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Clinical Focus    2023, 38 (12): 1150-1152.   DOI: 10.3969/j.issn.1004-583X.2023.12.017 Abstract （202）   HTML （4）    PDF（pc） （854KB）（49）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Screening of glycolysis-related genes for predicting the prognosis of patients with gastric cancer: Based on bioinformatics Zhao Xuhui, Huang Xiaomin, Da Dezhuan, Xu Yan, Cui Xiaodong, Li Hongling Clinical Focus    2024, 39 (1): 20-29.   DOI: 10.3969/j.issn.1004-583X.2024.01.003 Abstract （197）   HTML （4）    PDF（pc） （2487KB）（43）       Knowledge map    Save Objective To construct a glycolysis-related gene model for predicting the prognosis of gastric cancer (GC) patients based on bioinformatics. Methods The messenger RNA expression profiles of GC patients were analyzed in The Cancer Genome Atlas program, and gene sets with significant differences between GC tissues and normal tissues were verified using gene set enrichment analysis. A glycolysis-related genes model for predicting the prognosis of GC patients was constructed using least absolute shrinkage and selection operator regression analysis, and the predictive performance of the model was validated using Kaplan-Meier survival analysis, receiver operating characteristic curve, and univariate and multivariate Cox regression analysis. Gene set variation analysis was performed to analyze the differences in biological pathway states between high-risk and low-risk groups. Results Fourteen glycolysis-related genes (PFKFB2、UHRF1、ACYP1、CLDN9、STC1、EFNA3、NUP50、ADH4、ANGPTL4、PKP2、VCAN、HIF 1A、LHX9、ANKZF1、ALDH3A2) were identified as prognostic markers for GC patients. Based on a risk score derived from these 15 gene features using Cox regression analysis, patients were classified into high-risk and low-risk groups. These 15 gene markers were independent biomarkers for predicting the prognosis, and patients with a low-risk score had a better prognosis. The combination of gene markers and clinical prognostic factors in a Nomogram effectively predicted overall survival and disease-free survival. Conclusion The established panel of 15 glycolysis-related gene markers can serve as reliable tools for predicting the prognosis of GC patients and may provide potential targets for glycolysis-targeted therapy in GC. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1131-1134.   DOI: 10.3969/j.issn.1004-583X.2023.12.013 Abstract （179）   HTML （6）    PDF（pc） （877KB）（38）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Risk assessment of pancreatic cancer in patients with type 2 diabetes mellitus treated with sitagliptin: A meta-analysis of randomized controlled trials Zhu Chenglou, Wu Qiong, Da Mingxu Clinical Focus    2023, 38 (12): 1061-1066.   DOI: 10.3969/j.issn.1004-583X.2023.12.001 Abstract （165）   HTML （17）    PDF（pc） （1492KB）（47）       Knowledge map    Save Objective To evaluate the risk of pancreatic cancer (PC) in patients with type 2 diabetes mellitus (T2DM) who are treated with sitagliptin. Methods Articles reporting the risk of PC in T2DM patients treated with sitagliptin published before July 10, 2022 were searched in the online databases, including EMBASE, MEDLINE, the Cochrane Library, PubMed. STATA 12.0 software was used for meta-analysis. Two investigators were independently responsible for article screen, data collection and quality assessment. Results A total of 11 randomized controlled trials involving 33, 360 T2DM patients were identified. Meta-analysis using a fixed-effect model showed that sitagliptin treatment did not significantly increase the risk of PC in T2DM patients ( R R=0.74, 95% C I: 0.45-1.21, P=0.225). Subgroup analyses showed that the monotherapy ( R R=0.82, 95% C I: 0.39-1.71, P=0.600) and combination regimen of sitagliptin ( R R=0.68, 95% C I: 0.35-1.31, P=0.244) did not significantly increase the risk of PC in T2DM patients. Conclusion Sitagliptin treatment is not associated with the increase in the risk of PC. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (2): 188-192.   DOI: 10.3969/j.issn.1004-583X.2024.02.018 Abstract （163）   HTML （9）    PDF（pc） （847KB）（20）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Systematic evaluation of the incidence and the influencing factors of sleep disorders in breast cancer patients Liu Jiazhu, Liu Rong, Meng Limin, Guo Yinshu, Zhang Xiaobo, Ai Yiqin Clinical Focus    2024, 39 (6): 494-500.   DOI: 10.3969/j.issn.1004-583X.2024.06.002 Abstract （152）   HTML （5）    PDF（pc） （1121KB）（35）       Knowledge map    Save Objective To determine the incidence and the influencing factors of sleep disorders in breast cancer (BC) patients through a systematic evaluation. Methods Articles reporting the influencing factors of sleep disorders in BC patients published before December 2023 were searched in comprehensive databases, such as China National Knowledge Infrastructure (CNKI), Wanfang, VIP, sinomed, PubMed, Web of Science, Cochrane Library, Embase, EBSCO. The eligible data were evaluated using the Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa scale (NOS). Results Twenty papers representing a total of 4409 cases sample size and 29 influencing factors were included. The results of the systematic evaluation showed that the detection rate of sleep disorders in BC patients was 67%, the main influencing factors were chemotherapy, age, surgery, tumour classification, depression, anxiety, pain, fatigue, and exercise frequency, the secondary influencing factors were radiotherapy, genetics, income, family status, hormone levels, hot flushes, coping styles, environmental changes, and quality of life, and the other influencing factors included ethnicity, number of hospitalisations, physiological function, place of residence, constitutional type, hyperlipidaemia, religious beliefs, previous respiratory disease, self-image, social support and form of medical insurance payment. Conclusion The prevalence of sleep disorders in BC patients is high, and healthcare professionals can identify high-risk factors and intervene early for reducing the risk of sleep disorders in BC patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical application of GEMOX combined with target-immunity therapy in patients with advanced biliary tract cancer Wu Xiaomin, Fang Yipeng, Zhang Zhen, Zhang Ye, Jin Cheng Clinical Focus    2024, 39 (5): 408-412.   DOI: 10.3969/j.issn.1004-583X.2024.05.004 Abstract （151）   HTML （5）    PDF（pc） （1116KB）（20）       Knowledge map    Save Objective To evaluate the clinical efficacy and safety of gemcitabine and oxaliplatin (GEMOX) combined with target-immunity therapy (lenvatinib and programmed cell death 1 [PD-1] monoclonal antibody) in patients with advanced biliary tract cancer (BTC). Methods Twenty-four patients with advanced BTC received GEMOX combined with target-immunity therapy visited Integrative Oncology Department or Hepatobiliary Surgery Department of our hospital from January 2015 to January 2024 were recruited. The primary end points were set as overall survival (OS) and progression-free survival (PFS), and the secondary end points were objective response rate (ORR), disease control rate (DCR) and safety. The safety and overall clinical efficacy of GEMOX combined with target-immunity therapy regimen on advanced BTC were comprehensively evaluated via tumor marker indexes (carcinoembryonic antigen [CEA], carbohydrate antigen 125 [CA125], CA199), adverse reactions rates, quality of life scores, imaging indicators, and other data. Results None of the 24 patients had complete remission (CR). ORR was 33.3% (8/24, 8 patients had PR), DCR was 66.7% (16/24; 8 patients had SD and 8 patients had PD, respectively), median OS was 13 months and median PFS was 8 months. After treatment, the levels of CA199 were significantly lower than those before treatment (P<0.05). The incidence of adverse events in 24 patients were rash (14/24, 58.3%), leucopenia (22/24, 91.6%), anemia (20/24, 83.3%). One patient had serious adverse events and withdrew from treatment, one patient died of biliary obstruction with infection during treatment. Conclusion GEMOX combined with target-immunity therapy regimen is safe and effective in the treatment of advanced BTC, it may be used clinically. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Generative artificial intelligence: Ethical review on the empowerment in medical humanities education Zhao Xin, Liu Yun Clinical Focus    2024, 39 (1): 65-69.   DOI: 10.3969/j.issn.1004-583X.2024.01.012 Abstract （151）   HTML （5）    PDF（pc） （873KB）（71）       Knowledge map    Save Generative Artificial Intelligence (GAI) is emerged as a game-changing technology with far-reaching implications across various fields. It is expected to bring new opportunities for rapid development in numerous areas, including the education sector where GAI has already shown promising results through multi-platform integration. In the future, the iterative development of GAI will give rise to a plethora of potential applications in the field of medical humanities education, enhancing its effectiveness precisely, promoting its development, and creating innovative modes of panoramic experience in the teaching process. However, along with the inherent ethical issues of GAI technology, such as black box algorithms, information cocooning, data privacy and security, and discriminatory algorithms, there will also be risks with distinct medical humanities characteristics that arise from the deep integration of GAI and medical humanities education. For instance, there is a possibility of values being compromised, the diminishing of human dominance, and the imbalance of the binary relationship between teaching and learning due to an excessive reliance on GAI. In order to address these ethical concerns and devise effective countermeasures to mitigate the risks imposed by GAI in empowering medical humanities education, it is necessary to establish clear boundaries and maximize the potential of artificial intelligence. We must also ensure that GAI stays true to its original purpose in this era of rapid technological advancements, and create a conducive ecological environment for its development based on legal regulations. Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1135-1139.   DOI: 10.3969/j.issn.1004-583X.2023.12.014 Abstract （147）   HTML （4）    PDF（pc） （884KB）（34）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1140-1145.   DOI: 10.3969/j.issn.1004-583X.2023.12.015 Abstract （144）   HTML （2）    PDF（pc） （945KB）（40）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (1): 88-91.   DOI: 10.3969/j.issn.1004-583X.2024.01.017 Abstract （142）   HTML （6）    PDF（pc） （864KB）（26）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Meta-analysis of expression and clinical significance of HER-2 in hepatocellular carcinoma Tao Jianan, Li Wenqian, Ma Xiuwen, An Qi, Wang Xuehong Clinical Focus    2023, 38 (12): 1067-1072.   DOI: 10.3969/j.issn.1004-583X.2023.12.002 Abstract （138）   HTML （8）    PDF（pc） （1341KB）（31）       Knowledge map    Save Objective To systematically evaluate the relationship between the expression of human epidermal growth factor receptor-2 (HER-2) and clinicopathologic featurests in hepatocellular carcinoma (HCC). Methods Case-control studies regarding the expression of HER-2 in HCC were searched from PubMed, CNKI, Wanfang database and VIP database from establishment of the database to May 2023. Literature screening, data extraction and risk-of-bias assessment were independently performed by two researchers. Meta-analysis was performed using Revman5.3 software. Results Thirty one case-control studies representing 2558 patients were included. Meta-analysis showed that the positive rate of HER-2 in HCC cases was significantly higher than that in control cases (54.3% vs 50.5%, O R=1.87, 95% C I: 1.13-3.10, P=0.01). The expression of HER-2 in HCC cases in age ( O R=0.48, 95% C I: 0.25-0.94, P=0.03), differentiation degree( O R=2.61, 95% C I: 1.84-3.69, P<0.01), tumor diameter ( O R=1.93, 95% C I: 1.25-2.98, P=0.003), blood metastases ( O R=5.42, 95% C I: 3.15-9.31, P<0.01), clinical stage ( O R=2.02, 95% C I: 1.39-2.94, P=0.0003), portal vein invasion ( O R=1.73, 95% C I: 1.11-2.72, P=0.02) and serum HBsAg ( O R=2.22, 95% C I:1.55-3.18, P<0.01) were statistically significant. Conclusion HER-2 is differentially expressed in HCC, and its expression level is related to clinicopathological features of HCC, suggesting a important role in the pathogenesis of HCC, and which can provide a higher level of evidence for the diagnosis and molecular targeted therapy of HCC in the future. However, the evidence for its quantity and quality remains limited, the results need to be verified by more high-quality studies. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (2): 172-176.   DOI: 10.3969/j.issn.1004-583X.2024.02.015 Abstract （138）   HTML （6）    PDF（pc） （876KB）（27）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (3): 274-278.   DOI: 10.3969/j.issn.1004-583X.2024.03.014 Abstract （138）   HTML （4）    PDF（pc） （847KB）（34）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (1): 80-83.   DOI: 10.3969/j.issn.1004-583X.2024.01.015 Abstract （135）   HTML （5）    PDF（pc） （860KB）（34）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (6): 568-571.   DOI: 10.3969/j.issn.1004-583X.2024.06.015 Abstract （130）   HTML （3）    PDF（pc） （800KB）（23）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Bioequivalence of aspirin enteric-coated tablet in healthy volunteers Liu Junyu, Zhang Tiancai, Zhang Baie, Li Yizhou, Li Yafei, Liu Hongbin, Duan Liping, Zhang Quanying, Wang Yijun, Meng Fanhua, Sun Min Clinical Focus    2024, 39 (5): 433-439.   DOI: 10.3969/j.issn.1004-583X.2024.05.008 Abstract （124）   HTML （3）    PDF（pc） （1362KB）（26）       Knowledge map    Save Objective To evaluate the bioequivalence and safety of aspirin enteric-coated tablets in healthy Chinese adult. Methods A single-center, randomized, open, two-preparation, two-sequence, four-cycle, fully replicated design was used. The subjects took orally one tablet of test (T) or reference (R) preparation on fasting or fed condition every cycle. The plasma concentration of acetylsalicylic acid (ASA) was determined by liquid chromatography with tandem mass spectrometry (LC-MS/MS) method at different time points, and the bioequivalence and safety of the two formulations were evaluated. Results In the main results for pharmacokinetic parameters of T and R under fed condition, Cmax were (690.97±196.91) and (669.28±337.40) ng·ml-1, AUC0-t were (867.37±228.64) and (821.16±349.85) ng·h·ml-1, AUC0-∞ were (883.48±233.72) and (923.59±287.95) ng·h·ml-1, Tmax were (8.98±2.47) and (10.69±3.75) h. In the main result for pharmacokinetic parameters of T and R under fasting condition, Cmax were (466.83±222.89) and (441.42±211.99) ng·ml-1, AUC0-t were (753.24±269.49) and (678.50±278.85) ng·h·ml-1, AUC0-∞ were (809.11±309.27) and (726.51±267.00) ng·h·ml-1, Tmax were (5.81±2.53) and (6.41±2.47) h. The geometric mean ratios of the main pharmacokinetic parameters Cmax, AUC0-t and AUC0-∞ in the fed group were within the range of 80.00% to 125.00%, therefore the two formulations were bioequivalent. However,the fasting group did not meet the relevant criteria, and the two preparations were not equivalent. During the study period, 0 case and 2 cases of adverse events occurred under the fasting and the fed condition. No serious adverse events occurred. Conclusion The two kinds of aspirin enteric-coated tablets were bioequivalent in human under the fed condition, but not in the human under fasting conditions, and the formulations were safe and well tolerated. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (2): 177-182.   DOI: 10.3969/j.issn.1004-583X.2024.02.016 Abstract （121）   HTML （5）    PDF（pc） （895KB）（18）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Correlation between serum uric acid, homocysteine and cystatin C levels with motor symptoms and cognitive function in Parkinson's disease patients Wang Jiuxue, Li Na, Jin Wei, Wang Shuo, Chang Yajun, Wang Tianjun Clinical Focus    2024, 39 (2): 125-129.   DOI: 10.3969/j.issn.1004-583X.2024.02.005 Abstract （120）   HTML （9）    PDF（pc） （869KB）（30）       Knowledge map    Save Objective To investigate the correlation between serum uric acid (UA), homocysteine (HCY) and cystatin C (Cys C) with motor symptoms and cognitive function in Parkinson's disease (PD) patients. Methods A total of 200 PD patients admitted to Hebei General Hospital from January 2019 to August 2022 were enrolled. They were divided into tremor-dominant (TD) group(n=104) and non-tremor-dominant (NTD) group(n=96) according to first-onset motor symptoms. In addition, the PD patients were grouped also into cognitive normal(PD-CN) group(n=118) and cognitive impairment (PD-CI) group(n=82) according to Montreal Cognitive Assessment. The levels of serum UA, HCY and Cys C of the PD patients were compared. Multivariate logistic regression was used to analyze the risk factors of tremor and cognitive dysfunction in PD patients. Results The patients in TD group had significantly higher serum UA levels, significantly lower Hcy and Cys C levels compared with those of the NTD group (P<0.05). The results from multiple logistic regression analysis showed that UA, HCY, and Cys C were independent risk factors for tremor in PD patients. The patients in the PD-CN group pesented significantly higher serum UA levels, significantly lower HCY and Cys C levels relative to those of the PD-CI group (P<0.05). The results from multivariate logistic regression analysis verifyed that UA, HCY, and Cys C were independent risk factors for cognitive dysfunction in PD patients (P<0.05). Conclusion The serum levels of UA, HCY, and Cys C in PD patients are correlated with motor symptoms and cognitive function. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (3): 284-288.   DOI: 10.3969/j.issn.1004-583X.2024.03.016 Abstract （119）   HTML （1）    PDF（pc） （830KB）（31）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Colonic telangiectasia combined with bleeding: A case report and literature review Ren Huaijing, Tao Jianan, Ma Zhenqi, Wang Xuehong Clinical Focus    2024, 39 (2): 155-159.   DOI: 10.3969/j.issn.1004-583X.2024.02.011 Abstract （118）   HTML （6）    PDF（pc） （1034KB）（17）       Knowledge map    Save Objective To explore the clinical characteristics and diagnostic and therapeutic strategies of colonic telangiectasia. Methods A retrospective analysis was conducted on the clinical data of a patient with colonic telangiectasia who presented with repeated gastrointestinal bleeding and anemia, and relevant literature was reviewed. Results A 56-year-old female patient presented with recurrent black stools and alternating fresh bloody stools. Colonoscopy showed extensive network-like, dendritic, and spider nevus-like capillary dilation in multiple locations around the mucosa from the cecum to the descending colon, with the maximum of approximately 5mm × 5mm. She was finally diagnosed with colonic telangiectasia. Conclusion Colonic telangiectasia, also known as colonic vascular dysplasia, is more common in elderly patients. It is mostly asymptomatic, and gastrointestinal bleeding is an occasional symptom. Electronic colonoscopy is an important diagnostic method for colonic telangiectasia, and lesions are more common in the right colon. Asymptomatic patients do not require treatment, and those with concurrent bleeding may consider medications or local hemostasis under endoscopy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Effect of acceptance and commitment therapy on mental health and quality of life in cancer patients: A meta-analysis Gong Caifang, Zhao Junyu, You Chuan Clinical Focus    2024, 39 (2): 101-107.   DOI: 10.3969/j.issn.1004-583X.2024.02.001 Abstract （116）   HTML （19）    PDF（pc） （1514KB）（23）       Knowledge map    Save Objective To systematically evaluate the effect of acceptance and commitment therapy (ACT) on the mental health and quality of life of cancer patients. Methods Randomized clinical trials (RCTs) reporting the influence of ACT on mental health and quality of life in cancer patients were searched in the CBM, WanFang, CNKI, VIP, PubMed, Cochrane Library, Web of Science and EMbase databases, and the retrieval time was from the time of building the database to November 2022. Literature screening based on inclusion and exclusion criteria, quality assessment and data extraction were performed by two investigators. A meta-analysis was conducted using Revman5.4 software. Results A total of 14 RCTs representing 1,063 cancer patients were enrolled. Meta-analysis results showed that ACT significantly improved anxiety (SMD=-1.04, 95%CI [-1.19, -0.89], P<0.01), depression (SMD=-0.73, 95%CI[ -0.88, -0.59], P<0.01), psychological flexibility (MD=-2.17, 95%CI[-2.77, -1.57], P<0.01) and quality of life in cancer patients (MD=5.27, 95%CI [3.57, 6.98], P<0.01). Conclusion ACT can relieve anxiety and depression, improve psychological flexibility and quality of life, and positively promoting physical and mental health of cancer patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (1): 84-87.   DOI: 10.3969/j.issn.1004-583X.2024.01.016 Abstract （114）   HTML （4）    PDF（pc） （859KB）（36）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Mitochondrial mutation m.3243A> G associated with diabetes mellitus: One case report and literature review Lv Shasha, Song Jinlan, Shi Jian Clinical Focus    2024, 39 (2): 160-163.   DOI: 10.3969/j.issn.1004-583X.2024.02.012 Abstract （113）   HTML （5）    PDF（pc） （930KB）（23）       Knowledge map    Save Objective To investigate the screening and treatment of mitochondrial diabetes mellitus (MDM). Methods In this retrospective analysis, the clinical data and treatment process of one patient with m.3243A>G mutation-related MDM were analyzed, and relevant literature was reviewed. Results The 42-year-old female patient was admitted to the hospital due to poor blood glucose control and limb numbness. Combined with testing for mitochondrial gene, the patient received insulin combined with empagliflozin. Blood glucose control was improved and insulin dosage was reduced. Conclusion MDM has insulin resistance.Insulin combined with with SGLT-2 inhibitors can be treated, and its potential benefits need more comprehensive research. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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IgG4-related diseases characterized by increased IgE level and eosinophil count with multiple lymphadenopathy: A case report Song Jialiang, Jiang Yingjie, Kong Ruina, Cai Qing, Gao Jie Clinical Focus    2024, 39 (1): 57-60.   DOI: 10.3969/j.issn.1004-583X.2024.01.010 Abstract （112）   HTML （3）    PDF（pc） （1086KB）（23）       Knowledge map    Save Objective To explore the clinical features and treatment of immunoglobulin G4 (IgG4)-related diseases characterized by increased immunoglobulin E (IgE) level and eosinophilic count with multiple lymphadenopathy. Methods The clinical data, diagnosis and treatment process of a patient with IgG4-related disease characterized by increased IgE level and eosinophilic count with multiple lymphadenopathy were retrospective analyzed, and related literatures were reviewed. Results A 24-year-old male patient was admitted with the enlargement of bilateral inguinal lymph nodes for more than 2 years. The clinical manifestations, IgG4 test and pathology results suggested the diagnosis of IgG4-related disease. The therapeutic regimen was 20 mg prednisone orally once a day and 5 mg Tofacitinib citrate tablets orally twice a day. The dosage was adjusted according to the blood test and ultrasound results, and the symptoms of the patient were significantly improved at the final follow-up visit. Conclusion IgG4-related diseases are often characterized by significantly elevated serum IgG4 levels and lump-like lesions. Increased IgE level and eosinophil count are rarely observed in cases of IgG4-related diseases, although their important roles have been recently identified. Glucocorticoids are the first-line drugs, and targeted drugs like Tofacitinib may have potential therapeutic effects on IgG4-related diseases, which expand the new idea of the treatment. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Intracranial infection of varicella zoster virus in adults: Clinical analysis of 5 cases Liu Wanqi, Fan Shuqin, Zhuang Ruixue, He Feng, Liu Zhenchuan, Xie Zhongxiang Clinical Focus    2024, 39 (2): 149-154.   DOI: 10.3969/j.issn.1004-583X.2024.02.010 Abstract （111）   HTML （5）    PDF（pc） （1021KB）（20）       Knowledge map    Save Objective To investigate the clinical features, cerebrospinal fluid (CSF) examination, imaging findings, treatment and outcome of intracranial infection of varicella zoster virus (VZV), thus providing reference for clinical diagnosis and treatment. Methods Clinical data of 5 VZV patients admitted to the Department of Neurology of Linyi People's Hospital from April 2019 to April 2023 was retrospectively summarized for the assessments of clinical manifestations, auxiliary examination, treatment and prognosis. Results Among the five patients with intracranial infection of VZV, males were more than females, with the mean age of (53.6±10.9) years, and acute onset and a history of preinfection. Clinical manifestations of all patients with intracranial infection of VZV were headache, fever and focal neurological deficits. Imaging findings showed there were no obvious abnormalities or involvement of brain parenchymal in the 5 patients. The lesion infiltrated supratentorially and infratentorially with hemorrhage when the infection involved the brain parenchyma. Metagenomic next-generation sequencing (mNGS) of CSF suggested that 5 cases of increased leukocytes (399.4±84.20)×106/L, 4 cases of decreased chloride (107.65±7.17) mmol/L, 5 cases of significantly increased protein content (2.85±1.33) g/L, 4 cases of CSF/plasma glucose ratio <0.6, (0.52±0.05). Five patients were confirmed by mNGS of CSF. The prognosis of antiviral therapy was good. Conclusion The onset of intracranial infection of VZV is seen in middle-aged and elderly, with a younger trend. The severity of clinical symptoms depends on whether the infection involves the brain parenchyma. The CSF manifestations associated with intracranial infection of VZV were similar to those of tuberculous meningitis. The mNGS detection can improve the sensitivity and accuracy of the identification. The prognosis of most patients is relatively good with early treatment on the cause and symptoms. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (2): 168-171.   DOI: 10.3969/j.issn.1004-583X.2024.02.014 Abstract （110）   HTML （4）    PDF（pc） （853KB）（41）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Status and influencing factors of fear of progression in patients with type 2 diabetes mellitus Liao Kunfeng, Yao Yisong, Yang Jinpan, Yang Xining, Li Yaru, Zhou Hongyan, Liang Piao Clinical Focus    2023, 38 (12): 1095-1100.   DOI: 10.3969/j.issn.1004-583X.2023.12.007 Abstract （110）   HTML （2）    PDF（pc） （983KB）（32）       Knowledge map    Save Objective To investigate the status and influencing factors of fear of progression(FoP) in patients with type 2 diabetes mellitus (T2DM). Methods The convenience sampling method was performed to enroll 200 patients with T2DM who were hospitalized in a tertiary hospital in Nanning from July 2022 to December 2022 in the research. The general information questionnaire, Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Self-Perceived Burden Scale (SPBS), Perceived Social Support Scale (PSSS) were conducted to investigate. Results The FoP-Q-SF score of patients was (30.4±6.44), and 68 patients (34.0%) had ≥ 34 score; the SPBS score was (23.0±7.91), and the PSSS score was (51.54±9.50). The specificity of decision tree model was significantly better than that of multiple linear regression model. A combination of multiple linear regression with decision tree showed that occupational status, monthly household income per capita, SPBS and PSSS were the influencing factors of FoG in T2DM patients. Conclusion The average status of FoG in T2DM patients is at an intermediate level. Medical staff should pay more attention to the psychological status of in-service T2DM patients, and take relevant measures to improve the social support level of patients and reduce their self-perceived burden level, aiming to reduce FoG level and promote the mental health of patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Safety and efficacy of rivaroxaban in the treatment of discharged COVID-19 patients: A meta-analysis Yu Jingyi, Si Yuanguo, Lan Cuixia, Xing Jiaxuan Clinical Focus    2024, 39 (6): 485-493.   DOI: 10.3969/j.issn.1004-583X.2024.06.001 Abstract （105）   HTML （6）    PDF（pc） （1884KB）（41）       Knowledge map    Save Objective To evaluate the safety and efficacy of anticoagulation with rivaroxaban in discharged COVID-19 patients. Methods We searched related literatures on Embase, PubMed, Scopus, Cochrane library, Web of Science, Med Rxiv and Clinical Trials. Two independent researchers conducted literature selection and data extraction according to pre-determined inclusion and exclusion criteria. Results We included 6 studies with a total of 4605 patients with COVID-19, including 4 randomized controlled trials (RCTs) and 2 cohort studies. The results showed that no significant difference in mortality between patients with rivaroxaban and those without rivaroxaban (0.50% vs 1.50%; OR: 0.40; 95%CI: 0.11-1.44; P=0.16). When only RCTs were selected for meta-analysis, there was still no significant difference in mortality between subgroups, which negative result was confirmed after being adjusted by trial sequential analysis (TSA-adjusted CI: 0.09-6.23). There was also no difference in the incidence of major bleeding events between two groups, even adjusted by TSA (0.12% vs 0%; OR: 2.73; 95%CI: 0.43-17.4; P=0.29; TSA-adjusted CI: 0.08-114.92). The incidence of thrombotic events in the rivaroxaban group was significantly lower than that in the control group (0.42% vs 1.53%; OR: 0.28; 95%CI: 0.11-0.74; P=0.01; TSA-adjusted CI: 0.08-1.08). In addition, subgroup analysis results showed that mortality and thrombotic events were reduced in discharged patients treated with rivaroxaban. Conclusion Rivaroxaban can benefit COVID-19 patients, and reduce the occurrence of thrombotic events without increasing major bleeding, especially in discharged COVID-19 patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Tonsillectomy as a therapy for patients with IgA nephropathy: A meta-analysis Sun Shuaigang, Zhai Yaling, Zhang Wenhui, Tian Huijuan Clinical Focus    2024, 39 (3): 197-207.   DOI: 10.3969/j.issn.1004-583X.2024.03.001 Abstract （104）   HTML （10）    PDF（pc） （1879KB）（16）       Knowledge map    Save Objective The efficacy of tonsillectomy in immunoglobulin A nephropathy (IgAN) still remains controversial. This meta-analysis aims to evaluate the efficacy of tonsillectomy as an auxiliary or independent therapy and provide more evidence-based evidence for its clinical application. Methods We retrieved the literatures about the efficacy of tonsillectomy in IgAN published in Pubmed, Embase, ScienceDirect, Cochrane library, Web of science, Chinese National Knowledge Infrastructure (CNKI), VIP, China Biomedical Literature Database (CBM) and Wanfang databases from the time of establishment to November 1, 2022. The rate of proteinuria remission, hematuria remission, complete remission (CR) and end-stage renal disease (ESRD) were taken as observation points and meta-analyse were conducted by using Stata 12.0 software. Results A total of 36 studies representing 5797 patients with primary IgAN were ultimately enrolled. Meta-analysis showed that compared with drug therapy alone, tonsillectomy, as auxiliary or independent therapy, significantly improved proteinuria remission rate (OR=4.44, 95%CI: 3.14-6.27), hematuria remission rate (OR=5.11, 95%CI: 2.92-8.93) and CR rate (OR=3.32, 95%CI: 2.79-3.96), and significantly reduced incidence of ESRD (OR=0.24,95%CI: 0.17-0.33). Conclusion As auxiliary or independent treatment, tonsillectomy may induce clinical remission and inhibit the progression of ESRD in patients with IgAN and more attention should be paid to its application value in clinic. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Diagnostic value of contrast-enhanced ultrasound in differentiating focal testicular lesions: A meta-analysis Gao Ming, Liu Hao, Yu Hang, Lin Lin, Zhang Zijie, Xiong Ying Clinical Focus    2024, 39 (5): 389-395.   DOI: 10.3969/j.issn.1004-583X.2024.05.001 Abstract （103）   HTML （17）    PDF（pc） （1224KB）（28）       Knowledge map    Save Objective To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in focal testicular lesions. Methods Relevant studies regarding CEUS in differentiating focal testicular lesions which reported from the establishment of the databases to August 10, 2023 were retrieved from databases including PubMed, EMBASE, Cochrane Library, Web of Science, China BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data and VIP Data. Eligible documents were conducted for data extraction, quality evaluation. RevMan 5.4, Meta disc1.4 and Stata15.0 were employed to analyze the diagnostic performance of CEUS for differentiating testicular lesions in tumor-like lesions and differentiation of benign and malignant. Results Thirteen original studies representing 712 lesions were included. Meta analysis showed that the pooled sensitivity, specificity, positive likelihood radio and negative likelihood ratio of CEUS for differentiating testicular neoplastic tumors in tumor-like lesions were 0.95(95%CI: 0.87-0.98), 0.84(95%CI: 0.73-0.91), 5.8(95%CI: 3.3-10.2), 0.06(95%CI: 0.02-0.17), respectively, and the area under the curve (AUC) for the summary receiver operating characteristic (SROC) was 0.94 (95%CI: 0.92-0.96). The pooled sensitivity, specificity, positive likelihood radio and negative likelihood ratio of CEUS for differentiating testicular lesions in differentiation of benign and malignant were 0.95(95%CI: 0.85-0.99), 0.81(95%CI: 0.65-0.90), 4.9 (95%CI: 2.5-9.6), 0.06(95%CI: 0.02-0.20), respectively, and the AUC for SROC was 0.96(95%CI: 0.94-0.97). Conclusion CEUS has a high diagnostic value for focal testicular lesions and can provide a reference for clinical diagnosis and treatment. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Meta-analysis of the incidence of extracorporeal membrane oxygenation combined with incident thrombosis Peng Yimeng, Yao Yang, Li Siyu, Ding Ge, Sun Yanan, Wang Shengyu Clinical Focus    2024, 39 (1): 5-11.   DOI: 10.3969/j.issn.1004-583X.2024.01.001 Abstract （102）   HTML （3）    PDF（pc） （1254KB）（28）       Knowledge map    Save Objective To systematically evaluate the incidence of thrombotic complications in patients treated with extracorporeal membrane oxygenation technology (ECMO). Methods Articles reporting ECMO and incident thrombosis published before December 2022 were systematically searched in the PubMed, EMBASE, Wanfang and CNKI database using the following keywords: “Extracorporeal Membrane Oxygenation or ECMO”, “thrombus or complication”. Two investigators were responsible for screening eligible articles based on the inclusion and exclusion criteria. Meta-analysis and subgroup analysis were performed using Review Manager 5.4 software. The quality of the included articles was evaluated according to the Newcastle-Ottawa Scale (NOS) scoring system. Results A total of 16 literatures involving 1136 patients were selected. Meta-analysis showed that the incidence of thrombosis in ECMO patients was 52.0%(95% C I: 0.30-0.88) and I^2 was 91% ( P<0.01). Subgroup analysis showed that the incidence of ECMO concurrent thrombosis in patients <45 years old and 45-59 years old was 27.0%(95% C I: 0.14-0.50) and 53.0%(95% C I: 0.29-0.97), respectively. The incidence of patients with a mean duration of ECMO ≤10 days and >10 days was 50.0%(95% C I: 0.34-0.74) and 39.0%(95% C I: 0.11-1.38), respectively. The incidence of thrombosis with a body mass index(BMI) of 24-27.9 kg/m2 and ≥28 kg/m2 was 27.0%(95% C I: 0.07-1.07) and 66.0% (95% C I: 0.36-1.23), respectively. The incidence of thrombosis detected by the anticoagulation monitoring methods of partial thromboplastin time (APTT), activated clotting time (ACT) and anti-factor-Xa (anti-Xa) was 57.0%(95% C I: 0.47-0.69), 13.0%(95% C I: 0.08-0.20) and 45.0% (95% C I: 0.36-0.57), respectively. Conclusion The incidence of thrombotic complications in patients treated with ECMO is 52.0%. Patients with an older age, shorter duration of ECMO, greater BMI and monitored for APTT have a higher incidence of thrombotic complications. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Diagnostic of superb microvascular imaging for breast tumors: A meta-analysis Chen Sihan, Xiong Hu, Shui Dianya, Gao Xiaozhan, Liu Zewei Clinical Focus    2024, 39 (2): 108-114.   DOI: 10.3969/j.issn.1004-583X.2024.02.002 Abstract （98）   HTML （8）    PDF（pc） （1725KB）（19）       Knowledge map    Save Objective The purpose was to evaluate the value of superb microvascular imaging (SMI) for benign and malignant breast tumors by a meta-analysis. Methods We searched PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), WanFang, VIP for literature on the diagnosis of SMI for benign and malignant breast tumors from the time of building the database to September 20, 2022. Two researchers screened literature and extracted information based on inclusion and exclusion criteria. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was performed to assess the quality of the included primary literature, Review Manager 5.3 was conduted to plot the literature quality assessment chart, Stata 17.0 was used to calculate SMI for sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) of breast tumors. The area under the curve (AUC) was obtained by summary receiver operating characteristic (SROC) curve. Funnel plot was applicated to evaluate publication bias. Results Fifteen meta-analyses representing 1769 cases of breast tumor patients were included, with 1912 lesions (916 malignant nodules and 991 benign nodules). The results of the meta-analysis showed that the SEN, SPE, PLR, NLR, DOR and AUC of SROC curves for SMI in the assessment of breast lesions were 0.82 (95%CI 0.79 to 0.84), 0.87(95%CI 0.85 to 0.89), 6.58(95%CI 4.58 to 9.43), 0.19(95%CI 0.16 to 0.24), and 39.47(95%CI 27.18 to 57.31), 0.93(95%CI 0.90 to 0.95). Conclusion SMI has a high diagnostic accuracy in evaluating the differentiation of benign and malignant breast lesions. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Correlation analysis of Non-HDL-C/HDL-C and NHR with the severity of coronary artery disease Huang Yuling, Zhang Xinyue, Rong Pingping, Yang Wenqi, Cao Xinying, Xing Cainai, Wang Zhijun, Liu Ning Clinical Focus    2024, 39 (2): 115-120.   DOI: 10.3969/j.issn.1004-583X.2024.02.003 Abstract （97）   HTML （6）    PDF（pc） （961KB）（21）       Knowledge map    Save Objective To investigate the correlation of non-high-density lipoprotein cholesterol to high density lipoprotein cholesterol ratio (non-HDL-C/HDL-C), neutrophil to high-density lipoprotein cholesterol ratio (NHR) with the severity of coronary artery disease. Methods A total of 284 patients who underwent coronary angiography for the first time in the Cardiology Department of North China University of Technology Affiliated Hospital from January 2022 to June 2023 due to chest tightness and pain were selected. According to the results of coronary angiography, they were divided into the coronary artery disease group (n=223) and control group (n=61). Clinical data (general data and laboratory data), non-HDL-C/HDL-C and NHR were compared between groups. According to the Gensini score, patients in the coronary artery disease group were divided into low-score subgroup (Gensini score<30) and high-score subgroup (Gensini score≥30). Laboratory data of the two subgroups were compared. Spearman correlation analysis of the two subgroups was performed to explore the correlation of Gensini score with non-HDL-C/HDL-C and NHR count. Multivariate logistic regression analysis was performed to explore the influencing factors of high Gensini scores in patients with coronary artery disease. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of non-HDL-C/HDL-C and NHR on high Gensini scores in patients with coronary artery disease. Results The levels of non-HDL-C/HDL-C and NHR in coronary artery disease group were significantly higher than those of control group (P<0.05). Non-HDL-C/HDL-C and NHR levels in patients with high-score subgroup were significantly higher than those of low-score subgroup (P<0.05). Correlation analysis showed that non-HDL-C/HDL-C and NHR were positively correlated with Gensini scores (P<0.05). Multivariate Logistic regression analysis showed that an elevated NHR increased the risk of high Gensini score in patients with coronary artery disease (OR=1.650, 95%CI: 1.262-2.158, P<0.05). ROC curve analysis showed that the area under the curve of non-HDL-C/HDL-C and NHR to predict the severity of coronary lesions was 0.657 (95%CI: 0.582-0.732, P<0.01) and 0.736 (95%CI: 0.666-0.807, P<0.01), respectively. Conclusion Non-HDL-C/HDL-C and NHR are positively correlated with the severity of coronary artery disease, and NHR is an independent predictor of high Gensini score in patients with coronary artery disease. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Correlation between serum secreted frizzled-related protein 5 and early renal damage in patients with essential hypertension Liu Yi, Cui Kun, Liu Chang, Zhao Haotian, Li Li, Xue Hongyuan Clinical Focus    2023, 38 (12): 1073-1077.   DOI: 10.3969/j.issn.1004-583X.2023.12.003 Abstract （96）   HTML （6）    PDF（pc） （999KB）（48）       Knowledge map    Save Objective To investigate the correlation between serum secreted frizzled-related protein 5 (SFRP5) and early renal damage in patients with essential hypertension. Methods During January 2017 to December 2017, a total of 88 patients who were initially diagnosed as essential hypertension in the Second Hospital of Hebei Medical University were recruited, and they were divided into group B (UACR<30 mg/g, n=41) and group C (30 mg/g≤UACR≤300 mg/g, n=47) based on the urine albumin creatine ratio (UACR). During the same period, 32 healthy volunteers receiving physical examinations were included in group A. Serum SFRP5, cystatin C (Cys-C), blood urea nitrogen and serum creatinine were compared. Results Serum SFRP5 was significantly lower in group C than that of group A and group B ( P<0.01), which was significantly lower in group B than that of group A ( P<0.05). Cys-C was significantly higher in group C than that of group A and group B ( P<0.01). SFRP5 was negatively correlated with UACR ( r=-0.839, P<0.01) and Cys-C ( r=-0.378, P<0.05). Cys-C was positively correlated with UACR ( r=0.625, P<0.01). SFRP5 was an independent protective factor for hypertensive renal damage (β=-0.036, P<0.01), and Cys-C was an independent risk factor for it (β=0.288, P<0.01). Conclusion SFRP5 may be a protective factor for renal damage in hypertension, serving as a potential predictive and therapeutic target for it. Our findings provide a new direction for clinical medication and evaluation of drug efficacy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Correlation between systemic immune inflammation index and multivessel coronary disease in patients with acute coronary syndrome Wang Zhongqi, Li Jinzhao, Wu Nan Clinical Focus    2024, 39 (6): 512-517.   DOI: 10.3969/j.issn.1004-583X.2024.06.005 Abstract （94）   HTML （6）    PDF（pc） （907KB）（26）       Knowledge map    Save Objective To investigate the correlation between systemic immune inflammation (SII) index and severity of coronary artery disease in patients with acute coronary syndrome (ACS). Methods A total of 206 ACS patients with typical symptoms of chest pain and chest tightness underwent coronary angiography in the Department of Cardiology of Anshan Central Hospital from September 2021 to March 2023 were enrolled. The clinical data and the immune inflammation indexes were assessed. According to the coronary angiography results or the modified Gensini score, the patients were divided into single-vessel disease group (n=51) and multi-vessel disease group (n=155), or mild lesion group (n=89) and advanced lesion group (n=117). The inter-group differences in clinical data were compared, and the independent risk factors for severity of coronary artery disease were screened for evaluating their predictive value. Results The area under the curve of SII in predicting severity of coronary artery disease in ACS patients was 0.93. When SII was 631.31, the predictive ability for severity of coronary artery disease in ACS patients was the highest, with 81.9% of the sensitivity and 96.1% of specificity. Conclusion SII is an independent risk factor for severity of coronary artery disease in ACS patients, and it has a high predictive value. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1146-1149.   DOI: 10.3969/j.issn.1004-583X.2023.12.016 Abstract （94）   HTML （6）    PDF（pc） （875KB）（405）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Review: efficacy and pharmacogenomics of leflunomide plus methotrexate versus iguratimod plus methotrexate in the treatment of rheumatoid arthritis Zhu Suhua, Xu Shengqiu Clinical Focus    2024, 39 (4): 304-313.   DOI: 10.3969/j.issn.1004-583X.2024.04.002 Abstract （94）   HTML （3）    PDF（pc） （2744KB）（12）       Knowledge map    Save Objective To investigate the efficacy and pharmacoeconomics of leflunomide plus methotrexate versus iguratimod plus methotrexate in the treatment of rheumatoid arthritis (RA), and to provide reference for the rational selection of clinical drugs. Methods The randomized controlled trials about leflunomide plus methotrexate versus iguratimod plus methotrexate for RA were retrieved from Pubmed, Medline, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP from the establishment of the databases to July 2023. Meta-analysis was performed on the included literature by RevMan5.4 software. Ultimately, TreeAge Pro 2019 software was used to construct a decision tree model for cost-effectiveness analysis of leflunomide plus methotrexate versus iguratimod plus methotrexate for RA, and the sensitivity evaluation was assessed. Results The Meta-analysis showed the efficacy of leflunomide plus methotrexate or iguratimod plus methotrexate for RA was significantly higher than that of methotrexate alone (OR =2.95, 95%CI [1.91-4.56], P<0.01; OR =3.35, 95%CI [1.88-5.97], P<0.01; respectively). The incremental cost-effectiveness ratio(ICER) indicated that for each unit of increase in effectiveness of iguratimod plus methotrexate versus leflunomide plus methotrexate for RA, would lead to an increase the cost by 196, 312.5 RMB. The most influential factor on ICER was the treatment efficiency of iguratimod plus methotrexate or leflunomide plus methotrexate. Conclusion The efficacy of leflunomide plus methotrexate or iguratimod plus methotrexate is higher than that of methotrexate alone. Leflunomide plus methotrexate in the treatment of RA has economic advantages. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Effectiveness of cognitive interventions on elderly patients with amnestic mild cognitive impairment: A meta-analysis Xiao Huangyi, Yuan Jiankun, Yan Ziyu, Zeng Wenshu, Lu Lanmo, Wang Jun Clinical Focus    2024, 39 (1): 12-19.   DOI: 10.3969/j.issn.1004-583X.2024.01.002 Abstract （93）   HTML （5）    PDF（pc） （1455KB）（36）       Knowledge map    Save Objective To systematically evaluate the effect of cognitive interventions on elderly patients with amnestic mild cognitive impairment (aMCI). Methods Randomized controlled trials (RCTs) reporting the effects of cognitive interventions on patients with aMCI published from 2005 to January 2023 were searched in the PubMed, Embase, Cumulative Index for Nursing and Allied Health Literature (CINAHL), The Cochrane Library, Web of Science, China Biomedical Literature Database, China National Knowledge Internet (CNKI), Wanfang and VIP Database. Two investigators were responsible for literature screening, data collection and quality assessment based on the RCT evaluation criteria in the Cochrane 5.1.0 manual. Meta-analysis was performed using Rev Man 5.4. Results A total of 10 eligible studies involving 671 cases were included. Meta-analysis results showed that after the intervention, patients in the cognitive intervention group had significantly better scores of the Mini-Mental State Examination (MMSE) ( M D=1.99, 95% C I 1.40, 2.58; P<0.01), the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) and the Modified Alzheimer's Disease Assessment Scale-Cognitive Subscale (Modified-ADAS-Cog) ( M D=-3.65, 95% C I -4.89, -2.41; P<0.01), the Contentment Subscale of the Multifactorial Memory Questionnaire (MMQ-Contentment) ( M D=1.68, 95% C I -2.24, 5.60; P=0.40) and the Rivermead Behavioral Memory Test (RBMT) ( M D=4.69, 95% C I 3.41, 5.97; P<0.01) than those of the control group. The Quality of Life in Alzheimer Disease (QOL-AD) score was significantly higher in the cognitive intervention group than that of control group ( M D=1.79, 95% C I 0.60, 2.97; P=0.003). Conclusion The existing evidences have suggested that cognitive interventions may improve memory satisfaction, behavioral memory capacity and quality of survival, and delay the development of Alzheimer's disease in patients with aMCI. The effect of cognitive interventions on improving their cognitive function has been controversial possibly due to the small sample size, high rate of drop-out, and inconsistent baseline levels of cognitive function. Large-scale randomized controlled trials are needed to explore the function of cognitive interventions in Alzheimer's disease patients with aMCI. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Effect of serum s100A4 levels on polycystic ovary syndrome in patients with polycystic ovary syndrome Ren Yumei, Zhang Qiu, Hu Honglin Clinical Focus    2023, 38 (12): 1078-1085.   DOI: 10.3969/j.issn.1004-583X.2023.12.004 Abstract （93）   HTML （5）    PDF（pc） （1026KB）（22）       Knowledge map    Save Objective To detect serum S100A4 levels in patients with polycystic ovary syndrome (PCOS) and explore the effects of S100A4 on the development. Methods One hundred twenty-nine women of childbearing age with PCOS were enrolled into PCOS group from December 2021 to June 2023 at the Department of Endocrinology of the First Affiliated Hospital of Anhui Medical University, and 47 healthy women of childbearing age with regular menstrual cycles and no hyperandrogenemia, who underwent routine medical examinations at the hospital in the same period, were as the normal control group (NC group). According to the levels of body mass index (BMI) and glucose metabolism, the PCOS group was assigned into PCOS-over BIM group, PCOS-normal BIM group, PCOS-normal glucose metabolism group and PCOS-abnormal glucose metabolism group, respectively. The general data, S100A4 levels, and other biochemical indicators were collected, and the differences of clinical data between groups were compared. Results The serum S100A4 level of PCOS group was significantly higher than that of the NC group ( P<0.01). There was a significant difference in serum S100A4 levels amongNC group, PCOS-normal BIM group and PCOS-over BIM group ( P<0.01), which was significantly higher in the latter two groups than that of NC group ( P<0.05). There was a significant difference in serum S100A4 levels among NC group, PCOS-normal glucose metabolism group and PCOS-abnormal glucose metabolism group( P<0.01), which was significantly higher in the latter two groups than that of NC group ( P<0.05). Spearman related analysis results showed that serum S100A4 levels were negative correlation with homeostasis model assessment- β (HOMA-β) and positively correlated with low-density lipoprotein cholesterol (LDL-C) ( P<0.05). Multi-factor logistic regression analysis showed that S100A4 was the influencing factor for the occurrence of PCOS in women of childbearing age ( O R=1.046, 95% C I: 1.015-1.078, P<0.05). The area under receiver operating characteristic (ROC) curve for serum S100A4 levels predicting PCOS was 0.681, and its optimal cutoff value was 0.176 ng/ml ( P<0.01). Conclusion The increase in serum S100A4 in PCOS patients was related to obesity, insulin resistance, and abnormal lipid metabolism, and involving the development of PCOS. Table and Figures | Reference | Related Articles | Metrics | Comments（0）