcomes is crucial.
基金National Natural Science Foundation of China,No.U1604181Henan Province Key R&D and Promotion Special Project (Science and Technology Tackle),No.212102310834+1 种基金Henan Medical Education Research Project,No.Wjlx2020531the Joint project of Medical Science and Technology Research Program of Henan Province,No.LHGJ20190078 (all to JW)。
文摘Paraneoplastic neurological syndrome refers to certain malignant tumors that have affected the distant nervous system and caused corresponding dysfunction in the absence of tumor metastasis.Patients with this syndrome produce multiple antibodies,each targeting a different antigen and causing different symptoms and signs.The CV2/collapsin response mediator protein 5(CRMP5)antibody is a major antibody of this type.It damages the nervous system,which often manifests as limbic encephalitis,chorea,ocular manifestation,cerebellar ataxia,myelopathy,and peripheral neuropathy.Detecting CV2/CRMP5 antibody is crucial for the clinical diagnosis of paraneoplastic neurological syndrome,and anti-tumor and immunological therapies can help to alleviate symptoms and improve prognosis.However,because of the low incidence of this disease,few repo rts and no reviews have been published about it so far.This article intends to review the research on CV2/CRMP5antibody-associated paraneoplastic neurological syndrome and summarize its clinical features to help clinicians comprehensively understand the disease.Additionally,this review discusses the curre nt challenges that this disease poses,and the application prospects of new detection and diagnostic techniques in the field of paraneoplastic neurological syndrom e,including CV2/CRMP5-associated paraneoplastic neurological syndrome,in recent years.
文摘Objective To investigate the relationship among serum vitamin D levels, physical performance impairment, and geriatric syndromes in elders with hypertension. Methods According to the concentration of vitamin D levels, a total of 143 elderly patients with hypertension were classified into vitamin D deficient group （vitamin D 〈 20 ng/mL, n = 94） and vitamin D appropriate group （vitamin D 〉 20 ng/rnL, n = 49）. Geriatric syndromes and physical performance were assessed by using comprehensive geriatric assessment （CGA）. Correlation among vitamin D levels, geriatric syndromes and physical performance was analyzed. Results No statistical differences were found in various aspects of geriatric syndromes between the two groups （P 〉 0.05）. While correlation analysis indicated that vitamin D levels had a positive association with ADL score （r = 0.235, P 〈 0.01） and a negative association with Morse fall scale score （r = 0.238, P 〈 0.01）. Patients with deficient vitamin D level had longer time both in the Five Time Sit to Stand Test （5tSTS）, （15.765 ± 5.593） and the four-meter walk test [7.440 （5.620, 9.200）], a weaker hand-grip in the grip strength test （28.049 ± 9.522）, and a lower Tinetti performance-oriented mobility assessment （Tinetti POMA） [26 （22, 27）] and Balance subscale of the Tinetti performance-oriented mobility assessment （B-POMA） score [ 14 （12, 16）], compared with appropriate vitamin D level [（13.275 ± 3.692）; 5.810 （4.728, 7.325）]; （31.989 ± 10.217）; [26.5 （25, 28）]; [15 （14, 16）, respectively, all P 〈 0.05]. Furthermore, results of logistic regression indicated that vitamin D was significantly associated with 5tSTS （OR = 1.2, 95% CI = 1.050-1.331, P 〈 0.01）, Tinetti POMA （OR = 3.7, 95% CI：1.284-10.830, P 〈 0.05） and B-POMA （OR = 0.8, 95% CI：0.643-0.973, P 〈 0.05）. Conclusions In elderly hypertensive patients, serum vitamin D deficient level is associated with physical performance impairment. However, no statistical significance was found between vitamin D and geriatric syndromes. Further study is required to investigate possible mechanisms for the association between vitamin D and physical performance.
基金financially supported in part by the Fundamental Research Funds for the Central Universities(Scientific Research Innovation Team)(grant No.2019-JYB-TD004)the 12th FiveYear Plan(grant No.2013BAI02B00/Issue No.2013BAI02B05)。
文摘Objective:The clinical symptoms of diarrhea-predominant irritable bowel syndrome(IBS-D)can be effectively improved by traditional Chinese medicine(TCM)treatment,based on the usage of specific therapies for different TCM syndromes.However,in the stage of diagnosis,the standard criteria for the classification of TCM syndrome were still deficient.Through serum metabolic profiling,this study aimed to explore potential biomarkers in IBS-D patients with different TCM syndromes,which can assist in diagnosis of the disease.Methods:Serum samples were collected from healthy controls(30 cases),IBS-D patients with LiverStagnation and Spleen-Deficiency syndrome(LSSD,30 cases),Yang Deficiency of Spleen and Kidney syndrome(YDSK,11 cases)and Damp Abundance due to Spleen-Deficiency syndrome(DASD,22 cases).Serum metabolic profiling was conducted by ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry.The potential biomarkers were screened by orthogonal partial least square-discriminate analysis,while metabolic pathways undergoing alterations were identified by pathway enrichment analysis in Metabo Analyst 4.0.Results:Overall,34 potential biomarkers were identified in LSSD group,36 in YDSK group and 31 in DASD group.And the 13 metabolites shared by three groups were determined as the potential biomarkers of IBS-D.Glycerophospholipid metabolism was disturbed significantly in IBS-D patients,which may play a role in IBS-D through inflammation.What’s more,three TCM syndromes have the specific potential biomarkers in glycerophospholipid metabolism.Conclusion:The serum metabolomics revealed that different TCM syndrome types in IBS-D may have different metabolic patterns during disease progression and glycerophospholipid metabolism was one of the pathways,whose metabolism was disturbed differently among three TCM syndromes in IBS-D.Therefore,the specific potential biomarkers in glycerophospholipid metabolism of three TCM syndromes in IBS-D can serve as the objective indicators,which can facilitate the TCM-syndrome objective classification of IBS-D.
基金Traditional Chinese Medicine Three-Year Action Plan(21.24.03)
文摘OBJECTIVE: To investigate neuropsychological features of post-stroke cognitive impairment with no dementia(PSCIND) patients with different Traditional Chinese Medicine(TCM) syndromes.METHODS: We recruited 50 patients with PSCIND between April 2012 and March 2013. Patients were divided into different groups according to TCM classifications. Patients were assessed using neuropsychological tests, including cognitive screening(mini-mental state examination), memory testing (auditory verbal learning test), executive/attention[shape trails test, stroop color-word test(SCWT),reading the mind in the eyes test, the digit ordering test-A(DOT-A), and symbol digit modalities test], language(action naming test, Boston naming test, famous face test, similarity test, and verbal fluency test), and visuospatial functioning [complex figure test(CFT)].RESULTS: We found no significant differences between patients with and without a diagnosis of turbid phlegm blocking the upper orifices on neuropsychological test performance. Patients diagnosed with upper hyperactivity of liver Yang syndrome scored significantly lower on the SCWT-C executive test and the CFT-delayed recall memory test. Patients with excess syndrome scored significantly lower on the SCWT-C executive test, and significantly higher on the DOT-A executive test.CONCLUSION: Neuropsychological characteristics differ between PSCIND patients with different TCM classifications.
基金supported by grants from Canadian Institute of Health Research (NMD 15486)Heart & Stroke Foundation of Canada (T-4643)National Nature Science Foundation of China (No.81302927 and No.81273727)
文摘There is an increasing interest and popularity of Chinese herbal medicine worldwide, which is accompanied by increasing concerns about its effectiveness and potential toxicity. Several ingredients, such as polyphenolic compounds berberine, flavonoids, and curcumin, have been studied extensively by using various animal models. Effectiveness of treatment and amelioration of metabolic syndromes, including insulin resistance and dyslipidemia, has been demonstrated. This review summarizes the major checkpoints and contributing factors in regulation of exogenous and endogenous lipid metabolism, with particular emphasis centered on triglyceride-rich and cholesterol-rich lipoproteins. Available experimental evidence demonstrating the lipid-lowering effect of berberine, flavonoids and curcumin in cell culture and animal models is compiled, and the strengths and shortcomings of experimental designs in these studies are discussed.
文摘The myelodysplastic/myeloproliferative neoplasms(MDS/MPNs) are a unique group of hematologic malignancies characterized by concomitant myelodysplastic and myeloproliferative features. According to the 2008 WHO classification, the category includes atypical chronic myeloid leukemia(a CML), chronic myelomonocytic leukemia(CMML), juvenile myelomonocytic leukemia(JMML), MDS/MPN-unclassifiable(MDS/MPN-U), and the provisional entity refractory anemia with ring sideroblasts and thrombocytosis(RARS-T). Although diagnosis currently remains based on clinicopathologic features, the incorporation of nextgeneration platforms has allowed for the recent molecular characterization of these diseases which has revealed unique and complex mutational profiles that support their distinct biology and is anticipated to soon play an integral role in diagnosis,prognostication, and treatment. Future goals of research should include the development of disease-modifying therapies, and further genetic understanding of the category will likely form the foundation of these efforts.
基金Supported by The University of Medicine and Pharmacy of Tirgu-Mures,Romania,team research projects frame:UMFTGMPO-CC-02-F01,No.19/2014
文摘Because of the rarity of familial gastrointestinal cancerpredisposing syndromes,their exploration in literature is not extensive.In this review,an update of the clinicopathological and molecular criteria of gastrointestinal familial polyposis syndromes with potential malignant transformation is performed.In addition,a guide for screening and surveillance was synthesized and a distribution of gene mutations according to the specific syndromes and geographic distribution was included.The following inherited polyposes syndromes were analyzed: familial adenomatous polyposis,the hamartomatous familial polyposes(Juvenile polyposis,Peutz-Jeghers syndrome,Cowden syndrome,BannayanRiley-Ruvalcaba syndrome,hereditary mixed polyposis syndrome,Gorlin syndrome,Birt-Hogg-Dube syndrome,neurofibromatosis type Ⅰand multiple endocrine neoplasia syndrome 2B),Li-Fraumeni syndrome,and MUTYHassociated adenomatous polyposis.For proper medical care,subspecialization of gastroenterologists,pathologists,and genticists in the field of familial diseases should be introduced in the medical curriculum.
基金supported by the funding from the Spanish Society of Cardiology
文摘Background Elderly patients with non-ST-segment elevation acute coronary syndromes(NSTE-ACS)may present delirium but its clinical relevance is unknown.This study aimed at detennining the clinical associated factors,and prognostic implications of delirium in old-aged patients admitted for NSTE-ACS.Methods LONGEVO-SCA is a prospective multicenter registry including unselected patients with NSTE-ACS aged>80 years.Clinical variables and a complete geriatric evaluation were assessed during hospitalization.The association between delirium and 6-month mortality was assessed by a Cox regression model weighted for a propensity score including the potential confounding variables.We also analysed its association with 6-month bleeding and cognitive or functional decline.Results Among 527 patients included,thirty-seven(7%)patients presented delirium during the hospitalization.Delirium was more frequent in patients with dementia or depression and in those from nursing homes(27.0%vs.3.1%,24.3%vs.11.6%,and 11.1%V5.2.2%,respectively;all P<0.05).Delirium was significantly associated with in-hospital infections(27.0%vs.5.3%,P<0.001)and usage of diuretics(70.3%vs.49.8%,P=0.02).Patients with delirium had longer hospitalizations[median 8.5(5.5-14)vs.6.0(4.0-10)days,P=0.02]and higher incidence of 6-month bleeding and mortality(32.3%vs.10.0%and 24.3%vs.10.8%,respectively;both P<0.05)but similar cognitive or functional decline.Delirium was independently associated with 6-month mortality(HR=1.47,95%CI:1.02-2.13,P=0.04)and 6-month bleeding events(OR=2.87;95%CI:1.98-4」6,P<0.01).Conclusions In-hospital delirium in elderly patients with NSTE-ACS is associated with some preventable risk factors and it is an independent predictor of 6-month mortality.
基金Supported by China Academy of Chinese Medicine Scientific Foundation(ZZ13-YQ-010)National Natural Science Foundation of China(No.81603490)State Administration of Traditional Chinese Medicine Foundation(No.JDZX-2015264)。
文摘OBJECTIVE:To explore the relationship between the efficacy of realgar for the treatment of myelodysplastic syndromes with multilineage dysplasia(MDS-MLD)and arsenic concentration in the peripheral blood of patients.METHODS:In this prospective study,a total of 50 MDS-MLD patients were treated with traditional Chinese drugs containing realgar for 3 months in Xiyuan Hospital from March 2018 to January 2019.Routine blood examination as well as liver and kidney function were monitored before and after treatment.The concentration of arsenic in the peripheral blood was measured using an atomic fluorescence spectrometer after treatment.The correlation between clinical effect and arsenic concentration was analyzed by Spearman’s method.RESULTS:The treatment response rate was 54%.Two patients(4%)achieved complete remission,50%(25 of 50)showed hematologic improvement,and 23 patients had stable disease(23%).No disease progression was observed.Arsenic concentration in the peripheral blood ranged from 14.60 to 85.96μg/L.Clinical efficacy was positively correlated with arsenic concentration(P<0.05).The incidence of mild adverse reactions was 16%.CONCLUSION:A relatively high concentration of arsenic in the peripheral blood may improve the clinical efficacy of realgar in MDS-MLD patients.
文摘BACKGROUND:The complications of systemic inflammatory response syndrome(SIRS)include acute lung injury,acute kidney injury,shock,and multiple organ dysfunction syndrome(MODS).In recent years,how to clear inflammatory mediators has become a hot topic in critical care medicine.Researchers hypothesize that continuous blood purification(CBP) can effectively eliminate a variety of inflammatory mediators which participate in the occurrence of MODS and adjust the immune imbalance.This study aimed to observe the effects of CBP in MODS patients.METHODS:In this retrospective clinical study,a total of 38 MODS patients,18 males and 20 females,were enrolled.After conventional therapy,all the patients received CBP.Biochemistry,blood gas analysis,oxygenation index,mean arterial blood pressure(MAP),acute physiology and chronic health evaluation(APACHE) II scores were monitored.RESULTS:After CBP,the vital signs of patients were rapidly stable,and electrolyte disorders and acid-base imbalance were corrected.Renal function,blood gas,oxygenation index were all improved.MAP was increased,and APACHE II score was significantly decreased.All patients had good tolerance,stable hemodynamics,and no obvious adverse reaction on CBP compared with pre-CBP.CONCLUSION:CBP can effectively clean toxins,correct electrolyte acid-base balance,and improve systemic inflammatory response syndrome and the organ function of MODS patients.
基金Supported by A grant(in part)from the Municipal Key Discipline of Beijing,China,No.HK100230446the National Natural Science Foundation of China,No.81372578+1 种基金International Science and Technology Cooperation Projects,No.2010DFB33720Program for New Century Excellent Talents in University,No.NCET-11-0288
文摘AIM: To evaluate the risk factors for ampullary adenoma and ampullary cancer.
