Table of Content

20 October 2022, Volume 37 Issue 10

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Effects of common cardiovascular drugs on the risk of COVID-19 infection and poor prognosis

Zhou Zihan, Cui Wei

2022, 37(10):  869-888.  doi:10.3969/j.issn.1004-583X.2022.10.001

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Cardiovascular disease is the most-common complication of coronavirus disease 2019 (COVID-19). During the COVID-19 pandemic, the safety and efficacy of common cardiovascular drugs such as anti-hypertensive, lipid-lowering, antiplatelet, anticoagulant, hypoglycemic and antiarrhythmic drugs have remained controversial that required improved consensuses. With the increase of global cases of COVID-19 and the occurrence of the second wave of infection, it is urgent to reveal the effects of cardiovascular disease drugs on COVID-19 patients. This study aims to summarize the relationship between common cardiovascular drugs and the risk of COVID-19 infection and poor prognosis, thus providing references for medications in COVID-19 patients with cardiovascular diseases.

Sarcopenia on immune checkpoint inhibitors in solid tumor patients with sarcopenia: A meta-analysis

Ye Qian, Ling Zhi, Yin Xudong

2022, 37(10):  889-898.  doi:10.3969/j.issn.1004-583X.2022.10.002

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Objective To explore the effect of sarcopenia on the short-term efficacy, long-term prognosis and immune-related adverse events (irAEs) of immune checkpoint Inhibitor (ICIs). Methods A systematic search were conducted in the PubMed, EMBASE, and Cochrane databases to include relevant studies published before June 2021. Results A total of 27 studies were included in the Meta-analysis, which showed that the patients with sarcopenia had worse the objective response rate (RR=0.11, 95%CI: 0.02-0.54) and disease control rate (RR=0.55, 95%CI:0.39-0.78) than those without the disease. In addition, pooled sarcopenia was found to be a unfavorable prognostic factor of prognosis in tumor patients (OS: HR=1.60, 95%CI: 1.30-1.97; PFS: HR=2.81, 95%CI: 1.88-4.22). Furthermore, sarcopenia tended toward irAEs (RR=1.27;95%CI:0.74-2.19). Conclusion Sarcopenia may be considered as a risk factor for poor therapeutic effect and prognosis in cancer patients.

Radiofrequency ablation in treating pre-excited atrial fibrillation recurrence: A meta analysis

An Jingjing, Wang Xiaojuan, Deng Aiyun

2022, 37(10):  899-904.  doi:10.3969/j.issn.1004-583X.2022.10.003

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Objective To explore the effectiveness of radiofrequency ablation (RFA) in treating pre-excited atrial fibrillation(AF) recurrence, aiming to provide theoretical basis for clinical practice. Methods Related studies regarding the treatment of RFA in pre-excited AF recurrence were searched in PubMed, Embase, CNKI, and Wanfang using a computer. Data collection for this study took place from the establishment to March 26, 2022. Two researchers independently screened the literature and extracted information and evaluated the quality of the literature, and R4.1.0 software was applied for Meta-analysis. Results Fourteen studies representing 851 patients were included. After RFA intervention, the overall AF recurrence rate was 0.13(95%CI: 0.08-0.19, P<0.01) in Meta-analysis result. Wherein, the subgroup analysis showed that the AF recurrence rate of accessory pathway (AP) ablation alone and AP+ pulmonary vein isolation (PVI) was 0.15(95%CI: 0.09-0.21, P<0.01) and 0.07 (95%CI: 0.01-0.15, P<0.01), respectively. The AF recurrence rates of unilateral bypass and multiple bypass were 0.19(95%CI: 0.12-0.28, P=0.01) and 0.05(95%CI: 0.00-0.20, P=0.10), respectively; the AF recurrence rates of left side tract and right side tract were 0.14(95%CI: 0.07-0.21, P<0.01) and 0.10(95%CI: 0.06-0.16, P=0.07), respectively; the AF recurrence rates of patients aged ≤40 years old and >40 years old were 0.10(95%CI: 0.01-0.23, P<0.01) and 0.15(95%CI: 0.09-0.21, P<0.01) respectively; the AF recurrence rates of patients with follow-up ≤1 year and >1 year was 0.08(95%CI: 0.02-0.17, P=0.09) and 0.17(95%CI: 0.14-0.21, P=0.17), respectively; the AF recurrence rates of sample size ≤50 cases and >50 cases were 0.18(95%CI: 0.09-0.29, P<0.01) and 0.11(95%CI: 0.06-0.17, P<0.01), respectively; the AF recurrence rates of men and women were 0.10(95%CI: 0.04-0.19, P<0.01) and 0.19(95%CI: 0.12-0.28, P=0.26), respectively; the AF recurrence rates of patients with and without organic heart disease were 0.34(95%CI: 0.15-0.57, P<0.01) and 0.04(95%CI: 0.00-0.10, P<0.01), respectively. Conclusion After RFA, current evidences suggest a higher AF recurrence rate, AP + PVI is superior to AP alone for reducing the recurrence rate, and the age and follow-up time are positively associated with the AF recurrence rate.

Effect of subclinical hypothyroidism on prognosis of patients with chronic systolic heart failure: A meta-analysis

Zuo Xiuxiu, Hou Tianhua, Wang Hongxiang

2022, 37(10):  905-911.  doi:10.3969/j.issn.1004-583X.2022.10.004

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Objective To systematically evaluate the effect of subclinical hypothyroidism (SCH) on prognosis of patients with chronic systolic heart failure (CSHF). Methods A computer search was conducted in Web of Science, Cochrane Library, Chinese Biomedical Database (CBM), China National Knowledge Internet (CNKI), Wanfang, VIP database up to May 2022. The literatures regarding SCH-related prognosis of CSHF patients were extracted based on predefined inclusion/exclusion criteria. The Newcastle-Ottawa scale (NOS) was performed to evaluate the relevant data extracted, a Meta-analysis was conducted using STATA 12.0 statistical software, and the hazard ratio (HR) and its 95% confidence interval (95%CI) were used as the effect quantities. Results Eligible 9 literatures representing 21 723 CSHF patients (hypothyroidism in 1 225; euthyroidism in 19 120) were included in the meta-analysis. Meta-analysis results showed that all-cause mortality (HR=1.58, 95%CI: 1.30-1.92), cardiovascular adverse event and (or) re-hospitalization (HR=1.42, 95%CI: 1.16-1.73) were risk factors for hypothyroidism as compared to euthyroidism. SCH was associated with poor prognosis of CSHF patients in subgroup analysis. The less than 24 months follow-ups were most strongly associated with all-cause mortality (HR=2.50), Asian CSHF patients were most strongly associated with cardiovascular adverse event and (or) re-hospitalization(HR=1.59). Conclusion SCH might be associated with the risk factors for all-cause mortality, cardiovascular events, and/or hospitalization of CHF patients.

Correlations between serum inflammatory factors, coagulation function and prognosis of neurological function in patients with acute cerebral infarction

Shu Ming, Yu Gui

2022, 37(10):  912-915.  doi:10.3969/j.issn.1004-583X.2022.10.005

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Objective To explore correlations between serum inflammatory factors, coagulation function and prognosis of neurological function in patients with acute cerebral infaretion (ACI). Methods From January 2021 to January 2022, eighty ACI patients (observation group) and 40 health examiners (control group) in the Third Hospital of Nanchang were randomly enrolled. Clinical data of two groups were assessed. Results Compared to the control group, interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), fibrinogen (Fib) and D dimer (DD) in the observation group were significantly higher, and the level of plasma thrombin time (PT) and activated partial thromboplastin time (APTT) were significantly lower (P<0.05). IL-6, TNF-α, hs-CRP, DD and Fib escalate increased consistently with ACI in mild, moderate and severe subgroups of the observation group (P<0.05). The correlation analysis showed that the level of all indexes including serum IL-6, TNF-α, hs-CRP, Fib and DD in the observation group were positively correlated with the degree of neurological impairment (r denoted 0.402, 0.420, 0.498, 0.305 and 0.473, respectively, P<0.01), neither PT nor APTT was correlated with the degree of neurological impairment (P>0.05). Conclusion Serum inflammatory factors (IL-6, TNF-α, hs-CRP) and coagulation functions (Fib, DD) are certainly related to prognosis of neurological function in ACI patients.

Epidemiological investigation of adenovirus respiratory tract infection in hospitalized children

Hou Wei, Zhang Lijun, Zhang Man, Wang Yakun, Tian Liyuan

2022, 37(10):  916-920.  doi:10.3969/j.issn.1004-583X.2022.10.006

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Objective To explore the epidemiological characteristics of adenovirus respiratory tract infection in hospitalized children in southern Hebei Province. Methods The adenovirus respiratory tract infection children who were admitted to the Children's Hospital of Hebei Province (March 2017 to February 2021) were retrospectively analyzed. Results There were adenovirus respiratory tract infection 2, 356 of the 32, 682 hospitalized children with acute respiratory tract infection, with a detection rate of 7.2%. The viral positive rate was 12.4% in the group of 1-3 years old. The infection type was mainly bronchopneumonia (47.3%). The rate of severe pneumonia was 12.4%. Among children aged from 1 month to <1 year, the proportion of severe pneumonia was the highest, and the proportion of severe pneumonia in winter is the highest(all P<0.05). The classified 311 adenovirus strains contained three types: human adenovirus type 2 (Ad2)(n=54, 17.4%), Ad3 (n=146, 46.9%), Ad7 (n=111, 35.7%). The detection rate of Ad7 in severe pneumonia and death cases was the highest (all P<0.05). Conclusion In the comparison to national level, the acute respiratory tract infection children in southern Hebei Province have slightly higher detection rate of adenovirus respiratory tract infection detection and incidence of severe pneumonia. Children with aged 1 month to less than 1 year before, or incidence in winter, or Ad7 infection, or other pathogens co-infection are prone to severe pneumonia.

Clinicopathological analysis of colorectal mixed adeno-neuroendocrine carcinoma: 8 cases report

Zhang Yiming, Li Mingzhao, Gu Xin

2022, 37(10):  921-926.  doi:10.3969/j.issn.1004-583X.2022.10.007

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Objective To explore the clinicopathological features of colorectal mixed adeno-neuroendocrine carcinoma (MANEC). Methods A retrospective analysis were porformed in 8 patients underwent MANEC eradication in Tianjin Hospital of ITCWM (Nankai Hospital) from August 2016 to December 2020. Results There were 3 female and 5 male, age averaged 63 years among these patients. Their clinical manifestations obviously had no-specificity, with the imaging showing space occupying and lymph node metastasis.The tumor marker detection verified 2 cases of significantly elevated ferritin, 2 cases of significantly elevated carcinoembryonic antigen (CEA), and all cases of insignificantly elevated alpha-fetoprotein and carbohydrate antigen 199 (CA199). The preoperative biopsy were conducted in 6 cases, 5 cases of adenocarcinoma and 1 case of adenocarcinoma or MANEC, with main space occupying in colon. There were 5 cases for ulcer type, 3 cases for protuberant type, with the maximum diameter of tumor for 3-9 cm. Under light microscope, the tumor cells of adenocarcinoma were arranged like glandular tubes, and 2 cases were accompanied with mucinous adenocarcinoma; neuroendocrine tumor cells showed diffuse, nest like or organ like distribution, including 1 case of small cell type and 7 cases of large cell type. Lymph node metastasis was found in 7 cases and liver metastasis in 1 case. Immunohistochemistry indicated that cytokeratin8/18 (CK8/18), cytokeratin19 (CK19) and CEA were positive to varying degrees in adenocarcinoma, chromogranin A (CgA), synaptophysin (Syn) and cluster of differentiation 56 (CD56) were positive to varying degrees in neuroendocrine tumors, and 40%-80% of Ki-67 hot spots were positive. Five patients survived, the median survival time was 17 months, and two patients died, the average survival time was 8 months. Conclusion Colorectal MANEC is a highly malignant tumor characterized by lower morbidity, no-specificity, and incident lymph node metastasis, its diagnosis mainly depends on pathology with immunohistochemistry.

Magnetic resonance imaging characteristics of Andersson lesions associated with ankylosing spondylitis

Gao Ying, Han Zhongli, Wang Hongyan, Li Xiaofu

2022, 37(10):  927-930.  doi:10.3969/j.issn.1004-583X.2022.10.008

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Objective To investigate the magnetic resonance imaging (MRI) characteristics of Anderson lesions (AL) associated with ankylosing spondylitis (AS). Methods A retrospective analysis was made on 78 AS patients who underwent spinal MRI examination in the Department of Radiology, Harbin Institute of Technology Hospital from July 2018 to November 2021, and in the Department of MRI, the 2nd Affiliated Hospital of Harbin Medical University from January 2018 to November 2021.The clinical data were compared in two groups which comprised 23 (inflammatory group) and 10 (traumatic group) patients. Results Among 78 AS patients, 33 had AL, with a detection rate of 42.3%. The modified Stoke ankylosing spondylitis spine score (mSASSS) in traumatic group was higher than that in inflammatory group (P<0.05). The difference of involved discovertebral units (DVUs) between the two groups was statistically significant (P<0.05), and the MRI characteristics were different. Correlation analysis showed that erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), human leucocyte antigen-B27 (HLA-B27), Bath ankylosing spondylitis disease activity index (BASDAI), mSASSS were not correlated with the number of involved DVUs(P>0.05). Conclusion AL is not rare in AS patients. Inflammatory AL and traumatic AL have different MRI manifestations. MRI has important value in detecting and evaluating AL.

Acute eosinophilic pneumonia in the elderly: A case report and literature review

Zang Jiajia, Gao Yanfeng, Han Shuzhi, Ping Fen

2022, 37(10):  931-933.  doi:10.3969/j.issn.1004-583X.2022.10.009

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Objective To investigate the clinical characteristics, diagnosis and treatment of acute eosinophilic pneumonia. Methods The bronchoalveolar lavage and lung biopsy were performed in this patient, and glucocorticoid was managed, the pulmonary iconography result was recorded. Results The therapeutic result showed that the symptoms improved significantly, the pulmonary inflammatory exudates were completely absorbed. Conclusion This findings demonstrates that clinical symptoms of acute eosinophilic pneumonia are atypical, the glucocorticoid therapy following bronchoalveolar lavage and lung biopsy is quick and effective, with favourable prognosis.

Improving circulation aggravates the orthostatic hypotension in a patient with Parkinson's disease: A case report

Li Wenjun, Zhang Ce, Liu Junyan

2022, 37(10):  934-937.  doi:10.3969/j.issn.1004-583X.2022.10.010

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Objective To highlight non-motor symptoms in patients with Parkinson's disease (PD). Methods We reported therapeutic outcomes of a PD case with hypertension, who had been treated with anti-PD drugs, antihypertensive therapy and circulation-improving. Results The patient developed severe postural hypotension and syncope during the treatment. Conclusion Non-motor symptoms like orthostatic hypotension in PD patients should be highlighted by clinicians during the treatment.

Exploration path on integrating red doctor’s spirit into curricular ideology of medical humanities course

Wang Jingwei, Ji Yunfei, Zhou Di

2022, 37(10):  938-941.  doi:10.3969/j.issn.1004-583X.2022.10.011

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The red doctor’s spirit, formed in the Revolutionary War Time, and it is the specific embodiment of Jinggangshan spirit and Yan'an Spirit in medical and health undertakings. It includes the connotation of “political firmness, saving the dying and healing the wounded, hard work and selfless dedication”. The red doctor’s spirit still has its significance in the new era. It not only provided spiritual strength in the COVID-19 period, but also will play a guiding role in the post epidemic era. Integrating the red doctor’s spirit into the medical humanities course will help medical students establish lofty ideals, beliefs and value pursuit. It is the need to explore the path of integration in order to help students internalize and externalize the connotation of the red doctor’s spirit into their mind and action. This paper will suggest that we could use the mode of selecting teaching forms according to the connotation of red doctor’s spirit, so as to cultivate the medical humanistic quality of firm belief, life first, great medical skill & sincerity and shared common destiny.