Clinical Focus

Advances in stroke management and research in China in 2018

Liu Liping1, 2, Li Man1, 2, Liu Jingyi1, 2, Yang Zhonghua1, 2, Wang Yilong1, 2, David Wang3, Wang Yongjun1, 2

2019, 34(1): 5-10. doi:10.3969/j.issn.1004-583X.2019.01.001

Asbtract ( 629 )

PDF (509KB) ( 293 )

HTML

Related Articles | Metrics

China bears the biggest burden of stroke in the world. With the improvement of the medical quality of stroke, the mortality of stroke in our country is on the decline, but the morbidity is still on the rise.In recent years, China has made substantial progress in stroke education, research, and stroke care.This article reviews the influential academic achievements from recent years, summarizes and evaluates the latest advances in the improvement of stroke care quality in China, the exploration of thrombolysis and new treatment methods, it also touches upon the development of stroke construction, and takes a glimpse into the future of stroke management in China.

The year in clinical cardiology 2018

Cui Wei, Liu Demin, Geng Xue, Wang Qian

2019, 34(1): 11-16. doi:10.3969/j.issn.1004-583X.2019.01.002

Asbtract ( 707 )

PDF (480KB) ( 270 )

HTML

Related Articles | Metrics

The year 2018 saw great changes in clinical cardiology, especially in the treatment of hypertension, heart failure, coronary artery disease, and preventive cardiology. This review focuses on the definition and target of hypertension control, drug treatment of chronic heart failure and coronary artery disease, as well as the future of aspirin in primary prevention for cardiovascular disease.

Progress in hematological diseases in 2018

Chang Yingjun1, Wei Hui2, Ren Jinhai3

2019, 34(1): 17-22. doi:10.3969/j.issn.1004-583X.2019.01.003

Asbtract ( 764 )

PDF (829KB) ( 290 )

HTML

Related Articles | Metrics

This article summarizes the progress in hematological diseases in 2018, mainly focusing on the diagnosis and treatment of acute myeloid leukemia, chronic lymphoblastic leukemia, aplastic anemia, and nonHodgkin lymphoma. The progress in allogeneic stem cell transplantation is also discussed.

Major advances in clinical research of rheumatic diseases of 2018

Gao Lixia, Ma Liyan, Peng Chenxing, Guo Huifang

2019, 34(1): 23-32. doi:10.3969/j.issn.1004-583X.2019.01.004

Asbtract ( 543 )

PDF (611KB) ( 240 )

HTML

Related Articles | Metrics

The year 2018 witnessed the introduction of multiple management guidelines for systemic lupus erythematosus, rheumatoid arthritis and psoriatic arthritis. The treatment of rheumatic disease also went into more details which not only focused on systemic diseases, but also on single organ and symptom. And the related guidelines are also coming. Drug treatment is more cautious and extends to the screening of infection, cancer and comorbidity management. Multidisciplinary cooperation has become a trend. And imaging examinations in diagnosis, nondrug therapies and psychological needs of patients in treatment have all received attention. The classification of diseases also has been placed on the agenda. The clinical researches is attracting more and more public attention, especially in terms of the study of biological agents.

Clinical advances in endocrine and metabolic disease in 2018

Wang Mian, Zhang Lihui, Su Shengou

2019, 34(1): 33-40. doi:10.3969/j.issn.1004-583X.2019.01.005

Asbtract ( 486 )

PDF (550KB) ( 258 )

HTML

Related Articles | Metrics

In 2018, great headway has been made in clinical endocrine metabolism, for instance, the update of important guide and the announcement of large clinical trial results, covering multiple endocrine metabolic disease. This review summarizes the important contents in diabetes, thyroid disease, hypoparathyroidism, vitamin D deficiency, primary aldosteronism and polycystic ovarian syndrome.

Clinical advances of digestive diseases during 2018

Song Jia, Luo Yuxin, Guo Jinbo, Zhang Xiaolan

2019, 34(1): 41-48. doi:10.3969/j.issn.1004-583X.2019.01.006

Asbtract ( 676 )

PDF (588KB) ( 358 )

HTML

Related Articles | Metrics

Gastroenterology related guidelines and consensus have been well revised, updated or newly made in 2018, covering the maximum variety and updates of the digestive diseases. Clinical consensuses formulated by professors in China provided great convenience to diagnosis and treatment of diseases, as suiting the national condition. This paper focuses on helicobacter pylori infection, achalasia of cardia, gastrointestinal motor disease, gastrointestinal hemorrhage, inflammatory bowel disease, virus hepatitis, autoimmune liver disease, pancreatic disease, digestive system tumors, endoscopic progress, clinical application of probiotics and so on. We aim to give a support in the diagnosis and treatment of digestive diseases for gastroenterologists by summarizing the advances of above diseases.

Part of advances in respiratory disease during 2018

Yuan Boyun, Liu Xin, Yuan Yadong

2019, 34(1): 49-55. doi:10.3969/j.issn.1004-583X.2019.01.007

Asbtract ( 787 )

PDF (536KB) ( 453 )

HTML

Related Articles | Metrics

With the deepening of the researches on respiratory system disease in 2018, various guidelines were updated. This article introduces the related development in chronic obstructive pulmonary disease, interstitial lung disease, lung cancer, pulmonary hypertension, bronchiectasis, primary ciliary dyskinesia and so on.

Advances in kidney disease during 2018

Kang Yingli, Li Ying

2019, 34(1): 56-63. doi:kidney diseases; advances; diagnosis; treatment; guideline

Asbtract ( 344 )

PDF (730KB) ( 382 )

HTML

Related Articles | Metrics

The year of 2018 witnessed the boom of nephrology.Various progresses and innovation have been made,which involve the diagnosis, treatment, new drugs, prevention and treatment of complications of kidney disease, which further promote better understanding of the disease. In particular, the release and update of some guidelines and expert consensus are of great significance to the clinical and research work for nephrologists. This review focuses on the important advances in 2018 for readers.

Clinical study on blood stasis constitution of chronic renal failure treated

Cao Jinxia1, Shi Shaolong2, Dai Pengju3a, He Yuxu3b, Zhao Wei3a

2019, 34(1): 64-67. doi:10.3969/j.issn.1004-583X.2019.01.009

Asbtract ( 602 )

PDF (393KB) ( 177 )

HTML

Related Articles | Metrics

Objective To observe the effect of Huoxue Yishen Decoction on blood stasis constitution of chronic renal failure (CRF) and to explore the correlation between blood stasis constitution and CRF clinical efficacy. Methods A total of 100 CRF patients who met the inclusion criteria were divided into the control group and the treatment group by randomized blind method. The control group was treated with conventional western medicine, while the treatment group was treated with Huoxue Yishen decoction on the basis of conventional western medicine. The treatment continued for eight weeks. The scores of TCM constitution, TCM syndrome points, blood lipid, blood rheology and renal function of two groups before and after treatment were recorded, and the relationship between the degree of blood stasis constitution and the clinical efficacy of two groups was analyzed.Results The total effective rate of treatment group was 86.3%, and that of control group was 75.5%. There were statistically significant differences in improving the clinical syndromes of traditional chinese medicine, the degree of blood stasis constitution, plasma imbalance, reducing blood creatinine, cholesterol, triglyceride, plasma viscosity, and the clearance rate of endogenous creatinine between two groups (P<0.05). The degree of blood stasis bias was correlated with the clinical efficacy of patients with CRF. Conclusion Huoxue Yishen decoction has good clinical effect on blood stasis constitution of CRF. The higher the degree of blood stasis bias, the worse the clinical efficacy of CRF. Blood stasis constitution may be one of the factors that predispose or aggravate CRF.

Clinical significance of serum thymidine kinase 1 in treatment and prognosis of multiple myeloma

Zhang Wenjie, Zhang Qike, Wei Xiaofang, Feng Youfan

2019, 34(1): 68-71. doi:10.3969/j.issn.1004-583X.2019.01.010

Asbtract ( 811 )

PDF (418KB) ( 197 )

HTML

Related Articles | Metrics

Objective To study the clinical significance of serum thymidine kinase 1(TK1) in the treatment and prognosis of multiple myeloma(MM). Methods A total of 32 patients with multiple myeloma were included as MM group, 20 patients with monoclonal gammopathy of undetermined significance were included as monoclonal gammopathy of undetermined significance（MGUS） group, and 20 healthy subjects were included as healthy control group. The differences of lactate dehydrogenase (LDH), β2microglobulin (β2MG), globulin(GLB) and TK1 levels in three groups were analyzed.The MM group was divided into Ⅰ, Ⅱ, Ⅲ stage groups according to MM internationalstaging system(ISS).The differences of LDH, β2MG, GLB and TK1 levels in three groups were analyzed. The correlation between serum TK1 levels and LDH, β2MG, GLB levels before treatment were analyzed by Pearson. All patients in MM group were treated with chemotherapy. The TK1 expression levels were compared amomg CR/PR/SD/PD patients.The median survival of different TK1 levels in treatment group were analyzed. The effect of serum TK1 in the treatment and prognosis of patients with MM were analyzed.Results The levels of serum β2MG, GLB, LDH and TK1 in MM group had significant difference with those in MGUS group and healthy control group(P<0.05). The levels of serum β2MG, GLB, LDH and TK1 levels in stage Ⅱ and Ⅲ had significant difference with those in stage Ⅰ(P<0.05). The levels of serum β2MG, GLB, LDH and TK1 in stage Ⅲ had significant difference with those in stage Ⅱ(P<0.05) .Serum TK1 levels were positively correlated with the levels of β2MG, GLB, LDH. After treatment, TK1 expression level of CR/PR patients decreased significantly (P<0.05). The overall survival rate in TK1<4.97 pmol/L and TK1≥4.97 pmol/L groups were 64.7% and 20.0% according to the survival curve of KaplanMeier(P<0.05). Conclusion The serum levels of TK1 in patients with MM were significantly higher, and the level of TK1 has a certain reference significance for the evaluation of therapeutic effect, and affects the prognosis of MM patients.

Clinical features of 165 cases of narcolepsy

Zhao Yongjuna, Wang Fumina, Tang Minglua, Wang Xiaotingb, Liu Zhenhuaa

2019, 34(1): 72-76. doi:10.3969/j.issn.1004-583X.2019.01.011

Asbtract ( 463 )

PDF (418KB) ( 165 )

HTML

Related Articles | Metrics

Objective The clinical features of 165 patients with narcolepsy diagnosed in the sleep medicine center of Shandong Provincial Hospital to improve clinical physicians' understanding of narcolepsy. Methods To study the clinical data of 165 patients with narcolepsy who were diagnosed and treated in the sleep medicine center of our hospital from January 2015 to August 2018 were analyzed retrospectively. Results In 165 cases of narcolepsy, the number of man was 2.3 times higher than that of woman and patients with cataplexy accounted for 84.24%, which were more than that of previous studies. Most of the patients were from Shandong province, and most were diagnosed in August, February and March. Age of onset, incidence rate of the syndrome pentad of narcolepsy and other clinical manifestations were basically the same as those of the previous studies.Conclusion Narcolepsy is a relatively rare nervous system disease, whose onset is accompanied with diverse clinical manifestations and unknown etiology. Early diagnosis, treatment and management of patients should be strengthened to improve their quality of life.

Efficacy and safety of umeclidinium/inhaled corticosteroid/ longacting β2agonist in treatment of chronic obstructive pulmonary disease: a metaanalysis

Hu Guang1, Liu Zihan1, Du Linjiao1, Wei Yuna1, Zeng Ming2

2019, 34(1): 77-84. doi:10.3969/j.issn.1004-583X.2019.01.012

Asbtract ( 389 )

PDF (1278KB) ( 111 )

HTML

Related Articles | Metrics

Objective To evaluate the effectiveness and safety of umeclidinium/ inhaled corticosteroid/ longacting β2agonist (UMEC/ICS/LABA) in the treatment of chronic obstructive pulmonary disease(COPD).Methods PubMed, Embase, Cochrane Central Register of Controlled Trials(CENTRAL), ClinicalTrail.gov, CBM, VIP, CNKI and WanFang Data were electronically searched for randomized controlled trials (RCTs) about UMEC/ICS/LABA for COPD from inception to May 28, 2018. Two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies. Then, metaanalysis was performed using RevMan 5.3 and R software. Results Seven RCTs involving 13 219 patients were included. UMEC 62.5 μg/ICS/LABA vs PBO/ICS/LABA:UMEC 62.5 μg/ICS/LABA could significantly improve the lung function (trough FEV1［MD=0.13, 95%CI=0.10 to 0.15, P＜0.00001］, 06 h wmFEV1［MD=0.16, 95%CI 0.14 to 0.17, P＜0.00001］, Peak FEV1［MD=0.16, 95%CI 0.14 to 0.18, P＜0.00001］, Trough FVC ［MD=0.21, 95%CI 0.19 to 0.23, P＜0.00001］) and the quality of life (SGRQ score［MD=-1.83, 95%CI -2.31 to 1.34, P＜0.00001］, TDI score［MD=0.54, 95%CI 0.29 to 0.78, P＜0.00001］, CAT score［MD=-0.93, 95%CI -1.29 to -0.57, P＜0.00001］), reduce the use of rescue drugs(salbutamol) and the rate of COPD acute exacerbation (RR=0.84，95%CI［0.79，0.89］，P＜0.00001) while not increase the drugrelating adverse events (RR=1.00，95%CI［0.90，1.12］，P=0.99］. ②UMEC 125 μg/ICS/LABA vs PBO/ICS/LABA : UMEC 125 μg/ICS/LABA could significantly improve the lung function and the quality of life, reduce the use of rescue drugs(salbutamol).However there is no difference in the rate of COPD acute exacerbation ［RR=0.57，95%CI（0.24，1.37），P=0.21］ and a higher drugrelating adverse events rate than the control group ［RR=1.44，95%CI（1.00，2.08），P=0.05］ .Conclusion Both UMEC 62.5 μg and 125 μg in combination with ICS/LABA are superior to PBO/ICS/LABA in the treatment of COPD patients, which can significantly improve lung function and the quality of life. UMEC 62.5 μg is preferred because of the lower adverse events rate. However, due to the limitation of quantity of included studies, this conclusion should be further confirmed by more high quality studies.

Table of Content