Subjects: Nursing >> Nursing submitted time 2024-07-20
Abstract： Objective To observe the effect of the integrated traditional Chinese and Western medicine comprehensive nursing management model on patients with hypothetical tumors.Methods A total of 60 patients with tumor deficiency syndrome were selected as the research objects, and they were divided into control group and observation group according to different intervention regimens, with 30 cases in each group. The control group was given routine nursing, and the observation group was treated with traditional Chinese and Western medicine on the basis of conventional treatment and nursing, and 10 days was one course of treatment. To compare the efficacy of the two groups in the treatment of constipation.Results The time of first defecation in the observation group was (24.16±1.38) h, which was shorter than that in the control group (32.02±2.32) h, and the results were statistically different (P<0,05). The total effective rates of the observation group and the control group were 93.4% and 73.3%, respectively, and the efficacy of the observation group was better than that of the control group (P<0.05). The SDS and SAS scores in the observation group were significantly lower than those in the control group (P<0.01). The quality of life of the observation group was significantly improved compared with that of the control group (P<0.05 and 0.01 P<0.01).Conclusion The intervention of the comprehensive nursing management mode of integrated traditional Chinese and Western medicine on the basis of conventional treatment and nursing can effectively improve the health status and quality of life of patients with constipation associated with tumor deficiency syndrome, which is worthy of clinical promotion.
Peer Review Status:
Awaiting Review
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background China's aging population is expanding rapidly，highlighting the imperative of successful aging as a critical health management goal. Effective menopause management plays a crucial role but remains a significant challenge. Objective To construct a comprehensive health management evaluation indicator system for menopausal women based on the modified Delphi method. Methods Between September 2023 and February 2024，a preliminary construction of the comprehensive health management evaluation indicator system for menopausal women was executed via literature review and group discussion. 25 experts in the realms of climacteric health and related fields were selected as conference participants and correspondence subjects. Two rounds of electronic questionnaires using modified Delphi method were conducted，and the survey results were statistically analyzed using SPSS 24.0 software. Results The positive coefficients of the two rounds of expert correspondence were 100%，with the authoritative degree of expert opinions were 0.932 and 0.949，respectively. In the initial round，the primary and secondary indicators were assigned mean importance scores ranging from 4.44 to 4.84 and 4.00 to 4.88， respectively，alongside Kendall's W coefficients of concordance at 0.194（P=0.001） and 0.187（P<0.001）.The second round yielded mean importance scores for the primary and secondary indicators within the ranges of 4.44 to 4.84 and 3.84 to 4.96，with corresponding Kendall's W coefficients of 0.146（P=0.006）and 0.326（P<0.001），reflecting a notable enhancement in expert agreement for the secondary indicators. The tertiary indicators received mean rationality scores of 4.24 to 4.68（4.47±0.10） in the first round and 4.08 to 4.72（4.51±0.15）in the second，with Kendall's W coefficients of 0.063（P=0.025）and 0.129 （P<0.001），indicating a trend towards uniformity in expert opinions. The ultimate construction of the comprehensive health management evaluation indicator system for menopausal women encompasses five primary indicators：basic information， lifestyle，symptom assessment，laboratory tests，and key disease screenings. Additionally，it includes 34 secondary indicators such as age，duration since menopause，body mass index，and waist circumference，and so on. Each of these secondary indicators is meticulously subdivided and quantified to establish tertiary indicators，thereby providing a granular framework for assessment. Conclusion The indicator system，constructed through the modified Delphi method，is endowed with substantial authority and scientific rigor. It offers a holistic assessment of the health status of menopausal women，with a detailed classification and valuation of specific indicators. This systematic approach is conducive to comprehensive and stratified patient management by clinical practitioners，providing a valuable framework for clinical guidance and reference. Nonetheless，the efficacy of its practical application merits ongoing validation through empirical research.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background Neutrophil-to-lymphocyte ratio（NLR）has been shown to have significant predictive value for all-cause mortality risk in Patients with Maintenance Hemodialysis（MHD）in previous studies，however，whetherC-reactive protein-to-albumin ratio（CAR）and the combination of NLR and CAR can enhance the predictive value for all#2;cause mortality risk in Patients with MHD has not been investigated. Objective To investigate the combined predictive value of NLR and CAR for all-cause mortality of MHD patients，and to provide evidence for improving the quality of life of MHD patients. Methods The case data of 175 MHD patients in the blood purification center of Hainan General Hospital in January 2017 were included，the deadline was December 31，2021，with the outcome of all-cause death. Receiver operating characteristic（ROC） curves were plotted for the predictive value of NLR+CAR，NLR，and CAR for the risk of all-cause death in MHD patients. Kaplan-Meier survival curve was used to compare the cumulative survival rate between the two groups. Cox regression analysis was used to analyze the independent risk factors of 5-year all-cause death in MHD patients. Results The area under the ROC curve （AUC）of NLR for predicting the risk of all-cause death in MHD patients was 0.743（95%CI=0.669-0.817，P<0.001）. The AUC of CAR for predicting the risk of all-cause death in MHD patients was 0.710（95%CI=0.627-0.794，P<0.001）. The AUC of NLR+CAR for predicting the risk of all-cause death in MHD patients was 0.799（95%CI=0.732-0.867，P<0.001）. Kaplan#2;Meier survival curve analysis showed that patients with NLR>4.93 had lower cumulative survival than patients with NLR ≤ 4.93 （χ2 =32.753，P<0.001）. The patients with CAR>0.795 had a lower cumulative survival than patients with CAR ≤ 0.795 （χ2 =38.091，P<0.001）. According to the results of the multiple Cox regression equation，dialysis age（HR=0.984， 95%CI=0.976-0.992），ferritin（HR=0.984，95%CI=0.976-0.992），25-（OH）VD（HR=0.964，95%CI=0.941-0.987） and triglyceride（HR=0.984，95%CI=0.976-0.992）were protective factors for all-cause mortality in 5-year MHD patients； NLR>4.93（HR=2.071，95%CI=1.226-3.499）and CAR>0.795（HR=1.903，95%CI=1.155-3.136）were independent risk factors for all-cause death in 5-year MHD patients（P<0.05）. Conclusion Compared with NLR or CAR alone，the combination of NLR and CAR can better predict the risk of all-cause mortality in MHD patients. Increased NLR and CAR were independent risk factors for all-cause mortality in 5-year MHD patients.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background The prevalence of non-alcoholic fatty liver disease（NAFLD） significantly increases in patients with type 2 diabetes mellitus（T2DM）. However，the correlation of NAFLD with visceral fat area（VFA） and thyroid nodules in T2DM patients has been rarely reported. Objective This study aims to investigate the influencing factors for NAFLD in T2DM patients，and the correlation of NAFLD with VFA，thyroid nodules，and thyroid function in this population. Methods Hospitalized T2DM patients in the Department of Endocrinology，the Fourth Affiliated Hospital of Guangxi Medical University（Liuzhou Worker's Hospital） from January 2018 to April 2023 were retrospectively recruited. They were divided into two groups based on abdominal ultrasound findings：NAFLD group and non-NAFLD group. General data，including VFA， subcutaneous fat area（SFA），insulin function，thyroid function，prevalence of thyroid nodules，blood glucose levels，lipid levels，and liver and kidney function were compared between the two groups. Additionally，patients were divided into visceral obesity group（VFA ≥ 100 cm2 ） and non-visceral obesity group（VFA < 100 cm2 ） based on VFA. Age，sex，prevalence of NAFLD and thyroid nodule were compared between the two groups. Pearson and Spearman correlation analyses were employed to investigate factors associated with NAFLD and VFA，as well as their correlation with thyroid nodules. Influencing factors for the volume of thyroid nodules were explored as well. Furthermore，binary logistic regression analysis was used to determine risk factors for both NAFLD and thyroid nodules in T2DM patients. Receiver operating characteristic（ROC） curve analysis evaluated the predictive value of BMI，waist-hip circumference，and waist-hip ratio，VFA，homeostatic model assessment for insulin resistance（HOMA-IR）in predicting NAFLD in T2DM patients and their optimal cut-off values. Results A total of 578 T2DM patients were enrolled in this study，including 293 （50.69%） patients in the NAFLD group and 285 in the non#2;NAFLD group. The age of the NAFLD group was significantly lower than that of non-NAFLD group(P<0.05). Compared to those of the non-NAFLD group，patients in the NAFLD group had significantly higher body weight，body mass index （BMI），waist circumference，hip circumference，VFA，SFA，glycated hemoglobin A1C （HbA1c），fasting insulin levels（FINS），fasting C-peptide levels（FCP），HOMA-IR，homeostasis model assessment of β-cell function（HOMA-β），free triiodothyronine levels（FT3），blood uric acid（UA），total cholesterol （TC），triglyceride（TG） and C-reactive protein（CRP），but significantly lower serum creatinine（Cr） （P<0.05）. There were 251 cases in the visceral obesity group and 327 cases in the non-visceral obesity group. The age of the visceral obesity group was significantly lower than that of the non-visceral obesity group （P<0.05）. The incidence of NAFLD was significantly higher in the visceral obesity group than that of non-visceral obesity group （P<0.05）. However，there was no significant difference in the prevalence of thyroid nodules between the visceral obesity group and non#2;visceral obesity group （P>0.05）. Spearman correlation analysis revealed that the occurrence of NAFLD in T2DM patients was positively correlated with body mass，BMI，waist circumference，hip circumference，waist-to-hip ratio， VFA，SFA，HbA1c，FINS，FCP，HOMA-IR，HOMA-β ，triiodothyronine （TT3），FT3，and CRP （P<0.05）， but negatively correlated with age （P<0.05）. VFA in T2DM patients was found to be significantly correlated with gender， age，height，body mass，BMI，waist circumference，hip circumference，waist-to-hip ratio，SFA，diastolic blood pressure （DBP），FINS，FCP，HOMA-IR，HOMA-β，TT3，FT3，CRP and NAFLD （P<0.05）. The thyroid nodule area showed a negative correlation with TSH and waist-to-hip ratio （P<0.05），while it showed positive correlations with sex，age，TT3 ，TT4 and thyroglobulin （P<0.05）. Univariate unconditional logistic regression analysis revealed that age，weight，BMI， waist circumference，hip circumference，VFA，SFA，HbA1c，FCP，HOMA-IR，FT3，Cr，UA，TC and TG were theinfluencing factors for NAFLD in T2DM patients. Binary logistic regression results demonstrated that body weight， VFA，SFA，FT3 and HOMA-IR were the risk factors for NAFLD in T2DM patients. Gender，age and FT4 were risk factors for thyroid nodules in T2DM patients （P<0.05）. ROC curve results showed that the area under the curve （AUC） of BMI，waist circumference，hip circumference，waist-to-hip ratio，VFA and HOMA-IR was 0.704，0.704，0.705，0.629，0.757，and 0.569，respectively. The optimal cut-off value，sensitivity and specificity of them were listed as follows：BMI （25.37 kg/m2）， waist circumference （84.5 cm），hip circumference （96.5 cm），waist-to-hip ratio （0.895），VFA （88.4 cm2 in female and 99.45 cm2 in male），and HOMA-IR （3.08）. Conclusion The prevalence of NAFLD and thyroid nodules in T2DM patients significantly increase，but not correlated. Obese T2DM patients，especially those with visceral obesity，are more likely to suffer from NAFLD，thyroid nodules，hyperlipidemia，hyperuricemia and other metabolic diseases. HOMA-IR is a risk factor for NAFLD in T2DM patients， but it is not a risk factor for thyroid nodules. BMI，waist circumference，hip circumference and VFA are predictive factors of NAFLD in T2DM patients，and VFA has the highest diagnostic value and HOMA-IR has the lowest value. VFA predicts NAFLD in T2DM patients with the optimal cut-off value of 88.4 cm2 ，which is equal in females and 99.45 cm2 in males.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background Primary care general practitioners encounter significant challenges in diagnosing and managing skin diseases，highlighting the urgent need for artificial intelligence（AI） assisted systems. Although AI has the potential to improve diagnostic and treatment efficiency，research on its application in primary care settings remains limited. Objective To investigate the effectiveness and impact of an AI-assisted system in supporting primary care general practitioners with the diagnosis and management of skin diseases. Methods From December 2022 to March 2024，19 general practitioners from community health centers in Hangzhou were voluntarily recruited for this study. They were randomly divided into two groups：an AI group with 10 physicians and a control group with 9 physicians. During this period，these physicians treated a total of 90 patients with skin diseases：50 in the AI group and 40 in the control group. Physicians in the AI group utilized the Ruifu AI-assisted system for diagnosing and managing dermatological diseases，whereas those in the control group followed standard treatment protocols without AI assistance. Both groups compiled patients' medical records，auxiliary examination reports，and photographs of skin lesions during consultations. Two skin disease experts were invited to conduct remote consultations to evaluate the diagnostic accuracy of the two groups. On the first day（1 d） and the fourteenth day（14 d） of treatment，patients underwent assessments using the Dermatology Life Quality Index（DLQI），and satisfaction surveys were conducted separately for patients in the AI and control groups. A questionnaire survey was administered to doctors in the AI group to assess their experience with the Ruifu AI-assisted system. Results No significant differences were observed in gender，age，or education level among patients in the AI and control groups（P>0.05），nor among physicians in terms of gender，age，education，and professional titles（P>0.05）. The AI group's general practitioners achieved higher diagnostic accuracy for skin diseases than those in the control group（64.0% vs 37.5%，P=0.012）. Fourteen days post-treatment，improvements in the DLQI scores were observed in both the AI and control groups，with significant differences（P<0.05），and the improvement in the AI group was more significant（P<0.05）. The satisfaction level of the AI group was higher than that of the control group（P=0.024），and there was a positive correlation between the 14 d DLQI score and patient satisfaction in the AI group（rs=0.471，95%CI=0.186-0.683，P=0.002），the correlation between the improvement in DLQI score and patient satisfaction was even more significant（rs=0.816，95%CI=0.676-0.899，P<0.001）. The results of the questionnaire survey revealed that a majority of physicians demonstrated a positive attitude towards their use of the AI-assisted system，acknowledging its practical value in several areas：diagnosis selection（70.0%），auxiliary diagnosis（80.0%），treatment recommendations（60.0%），and the provision of professional knowledge（90.0%）. Remarkably，90% of the physicians indicated their intention to continue utilizing the AI assisted system. Conclusion In the primary care setting，the application of AI-assisted systems has enhanced the diagnostic accuracy of general practitioners in identifying skin diseases，improves the quality of life for patients，and increases patient satisfaction. The majority of general practitioners report positive experiences with the use of AI-assisted systems.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： At present，the aging situation in China is becoming increasingly severe. The elderly are facing difficulties in acquiring elderly service and medical care in the process，in which the elderly need digital service of the combination between medical and nursing care urgently. However，there still exist some problems of the combination of medical and nursing care in the present stage，such as imperfect models，low level of intelligence，inefficient integration mechanism of resources related to "medical care" and "nursing care"，and the inadequate phenomenon in which the service of combination of medical and nursing care leads to “the castle in the air”. In view of the current difficulties and blocking points in the combination of medical and nursing care，the research team of this paper use digital and intelligent methods to construct 5 types of smart medical and nursing service models，including "full chain" "multi-subject integration" "active health" of traditional Chinese medicine，"return to the community" and "return to the home". Furthermore，the research team issused 6 group standards，seted up 2 landmark projects，and established more than 20 demonstration application bases across the country in the meantime as well as incorporate 500 community/township promotion plans of Henan Provincial government，which achieve good demonstration effects. This paper briefly introduces five types of model specifications from four aspects of model conception，model composition，model operation mechanism and model function，so as to facilitate the further study and popularization of the five models.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background Post-stroke cognitive impairment（PSCI） brings a heavy burden to affected patients and their families. An early recognition and intervention can help delay the occurrence and development of PSCI. Therefore，the use of accurate neuropsychological assessment tools to screen for PSCI is essential for the management and treatment of PSCI. Objective To analyze the screening accuracy of assessment tools for PSCI by meta-analysis，thus providing references for an accurate screening of PSCI. Methods Diagnostic trials on screening tools of PSCI published from the establishment of the database to December 2022 were searched in China National Knowledge Infrastructure（CNKI），VIP，Wanfang Database，Chinese Biomedical Literature Database（CBM），PubMed，Embase，Web of Science，Cochrane Library. Two researchers respectively screened literatures，extracted data，and assessed the risk of bias. Stata 17.0 software was used to analyze the data. Results A total of 57 articles were included，involving 7 assessment tools ［the National Institute of Neurological Disorders and Stroke Canadian Stroke Network 5-Minute Battery（NINDS-CSN 5-Minutes），the Montreal Cognitive Assessment（MoCA），the Mini-Mental State Examination（MMSE），the Informant Questionnaire on Cognitive Decline in the Elderly（IQCODE），the Addenbrooke's Cognitive Examination-Revised（ACE-R），the Telephone Interview for Cognitive Status Modified（TICSm）and the Montreal Cognitive Assessment 5-minute protocol（MoCA-5 min）］ to screen 12 113 patients. Meta-analysis results showed that the combined sensitivity and specificity of MoCA in screening PSCI were 0.83（95%CI=0.79-0.87） and 0.79 （95%CI=0.72-0.84），respectively，with a combined area under the curve（AUC） of 0.87（95%CI=0.84-0.90）. The combined sensitivity and specificity of MMSE in screening PSCI were 0.75（95%CI=0.69-0.80）and 0.76（95%CI=0.68-0.83），respectively，with a combined AUC of 0.81（95%CI=0.77-0.84）. The combined sensitivity and specificity of IQCODE in screening PSCI were 0.73（95%CI=0.48-0.89） and 0.95（95%CI=0.75-0.99），respectively，with a combined AUC of 0.91（95%CI=0.88-0.93）. The combined sensitivity and specificity of the NINDS-CSN 5-min in screening PSCI were 0.83（95%CI=0.78-0.87） and 0.69（95%CI=0.60-0.76），respectively，with a combined AUC of 0.85（95%CI=0.81-0.88）. The combined sensitivity and specificity of the ACE-R in screening PSCI were 0.90（95%CI=0.80-0.95） and 0.61（95%CI=0.19-0.91），respectively，with a combined AUC of 0.90（95%CI=0.87-0.92）. The combined sensitivity and specificity of TICSm in screening PSCI were 0.84（95%CI=0.75-0.91） and 0.67（95%CI=0.61-0.74），respectively， with a combined AUC of 0.86. Conclusion Based on the available evidence，the combined AUC of IQCODE and ACE-R is larger，and the former as a higher combined specificity and the latter has a higher combined sensitivity. Therefore，this meta-analysis suggested that IQCODE and ACE-R are optimal assessment tools to accurately screen PSCI. Although the MMSE and MoCA are common tools to screen PSCI，their combined AUCs are lower than the AUC of IQCODE and ACE-R. Due to the limited number of literatures reporting the IQCODE and ACE-R in screening PSCI，our conclusions still need to be validated by multicenter and large-sample studies.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
MA Wenyuan
QI Shuo
SHANG Jianwei
CHEN Xiaoheng
LI Zhe
LI Huilong
HU Rui
LI Lu
SI Xinying
DING Zhiguo
Abstract： Background The efficacy of traditional Chinese medicine （TCM） on the treatment of Hashimoto thyroiditis with normal thyroid function is increasingly pronounced. Under the current diagnosis and treatment mode combining both the disease itself and the relevant syndrome，TCM syndrome evaluation serves as an evaluation index that superiorly reflects the advantages of TCM. However，most clinical studies lack quantitative and standardized evaluation methods for the efficacy of TCM syndromes. Objective To preliminarily develop a TCM syndrome evaluation scale for Hashimoto's thyroiditis in patients with normal thyroid function. Methods The study period was from August 2023 to December 2023. Guided by the TCM theory and international scale development methods，a theoretical framework for developing a TCM syndrome evaluation scale for Hashimoto's thyroiditis in patients with normal thyroid function was established. An initial scale item pool was generated through literature review and preliminary clinical surveys by the research team. Items were refined using a combination analysis of subjective selection via the Delphi method and objective selection methods of item distribution，dispersion trends， Cronbach's alpha coefficient，and correlation coefficient analyses. Results Two rounds of expert consultations yielded 44 valid questionnaires，with the participation rate of 95.83% and 100%，respectively，and authority coefficient of 0.827 and 0.831，respectively. Eight key syndromes and 71 diagnostic information items associated with TCM syndrome evaluation were screened. A total of 369 valid questionnaires were collected from clinical surveys. Through the integration of four mathematical statistical methods and discussions with the expert panel，5 items for Qi stagnation syndrome，4 for Qi deficiency syndrome，3 for Phlegm syndrome，8 for Yin deficiency syndrome，3 for Blood stasis syndrome，6 for Yang deficiency syndrome，5 for Fire（Heat）syndrome，and 2 for Blood deficiency syndrome were removed. A preliminary formation of the TCM syndrome evaluation scale for Hashimoto's thyroiditis in patients with normal thyroid function was yielded，containing 51 diagnostic items in eight syndromes：9 items for Qi stagnation syndrome，10 for Qi deficiency syndrome，8 for Phlegm syndrome，9 for Yin deficiency syndrome，5 for Blood stasis syndrome，13 for Yang deficiency syndrome，8 for Fire（Heat） syndrome，and 8 for Blood deficiency syndrome.Conclusion This study has preliminarily developed a TCM syndrome evaluation scale for Hashimoto's thyroiditis with normal thyroid function，laying a foundation for the quantification of items and providing a methodological reference for the development of relevant scales.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background Functional Dyspepsia（FD） is a common clinical disease with numerous guidelines and consensus，but the quality is uneven. Objective To explore current status of clinical guidelines and consensus of FD，to evaluate and analyze their quality and to provide a reference for future clinical decision-making and guideline revision. Methods China national knowledge internet，Wanfang Data Knowledge Service Platform，China Science and Technology Journal Database，PubMed，Web of Science，OVID，and Embase were searched from the time of construction to March 30，2024. Supplemental searches were conducted on Guidelines International Network，National Institute for Health and Care Excellence，Scottish Intercollegiate guidelines network，National guideline clearinghouse，Medlive guide and Chinese Medical Association. The AGREE Ⅱ and RIGHT checklists were used to evaluate the methodological and reporting quality of included studies by well-trained investigators with consistent understanding of the entries independently. Results A total of 17 guidelines and consensus were included. The results of AGREE Ⅱ quality evaluation showed that average scores for each of the 6 areas were scope and purpose（71.49%±2.38%），stakeholder involvement（42.48%±5.03%），rigour of development（36.00%±5.88%），clarity of presentation（60.29%±5.05%），applicability（20.47%±2.69%），and editorial independence 50.00%（0，57.29%）. 9 literatures were recommended as grade B，8 literatures as grade C，and no A-rated literature. The results of RIGHT evaluation showed that average reporting rates for each of the seven areas were basic information（70.83%±3.03%），background（68.02%±2.98%），evidence 15.00%（10.00%，55.00%），recommendation（36.76%±3.21%），review and quality assurance 0（0，6.25%），funding and declaration and management of interests（25.37%±5.18%），and other information 16.67%（0，37.50%）. Conclusion The overall methodological and reporting quality of clinical guidelines and expert consensus needs to be improved，and it is recommended that guidelines should be written in strict accordance with the requirements of AGREE Ⅱ and RIGHT checklist.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Brain metastases are a major factor in the poor prognosis of patients with non-small cell lung cancer.The incidence of brain metastases is higher in patients with EGFR-mutated non-small cell lung cancer，and tyrosine kinase inhibitors targeting this target have become the first-line treatment for patients with stable brain metastases from EGFR-mutated NSCLC due to their excellent efficacy and safety，especially third-generation EGFR-TKIs. Combination of other treatments such as chemotherapy，angiogenesis inhibitor，and radiotherapy has also obtained preliminary efficacy.This article provides a review of the efficacy，safety，and future challenges of single-agent EGFR-TKIs and combination therapy in patients with brain metastases from EGFR-mutant non-small cell lung cancer.This article suggests that EGFR-TKI in combination with chemotherapy may be a potential alternative treatment option for patients with EGFR-mutated NSCLC brain metastases，especially for Asian patients，whereas for EGFR-TKI in combination with antiangiogenic or radiotherapy，the frontal benefit of the combination therapy was not obvious，and large prospective studies could be conducted to further validate and find individualized treatment options based on stratification factors such as EGFR mutation type，comorbid mutations，and clinicopathological features. As for EGFR-TKI combined with immunotherapy，the safety of the combined treatment still needs to be further explored.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Lipoprotein（a）［Lp（a）］ is significantly related to atherosclerotic cardiovascular disease（ASCVD），but it is unclear whether clinical agents that lower Lp（a） can reduce the risk of ASCVD. Here，we systematically reviewed the structure，function，genetic characteristics and detection status of Lp（a），discussed the relationship of Lp（a） with ASCVD，aortic valve stenosis and other cardiovascular diseases，and summarized new advance of Lp（a）-lowering therapies. The structural composition of Lp（a） indicates that Lp（a） may promote atherosclerosis，inhibit fibrinolytic reaction and promote inflammation. Multiple evidence from genetic studies and epidemiological studies supports that Lp（a） is significantly associated with an increased risk of ASCVD and major adverse cardiovascular events. In addition，Lp（a） is also associated with other cardiovascular diseases such as aortic valve stenosis. At present，several emerging drugs that lower Lp（a） are in clinical trials and may further reduce residual cardiovascular risk. This paper hopes to offer new thought for the study of Lp（a），and provide a basis for the monitoring and management of blood lipids.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background The prevalence and epidemiology of pre-treatment drug resistance and acquired drug resistance among HIV-infected individuals vary considerably in different regions of China. Both types of drug resistance have adverse effects on the antiviral treatment outcomes for patients，potentially exacerbating their poor prognosis. Currently，there is a paucity of research on the prevalence and epidemiology of PDR and ADR among HIV-infected individuals in Southwest China.Objective This study investigated the prevalence and epidemiology of pre-treatment drug resistance and acquired drug resistance among people living with HIV（PLWH） in Southwest China. Methods This was a large cross-sectional study that enrolled PLWH who visited the infectious diseases department of the largest infectious disease hospital in Southwest China between January 1，2021，and June 30，2023，and underwent drug resistance gene testing. HIV-1 genotype and drug resistance were analyzed using HIV-1 pol sequence. The Stanford University HIV Drug Resistance Database was used to analyze major drug resistance mutations in the reverse transcriptase and protease Sanger sequences. Risk factors associated with pre-treatment drug resistance were evaluated using a Logistic regression model. Results A total of 1 613 individuals were included in the study，with 824 ART-naive and 789 ART-experienced. The most common genotype among ART-naive patients was B+C（47%），and the drug resistance rate was 18.7%（154/824） with non-nucleoside reverse transcriptase inhibitors（NNRTIs） accounting for 14.9%（123/824），nucleoside reverse transcriptase inhibitors（NRTIs）accounting for 1.7%（14/824），protease inhibitors（PIs）accounting for 2.7%（22/824），and integrase strand transfer inhibitors（INSTIs） accounting for 1.9%（16/824）. Among the ART-experienced patients，the most common genotype was CRF01-AE（37.4%），with a drug resistance rate of 27.8%（219/789）. The mutation rates for NNRTIs，NRTIs，PIs，and INSTIs were 7.7%（61/789），19.3%（152/789），2.7%（21/789），and 1.1%（9/789），respectively. Furthermore，Logistic regression modeling revealed that transmission route，CD4 + T-cell count，viral load，and the time interval between diagnosis and ART initiation were associated with an increased risk of pre-treatment drug resistance. Conclusion The incidence of pre-treatment drug resistance and acquired drug resistance mutations among PLWH in Southwest China is relatively high，18.7% and 27.8% respectively. Transmission route，CD4 + T-cell count，viral load，and the time interval between diagnosis and ART initiation are associated with an increased risk of pretreatment drug resistance. Therefore，to ensure long-term treatment success，there is an urgent need for routine baseline genotypic resistance testing and adequate intervals for viral load monitoring.
Subjects: Mathematics >> Control and Optimization. submitted time 2024-07-18
Abstract： For a 4th order 3-dimensional symmetric tensor with its entries $1$ or $-1$, we show the analytic sufficient and necessary conditions of its positive definiteness. By applying these conclusions, several strict inequalities is bulit for ternary quartic homogeneous polynomials.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2024-07-18 Cooperative journals: 《中国全科医学》
Abstract： Halitosis is a common clinical disease，which seriously affects the social and mental health of patients. General practitioners play a key role in the diagnosis and treatment of halitosis. Based on the review of the literature，this paper puts forward a set of ideas for the diagnosis and treatment of halitosis from the perspective of general medicine，including medical history inquiry，physical examination，detection methods and treatment strategies. This paper emphasizes the importance of personalized diagnosis and treatment，and points out that general practitioners should pay more attention to and manage patients with halitosis.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-18 Cooperative journals: 《中国全科医学》
YANG Jianuo
WANG Guanli
YANG Jiafu
HE Jiahao
CHEN Shumin
SHEN Yi
LI Juan
REN Ni
LIU Chunli
DENG Fangge
Abstract： As a non-invasive and non-radiative non-contact clinical detection technology，infrared thermography can identify various diseases early by detecting the body surface temperature and reconstructing the temperature distribution image，and achieve early diagnosis and intervention. This article focuses on reviewing the application and related research progress of infrared thermography in the fields of acute respiratory infectious diseases，sleep apnea syndrome，traditional Chinese medicine lung disease research，neonatal intensive care，and early screening of pulmonary embolism，which has important clinical guidance significance. As a Functional imaging technology，the core advantage of infrared imaging is “Early”. Unlike structural changes in the course of a disease，the early stages of a disease are often Hemodynamics，the functional changes of local abnormal temperature distribution caused by local inflammation and so on can be early diagnosed，early intervention and dynamic monitoring by means of infrared thermography technology based on thermal sensitivity.
Subjects: Physics >> Geophysics, Astronomy, and Astrophysics submitted time 2024-07-18
Abstract： This paper presents a new development in revealing the nature of the inertial force, a concept that has long stimulated discussion in the history of physics. On this basis, its implications are systematically introduced for the improvement of physics teaching. Firstly, all the theorems in the framework of classical mechanics can be form-invariant generalized to any translational frame of reference, provided that the physical meaning of the force term of the particle in the original formulation is replaced from the total forces to the forces being relatively accounted for. Secondly, in analytical mechanics, since in general the conservative force corresponding to the potential energy is typically a part of the forces acting on the particle, it is enough to ensure that the reference origin is chosen at a position where the vector sum of the conservative forces corresponding to the potential energy is always zero. However, in the case of a general translational reference frame, a correction term for the potential energy due to the forces acting on the reference object must be included in the expression of the Lagrangian and Hamiltonian quantities. Thirdly, the symmetric new equation is applied to the system of particles. The generalized center-of-mass motion theorem and the generalized fixed-axis rotation theorem in the translational reference frame are developed. Finally, for instance, the multi-body dynamics is discussed. In principle, the detour that is introduced by the center-of-mass reference frame can be directly omitted and crossed. To illustrate this, the planetary perturbation equation is demonstrated to be derived in a single step by applying the symmetric new equation of Newtonian dynamics. Besides, the introduction of the symmetric new equation has led to further improvements and refinements in the planetary perturbation equation.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： Background Systemic lupus erythematosus（SLE）is a chronic multisystem autoimmune disease. At present，three biological agents have been approved for treating SLE，including belimumab，anifrolumab，and telitacicept. However，a direct comparison of their efficacy and safety is lacked. Objective To analyze the clinical efficacy and safety of belimumab，anifrolumab，and telitacicept on the treatment of SLE using network meta-analysis. Methods Randomized controlled trials（RCTs）reporting belimumab，anifrolumab，and telitacicept to treat SLE were searched in the databases of PubMed，Web of Science，Cochrane Library，and Embase from the establishment of the databases until August 2023. After screening the relevant literatures and obtaining data from eligible RCTs based on the inclusion and exclusion criteria，direct or network meta-analysis was performed using the RevMan 5.4.1，R language 4.3.1，and Aggregate Data Drug Information System（ADDIS）1.16.8 software. Results After screening，4 789 SLE patients from 12 RCTs were included，including 2 721 patients in the experimental group and 2 068 patients in the placebo group. The direct meta-analysis results showed that the relief rate of SLE responder index 4（SRI4）in SLE patients treated with belimumab，anifrolumab，and telitacicept was significantly higher in the experimental group compared with that of the placebo group（OR=1.62，95%CI=1.40-1.88，P<0.001；OR=2.39，95%CI=1.70-3.37，P<0.001；OR=6.28，95%CI=3.20-12.33，P<0.001）. Compared with that of the placebo，the proportion of SLE patients with a reduced oral corticosteroid dosage after belimumab and anifrolumab treatment was significantly higher （OR=1.48，95%CI=1.09-2.02，P<0.001；OR=2.45，95% CI=1.69-3.54，P<0.001），and the severe recurrence（SR）rate was significantly lower（OR=0.59，95%CI=0.49-0.71，P<0.001；OR=0.52，95%CI=0.39-0.69，P<0.001）. The incidence of total adverse events（TAEs）of anifrolumab and telitacicept was significantly higher than that of the placebo group（OR=1.80，95%CI=1.25-2.59，P=0.001；OR=2.13，95%CI=1.18-3.83，P=0.01），while the incidence of serious adverse events（SAEs） of anifrolumab was significantly lower（OR=0.67，95%CI=0.46-0.97，P=0.04）.There were no significant differences in the incidence of TAEs（OR=0.89，95%CI=0.72-1.08，P=0.24）and SAEs（OR=0.82，95%CI=0.59-1.12，P=0.25）between the belimumab group and placebo group. The results of network Meta-analysis showed that the highest SRI4 was detected after the treatment of telitacicept，followed by anifrolumab，subcutaneous injection of belimumab and intravenous injection of belimumab. The highest incidence of TAEs was detected after the treatment of telitacicept，followed by anifrolumab，intravenous injection of belimumaband subcutaneous injection of belimumab. Conclusion Aelimumab，anifrolumab，and telitacicept all exhibit good clinical efficacy on the treatment of SLE，especially telitacicept. Although anifrolumab and telitacicept increase the overall incidence of TAEs after treatment，they reduce the incidence of SAEs. Of note，belimumab exhibits the highest safety on treating SLE.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： In children，autism spectrum disorder（ASD）is primarily characterized by social（communication） impairments and repetitive，stereotyped behaviors and restricted interests，affecting children's social interaction，communication abilities，and behavioral patterns. In recent years，with technological advancements，Digital Therapeutics has played a significant role in managing ASD. For instance，multimodal data integration and machine learning algorithms have been used for the early identification of ASD，while virtual reality，augmented reality，and gamified learning platforms have been widely applied to enhance the social skills and cognitive functions of children with ASD. Although digital therapy has shown great potential and benefits in the field of autism，it also faces challenges，including individual differences in treatment response，uncertainty of long-term effectiveness，and data privacy protection. Overall，Digital Therapeutics has opened up a new path for the management of autism，and also points out important directions for future research and applications.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
WEN Yining1，2，3，4，HUANG Huichang1，3，4，5，ZHAO Mingming1，3，4*
WEN Yining1，2，3，4，HUANG Huichang1，3，4，5，ZHAO Mingming1，3，4*
WEN Yining1，2，3，4，HUANG Huichang1，3，4，5，ZHAO Mingming1，3，4*
Abstract： Subjective cognitive decline（SCD）usually predicts the risk of future cognitive decline，and sleep disturbances are very common in patients with SCD and often precede detectable cognitive changes. Although there is a lack of clarity regarding the relationship between sleep and SCD and the underlying mechanisms of sleep-related cognitive deterioration，studies in recent years have shown a strong link between sleep and cognitive decline. Cognitive decline may be triggered by either sleep deprivation or decreased sleep quality. Therefore，the aim of this review is to provide a comprehensive overview of the research progress on sleep and subjective cognitive decline，and to explore in depth the mechanism of their interaction，with a view to providing new ideas and methods for preventing and delaying cognitive decline，and providing useful references for research and practice in related fields.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-17 Cooperative journals: 《中国全科医学》
Abstract： The concept landscape of frailty has evolved from a single dimension which emphasising predominantly physical frailty into a multidimensional concept encompassing physical，psychological and social frailty.Conducting researches on multidimensional frailty armong community-dwelling older adults is an important way to address the current fragmentation of community-based elderly care services and enhance the comprehensive health of this population. In this paper，firstly，we review the evolution of the concept of multidimensional frailty;secondly，classify and describe the multidi. mensional frailty assessment tools that can be applied to community-dwelling older adults;thirdly，analysis the influencing factors of multidimensional frailty in community-dwelling older adults as well as the interactions between the dimensions of frailty，finally，assess the predictive value of multidimensional frailty in community-dwelling older adults in relation to health outcomes. Existing evidences suggest that the multidimensional frailty is found to be the result of a combination of physiological，psychological，and social factors，and that assessing multidimensional frailty in community-dwelling older adults can predict a variety of health outcomes such as disability，disease risk，and mortality，and that the different dimensions of frailty are correlated and interact with each others.However，there is no a standardized tool for evaluating multidimensional frailty in the community-dwelling older adults，and the underlying mechanisms of its occurrence and development have not been clarified.So，the follow-up studies could explore the developmental trajectory of multidimensional debility based on large prospective cohort studies，in order to provide a referable basis for the development of intervention strategies to reverse or delay the frail process in community-dwelling older adults.
Hits
Hits
Downloads
Comment