ObjectiveTo investigate research advance on the value of B-type RAF kinase (BRAF) gene mutation assisted diagnosis of papillary thyroid cancer (PTC) in thyroid nodule.MethodThe recent literatures on the BRAF gene mutation and its combination with fine needle aspiration cytology (FNAC) in the diagnosis of benign and malignant thyroid nodules and PTC were collected and reviewed.ResultsThe BRAFV600E gene mutation was the most common type of gene mutation in the genetic molecule of PTC. The combination of the FNAC and BRAF gene mutation detection could improve the diagnostic value of the benign and malignant thyroid nodules, especially the diagnostic accuracy of PTC. However, the negative detection of BRAF gene mutation did not rule out the possibility of PTC. It still remained controversial that the detection of BRAF gene mutation could differentiate between the benign and malignant thyroid nodules.ConclusionsBRAF gene mutation detection has different diagnostic values in different types of thyroid nodules. It has considerable diagnostic value in thyroid nodules with high BRAF mutation incidence (suspicious for malignancy, undetermined significance or follicular lesion of undetermined significance nodules) while presents false negative result in thyroid nodule with very low mutation incidence category to a large extent. BRAF gene detection might become a specific diagnostic molecular marker to promote diagnosis accuracy of PTC.
Objective To analyze the research hotspots and development trend of medical advice at home and abroad, and provide the basis for the research related to medical advice in China. Methods The China National Knowledge Infrastructure and Web of Science were searched from January 1991 to November 2023 to collect domestic and international studies on medical prescriptions. Bibliometrics and CiteSpace software were used for analysis. Results A total of 3 155 articles were included. The number of publications on medical advice reached its peak in 2013, and the trend of domestic and foreign publications was consistent; the institution with the largest number of publications in China was Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology; the top three hotspots of attention in China were rational medication use, intravenous medication dispensing center and nursing care; the top three hotspots of attention in foreign countries were care, impact, and system; the top three hotspots of attention in China were intravenous medication (centralized) dispensing center and medical prescription audit 2 emergent words emergent rate had been continued to date; foreign polst, palliative care and advance care planning 3 emergent words emergent rate had been continued to date; domestic in the past five years, the key words were quality improvement, lean management, transitional care, rationality evaluation, prescription front audit system and medication adherence; the keywords for the last five years in foreign countries were assessmen, risk factor, clincial pathway. ConclusionsDomestic research on medical prescriptions needs to pay more attention to the decision-making of doctors when they give medical prescriptions and the timely monitoring of medication errors, and based on the more mature research on medical prescriptions in foreign countries, domestic research needs to combine the concepts of computer-assisted decision-making and value-based medicine to explore in-depth the correlation between medical prescriptions and the quality of medical care and patient value. It is also needed to combine computer-assisted decision-making and the concept of value-based medicine to explore the intrinsic connection between medical advice and medical quality and patient value.
ObjectiveTo explore the regional and urban-rural disparities in the hypertension incidence of Chinese adults. MethodsBased on the data from the China Health and Nutrition Survey (CHNS), as well as the consumption level and altitude data from the National Bureau of Statistics and government official website, a robust multilevel Poisson regression was performed to explore the regional and urban-rural disparities in the hypertension incidence of Chinese adults, according to data and design types. ResultsAccording to the inclusion and exclusion criteria, 11 579 subjects and totaling 50 957 lines of data were enrolled. The 24 years follow-up results indicated that the crude incidence density of hypertension was 37.08/1 000 person years, with 40.51/1 000 person years for males and 34.13/1 000 person years for females. The robust multilevel Poisson regression results indicated that, by adjusting the high-level factors such as time, the proportion of the community mainly engaged in agricultural labor, and the consumption level of subjects, as well as sociodemographic characteristics such as age and gender, the Middle (RR=1.20, 95%CI 1.04 to 1.39), Northeast (RR=1.25, 95%CI 1.03 to 1.52), and Eastern (RR=1.25, 95%CI 1.05 to 1.48) China had a higher risk of developing hypertension than the Western China. The risk of hypertension in urban area was lower than that in rural area (RR=0.87, 95%CI 0.77 to 0.96). ConclusionThe incidence density of hypertension in China is relatively high, and male is higher than female. The incidence of hypertension in the Western China is lower than that in the Middle, Northeast and Eastern China, and urban area is lower than rural area.
Hypertension and its associated cardiovascular diseases such as stroke and ischemic heart disease result in a high burden of disease and health losses, making it the most burdensome disease in the world and one of the important public health issues in China. Currently Chinese scholars have carried out a large number of studies on the prevalence of hypertension, including regional and national prevalence studies. However, long-term follow-up studies on incidence of hypertension are relatively few and mostly limited to specific ages and regions. This paper summarizes the prevalence, incidence and epidemiological trend of hypertension in Chinese adults. The hypertension prevalence increased from 5.1% in 1959 to 27.5% in 2018, and presents an overall trend of high in the north and low in the south. The hypertension incidence is at a high level (the cumulative incidence was 33.4% after 22 years-follow-up), but there are few researches on the trend of hypertension incidence in huge region.
Objective To assess any potential associations between lung cancer and gut microbiota. Methods Mendelian randomization (MR) analysis was carried out by utilizing summary data from genome-wide association studies (GWAS) of the gut microbiota and lung cancer. The gut microbiota served as an exposure. Instrumental ariables (IVs) were identified from the GWAS of 18340 participants. The GWAS study of lung cancer from Europe served as an outcome, including 29 266 lung cancer patients and 56450 controls. We used the inverse-variance weighted (IVW) method as the primary analysis. Sensitivity analysis was used to test the reliability of MR analysis results. Results IVW results showed that Genus Parabacteroides (OR=1.258, 95%CI 1.034 to 1.531, P=0.022) and Phylum Bacteroidetes (OR=1.192, 95%CI 1.001 to 1.419, P=0.048) had a positive causal association with lung cancer, and there was a negative causal association between family Bifidobacteriaceae (OR=0.845, 95%CI 0.721 to 0.989, P=0.037) and order Bifidobacteriales (OR=0.865, 95%CI 0.721 to 0.989, P=0.037) with lung cancer. Sensitivity analysis showed no evidence of reverse causality, pleiotropy, and heterogeneity. Conclusion This study demonstrates that Genus Parabacteroides and Phylum Bacteroidetes are related to an increased risk of lung cancer, family Bifidobacteriaceae and order Bifidobacteriales can reduce the risk of lung cancer. Our thorough investigations provide evidence in favor of a potential causal relationship between a number of gut microbiota-taxa and lung cancer. To demonstrate how gut microbiota influences the development of lung cancer, further research is necessary.
Objective To develop a radiomics nomogram based on contrast-enhanced CT (CECT) for preoperative prediction of high-risk and low-risk thymomas. Methods Clinical data of patients with thymoma who underwent surgical resection and pathological confirmation at Northern Jiangsu People's Hospital from January 2018 to February 2023 were retrospectively analyzed. Feature selection was performed using the Pearson correlation coefficient and least absolute shrinkage and selection operator (LASSO) method. An ExtraTrees classifier was used to construct the radiomics signature model and the radiomics signature. Univariate and multivariable logistic regression was applied to analyze clinical-radiological characteristics and identify variables for developing a clinical model. The radiomics nomogram model was developed by combining the radiomics signature and clinical features. Model performance was evaluated using area under the curve (AUC), sensitivity, specificity, accuracy, negative predictive value, and positive predictive value. Calibration curves and decision curves were plotted to assess model accuracy and clinical values. Results A total of 120 patients including 59 females and 61 males with an average age of 56.30±12.10 years. There were 84 patients in the training group and 36 in the validation group, 62 in the low-risk thymoma group and 58 in the high-risk thymoma group. Radiomics features (1 038 in total) were extracted from the arterial phase of CECT scans, among which 6 radiomics features were used to construct the radiomics signature. The radiomics nomogram model, combining clinical-radiological characteristics and the radiomics signature, achieved an AUC of 0.872 in the training group and 0.833 in the validation group. Decision curve analysis demonstrated better clinical efficacy of the radiomics nomogram than the radiomics signature and clinical model. Conclusion The radiomics nomogram based on CECT showed good diagnostic value in distinguishing high-risk and low-risk thymoma, which may provide a noninvasive and efficient method for clinical decision-making.
ObjectiveTo explore the clinical features and prognostic factors of diffuse brain stem glioma in children. MethodsA retrospective analysis was conducted on pediatric diffuse brain stem glioma diagnosed by pathology in West China Hospital of Sichuan University between January 2016 and May 2019. The demographic data, clinical manifestations, MRI findings, pathological results, and treatment were included in the prognosis study.ResultsA total of 39 cases of pediatric diffuse brain stem glioma confirmed by pathology were enrolled, including 21 males and 18 females aged between 3 and 14 years with an average of (8.1±2.8) years and mostly between 5 and 10 years (29 cases). The mean maximum diameter of gliomas was (4.46±0.81) cm. Among the 39 cases, there were 15 cases complicated with hydrocephalus and 16 cases whose tumors completely surrounded the basilar artery. The median survival time was 6 months. The one-year survival rate was 15.4%, and the two-year survival rate was 5.1%. Univariate analyses showed that the tumor enhancement and completely enclosed basilar artery had significant impact on the prognosis (P<0.05). Multiple Cox regression analysis showed that whether the basilar artery was completely wrapped was related to the prognosis [hazard ratio=4.596, 95% confidence interval (1.839, 11.488), P=0.001]. ConclusionsPediatric diffuse brain stem gliomas are common in children aged 5-10 years with poor prognosis. Whether the tumor completely surrounds the basilar artery is closely related to the short overall survival time.