Clinical Focus

The year in cardiology 2016

Cui Wei， Liu Demin， Geng Xue

2017, 32(2): 93-101. doi:10.3969/j.issn.1004-583X.2017.02.001

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Many guidelines and a lot of progresses in cardiology have been changed in 2016， especially in hypertension， heart failure， coronary artery disease， lipid lowering， and cardiac arrhythmias. This review focuses on the target of hypertension control， drug treatment of chronic heart failure and coronary artery disease， pleiotropic effects of statins in cardiovascular disease， and device treatment for cardiac arrhythmias.

Progress on treatment of hematological disease in 2016

Chang Yingjun， Zhang Yuanyuan

2017, 32(2): 102-106. doi:10.3969/j.issn.1004-583X.2017.02.002

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Great progress was made in the basic and clinical research of hematological diseases in 2016. Here， we summarized donor selection of allogeneic stem cell transplantation， graftversushost disease prophylaxis， target therapies for acute and chronic GVHD， and treatment of immune thrombocytopenia and gave related comments.

Advances on cerebrovascular disease researches in 2016

Chen Junmin， Song Degang， Liu Xiaoxia， Cao Xiaoyun， Sun Qian， Zhang Xiangjian

2017, 32(2): 107-112. doi:10.3969/j.issn.1004-583X.2017.02.003

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Many substantial advances have been made in the clinical researches on cerebrovascular diseases in 2016. The article reviews the etiology of stroke， endovascular treatment of acute ischemic stroke， thrombolytic drugs， antiplatelet drugs， anticoagulation drugs， poststroke rehabilitation，and the guidelines on highrisk nondisabling ischemic cerebrovascular events.

Major advances in kidney disease study of 2016

Xu Jinsheng， He Lei， Zhang Shenglei

2017, 32(2): 113-120. doi:10.3969/j.issn.1004-583X.2017.02.004

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Major aspects of kidney disease study in 2016 were reviewed， such as acute kidney injury， chronic kidney disease， and the complications related to chronic kidney disease. This paper summarized particularly the progress in the epidemiology， biomarkers and clinical treatment of acute kidney injury， the pathological classification， diagnosis and treatment of chronic kidney disease， and complications of the diseases.

Clinical advances on digestive diseases in 2016

Zhang Xiaolan， Guo Jinbo， Han Fei， Niu Weiwei， Luo Yuxin

2017, 32(2): 121-131. doi:10.3969/j.issn.1004-583X.2017.02.005

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Gastroenterology related guidelines and consensus have been well revised， updated or newly made in 2016，covering the maximum variety and updates of the digestive diseases. Clinical consensuses formulated by professors in China provide great convenience to diagnosis and treatment of digestive diseases， as suiting the national condition. This paper will focus on gastrointestinal disease (Helicobacter pylori associated gastritis， gastroesophageal reflux disease， peptic ulcer， inflammatory bowel disease and so on)， hepatic disease (nonalcoholic fatty liver disease， chronic viral hepatitis and so on)， pancreaticobiliary disease (cholelithiasis， acute pancreatitis， and so on). We aim to give support in the diagnosis and treatment of digestive diseases by summarizing the advances of above diseases.

Clinical advances in respiratory diseases during 2016

Yuan Yadong， Shen Lixiao， Wang Li， Cao Yi

2017, 32(2): 132-138. doi:10.3969/j.issn.1004-583X.2017.02.006

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In 2016， various guides and consensus are also constantly updated with the development of the clinical and basic research on respiratory system diseases. Now， we will do some introductions about the update in lung infection， pulmonary embolism， idiopathic pulmonary fibrosis， chronic bronchial disease and so on.

Clinical advances in endocrine and metabolic disease in 2016

Wang Mian， Zhang Lihui， Su Shengou

2017, 32(2): 139-145. doi:10.3969/j.issn.1004-583X.2017.02.007

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In 2016，more highlights in the field of endocrine metabolism need concern. A lot of clinical researches were published， and also many important guidelines were updated or issued， covering diabetes， thyroid disease， osteoporosis and adrenal gland disease， here we review some of the main clinical advances.

Major advances in clinical research of rheumatic diseases of 2016

Guo Huifang，Gao Lixia

2017, 32(2): 146-151. doi:10.3969/j.issn.1004-583X.2017.02.008

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In 2016， many guidelines for the diagnosis and treatment of rheumatoid arthritis， Sjgren syndrome， gout and other rheumatic diseases updated again.The concepts of “long range management， treat to target” which originated from the management of rheumatoid arthritis， have gradually infiltrated into the treatment decisions about systemic lupus erythematosus，gout，spondyloarthritis and other rheumatic diseases. New biological agents continue to emerge.The exchange principles from traditional disease modifying antirheumatic drugs to biological agents have been more and more organized. The diagnosis and treatment methods of rheumatic disease have been more and more standardized.

Major clinical progresses of infectious diseases in 2016

Song Ning，Yuan Shengfang，Jia Weihua

2017, 32(2): 152-159. doi:10.3969/j.issn.1004-583X.2017.02.009

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Great developments in clinical diagnosis and treatment of infectious diseases were achieved in 2016. Infectious Diseases Society of America (IDSA) has published a series of important guidelines in the management of antibiotics， diagnosis of tuberculosis in adults and children， drug sensitive tuberculosis treatment in adults and children，diagnosis and treatment of hospital acquired pneumonia (HAP) and ventilatorassociated pneumonia (VAP). This article will summarize the researches of the above mentioned infectious diseases involved in the guidelines published by IDSA in 2016.

Effect evaluation of stepped salt restriction on salt threshold and urinary sodium excretion in aged hypertention

Zhai Zhihong1， Wang Zhong1， Wu Xinling2， Zhang Jingyu3， Ren Hongqiang1， Chen Shaoze1

2017, 32(2): 160-162,166. doi:10.3969/j.issn.1004-583X.2017.02.010

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ObjectiveTo evaluate the effects of stepped salt restriction on salt threshold， 24hour urinary sodium excretion(24 h USE) and blood pressure control in aged hypertension patients. MethodsAged hypertension patients in five residential areas of Shihezi were randomly divided into two groups: stepped salt restriction group(138 cases)， unified salt restriction group(124 cases).Process control lasted for half a year. Salt threshold and 24 h USE were detected before the salt restriction and examined again when the salt restriction was completed. ResultsSalt threshold， 24 h USE and average daily intake of salt were significantly decreased in stepped salt restriction group compared with those of unified salt restriction group(P<0.05). Systolic blood pressure and diastolic blood pressure decreased significantly in stepped salt restriction group than in unified salt restriction group（P<0.05）.ConclusionThe stepped salt restriction model is feasible and effective in elderly patients with hypertension.

Clinical observation of caspofungin combined with trimethoprimsulfamethoxazole in treatment of AIDS complicated with pneumocystis pneumonia

Li Aixin， Wang Wen， Zhang Tong， Wu Hao， Zhang Hongwei

2017, 32(2): 163-166. doi:10.3969/j.issn.1004-583X.2017.02.011

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ObjectiveTo evaluate efficacy of caspofungin combined with trimethoprimsulfamethoxazole (TMPSMZ) in treatment of AIDS complicated with pneumocystis pneumonia (PCP). MethodsThe study enrolled 102 AIDS patients complicated with PCP who were treated with caspofungin combined with TMPSMZ. In the meantime， 102 patients treated with TMPSMZ alone and matched with age， gender and admission condition were selected as control group. The therapeutic efficacy was analyzed between two groups. ResultsAfter antiPCP treatment， changes of PaO2， plasma β(1，3)Dglucan and serum LDH in combination treatment group were (13.4±7.9) mmHg（1 mmHg=0.133 kPa）， (123.9±84.6) ng/L and (104.5±58.9) U/L， respectively， and those in control group were (10.2±6.7) mmHg， (98.6±83.7) ng/L and (87.3±63.4) U/L， respectively. There were significant differences between two groups (P=0.002，0.033 and 0.046， respectively). There were no significant difference in WBC count， liver and kidney function between two groups (P>0.05). Effective rate was significantly higher in the combined group than that in control group (93.1% vs 82.4%，P=0.034). ConclusionCaspofungin combined with TMPSMZ is more effective than TMPSMZ alone in AIDS patients complicated with PCP， which is worthy of further clinical validation.

Peripherally inserted central catheters and centralvenous catheters related vein thrombosis: a metaanalysis

Wu Yuhuai1a， Liu Jianwei2， Liu Jianping1b， Yang Yaopeng1c

2017, 32(2): 167-171. doi:10.3969/j.issn.1004-583X.2017.02.012

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ObjectiveTo systematically compare the risk of peripherally inserted central catheters(PICCs) and centralvenous catheters(CVCs) related vein thrombosis. MethodsThe PubMed， the Cochrane Library， CNKI， CBM and Wan fang databases were searched to find literatures evaluating PICCs and CVCs related vein thrombosis. ResultsA total of 17 studies with 6 299 participants were finally included in the metaanalysis. The pooled odd risk for PICCs related vein thrombosis was 2.785（95%CI=1.7964.321，P<0.01）. The pooled odd risk for malignant tumor and intensive care were 3.049 （95%CI=1.9494.770，P<0.01） and 3.954（95%CI=2.1817.168，P<0.01）， respectively. NNT=-30， 95%CI=-31.25 -27.78. There were no publication bias，and the outcome was stable by the sensitivity analysis. ConclusionPICCs increased the morbidity of vein thrombosis， especially for malignant tumor and intensive care， so PICCs related vein thrombosis needs more attention in clinic.

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