AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2....AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.展开更多
Objective To investigate the clinical features of autoimmune hepatitis(AIH)patients with poor response to treatment.Methods A total of 61 AIH patients were enrolled,among whom 49(80.33%)achieved complete response(good...Objective To investigate the clinical features of autoimmune hepatitis(AIH)patients with poor response to treatment.Methods A total of 61 AIH patients were enrolled,among whom 49(80.33%)achieved complete response(good response group)and 12(19.67%)had incomplete response(poor response group).The展开更多
Objective:To evaluate whether Ding Kun Dan(DKD)can improve the vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)outcomes in patients with predicted poor ovarian response(POR)safely ...Objective:To evaluate whether Ding Kun Dan(DKD)can improve the vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)outcomes in patients with predicted poor ovarian response(POR)safely and effectively.Methods:Prospective,multicenter,randomized controlled trial;A total of 278 POR patients were randomized in DKD group or immediate treatment group.Both groups received IVF or ICSI as a standard treatment while in the DKD group,DKD was administrated for 3 months before the IVF/ICSI cycle.The primary outcome was the ongoing pregnancy rate.The secondary outcomes include clinical pregnancy rate,biochemical pregnancy rate,total gonadotropin(Gn)dosage and duration,estradiol(E2)and progesterone(P)levels on human chorionic gonadotropin(hCG)trigger day,cycle cancellation rate,number of oocytes retrieved,high-quality embryo rate and any adverse events.Results:Compared to the immediate IVF treatment group,oral administration of DKD for 3 months before IVF led to a significant increase in ongoing pregnancy rate(30.0%v.s.17.6%,P<0.05),biochemical pregnancy rate(39.2%vs.25.2%,P<0.05),clinical pregnancy rate(36.7%vs.22.7%,P<0.05)and high-quality embryo rate(40.8%vs.32.4%,P<0.05),and a significant decrease in Gn duration(P<0.05).However,no significant differences were found in total dosage of Gn,number of retrieved oocytes,cycle cancellation rate,E2 level and P level on hCG trigger days(P>0.05).No serious adverse events occurred during the intervention period in either group.Conclusion:DKD is a safe and effective intervention to improve the IVF/ICSI-ET outcomes in patients with POR.展开更多
Introduction: More than half of patients with central nervous system tuberculosis (CNS TB) die or are left with severe neurological deficits despite receiving anti-TB treatment. Aims of the study: This study examined ...Introduction: More than half of patients with central nervous system tuberculosis (CNS TB) die or are left with severe neurological deficits despite receiving anti-TB treatment. Aims of the study: This study examined risk factors associated with poor response to initial treatment with four anti-TB drug regimens or three drug regimens with steroids as adjuvant therapy. Methods: This study analyzed medical records from two tertiary hospitals in Busan, Korea, between January 2009 and March 2012. The subjects were non-human immunodeficiency virus (HIV)-infected patients aged ≥16 years with clinical CNS TB. The subjects were divided into two groups according to response to treatment. Results: In totally, 52 patients with CNS TB were included. Of these, 14 (26%) and 38 (73%) showed poor and good responses, respectively. Of the patients with poor response, nine had stage III disease (64.3%) according to the British Medical Research Council (BMRC) staging system. A significantly higher proportion was seen in the good response group (p < 0.05). Patients with positive cerebrospinal fluid (CSF) acid-fast bacillus (AFB) culture, positive sputum AFB culture, positive CSF TB polymerase chain reaction (PCR) results, and brain tuberculoma had poorer responses (p < 0.05). Multivariate analysis to determine risk factors associated with poor response to anti-TB therapy revealed that a poor response was associated with stage III clinical signs upon diagnosis (odds ratio [OR] 32.122;95% confidence interval [CI] 2.221 - 464.605), positive sputum AFB culture (OR 13.624;95% CI 1.066 - 174.149), and tuberculoma on brain images (OR 45.714;95% CI 1.893 - 1104.018). Conclusions: The results demonstrate the importance of identifying the severity of CNS TB and promptly administering anti-TB drugs. It is necessary to perform drug susceptibility testing for anti-TB drugs. Further studies are needed to confirm the correlations between risk factors associated with poor response and anti-TB drug resistance and the other risk factors.展开更多
Objective To determine efficacy of gonadotropin （Gn） co-treated with growth hormone （GH） on poor ovarian response （POR） patients undergoing in vitro fertiliza- tion/intracytoplasmic sperm injection （1VF/ICSI）....Objective To determine efficacy of gonadotropin （Gn） co-treated with growth hormone （GH） on poor ovarian response （POR） patients undergoing in vitro fertiliza- tion/intracytoplasmic sperm injection （1VF/ICSI）. Methods A total of 58 IVF/ICSI-embryo transfer （ET） cycles in POR patients were retrospectively identified. The POR criteria were defined by Bologna consensus. The cycles were divided into two groups： Gn co-treated with GH group （GH~ group, 25 cycles） and Gn only group （GH- group, 33 cycles）. Results of lVF/ICSI for these two groups were compared. Results The number of oocyte retrieved and the normal fertilization rate in the two groups were no difference （P〉O.05）. High-quality embryo rate and implantation rate in the GH＋ group were 39.6% and 38.5%, respectively, which were slightly higher than those in the GH group （35.9% and 25.0%）, but no difference was found on these two parameters （P〉0. 05）. Conclusion GH, to some extent, can improve the quality of embryo and the implantation rate. Whether GH co-therapy has a definite role in improving the outcome of POR patients still needs further evaluation.展开更多
Lung cancer remains the leading cause of cancer death in 2024,with∼80%being non-small cell lung cancer(NSCLC).Anaplastic lymphoma kinase(ALK)rearrangements occur in∼5%of NSCLC cases,typically treated with ALK inhibi...Lung cancer remains the leading cause of cancer death in 2024,with∼80%being non-small cell lung cancer(NSCLC).Anaplastic lymphoma kinase(ALK)rearrangements occur in∼5%of NSCLC cases,typically treated with ALK inhibitors,though resistance often develops[1].Immunotherapy has been explored for advanced or resistant ALK-positive NSCLC,but immune checkpoint blockade(ICB)treatments have shown limited clinical benefits[1].展开更多
Objective To develop and validate clinical predictive models for identifying poor short-term response to recombinant human growth hormone (rhGH) treatment in children with short stature.Methods A retrospective analysi...Objective To develop and validate clinical predictive models for identifying poor short-term response to recombinant human growth hormone (rhGH) treatment in children with short stature.Methods A retrospective analysis was conducted on 118 children diagnosed with growth hormone deficiency or idiopathic short stature who were treated at the First Affiliated Hospital of Zhengzhou University and two other hospitals between January 1,2020,and January 1,2024.展开更多
Objective： The combination of interferon （IFN） and ribavirin （RBV） is the standard therapy for hepatitis C virus （HCV） infection. HCV genotype 2a has proved more amenable to the therapy, but its efficacy is yet...Objective： The combination of interferon （IFN） and ribavirin （RBV） is the standard therapy for hepatitis C virus （HCV） infection. HCV genotype 2a has proved more amenable to the therapy, but its efficacy is yet fimited. This study aimed to investigate the mechanism of the poor response in a case ofHCV genotype 2a infection. Methods： We analyzed dynamic change of HCV RNA from a patient, infected with HCV genotype 2a, showing a poor virological response to 1FN/RBV as judged 12 weeks after initiation of the therapy by HCV clone sequencing. Then we constructed subgenomic Japanese fulminant hepatitis-1 （JFH1） replicon and different chimeric replicons with humanized Gaussia luciferase gene. The chimeric replicons were derived from subgenomic JFH1 replicon, in which the NS5A region was replaced by the patient＇s sequence from the pre/post- treatment, and the chimeric replicons＇ susceptibility to IFN were evaluated by relative Gausia Luciferase activity. Results： The pretreatment HCV sequences appeared almost uniform, and the quasispecies variation was further more simplified after 12 weeks of therapy. Besides, the quasispecies variation seemed to be more diversified in the NS5A, relatively, a region crucial for IFN response, and each of chimeric replicons exhibited distinct response to IFN. Conclusions： During the course of the chronic infection, HCV population seems to be adapted to the patient＇s immunological system, and further to be selected by combination of 1FN/RBV therapy, indicating quasispecies may completely eliminated by addition of other drugs with targets different from those of IFN. In addition, each different response of chimeric replicon to IFN is most likely related to amino acid changes in or near the IFN-sensitivity determining region （ISDR） of NSSA during chronic infection and IFN/RBV therapy.展开更多
Objective:This study aimed to assess the effects of the Jinfeng pill on ovarian volume and endocrine function in rats with poor ovarian response and to elucidate the gene expression changes that contribute to the Jinf...Objective:This study aimed to assess the effects of the Jinfeng pill on ovarian volume and endocrine function in rats with poor ovarian response and to elucidate the gene expression changes that contribute to the Jinfeng pill’s role in improving ovarian function.Methods:Thirty 8-week-old specific pathogen-free(SPF)female rats were randomly assigned to five groups:control,model,estradiol,Jinfeng pill,and Jinfeng pill+estradiol,with six rats in each group.All groups,except the control were administered Tripterygium glycoside tablets.After establishing the poor ovarian response model,the three intervention groups(estradiol,Jinfeng pill,and Jinfeng pill+estradiol)received their respective drug interventions.Hematoxylin-eosin staining was employed to assess follicle distribution,and immunohistochemistry was used to evaluate the expression of vascular endothelial growth factor and endostatin in rat ovaries.Hormone levels were measured using ELISA.Results:The uterine and total ovarian masses in the three intervention groups were higher than those in the model group;however,the differences were not statistically significant.The ovaries of the Jinfeng pill and Jinfeng pill+estradiol groups contained more follicles at various developmental stages.The three intervention groups showed significantly increased vascular endothelial growth factor expression and decreased endostatin expression compared with the model group,with the Jinfeng pill+estradiol group exhibiting the most pronounced differences.Anti-Müllerian hormone levels were slightly elevated in the Jinfeng pill group compared to the model group.However,only the Jinfeng pill+estradiol group showed a statistically significant decrease in follicle-stimulating hormone levels compared to the model group(P=0.01).Conclusions:Jinfeng pill modulates ovarian protein expression,increases ovarian volume,and improves blood circulation.Additionally,it may elevate hormone levels and enhance ovarian response function in rats with poor ovarian function.展开更多
基金Supported by the National Natural Science Foundation of China(No.82271100)the Jiangsu Science and Technology Support Program(No.BE2022805)the Clinical Skills Enhancement Program of Jiangsu Province Hospital(No.JSPH-MC-2022-24).
文摘AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.
文摘Objective To investigate the clinical features of autoimmune hepatitis(AIH)patients with poor response to treatment.Methods A total of 61 AIH patients were enrolled,among whom 49(80.33%)achieved complete response(good response group)and 12(19.67%)had incomplete response(poor response group).The
基金This study was supported by the National Natural Science Foundation of China Nos.81774351the Tianjin Health&Family Planning Commission(Tianjin scientific research project of priority area of traditional Chinese medicine,Nos.2018008)Shanxi Guangyuyuan TCM Co.,Ltd.
文摘Objective:To evaluate whether Ding Kun Dan(DKD)can improve the vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)outcomes in patients with predicted poor ovarian response(POR)safely and effectively.Methods:Prospective,multicenter,randomized controlled trial;A total of 278 POR patients were randomized in DKD group or immediate treatment group.Both groups received IVF or ICSI as a standard treatment while in the DKD group,DKD was administrated for 3 months before the IVF/ICSI cycle.The primary outcome was the ongoing pregnancy rate.The secondary outcomes include clinical pregnancy rate,biochemical pregnancy rate,total gonadotropin(Gn)dosage and duration,estradiol(E2)and progesterone(P)levels on human chorionic gonadotropin(hCG)trigger day,cycle cancellation rate,number of oocytes retrieved,high-quality embryo rate and any adverse events.Results:Compared to the immediate IVF treatment group,oral administration of DKD for 3 months before IVF led to a significant increase in ongoing pregnancy rate(30.0%v.s.17.6%,P<0.05),biochemical pregnancy rate(39.2%vs.25.2%,P<0.05),clinical pregnancy rate(36.7%vs.22.7%,P<0.05)and high-quality embryo rate(40.8%vs.32.4%,P<0.05),and a significant decrease in Gn duration(P<0.05).However,no significant differences were found in total dosage of Gn,number of retrieved oocytes,cycle cancellation rate,E2 level and P level on hCG trigger days(P>0.05).No serious adverse events occurred during the intervention period in either group.Conclusion:DKD is a safe and effective intervention to improve the IVF/ICSI-ET outcomes in patients with POR.
文摘Introduction: More than half of patients with central nervous system tuberculosis (CNS TB) die or are left with severe neurological deficits despite receiving anti-TB treatment. Aims of the study: This study examined risk factors associated with poor response to initial treatment with four anti-TB drug regimens or three drug regimens with steroids as adjuvant therapy. Methods: This study analyzed medical records from two tertiary hospitals in Busan, Korea, between January 2009 and March 2012. The subjects were non-human immunodeficiency virus (HIV)-infected patients aged ≥16 years with clinical CNS TB. The subjects were divided into two groups according to response to treatment. Results: In totally, 52 patients with CNS TB were included. Of these, 14 (26%) and 38 (73%) showed poor and good responses, respectively. Of the patients with poor response, nine had stage III disease (64.3%) according to the British Medical Research Council (BMRC) staging system. A significantly higher proportion was seen in the good response group (p < 0.05). Patients with positive cerebrospinal fluid (CSF) acid-fast bacillus (AFB) culture, positive sputum AFB culture, positive CSF TB polymerase chain reaction (PCR) results, and brain tuberculoma had poorer responses (p < 0.05). Multivariate analysis to determine risk factors associated with poor response to anti-TB therapy revealed that a poor response was associated with stage III clinical signs upon diagnosis (odds ratio [OR] 32.122;95% confidence interval [CI] 2.221 - 464.605), positive sputum AFB culture (OR 13.624;95% CI 1.066 - 174.149), and tuberculoma on brain images (OR 45.714;95% CI 1.893 - 1104.018). Conclusions: The results demonstrate the importance of identifying the severity of CNS TB and promptly administering anti-TB drugs. It is necessary to perform drug susceptibility testing for anti-TB drugs. Further studies are needed to confirm the correlations between risk factors associated with poor response and anti-TB drug resistance and the other risk factors.
文摘Objective To determine efficacy of gonadotropin （Gn） co-treated with growth hormone （GH） on poor ovarian response （POR） patients undergoing in vitro fertiliza- tion/intracytoplasmic sperm injection （1VF/ICSI）. Methods A total of 58 IVF/ICSI-embryo transfer （ET） cycles in POR patients were retrospectively identified. The POR criteria were defined by Bologna consensus. The cycles were divided into two groups： Gn co-treated with GH group （GH~ group, 25 cycles） and Gn only group （GH- group, 33 cycles）. Results of lVF/ICSI for these two groups were compared. Results The number of oocyte retrieved and the normal fertilization rate in the two groups were no difference （P〉O.05）. High-quality embryo rate and implantation rate in the GH＋ group were 39.6% and 38.5%, respectively, which were slightly higher than those in the GH group （35.9% and 25.0%）, but no difference was found on these two parameters （P〉0. 05）. Conclusion GH, to some extent, can improve the quality of embryo and the implantation rate. Whether GH co-therapy has a definite role in improving the outcome of POR patients still needs further evaluation.
基金supported by the Bio&Medical Technology Development Program of the National Research Foundation funded by the Ministry of Science and ICT(2021R1A2C2094629 and 2017M3A9E9072669 to Hye Ryun Kim,and 2018R1A5A2025079,2022M3A9F3016364,and 2022R1A2C1092062 to Insuk Lee)supported in part by Brain Korea 21(BK21)FOUR program+1 种基金supported by the Technology Innovation Program(20022947)funded by the Ministry of Trade Industry&Energy(MOTIE,Korea)supported by the Yonsei Fellow Program,funded by Lee Youn Jae.
文摘Lung cancer remains the leading cause of cancer death in 2024,with∼80%being non-small cell lung cancer(NSCLC).Anaplastic lymphoma kinase(ALK)rearrangements occur in∼5%of NSCLC cases,typically treated with ALK inhibitors,though resistance often develops[1].Immunotherapy has been explored for advanced or resistant ALK-positive NSCLC,but immune checkpoint blockade(ICB)treatments have shown limited clinical benefits[1].
文摘Objective To develop and validate clinical predictive models for identifying poor short-term response to recombinant human growth hormone (rhGH) treatment in children with short stature.Methods A retrospective analysis was conducted on 118 children diagnosed with growth hormone deficiency or idiopathic short stature who were treated at the First Affiliated Hospital of Zhengzhou University and two other hospitals between January 1,2020,and January 1,2024.
文摘Objective： The combination of interferon （IFN） and ribavirin （RBV） is the standard therapy for hepatitis C virus （HCV） infection. HCV genotype 2a has proved more amenable to the therapy, but its efficacy is yet fimited. This study aimed to investigate the mechanism of the poor response in a case ofHCV genotype 2a infection. Methods： We analyzed dynamic change of HCV RNA from a patient, infected with HCV genotype 2a, showing a poor virological response to 1FN/RBV as judged 12 weeks after initiation of the therapy by HCV clone sequencing. Then we constructed subgenomic Japanese fulminant hepatitis-1 （JFH1） replicon and different chimeric replicons with humanized Gaussia luciferase gene. The chimeric replicons were derived from subgenomic JFH1 replicon, in which the NS5A region was replaced by the patient＇s sequence from the pre/post- treatment, and the chimeric replicons＇ susceptibility to IFN were evaluated by relative Gausia Luciferase activity. Results： The pretreatment HCV sequences appeared almost uniform, and the quasispecies variation was further more simplified after 12 weeks of therapy. Besides, the quasispecies variation seemed to be more diversified in the NS5A, relatively, a region crucial for IFN response, and each of chimeric replicons exhibited distinct response to IFN. Conclusions： During the course of the chronic infection, HCV population seems to be adapted to the patient＇s immunological system, and further to be selected by combination of 1FN/RBV therapy, indicating quasispecies may completely eliminated by addition of other drugs with targets different from those of IFN. In addition, each different response of chimeric replicon to IFN is most likely related to amino acid changes in or near the IFN-sensitivity determining region （ISDR） of NSSA during chronic infection and IFN/RBV therapy.
基金Tong Yi Tang Pharmaceutical Co.,Ltd.,Wu Jieping Foundation Clinical Research Special Project(320.6750.2021-19-2)Fujian Province Natural Science Foundation Project(2023J011619)Xiamen Science and Technology Program(No.3502Z20227342)。
文摘Objective:This study aimed to assess the effects of the Jinfeng pill on ovarian volume and endocrine function in rats with poor ovarian response and to elucidate the gene expression changes that contribute to the Jinfeng pill’s role in improving ovarian function.Methods:Thirty 8-week-old specific pathogen-free(SPF)female rats were randomly assigned to five groups:control,model,estradiol,Jinfeng pill,and Jinfeng pill+estradiol,with six rats in each group.All groups,except the control were administered Tripterygium glycoside tablets.After establishing the poor ovarian response model,the three intervention groups(estradiol,Jinfeng pill,and Jinfeng pill+estradiol)received their respective drug interventions.Hematoxylin-eosin staining was employed to assess follicle distribution,and immunohistochemistry was used to evaluate the expression of vascular endothelial growth factor and endostatin in rat ovaries.Hormone levels were measured using ELISA.Results:The uterine and total ovarian masses in the three intervention groups were higher than those in the model group;however,the differences were not statistically significant.The ovaries of the Jinfeng pill and Jinfeng pill+estradiol groups contained more follicles at various developmental stages.The three intervention groups showed significantly increased vascular endothelial growth factor expression and decreased endostatin expression compared with the model group,with the Jinfeng pill+estradiol group exhibiting the most pronounced differences.Anti-Müllerian hormone levels were slightly elevated in the Jinfeng pill group compared to the model group.However,only the Jinfeng pill+estradiol group showed a statistically significant decrease in follicle-stimulating hormone levels compared to the model group(P=0.01).Conclusions:Jinfeng pill modulates ovarian protein expression,increases ovarian volume,and improves blood circulation.Additionally,it may elevate hormone levels and enhance ovarian response function in rats with poor ovarian function.
