ObjectiveTo analyze the disease burden and development trend of non-Hodgkin lymphoma (NHL) in China from 1990 to 2019. MethodsThe changes of incidence, mortality, disability-adjusted life years (DALY) and their corresponding age-normalization rates for NHL were analyzed by using the 2019 Global Burden of Disease Database. Regression analysis was performed by Joinpoint software to calculate annual percentage change (APC) and average annual percentage change (AAPC) of standardized morbidity, standardized mortality, standardized DALY rate to reflect the change trend of disease burden. And the results were compared with global data. ResultsFrom 1990 to 2019, the disease burden of NHL in China showed an overall increasing trend. Compared with 2019, the standard incidence rate, standard mortality rate and standard DALY rate of NHL in China increased by 144.72%, 27.17% and 15.61%, respectively. The annual rates of change were 3.12%, 0.80% and 0.51%, respectively. There were gender and age differences in disease burden. The burden of disease increased with age, and the burden of disease was higher in males than in females. ConclusionThe disease burden of NHL in China shows an increasing trend from 1990 to 2019. With the development of diagnosis and treatment options, the disease burden has decreased in recent years, but it is still higher than the global level. There is still a need to strengthen research on its pathogenesis and treatment options, and to actively intervene in high-risk groups to reduce the disease burden of NHL.
ObjectiveTo systematically review the accuracy of T-cell receptor excision circles (TRECs) in screening newborns for severe combined immunodeficiency (SCID). MethodsThe PubMed, EMbase, Cochrane Library, Web of Science, CBM, WanFang Data and CNKI databases were electronically searched to collect the diagnostic accuracy studies related to the objects from inception to October 26, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies using the QUADAS-2 scale. Meta-analysis was performed using Stata 15.0 and Meta-Disc 1.4 software. ResultsA total of 18 studies involving 6 243 718 neonates were included. The results of meta-analysis showed that the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnosis odds ratio (DOR) were 0.97 (95%CI 0.92 to 0.99), 1.00 (95%CI 1.00 to 1.00), 1447.05 (95%CI 528.49 to 3962.11), 0.13 (95%CI 0.08 to 0.22) and 11698.21 (95%CI 2853.44 to 47958.98), respectively. The area under the summary receiver operating characteristic curve (SROC) was 0.97. ConclusionThe application of TRECs in screening neonatal SCID has high accuracy, which is helpful for early diagnosis of SCID. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To summarize the advances of total femur replacement in recent years. Methods The literature related to total femur replacement was reviewed, and the indications, techniques, prosthesis design, complications, rehabilitation, and function were summarized. Results The indication of total femur replacement is a wide involvement of the femur, skip lesions and a huge bone defect in revision. Watson-Jone is the main incision in the proximal, and then the full length of the thigh to the patella. Vascular and nerve bundle, abduction muscles are well protected, and combined or costumed prosthesis are replaced. The prosthesis design progresses, showing a diversified prostheses. Complication is frequent and varied. Rehabilitation in early stage is physical therapy, weight training is evolutionary. The main function evaluation system is Musculoskeletal Tumor Society (MSTS) score. Conclusion Total femur replacement is effective in limb salvage. Large sample size and long-term follow-up study should be carried out to unify indications and functional exercise standards and reduce postoperative complications.
Objective To evaluate the clinical value and safety of adenosine monophosphate( AMP)bronchoprovocation test in patients with asthma. Methods Sixty asthmatics, including 19 cases with uncontrolled asthma, 22 with partially controlled asthma, and 19 with controlled asthma were enrolled. Twenty-four healthy volunteers were enrolled as control and 20 patients with upper respiratory tract infection ( URI) were also included. AMP bronchoprovocation test ( AMP-BPT) was performed. PD20 FEV1-AMP lt;40 mg was set as a cut-off value of positive response to AMP. Positive rate, sensitivity, specificity, accuracy and adverse reactions of AMP-BPT were evaluated. Eleven cases with uncontrolled asthma and 12 cases with partially controlled asthma were followed up with AMP-BPT three months and six months after inhaledcorticosteroids treatment. Asthma symptom scores were recorded a week early before each challenge. The correlation between PD20FEV1 -AMP and asthma symptom score was analyzed. Values of PD20 FEV1 -AMP were represented as median and quartile range [ M( QR) ] . Results No positive responses to AMP were found in both healthy and URI subjects. On the other hand, positive responses to AMP were found in all the uncontrolled asthmatics ( 100% ) with PD20FEV1 -AMP as 0. 6 mg ( 0. 4 mg) , in 19 partially controlled asthmatics ( 86. 4% ) with PD20 FEV1 -AMP as 5. 38 mg ( 32. 67 mg ) , and in 5 controlled asthmatics( 26. 3% ) with PD20FEV1 -AMP as 40 mg ( 29. 3 mg) . There were negative correlations between the logarithms of PD20 FEV1 -AMP and logarithms of asthma symptom scores ( r = - 0. 598, P lt; 0. 01) . The sensitivity, specificity and accuracy was 72% , 100%, and 84% , respectively. Percentage of subjects who experienced wheezing, cough, dyspnea, swallows stimulation, chest tightness, expectoration and cyanosis during AMP-BPT were 37. 5%, 21. 2%, 15. 4%,7. 7%, 7. 7%, 4. 8%, and 1. 0%, respectively. No severe adverse reaction was found. Conclusions AMP-BPT is helpful to the diagnosis and differential diagnosis of bronchial asthma. It also can be used to evaluate the severity and control level, and to monitor the therapeutic efficacy in clinical practice. Moreover, AMP-BPT is well tolerated with little adverse reaction.
Objective To compare the short-term outcomes between laparoscopic surgery and open surgery with fast-track (FT) in patients with colorectal cancer. Methods Between February 2008 and August 2008, the clinical data of 177 patients with colorectal cancer were analyzed retrospectively, who were divided into open group (n=122) and laparoscopic group (n=55) by surgery methods. Open group was further divided into FT group (n=66) and traditional group (n=56). Early rehabilitations were studied and compared among three groups. Results ① The baseline characteristics of patients among three groups were no significant differences (Pgt;0.05) exclude operation time. ② In early rehabilitation, the first flatus of patients in both the FT group 〔(3.86±1.01) d〕 and the laparoscopic group 〔(3.78±1.10) d〕 was significantly earlier than that in the traditional group 〔(4.43±1.25) d〕, Plt;0.05. ③ The first oral intaking in the FT group 〔(2.52±1.14) d〕 was earlier than that in the traditional group 〔(3.38±1.43) d〕 and the laparoscopic group 〔(5.04±2.24) d〕, Plt;0.05, while in the traditional group was earlier than that in the laparoscopic group (Plt;0.05). ④ For drainage management, both the FT group and the traditional group were significantly earlier than those in the laparoscopic group (Plt;0.05). ⑤ For postoperative hospital stay, in the FT group 〔(8.33±1.98) d〕 was also much shorter than that in the laparoscopic group 〔(10.55±3.14) d〕 and the traditional group 〔(10.82±3.76) d〕, Plt;0.05. ⑥ For the postoperative complications, there was no significant difference among three groups (Pgt;0.05). Conclusions FT surgery and laparoscopic technique could both enhance recovery of bowel function, and FT could also shorten postoperative hospital stay. However, further studies are needed to develop a better management.
Objective To investigate perindopiI influence for the complication in hypertensive patients with stroke history by lowering blood pressure. Methods One-hundred and fifty-five essential hypertensive patients with stroke history were randomly assigned to either perindopril group or placebo group, receiving a randomized, double-blind, placebo-controlled trial as long as 3 years. Their blood pressure, the morbidity and mortality of cardiocerebral complications were monitored. At the end of trial, three days Ambulatory Blood Pressure Monitoring were performed. Result It was shown that in perindopril group blood pressure was controlled satisfactorily, and the morbidity and mortality of cardiocerebral incidences (6.85 % and 2.74 %repectively) were lower than those of placebo group (17.10% and 9.21% respectively). Conclusions Perindopril lowers blood pressure effectively and persistently. It has important clinical effect for prevention the cardiocerebral complications in hypertensive patients with stroke history by lowering blood pressure.
Anesthesia consciousness monitoring is an important issue in basic neuroscience and clinical applications, which has received extensive attention. In this study, in order to find the indicators for monitoring the state of clinical anesthesia, a total of 14 patients undergoing general anesthesia were collected for 5 minutes resting electroencephalogram data under three states of consciousness (awake, moderate and deep anesthesia). Sparse partial least squares (SPLS) and traditional synchronized likelihood (SL) are used to calculate brain functional connectivity, and the three conscious states before and after anesthesia were distinguished by the connection features. The results show that through the whole brain network analysis, SPLS and traditional SL method have the same trend of network parameters in different states of consciousness, and the results obtained by SPLS method are statistically significant (P<0.05). The connection features obtained by the SPLS method are classified by the support vector machine, and the classification accuracy is 87.93%, which is 7.69% higher than that of the connection feature classification obtained by SL method. The results of this study show that the functional connectivity based on the SPLS method has better performance in distinguishing three kinds of consciousness states, and may provides a new idea for clinical anesthesia monitoring.
Objective To explore the effect of antihypertensive treatment on target-organ damage in very elderly patients (gt;80 years). Methods One hundred and sixty-seven very elderly hypertensive patients were randomized into two groups, i.e. anti-hypertension treatment group and placebo-control group. All the patients received echocardiographic examination of left ventricular mass index, laboratory tests of urinary creatinine and urinary albumin and 24-hour ambulatory blood pressure monitoring 2 months after placebo washout period and at the end of the one year treatment, respectively. Results After treatment, the improvement in all the dynamic blood pressure parameters except daytime diastolic blood pressure and heart rate(24 h, daytime and night time), were significantly better than that of placebo-control group(Plt;0.05).The improvement in left ventricular and renal functional parameters were significantly better than that of placebo-control group(Plt;0.05). Conclusion Anti-hypertension treatment may significantly improve left ventricular pachynsis and renal function damage in very elderly hypertensive patients.
ObjectiveTo explore the feasibility of the clinical application of individualized simulated S1 pedicle screw.MethodsThe data of patients with lumbar disease diagnosed and treated in the Fourth People’s Hospital of Zigong from May 2017 to April 2019 were retrospectively analyzed. According to the preoperative individualized design of the S1 pedicle screw placement path, the patients were divided into individualized screw placement group and traditional screw placement group. The distance D between the screw tip and the endplate of the S1, the angle α of the screw in the plane of the dysplasia and the lumbar pedicle of the L5, the angle of oblique angle β, the number of screws of 35 and 40 mm in length, and the screw loosening rate (followed-up within 1 year) in the two groups were analyzed.ResultsA total of 59 patients were enrolled in this study, 31 in the individualized screw placement group and 28 in the traditional screw placement group. The differences in the distance D between the screw tip and the endplate of the S1 [(2.61±0.82) vs.(4.13±1.51) mm; t=-5.718, P<0.001], the angle α of the screw in the plane of the dysplasia and the lumbar pedicle of the L5 [(9.31±3.52) vs. (13.53±4.78)°; t=-5.646, P<0.001], the angle of oblique angle β [(15.73±6.04) vs. (10.65±5.09)°; t=3.022, P=0.004], the proportion of using screw models [40 mm in length: 56 vs. 8; 35 mm in length: 6 vs. 48; χ2=68.539, P<0.001], and the screw loosening rate followed-up within 1 year [3.22% vs. 16.07%; χ2=5.774, P<0.001] were statistically significant between the individualized screw placement group and the traditional screw placement group.ConclusionsPreoperative individualized design of the pedicle screw of the S1 pedicle screw can be used in clinical practice. The biomechanical stability of the S1 pedicle screw can be improved and the sagittal balance can be achieved.
Objective To analyze the factors associated with the adoption of targeted therapy in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer and to generate evidence to inform decision-making on public security policy regarding innovative anticancer medicines for the benefit of patients. Methods The study population comprised female patients diagnosed with HER2-positive breast cancer and treated at Fujian Cancer Hospital from 2014 to 2020. The patients were eligible for targeted therapy. The demographic and sociological characteristics and clinical information of patients were extracted from the hospital information system. We performed binary logistic regression analysis of factors associated with the adoption of targeted therapy in patients with HER2-positive breast cancer. We also divided the participants into two groups according to their tumor stage for subgroup analysis. Results A total of 1 041 female patients with HER2-positive breast cancer were included, among them, 803 received targeted therapy. In September 2017, molecular-targeted medicines for HER2-positive breast cancer began to be included in the local basic health insurance program. Only 282 (35.1%) patients adopted targeted therapy before September 2017, after which this number increased to 521 (64.9%). Among the patients who adopted targeted therapy, most were formally employed (45.8%) and enrollees of the urban employee health insurance program (66.0%). Among those who did not adopt targeted therapy, most were unemployed (42.4%) and enrollees of the resident health insurance program (50.0%). Binary logistic regression analysis revealed that patient occupation, gene expression of estrogen receptor, tumor stage, surgery or not, radiotherapy or not, and undergoing treatment before or after September 2017 were correlated with the adoption of targeted therapy (P<0.05). Conclusions Inclusion of targeted medicines for HER2-positive breast cancer in the health insurance program substantially increased the overall administration of these therapies. Individual affordability is a critical factor associated with the application of targeted therapy in eligible patients. Future policies should enhance the public security of patients with a relatively weak ability to pay and provide insurance coverage for innovative anti-cancer medicines.