Zhonghua yi xue za zhi最新文献

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[Predictive model for ejection fraction improvement at one year in patients with acute ST-segment elevation myocardial infarction complicated with heart failure with reduced ejection fraction].
Zhonghua yi xue za zhi Pub Date : 2025-01-28 DOI: 10.3760/cma.j.cn112137-20241023-02390
Z Y Tao, H Zhao, Z Wang, Y Z Chai, X N Guo, Q Z Wu, Y N Wang, C Wu, L Y Ni, X X Li, Y P Zhou, C Y Li, X L Li, X W Sun, M Jiang, J Pu
{"title":"[Predictive model for ejection fraction improvement at one year in patients with acute ST-segment elevation myocardial infarction complicated with heart failure with reduced ejection fraction].","authors":"Z Y Tao, H Zhao, Z Wang, Y Z Chai, X N Guo, Q Z Wu, Y N Wang, C Wu, L Y Ni, X X Li, Y P Zhou, C Y Li, X L Li, X W Sun, M Jiang, J Pu","doi":"10.3760/cma.j.cn112137-20241023-02390","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20241023-02390","url":null,"abstract":"<p><p><b>Objective:</b> To develop a predictive model for improvement of ejection fraction 1 year after heart failure with reduced ejection fraction (HFrEF) following acute ST-segment elevation myocardial infarction (STEMI). <b>Methods:</b> This nested case-control study included STEMI patients diagnosed with HFrEF from a prospective multicenter multimodality imaging cohort between August 2014 and March 2021. Based on the improvement of left ventricular ejection fraction (LVEF) at baseline and 1-year follow-up, the patients were classified into the heart failure with improved ejection fraction (HFimpEF) group and the persistent HFrEF group. The clinical data were collected, and cardiac histological changes were assessed using cardiac magnetic resonance imaging. Multivariate logistic regression analysis was performed to identify factors associated with ejection fraction improvement at one year, and a predictive model was developed and internally validated. The performance and clinical applicability of the model were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis. <b>Results:</b> A total of 117 STEMI patients (102 males and 15 females) aged (61.6±11.6) years were included in the study. At the 1-year follow-up, there were 61 patients (52.1%)in the HFimpEF group,and 56 patients (47.9%) in the HFrEF group . Compared with persistent HFrEF group, patients in HFimpEF group had smaller baseline left ventricular end-systolic diameter (LVESD) [33.0 (30.0, 36.0) mm vs 35.5 (32.0, 39.0) mm], smaller infarct size [26.1% (20.3%, 36.0)% vs 40.6% (33.0%, 45.4)%], lower peak B-type natriuretic peptide (BNP) level [340.0 (190.5, 692.5) ng/L vs 636.0 (318.5, 1 188.8) ng/L], lower peak level of soluble suppression of tumorigenicity 2 (sST2) [36.7 (25.8, 60.5) μg/L vs 62.4 (30.6, 120.7) μg/L], and higher hematocrit [(43.5%±3.5%) vs (40.8%±5.6%)] (all <i>P</i><0.05). Multivariate logistic regression analysis revealed that smaller baseline LVESD (<i>OR</i>=0.825, 95%<i>CI</i>: 0.745-0.914), smaller infarct size (<i>OR</i>=0.967, 95%<i>CI</i>: 0.939-0.995), peak BNP level≤400 ng/L (<i>OR</i>=3.062, 95%<i>CI</i>: 1.283-7.306), peak sST2 level≤35 μg/L (<i>OR</i>=2.600, 95%<i>CI</i>: 1.040-6.501), and higher hematocrit (<i>OR</i>=1.109, 95%<i>CI</i>: 1.030-1.193) were predictors of LVEF improvement in STEMI patients with HFrEF. The predictive model formula: logit (P)=2.619-0.034×infarcted myocardium percentage (%)+1.119×(peak BNP level≤400 ng/L)+0.956×(peak sST2 level≤35 μg/L)+0.103×hematocrit (%)-0.192×LVESC (mm) (where peak BNP level≤400 ng/L and peak sST2 level≤35 μg/L are binary variables: Yes=1, No=0). The area under the ROC curve (AUC) was 0.805 (95%<i>CI</i>: 0.723-0.887), indicating good predictive ability. Calibration curves and decision curve analysis indicated good model consistency and clinical utility. <b>Conclusions:</b> Smaller LVESD, smaller infarct size, peak BNP level≤400 ng/L, peak sST2 leve","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 4","pages":"297-305"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Efficacy of inverted door flap combined with transcanal approach to the tympanic antrum technique for the treatment of middle ear cholesteatoma under endoscope].
Zhonghua yi xue za zhi Pub Date : 2025-01-28 DOI: 10.3760/cma.j.cn112137-20240627-01441
Y B Lai, X L Wen, Y Q Liang, B C Wang, Y J Yu
{"title":"[Efficacy of inverted door flap combined with transcanal approach to the tympanic antrum technique for the treatment of middle ear cholesteatoma under endoscope].","authors":"Y B Lai, X L Wen, Y Q Liang, B C Wang, Y J Yu","doi":"10.3760/cma.j.cn112137-20240627-01441","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240627-01441","url":null,"abstract":"<p><p>This study aimed to investigate the efficacy of inverted door flap (IDF) combined with transcanal approach to the tympanic antrum (TCAA) technique under the endoscope for treatment of middle ear cholesteatoma. Outcomes of patients treated with combined techniques at the First People's Hospital of Foshan City between March 2021 and March 2023 were evaluated. A total of 31 patients (33 ears, 16 males and 15 females) aged (42.9±15.9) years were included. The patients were divided into three groups based on the extent of cholesteatoma involvement: the lateral ossicular chain (LOC) group (8 ears), the internal ossicular chain (IOC) group (11 ears), and the mastoid antrum and mastoid process (MA/MP) group (14 ears). No complications occurred postoperatively, such as cholesteatoma recurrence, facial paralysis and infection. The median (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>) follow-up duration was 12 (7, 18) months. The results showed a median (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>) dry ear duration of 1.5 (1.5, 2.0) months, and a dry ear rate of 97.0% (32/33) at six months postoperatively. Specifically, 7 out of 8 patients in the LOC group had dry ears, while all patients in the IOC group and the MA/MP group had dry ears 6 months after surgery. The current study demonstrates that IDF combined with TCAA techniques are safe and effective in the treatment of middle ear cholesteatoma, with rapid achievement of dry ear.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 4","pages":"312-315"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Development and validation of a nomogram combining clinical and 18F-FDG PET/CT parameters for prediction of high-grade patterns in invasive lung adenocarcinoma].
Zhonghua yi xue za zhi Pub Date : 2025-01-28 DOI: 10.3760/cma.j.cn112137-20240708-01547
Y Guo, H Zhu, X Chen, S Qin, F G Liu
{"title":"[Development and validation of a nomogram combining clinical and <sup>18</sup>F-FDG PET/CT parameters for prediction of high-grade patterns in invasive lung adenocarcinoma].","authors":"Y Guo, H Zhu, X Chen, S Qin, F G Liu","doi":"10.3760/cma.j.cn112137-20240708-01547","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240708-01547","url":null,"abstract":"<p><p><b>Objective:</b> To establish and validate a nomogram based on clinical characteristics and metabolic parameters derived from <sup>18</sup>F-fluorodeoxyglucose positron emission tomography and computed tomography (<sup>18</sup>F-FDG PET/CT) for prediction of high-grade patterns (HGP) in invasive lung adenocarcinoma. <b>Methods:</b> The clinical and PET/CT image data of 311 patients who were confirmed invasive lung adenocarcinoma and underwent pre-treatment <sup>18</sup>F-FDG PET/CT scan in Beijing Hospital between October 2017 and March 2022 were retrospectively collected. The enrolled patients were divided into HGP group (196 patients) and non-HGP group (115 patients) according to the presence and absence of HGP. The data were divided into training set and validation set at 7∶3 ratio using R statistical software and simple random allocation. A nomogram prediction model was constructed in training set. The area under the curve (AUC) of receiver operating characteristic (ROC) was depicted in the training and validation set respectively for assessing the prediction efficacy. The goodness of fit, consistency between predicted and observed probability and clinical usefulness of the model were evaluated by Hosmer-Lemeshow test, calibration curve and decision curve analysis (DCA). <b>Results:</b> The age of 311 patients were (65.6±10.9) years and included 148 males (47.6%). In training set of 217 patients, 141 (65.0%) contained HGP while in validation set of 94 patients, 55 (58.5%) contained HGP. Gender in training set, serum carcino-embryonic antigen (CEA) in validation set, smoking history, clinical stage, cytokeratin fragments (CYFRA21-1), maximum standardized uptake value (SUV<sub>max</sub>), mean standardized uptake value (SUV<sub>mean</sub>), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and maximum diameter (D<sub>max</sub>) in both sets showed significant differences between HGP and non-HGP groups (all <i>P</i><0.05). The variables integrated in the model were gender, clinical stage, CYFRA21-1, SUV<sub>mean</sub> and TLG. The AUC (95%<i>CI</i>) of the ROC curve in training and validation set were 0.888 (0.844-0.932) and 0.925 (0.872-0.977), the sensitivity and specificity were 85.1%, 79.0% and 83.6%, 89.7%, respectively. The model showed good goodness of fit (training set: χ<sup>2</sup>=8.247, <i>P</i>=0.410, validation set: χ<sup>2</sup>=1.636, <i>P</i>=0.990). Calibration curve and DCA also indicated good consistency and clinical net benefit of the nomogram model. <b>Conclusion:</b> The nomogram model based on clinical features and metabolic parameters derived from <sup>18</sup>F-FDG PET/CT could effectively predict the presence of HGP in invasive lung adenocarcinoma and be beneficial to treatment planning.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 4","pages":"284-290"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Expert consensus on flow cytometry-based assays for SARS-CoV-2-specific T cells and related operating procedure].
Zhonghua yi xue za zhi Pub Date : 2025-01-28 DOI: 10.3760/cma.j.cn112137-20240923-02164
{"title":"[Expert consensus on flow cytometry-based assays for SARS-CoV-2-specific T cells and related operating procedure].","authors":"","doi":"10.3760/cma.j.cn112137-20240923-02164","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240923-02164","url":null,"abstract":"<p><p>T-cell immune response is an important component of antiviral immunity, it is of great significance to determine their absolute counts, relative frequencies and functionalities for evaluating protective immunity in individuals and population. However, there is a lack of guidelines or a consensus on assays for antigen-specific T cells. It is necessary to evaluate the SARS-CoV-2-specific T cells in population during and after COVID-19 epidemic. To standardize the detection method for SARS-CoV-2-specific T cells, the Chinese Society for Immunology organized experts and reached a consensus on the detection method, biomarker combination scheme, technical points of SOP, quality control, data analysis and interpretation of results, personnel training, etc. The consensus is of guiding significance to establish standard detection methods and operating procedures for SARS-CoV-2-specific T cells, which is beneficial for the consistency and comparability of results from different laboratories, and also provides reference for antigen-specific T cell standard detection methods for other pathogens (such as influenza) infection.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 4","pages":"261-270"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A comparative study on the diagnostic value of 18F-PSMA PET/CT PRIMARY score and PSMA expression score for clinically significant prostate cancer].
Zhonghua yi xue za zhi Pub Date : 2025-01-28 DOI: 10.3760/cma.j.cn112137-20240715-01614
H Zhu, Y Guo, W R Xu, L T Liu, M Wang, H M Hou, C M Li, W Zhang, F G Liu, M Liu
{"title":"[A comparative study on the diagnostic value of <sup>18</sup>F-PSMA PET/CT PRIMARY score and PSMA expression score for clinically significant prostate cancer].","authors":"H Zhu, Y Guo, W R Xu, L T Liu, M Wang, H M Hou, C M Li, W Zhang, F G Liu, M Liu","doi":"10.3760/cma.j.cn112137-20240715-01614","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240715-01614","url":null,"abstract":"<p><p><b>Objective:</b> To compare the diagnostic value of fluorine 18-labelled prostate-specific membrane antigen (PSMA) PET/CT PRIMARY score and PSMA expression score for clinically significant prostate cancer (csPCa). <b>Methods:</b> The data of 70 patients with prostate cancer who underwent radical prostatectomy at Beijing Hospital from February 1, 2019 to February 29, 2024 were retrospectively analyzed. All patients underwent whole body <sup>18</sup>F-PSMA PET/CT examination before surgery and pathological large sections of prostate specimens were made after surgery. According to the pathological section results, the lesions were divided into csPCa group (Gleason scores≥7) and non-csPCa group (Gleason scores=6 or benign). The PRIMARY score and PSMA expression score were used to evaluate prostatic lesions on PSMA PET/CT images, respectively. The differences in PRIMARY score, PSMA expression score, maximum standardized uptake value (SUV<sub>max</sub>), lesion-to-background ratios (LBR), PSMA uptake characteristics, and location distribution were compared between csPCa group and non-csPCa group. Multivariate logistic regression analysis was performed to determine the correlation factors for the incidence of csPCa. By plotting the receiver operator characteristic (ROC) curve and calculating the area under the curve (AUC), the optimal diagnostic threshold for csPCa of each factor was determined. The differences in AUC were compared using the Delong test. Quantitative data was represented as <i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>). <b>Results:</b> The 70 patients aged 70 (64, 75) years with a total of 108 lesions, including 83 lesions (76.9%) in the csPCa group and 25 lesions (23.1%) in the non-csPCa group. There were differences between csPCa group and non-csPCa group in PRIMARY score [4 (3, 5) vs 2 (1, 4)], PSMA expression score [2 (2, 2) vs 1 (1, 2)], SUV<sub>max</sub> [9.10 (5.70, 15.80) vs 5.40 (3.35, 6.90)], LBR [2.86 (2.09, 4.53) vs 1.96 (1.42, 2.58)], and proportion of focal uptake patterns [74.7% (62/83) vs 32.0% (8/25)] (all <i>P</i><0.05). There was no statistically significant difference in the location distribution between the two groups (<i>P</i>>0.05). Multivariate logistic regression analysis indicated the higher the PRIMARY score, the higher the risk of developing csPCa (<i>OR</i>=1.863, 95%<i>CI</i>: 1.360-2.552). ROC curves revealed that the AUCs of the PRIMARY score and PSMA expression score for csPCa were 0.751 (95%<i>CI</i>: 0.659-0.829) and 0.697 (95%<i>CI</i>: 0.601-0.781), respectively, without statistically difference (<i>Z</i>=1.438, <i>P</i>>0.05). The cut-off values for diagnosing csPCa were 3 score for PRIMARY score and 2 score for PSMA expression score, respectively. <b>Conclusions:</b> The higher the <sup>18</sup>F-PSMA PET/CT PRIMARY score, the higher the risk of developing csPCa. The PRIMARY score has good diagnostic efficacy for csPCa.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 4","pages":"291-296"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Development and evaluation of a simplified Chinese version of the visually induced motion sickness susceptibility questionnaire].
Zhonghua yi xue za zhi Pub Date : 2025-01-28 DOI: 10.3760/cma.j.cn112137-20240910-02076
S Pan, J Wang, J M Lu, J Zhao, F Wang, X W Li, S G Yan, Z G Jin
{"title":"[Development and evaluation of a simplified Chinese version of the visually induced motion sickness susceptibility questionnaire].","authors":"S Pan, J Wang, J M Lu, J Zhao, F Wang, X W Li, S G Yan, Z G Jin","doi":"10.3760/cma.j.cn112137-20240910-02076","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240910-02076","url":null,"abstract":"<p><p><b>Objective:</b> To simplify the Chinese version of the Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ), develop the simplified Chinese version of VIMSSQ, and evaluate its performance. <b>Methods:</b> A cross-sectional study was conducted between May and July 2023. The Chinese version of the VIMSSQ was distributed to 783 university students at North China University of Science and Technology. Items were selected on the basis of their coverage rates, item-total correlation coefficients, Cronbach's alpha coefficients, and factor loadings, resulting in the simplified Chinese VIMSSQ. Eighty participants from the initial cohort were recruited to complete a virtual reality (VR) black-and-white checkerboard visual stimulation test, the simplified Chinese VIMSSQ, and the Simulator Sickness Questionnaire (SSQ). The internal consistency, test-retest reliability, criterion validity, and discriminative ability of the simplified Chinese VIMSSQ were evaluated. <b>Results:</b> A total of 757 valid questionnaires were collected, with an effective response rate of 96.68% (757/783). Among the 757 participants, 205 were male and 552 were female, with a median age (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>) of 19 (18, 20) years. Smartphone usage showed the highest coverage rate [99.60% (754/757)]. The simplified Chinese VIMSSQ included three items, with the Cronbach's alpha coefficient of 0.909, the test-retest reliability of 0.908, and the criterion validity of 0.899. SSQ symptom scores were lower in mildly susceptible participants compared to moderately susceptible participants [30 (15, 63) vs 77 (53, 105), <i>P</i>=0.012], and significantly lower in moderately susceptible participants compared to severely susceptible participants [77 (53, 105) vs 137 (94, 164), <i>P</i><0.001]. <b>Conclusion:</b> The simplified Chinese VIMSSQ demonstrates good reliability, validity, and discriminative ability.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 4","pages":"277-283"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Effect of SMARCA4 mutations on the outcomes of patients with advanced EGFR mutant lung adenocarcinoma].
Zhonghua yi xue za zhi Pub Date : 2025-01-28 DOI: 10.3760/cma.j.cn112137-20240904-02043
X Liang, Y Q Jiang, X Y Liu, J L Xu, J Li, R H Guo
{"title":"[Effect of SMARCA4 mutations on the outcomes of patients with advanced EGFR mutant lung adenocarcinoma].","authors":"X Liang, Y Q Jiang, X Y Liu, J L Xu, J Li, R H Guo","doi":"10.3760/cma.j.cn112137-20240904-02043","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240904-02043","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the impact of SMARCA4 mutations on the outcomes of patients with advanced lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutations. <b>Methods:</b> In the Memorial Sloan Kettering Cancer Center (MSK) MetTropism study, 960 patients with advanced EGFR-mutated lung adenocarcinoma were screened and included in the MSK cohort, composing of 313 males and 647 females, with a median [<i>M</i>(<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] age of 64 (56, 72) years. A retrospective analysis was conducted on the data of 178 patients with advanced EGFR-mutated lung adenocarcinoma who received EGFR tyrosine kinase inhibitors (TKIs) treatment in the Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, from January 2018 to December 2022. Among these patients, 69 were males and 109 were females, with a median age of 63 (54, 69) years. The follow-up of patients from the First Affiliated Hospital of Nanjing Medical University was conducted up to December 31, 2023, with a median follow-up time of 26.6 (95%<i>CI</i>: 24.6-28.6) months for the entire cohort, and 29 patients were lost to follow-up. Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was used to compare the relationship between SMARCA4 gene alternations and prognosis. <b>Results:</b> In the 960 patients of the MSK cohort with advanced EGFR-mutated lung adenocarcinoma, the SMARCA4 gene alternations rate was 4.2% (40/960). The median overall survival (OS) for patients without SMARCA4 gene alternations was 41.5 (95%<i>CI</i>: 35.6-47.3) months, which was superior to that of patients with SMARCA4 gene alternations [15.6 (95%<i>CI</i>: 7.9-23.4) months, <i>P</i><0.001]. Patients with SMARCA4 gene alternations had a higher risk of mortality, with an <i>HR</i> (95%<i>CI</i>) of 1.97 (1.35 to 2.88). Among the 178 patients with advanced EGFR-mutated lung adenocarcinoma from the First Affiliated Hospital of Nanjing Medical University, the SMARCA4 gene alternations rate was 4.5% (8/178). The median progression-free survival (PFS) for patients without SMARCA4 gene alternations was 16.1 (95%<i>CI</i>: 12.2-20.0) months, which was superior to the median PFS of patients with SMARCA4 gene alternations [6.0 (95%<i>CI</i>: 1.3-10.7) months, <i>P</i><0.001]. The median OS for patients without SMARCA4 gene alternations was 50.1 (95%<i>CI</i>: 28.1-72.1) months, which was also superior to the median OS of patients with SMARCA4 gene alternations [17.6 (95%<i>CI</i>: 15.4-19.8) months, <i>P</i>=0.001]. <b>Conclusion:</b> SMARCA4 alternation is an important factor associated with poor prognosis in patients with advanced EGFR-mutant lung adenocarcinoma.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 4","pages":"306-311"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Epidemiological characteristics and surgical treatment of inpatients with superficial hemangioma in Shandong province from 2019 to 2020]. [2019 - 2020年山东省住院浅表血管瘤患者流行病学特征及手术治疗]。
Zhonghua yi xue za zhi Pub Date : 2025-01-21 DOI: 10.3760/cma.j.cn112137-20241205-02747
M L Xu, B Y Zhang, X L Guo, R Huo
{"title":"[Epidemiological characteristics and surgical treatment of inpatients with superficial hemangioma in Shandong province from 2019 to 2020].","authors":"M L Xu, B Y Zhang, X L Guo, R Huo","doi":"10.3760/cma.j.cn112137-20241205-02747","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20241205-02747","url":null,"abstract":"<p><p>The epidemiological characteristics and surgical treatment of inpatients with superficial hemangioma in Shandong province were investigated and analyzed. The first-page medical records of hospitalized patients with superficial hemangioma from 2019 to 2020 reported by all secondary and above medical institutions in Shandong province were selected from the National Health Information Platform of Shandong province to analyze their population characteristics and surgical treatment. A total of 3 775 patients with superficial hemangioma were included, with the age of [<i>M</i>(<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] 3.0(0, 33.0)years, including 1 419 males (37.6%) and 2 356 females (62.4%). The head and neck superficial hemangioma accounted for the highest proportion of 37.8% (1 425/3 775), followed by limbs 34.5% (1 302/3 775) and trunk 24.4% (922/3 775). Infants accounted for the highest proportion of 37.2% (1 406/3 775). There were 2 874 (76.1%) patients with superficial hemangioma received surgical treatment, and the proportion of male patients receiving surgery was higher than that of female patients[78.2%(1 110/1 419) vs 74.9%(1 764/2 356), <i>P</i>=0.019]. The proportion of patients receiving surgery increased with age (<i>P</i><sub>trend</sub><i><</i>0.001). In terms of different parts, the proportion of patients with superficial hemangioma in the limbs who received surgery was the highest at 86.2%(1 123/1 302) (<i>P</i><0.001). The majority of the surgical operations were secondary surgery (55.8%, 1 110/1 988), elective surgery (91.4%, 1 818/1 988), class Ⅰ incision (53.5%, 1 338/2 501), and general anesthesia (50.9%, 1 219/2 397). The main treatment method was resection (48.1%, 1 816/3 775). The study found that the majority of inpatients with superficial hemangioma in Shandong province were mostly in head and neck, with more females than males, and infants being the main group, and surgical treatment was the main treatment.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 3","pages":"240-243"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Expert consensus on neuropsychological assessment for mild cognitive impairment (2025 edition)]. [轻度认知障碍神经心理学评估专家共识(2025年版)]。
Zhonghua yi xue za zhi Pub Date : 2025-01-21 DOI: 10.3760/cma.j.cn112137-20240612-01322
{"title":"[Expert consensus on neuropsychological assessment for mild cognitive impairment (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20240612-01322","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240612-01322","url":null,"abstract":"<p><p>Mild cognitive impairment (MCI) is a state of objective cognitive decline that falls between normal aging and dementia, with a high prevalence among the elderly in China. Cognitive impairments in MCI patients involve multiple cognitive domains such as memory, language, attention, executive, visuospatial functions, and social cognition, as well as non-cognitive domains such as neuropsychiatric, mood, sleep, daily living activities, and frailty. The assessment and clinical diagnosis of MCI highly rely on neuropsychological testing. In order to standardize the neuropsychological assessment of MCI, the Dementia and Cognitive Disorders Group of the Chinese Society of Neurology formulated this consensus document. It recommends tools for assessing global cognition, various cognitive domains, and non-cognitive functions suitable for both clinical and research settings. The consensus proposes assessment procedures and precautions based on the experiences of domestic researchers. Based on the latest international and domestic research advancements, using the Delphi method and the GRADE evidence system, 24 recommendations were formulated in 5 aspects of MCI: global cognitive function assessment, various cognitive domains assessment, non-cognitive assessment, the use of neuropsychological scales, and precautions in neuropsychological assessment, aiming to improve the diagnosis and management of MCI in China.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 3","pages":"204-218"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Analysis of etiology and short-term prognosis of childhood arterial ischemic stroke based on the COIST classification]. [基于COIST分类的儿童动脉缺血性脑卒中病因及短期预后分析]。
Zhonghua yi xue za zhi Pub Date : 2025-01-21 DOI: 10.3760/cma.j.cn112137-20240422-00948
Z M Yu, J J Jia, J W Li, L B Meng, J Zhou, W H Zhang, H Xiong, F Fang, X W Zhuo
{"title":"[Analysis of etiology and short-term prognosis of childhood arterial ischemic stroke based on the COIST classification].","authors":"Z M Yu, J J Jia, J W Li, L B Meng, J Zhou, W H Zhang, H Xiong, F Fang, X W Zhuo","doi":"10.3760/cma.j.cn112137-20240422-00948","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240422-00948","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; This study aims to analyze the etiology and short-term prognosis of childhood arterial ischemic stroke (AIS) in Chinese children, based on the COIST classification system. &lt;b&gt;Methods:&lt;/b&gt; A total of 380 pediatric patients with a first-ever diagnosis of AIS treated at Beijing Children's Hospital between September 2015 and April 2024 were retrospectively included. Etiology was analyzed according to COIST classification. The patients were categorized into infant and toddler group with 117 cases (&gt;28 days to≤3 years), preschool group with 90 cases (&gt;3 years to≤7 years), school-age group with 90 cases (&gt;7 years to≤11 years), and adolescent group with 83 cases (&gt;11 years to≤18 years). The etiological distribution across age groups and the short-term prognosis of patients with different etiologies were further analyzed. &lt;b&gt;Results:&lt;/b&gt; Among the 380 patients, 235 were male (61.8%) and 145 were female (38.2%), with a mean age at presentation of(6.6±4.6)years. Approximately 2/3 of the patients were admitted in the Department of Neurology, with a mean hospital stay of (13.2±6.7)days. (1) Etiological analysis: \"Vascular structural abnormalities\" were the most common cause, accounting for 38.2% (145/380), followed by \"Inflammatory\" causes at 31.1% (118/380), \"Undetermined\" at 11.1% (42/380), \"Other identifiable causes\" at 9.2% (35/380), \"Cardiac diseases\" at 6.3% (24/380), and \"thrombophilia\" at 4.2% (16/380). (2) Etiological distribution by age group: in the infant and toddler group, \"vascular structural abnormalities\" were 47.9% (56/117), with basal ganglia infarction following minor trauma(combined with basal ganglia calcification) being the most common (40/117). In the preschool group, there were 34 cases (34/90) of \"inflammatory\" and 33 cases (33/90) of \"vascular structural abnormalities\", with Moyamoya disease being the most frequent cause (15/90). In the school-age group, there were 37(37/90) cases of \"vascular structural abnormalities\", with arterial dissection (12/90)being the most common, followed by FCA-i (11/90), and Moyamoya disease (11/90). In the adolescent group, there were 34 cases of \"inflammatory\"(34/83), with the highest proportion of FCA-i (13/83) in the subgroup, followed by thrombophilia (9/83) and systemic lupus erythematosus (8/83). (3) Short-term prognosis: based on the PSOM scale, 188 cases had good prognosis, accounting for 49.5% (188/380), while 192 cases had poor prognosis, accounting for 50.5% (192/380). According to the mRS score, 207 cases had good prognosis (54.5%) and 173 cases had poor prognosis (45.5%). Subtypes such as \"Inflammatory-noninfectious, \" FCA-i, Moyamoya disease, and arterial dissection were associated with relatively better outcomes. Less than 1/3 of patients in the \"other identifiable causes\" group had favorable prognosis. The in-hospital mortality rate was 3.7% (14/380). &lt;b&gt;Conclusions:&lt;/b&gt; Vascular structural abnormalities and inflammatory (including infectious and non-infectious) f","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 3","pages":"225-232"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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