Most immune-related adverse event (irAE) associated with immune checkpoint inhibitors (ICIs) resulted from excessive immune response against normal organs. The severity, timing, and organs affected by these events were often unpredictable. Adverse reactions could cause treatment delays or interruptions, in rare cases, pose a life-threatening risk. The mechanisms underlying irAE involved immune cell dysregulation, imbalances in inflammatory factor expression, alterations in autoantibodies and complement activation, even dysbiosis of intestinal microorganisms. However, the mechanisms of irAE occurrence might differ slightly among organs due to variations in their structures and the functions of resident immune cells. Future research should focus on the development of targeted drugs for the prevention or treatment of irAE based on the mechanisms by which irAE occurs in different organs. A deeper understanding of the mechanisms underlying irAE occurrence would aid clinicians in effectively utilizing ICIs and provide valuable guidance for their clinical application.
In 1984, according to the criteria of the classifieation for congenital hand deformity which wasput out by the International Hand Surgery Committee, we had made an investigation for congenitalhand deformity among 318066 newborns in Shanghai. It was found that the inctdence of a congenitalhand malformation was 0. 0808 percent among the total newborns. The congenital malformation ofthe thumb was 37. 74 percent of all deformities of the hand. According to the statistical analysis, we ...
Objective To investigate the incidence and management of CTEPH in the Department of Pulmonary and Critical Care Medicine in Xijing Hospital to enrich the epidemiological data of chronic thromboembolic pulmonary hypertension (CTEPH) in China.Methods We conducted a retrospective study to investigate the incidence and management of CTEPH in the Department of Pulmonary and Critical Care Medicine in Xijing Hospital from 2008 to 2012. Results The incidence of CTEPH was 5.24% . About 62.90% of venous thromboembolism/pulmonary embolism (VTE/PE) patients were unprovoked, and about 53.85% of CTEPH patients was unprovoked. About 38% of CTEPH patients had no history of VTE, and 62% of CTEPH patients had no history of acute pulmonary embolism. None of the CTEPH patients was treated by pulmonary thromboendarterctom (PTE) , and about 53.85% of patients were only given anticoagulant monotherapy. Conclusions The incidence of CTEPH is higher in our hospital than reported. This phenomenon may be related to the lack of awareness of risk factors of CTEPH and the insufficient thrombolytic and anticoagulant therapy to acute pulmonary embolism. It’s very urgent to standardize the diagnosis and management of CTEPH in pulmonologists.
Objective To investigate the incidence of urolithiasis in infants aged 0-3 years old fed by milk powder tainted with melamine in the middle area of the Anhui province, as well as its relationship to gender, age, milk powder consumption and drinking water. Methods Questionnaires were distributed to 1079 infants who were screened for urolithiasis by ultrasound examination from September 25, 2008 to October 17, 2008. Data was collected by Epidata and analyzed by SPSS 13.0 software. Results A total of 646 (59.87%) male infants and 433 (40.13%) female infants underwent ultrasound examination in Anhui Provincial Hospital. Of these, 86 infants were diagnosed with urolithiasis with an incidence of 7.97%, including 62 males (72.09%) and 24 females (27.91%). The mean age of those infants with urolithiasis was 1.85±0.77, and all of calculus was located in kidney. The relationship between the incidence of urolithiasis and gender, age, drinking water, feeding bottle sanitation, birth status, as well as the amount of milk powder intake was assessed by using the Pearson Chi-square test. Results showed that significant differences were noted in the incidence of urolithiasis among infants of different genders or with different drinking water sources (Plt;0.05). The result of multiple logistic regression analyses indicated that gender was related to the incidence of urolithiasis (Plt;0.05). The incidence of urolithiasis in female infants was only 58.7% of that in male infants (OR 0.587, 95%CI 0.359 to 0.959). Conclusion The incidence of urolithiasis in infants aged 0-3 years of old in the middle area of Anhui province is relatively high and has anatomical specificity. Further data during the follow-up of these cases should be collected.
ObjectiveTo systematically review the risk of hemorrhage in pregnant cerebral arteriovenous malformation (CAVM) patients. MethodsThe Web of Science, PubMed, Cochrane Library, WanFang Data, VIP and CNKI databases were electronically searched to collect clinical studies related to hemorrhage in pregnant CAVM patients from inception to June, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 13.1 and R 4.0.4 software. ResultsA total of 13 studies involving 2 273 patients were included. The results of meta-analysis showed that the pooled incidence of hemorrhage in pregnant CAVM patients was 0.18 (95%CI 0.12 to 0.24). The subgroup analyses were carried out based on world regions and the study duration, with the higher pooled incidence of 0.37 (95%CI 0.05 to 0.80) in Europe and 10 to 20 years of study duration of 0.37 (95%CI 0.17 to 0.57). Conclusion Current evidence shows that the incidence of hemorrhage in pregnant CAVM patients is about 18%. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To evaluate the predictive effect of three machine learning methods, namely support vector machine (SVM), K-nearest neighbor (KNN) and decision tree, on the daily number of new patients with ischemic stroke in Chengdu. Methods The numbers of daily new ischemic stroke patients from January 1st, 2019 to March 28th, 2021 were extracted from the Third People’s Hospital of Chengdu. The weather and meteorological data and air quality data of Chengdu came from China Weather Network in the same period. Correlation analyses, multinominal logistic regression, and principal component analysis were used to explore the influencing factors for the level of daily number of new ischemic stroke patients in this hospital. Then, using R 4.1.2 software, the data were randomly divided in a ratio of 7∶3 (70% into train set and 30% into validation set), and were respectively used to train and certify the three machine learning methods, SVM, KNN and decision tree, and logistic regression model was used as the benchmark model. F1 score, the area under the receiver operating characteristic curve (AUC) and accuracy of each model were calculated. The data dividing, training and validation were repeated for three times, and the average F1 scores, AUCs and accuracies of the three times were used to compare the prediction effects of the four models. Results According to the accuracies from high to low, the prediction effects of the four models were ranked as SVM (88.9%), logistic regression model (87.5%), decision tree (85.9%), and KNN (85.1%); according to the F1 scores, the models were ranked as SVM (66.9%), KNN (62.7%), decision tree (59.1%), and logistic regression model (57.7%); according to the AUCs, the order from high to low was SVM (88.5%), logistic regression model (87.7%), KNN (84.7%), and decision tree (71.5%). Conclusion The prediction result of SVM is better than the traditional logistic regression model and the other two machine learning models.
Objective To assess the midterm follow-up outcomes of total hip arthroplasty (THA) for the treatment of patients with juvenile-onset ankylosing spondylitis (JAS). Methods The clinical data of 81 patients (127 hips) with JAS (age≤16 years, JAS group) and 267 patients (391 hips) with adult onset ankylosing spondylitis (AAS) (age>16 years, AAS group) between January 2004 and March 2018 were retrospectively analysed. The baseline demographics, clinical, radiographic, and laboratory parameters were collected. Before operation and at last follow-up, the overall disease activity [Bath ankylosing spondylitis disease activity index (BASDAI)] and function status [Bath ankylosing spondylitis functional index (BASFI)], hip subjective score [Harris hip score (HHS)] and objective score [12-item short form health survey (SF-12), including physical component score (PCS) and mental component score (MCS)], and patient satisfaction for THA were reviewed. The major orthopedic complications, including periprosthetic infection, dislocation, periprosthetic fractures, and poor incision healing, were also recorded during the follow-up period. Results The comparison of preoperative baseline parameters showed that the body mass, body mass index, age of onset, age of surgery, disease duration, and the proportion of combined smoking history in the JAS group were significantly lower than those in the AAS group (P<0.05), the proportion of bilateral surgeries, proportion of uveitis, proportion of combined family history, C-reactive protein, albumin, and preoperative BASFI were significantly higher than those in the AAS group (P<0.05). Both groups were followed up. The follow-up time in the JAS group was 29-199 months, with an average of 113 months; in the AAS group was 35-199 months, with an average of 98 months. Incisions in both groups healed by first intention. During the follow-up period, there were 1 case of periprosthetic fracture, 1 case of dislocation, and 1 case of ceramic fragmentation in the JAS group, 1 case of periprosthetic infection and 6 cases of periprosthetic fracture in the AAS group. There was no significant difference in the incidence of complications between the two groups (P>0.05). At last follow-up, the BASDAI, BASFI, SF-12 MCS, SF-12 PCS, and HHS score of the two groups were significantly improved when compared with those before operation (P<0.05); but there was no significan difference in the difference of the above parameters before and after operation and the patient satisfaction between the two groups (P>0.05). Conclusion The midterm follow-up outcomes of THA for the treatment of JAS patients were reliable. A low age at disease onset did not exert a significant negative effect on THA reconstruction for the treatment of ankylosing spondylitis.
Non-alcoholic fatty liver disease (NAFLD) is one of the major chronic liver diseases that endanger human health. It is characterized by hepatic steatosis and absence of other causes of hepatic fat accumulation, such as alcohol abuse. The incidence of NAFLD is increasing year by year. However, the pathogenesis is still undefined. Porphyromonas gingivalis is a major periodontal pathogen of various periodontal disease. Apart from affecting periodontal health, Porphyromonas gingivalis is also related to the incidence of many systemic diseases. In recent years, Porphyromonas gingivalis is considered to be a risk factor of NAFLD. In this paper, the relationship between NAFLD and Porphyromonas gingivalis, as well as the possible pathogenesis are discussed.
ObjectivesTo analyze the trend of incidence and mortality of bladder cancer from 1990 to 2017 and the effects of age, time period and birth cohort on bladder cancer incidence and mortality.MethodsData on age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) of bladder cancer from 1990 to 2017 were extracted from the Global Burden of Disease 2017 (GBD 2017) database. Joinpoint regression model was used to analyze the average annual percentage change of ASIR and ASDR of bladder cancer. The age-period-cohort model was established to analyze the age, period and birth cohort effects on ASIR and ASDR of bladder cancer.ResultsFrom 1990 to 2017, both ASIR and ASDR of bladder cancer decreased slightly. ASIR decreased from 6.42 per 100 000 in 1990 to 6.04 per 100 000 in 2017, with an average annual percentage change of −0.9% (−1.0% to −0.8%), and ASDR decreased from 3.15 per 100 000 in 1990 to 2017 2.57/100 000, with an average annual percentage change of −0.4% (−0.4% to −0.3%). The age-period-cohort model results showed that as age increased, the risk of bladder cancer incidence and mortality increased; as the birth cohort progressed, the risk of bladder cancer morbidity and mortality decreased. The time period had little effect on the incidence and mortality of bladder cancer.ConclusionsThe incidence and mortality of bladder cancer are declining globally. On the other hand, the increase of the aging global population could reverse the incidence and mortality trend, active measures should be taken to address the adverse effects of aging.