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Guidelines for Diagnosis and Treatment of Chronic Gastritis in China (2022, Shanghai): An interpretation Wu Haotian, Fan Yuwen, Zhang Xiaolan Clinical Focus    2023, 38 (10): 926-930.   DOI: 10.3969/j.issn.1004-583X.2023.10.012 Abstract （607）   HTML （31）    PDF（pc） （843KB）（2127）       Knowledge map    Save In 2022, the Chinese Society of Gastroenterology has referred the research and guidelines associated with chronic gastritis at home and abroad in recent years, formulated a total of 53 recommendations on the epidemiology, clinical manifestations, endoscopic and laboratory diagnosis, treatment principles, outcomes and prognosis, and unsolved problems at home and abroad, and published the Guidelines for Diagnosis and Treatment of Chronic Gastritis in China (2022, Shanghai). This article interprets the updates and highlights of this guideline. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (7): 647-653.   DOI: 10.3969/j.issn.1004-583X.2023.07.011 Abstract （448）   HTML （6）    PDF（pc） （1086KB）（97）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (11): 1038-1041.   DOI: 10.3969/j.issn.1004-583X.2023.11.015 Abstract （398）   HTML （12）    PDF（pc） （835KB）（49）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (8): 753-756.   DOI: 10.3969/j.issn.1004-583X.2023.08.014 Abstract （319）   HTML （11）    PDF（pc） （848KB）（72）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1150-1152.   DOI: 10.3969/j.issn.1004-583X.2023.12.017 Abstract （306）   HTML （4）    PDF（pc） （854KB）（87）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Screening of glycolysis-related genes for predicting the prognosis of patients with gastric cancer: Based on bioinformatics Zhao Xuhui, Huang Xiaomin, Da Dezhuan, Xu Yan, Cui Xiaodong, Li Hongling Clinical Focus    2024, 39 (1): 20-29.   DOI: 10.3969/j.issn.1004-583X.2024.01.003 Abstract （298）   HTML （6）    PDF（pc） （2487KB）（56）       Knowledge map    Save Objective To construct a glycolysis-related gene model for predicting the prognosis of gastric cancer (GC) patients based on bioinformatics. Methods The messenger RNA expression profiles of GC patients were analyzed in The Cancer Genome Atlas program, and gene sets with significant differences between GC tissues and normal tissues were verified using gene set enrichment analysis. A glycolysis-related genes model for predicting the prognosis of GC patients was constructed using least absolute shrinkage and selection operator regression analysis, and the predictive performance of the model was validated using Kaplan-Meier survival analysis, receiver operating characteristic curve, and univariate and multivariate Cox regression analysis. Gene set variation analysis was performed to analyze the differences in biological pathway states between high-risk and low-risk groups. Results Fourteen glycolysis-related genes (PFKFB2、UHRF1、ACYP1、CLDN9、STC1、EFNA3、NUP50、ADH4、ANGPTL4、PKP2、VCAN、HIF 1A、LHX9、ANKZF1、ALDH3A2) were identified as prognostic markers for GC patients. Based on a risk score derived from these 15 gene features using Cox regression analysis, patients were classified into high-risk and low-risk groups. These 15 gene markers were independent biomarkers for predicting the prognosis, and patients with a low-risk score had a better prognosis. The combination of gene markers and clinical prognostic factors in a Nomogram effectively predicted overall survival and disease-free survival. Conclusion The established panel of 15 glycolysis-related gene markers can serve as reliable tools for predicting the prognosis of GC patients and may provide potential targets for glycolysis-targeted therapy in GC. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Probiotic supplementation on improving glucose metabolism in patients with type 2 diabetes mellitus: A meta-analysis Jin Jiahui, Yang Yang, Qin Tong, He Yuxin, Su Meihua Clinical Focus    2023, 38 (7): 581-587.   DOI: 10.3969/j.issn.1004-583X.2023.07.001 Abstract （298）   HTML （3）    PDF（pc） （1904KB）（64）       Knowledge map    Save Objective To evaluate the effect of probiotics on glucose metabolism in patients with type 2 diabetes mellitus (T2DM), and to elaborate its mechanism of action, so as to provide ideas and approaches for clinical diagnosis and treatment of T2DM. Methods Randomized controlled trials (RCTs) reporting the effect of probiotics on glucose metabolism in T2DM patients published before 31st November 2022 were searched in the online databases of PubMed, Embase, Web of science, CNKI, Wanfang Data Knowledge Service Platform and CQVIP database were searched. Two investigators were independently responsible for literature screening. The included literatures were assessed and data were extracted and analyzed using RevMan 5.4 software. Results A total of 11 studies were included in the study, involving 709 T2DM patients. There were 371 T2DM patients in the experimental group and 338 in the control group. Meta-analysis showed that probiotic supplementation significantly reduced fasting plasma glucose (FPG), hemoglobin A1C (HbA1C), homeostatic model assessment for insulin resistance (HOMA-IR), and fasting insulin levels in the experimental group than those in the control group. Conclusion Probiotic supplementation can improve glucose metabolism in T2DM patients, and probiotics can be used as one of the adjuvant treatments for T2DM patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Bioequivalence of aspirin enteric-coated tablet in healthy volunteers Liu Junyu, Zhang Tiancai, Zhang Baie, Li Yizhou, Li Yafei, Liu Hongbin, Duan Liping, Zhang Quanying, Wang Yijun, Meng Fanhua, Sun Min Clinical Focus    2024, 39 (5): 433-439.   DOI: 10.3969/j.issn.1004-583X.2024.05.008 Abstract （277）   HTML （4）    PDF（pc） （1362KB）（68）       Knowledge map    Save Objective To evaluate the bioequivalence and safety of aspirin enteric-coated tablets in healthy Chinese adult. Methods A single-center, randomized, open, two-preparation, two-sequence, four-cycle, fully replicated design was used. The subjects took orally one tablet of test (T) or reference (R) preparation on fasting or fed condition every cycle. The plasma concentration of acetylsalicylic acid (ASA) was determined by liquid chromatography with tandem mass spectrometry (LC-MS/MS) method at different time points, and the bioequivalence and safety of the two formulations were evaluated. Results In the main results for pharmacokinetic parameters of T and R under fed condition, Cmax were (690.97±196.91) and (669.28±337.40) ng·ml-1, AUC0-t were (867.37±228.64) and (821.16±349.85) ng·h·ml-1, AUC0-∞ were (883.48±233.72) and (923.59±287.95) ng·h·ml-1, Tmax were (8.98±2.47) and (10.69±3.75) h. In the main result for pharmacokinetic parameters of T and R under fasting condition, Cmax were (466.83±222.89) and (441.42±211.99) ng·ml-1, AUC0-t were (753.24±269.49) and (678.50±278.85) ng·h·ml-1, AUC0-∞ were (809.11±309.27) and (726.51±267.00) ng·h·ml-1, Tmax were (5.81±2.53) and (6.41±2.47) h. The geometric mean ratios of the main pharmacokinetic parameters Cmax, AUC0-t and AUC0-∞ in the fed group were within the range of 80.00% to 125.00%, therefore the two formulations were bioequivalent. However,the fasting group did not meet the relevant criteria, and the two preparations were not equivalent. During the study period, 0 case and 2 cases of adverse events occurred under the fasting and the fed condition. No serious adverse events occurred. Conclusion The two kinds of aspirin enteric-coated tablets were bioequivalent in human under the fed condition, but not in the human under fasting conditions, and the formulations were safe and well tolerated. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Correlation of anti-phospholipase A2 receptor antibody with idiopathic membranous nephropathy Wang Tao, Gao Yuwei, Wang Xinghua, Hu Xiuhong, Cui Hongrui, Xu Baozhen, Yang Hongjuan Clinical Focus    2023, 38 (7): 606-612.   DOI: 10.3969/j.issn.1004-583X.2023.07.004 Abstract （277）   HTML （0）    PDF（pc） （1050KB）（52）       Knowledge map    Save Objective To explore the correlation of anti-phospholipase A2 receptor (PLA2R) antibody with idiopathic membranous nephropathy (IMN). Methods Clinical data of 110 IMN patients in Department of Nephrology, the First Hospital of Hebei Medical University were retrospectively analyzed. They were divided into antibody-negative group and antibody-positive group based on the anti-PLA2R antibody (anti-PLA2R-Ab) testing before treatment. Differences between the two groups were compared. The correlation of anti-PLA2R antibody titers with clinical efficacy on IMN was analyzed, and relevant factors affecting clinical remission of IMN were identified. Results A total of 89 IMN patients were followed up for 12 months. Compared with the antibody-negative group, IMN patients in the antibody-positive group had significantly increased proteinuria, decreased serum albumin (ALB) and thicker basement membrane (P<0.05). After 12 months of treatment, the IMN remission rate in the antibody-positive group and the antibody-negative group was 69.35% and 88.89%, respectively, and the cumulative remission rate in the antibody- negative group was significantly higher than that in the antibody-positive group (P<0.05). At 3, 6, and 12 months after treatment, the 24-hour urine protein in both groups was significantly lower than that before treatment, and the ALB level was significantly higher than before treatment (P<0.05). ALB level in the antibody-negative group significantly increased at 3 months, and that in the antibody-positive group significantly increased at 6 months (P<0.05). Before and after treatment, there was no significant difference in serum creatinine between groups. With the decrease of anti-PLA2R-Ab titer, the 24 h urine protein of the antibody-positive group gradually decreased, and ALB level increased. Correlation analysis showed that the anti-PLA2R-Ab titer was positively correlated with 24 h urine protein, and the decrease in the anti-PLA2R-Ab titer was prior to the decrease in 24 h urine protein. Serum anti-PLA2R antibody titer, baseline ALB level, urine protein level, age, gender, and blood pressure were introduced in the multivariate Logistic regression model. It is found that the baseline anti-PLA2R antibody titer was an independent risk factor for non-remission of IMN at 12 months of treatment (OR=2.571, 95%CI: 0.983-3.354, P=0.024). Spearman correlation analysis showed that patients with lower anti-PLA2R antibody titers were more likely to be in remission, and the area under the curve (AUC) of baseline anti-PLA2R-Ab titer in predicting 12-month clinical remission of IMN was 0.7781(95%CI: 0.648-0.816, P<0.01), with the sensitivity and specificity of 68.27% and 77.38%, respectively. Conclusion There is a positive correlation between the anti-PLA2R antibody titer and 24-hour urine protein. The baseline anti-PLA2R antibody titer is an independent risk factor for non-remission of IMN. The change from the assessment of proteinuria to that of serum anti-PLA2R antibody titer is helpful to improve the accuracy of diagnosis and prognosis of IMN and reduce the adverse events of immunosuppressive drugs. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1140-1145.   DOI: 10.3969/j.issn.1004-583X.2023.12.015 Abstract （276）   HTML （2）    PDF（pc） （945KB）（71）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical application of GEMOX combined with target-immunity therapy in patients with advanced biliary tract cancer Wu Xiaomin, Fang Yipeng, Zhang Zhen, Zhang Ye, Jin Cheng Clinical Focus    2024, 39 (5): 408-412.   DOI: 10.3969/j.issn.1004-583X.2024.05.004 Abstract （270）   HTML （6）    PDF（pc） （1116KB）（31）       Knowledge map    Save Objective To evaluate the clinical efficacy and safety of gemcitabine and oxaliplatin (GEMOX) combined with target-immunity therapy (lenvatinib and programmed cell death 1 [PD-1] monoclonal antibody) in patients with advanced biliary tract cancer (BTC). Methods Twenty-four patients with advanced BTC received GEMOX combined with target-immunity therapy visited Integrative Oncology Department or Hepatobiliary Surgery Department of our hospital from January 2015 to January 2024 were recruited. The primary end points were set as overall survival (OS) and progression-free survival (PFS), and the secondary end points were objective response rate (ORR), disease control rate (DCR) and safety. The safety and overall clinical efficacy of GEMOX combined with target-immunity therapy regimen on advanced BTC were comprehensively evaluated via tumor marker indexes (carcinoembryonic antigen [CEA], carbohydrate antigen 125 [CA125], CA199), adverse reactions rates, quality of life scores, imaging indicators, and other data. Results None of the 24 patients had complete remission (CR). ORR was 33.3% (8/24, 8 patients had PR), DCR was 66.7% (16/24; 8 patients had SD and 8 patients had PD, respectively), median OS was 13 months and median PFS was 8 months. After treatment, the levels of CA199 were significantly lower than those before treatment (P<0.05). The incidence of adverse events in 24 patients were rash (14/24, 58.3%), leucopenia (22/24, 91.6%), anemia (20/24, 83.3%). One patient had serious adverse events and withdrew from treatment, one patient died of biliary obstruction with infection during treatment. Conclusion GEMOX combined with target-immunity therapy regimen is safe and effective in the treatment of advanced BTC, it may be used clinically. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (7): 663-667.   DOI: 10.3969/j.issn.1004-583X.2023.07.014 Abstract （266）   HTML （1）    PDF（pc） （842KB）（73）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Systematic evaluation of the incidence and the influencing factors of sleep disorders in breast cancer patients Liu Jiazhu, Liu Rong, Meng Limin, Guo Yinshu, Zhang Xiaobo, Ai Yiqin Clinical Focus    2024, 39 (6): 494-500.   DOI: 10.3969/j.issn.1004-583X.2024.06.002 Abstract （265）   HTML （7）    PDF（pc） （1121KB）（54）       Knowledge map    Save Objective To determine the incidence and the influencing factors of sleep disorders in breast cancer (BC) patients through a systematic evaluation. Methods Articles reporting the influencing factors of sleep disorders in BC patients published before December 2023 were searched in comprehensive databases, such as China National Knowledge Infrastructure (CNKI), Wanfang, VIP, sinomed, PubMed, Web of Science, Cochrane Library, Embase, EBSCO. The eligible data were evaluated using the Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa scale (NOS). Results Twenty papers representing a total of 4409 cases sample size and 29 influencing factors were included. The results of the systematic evaluation showed that the detection rate of sleep disorders in BC patients was 67%, the main influencing factors were chemotherapy, age, surgery, tumour classification, depression, anxiety, pain, fatigue, and exercise frequency, the secondary influencing factors were radiotherapy, genetics, income, family status, hormone levels, hot flushes, coping styles, environmental changes, and quality of life, and the other influencing factors included ethnicity, number of hospitalisations, physiological function, place of residence, constitutional type, hyperlipidaemia, religious beliefs, previous respiratory disease, self-image, social support and form of medical insurance payment. Conclusion The prevalence of sleep disorders in BC patients is high, and healthcare professionals can identify high-risk factors and intervene early for reducing the risk of sleep disorders in BC patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (1): 88-91.   DOI: 10.3969/j.issn.1004-583X.2024.01.017 Abstract （263）   HTML （7）    PDF（pc） （864KB）（65）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (6): 568-571.   DOI: 10.3969/j.issn.1004-583X.2024.06.015 Abstract （256）   HTML （6）    PDF（pc） （800KB）（33）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1131-1134.   DOI: 10.3969/j.issn.1004-583X.2023.12.013 Abstract （252）   HTML （6）    PDF（pc） （877KB）（50）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Generative artificial intelligence: Ethical review on the empowerment in medical humanities education Zhao Xin, Liu Yun Clinical Focus    2024, 39 (1): 65-69.   DOI: 10.3969/j.issn.1004-583X.2024.01.012 Abstract （242）   HTML （9）    PDF（pc） （873KB）（98）       Knowledge map    Save Generative Artificial Intelligence (GAI) is emerged as a game-changing technology with far-reaching implications across various fields. It is expected to bring new opportunities for rapid development in numerous areas, including the education sector where GAI has already shown promising results through multi-platform integration. In the future, the iterative development of GAI will give rise to a plethora of potential applications in the field of medical humanities education, enhancing its effectiveness precisely, promoting its development, and creating innovative modes of panoramic experience in the teaching process. However, along with the inherent ethical issues of GAI technology, such as black box algorithms, information cocooning, data privacy and security, and discriminatory algorithms, there will also be risks with distinct medical humanities characteristics that arise from the deep integration of GAI and medical humanities education. For instance, there is a possibility of values being compromised, the diminishing of human dominance, and the imbalance of the binary relationship between teaching and learning due to an excessive reliance on GAI. In order to address these ethical concerns and devise effective countermeasures to mitigate the risks imposed by GAI in empowering medical humanities education, it is necessary to establish clear boundaries and maximize the potential of artificial intelligence. We must also ensure that GAI stays true to its original purpose in this era of rapid technological advancements, and create a conducive ecological environment for its development based on legal regulations. Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (8): 743-748.   DOI: 10.3969/j.issn.1004-583X.2023.08.012 Abstract （238）   HTML （2）    PDF（pc） （896KB）（822）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Application principles of vasodilators in the treatment of acute heart failure Duan Fang, Cui Wei Clinical Focus    2023, 38 (9): 773-778.   DOI: 10.3969/j.issn.1004-583X.2023.09.001 Abstract （237）   HTML （3）    PDF（pc） （422KB）（57）       Knowledge map    Save Acute heart failure (AHF) is one of the common diseases in cardiovascular medicine. Its treatment principles include reducing cardiac preload and afterload, and improving cardiac systolic and diastolic function. Currently, evidences supporting the feasibility of vasodilators in the treatment of AHF are scant. The clinical application of vasodilators remains controversial. This review thoroughly described the pathophysiological basis, populations, and blood pressure control goals of intravenous vasodilators in the treatment of AHF, thus providing references for the clinical application. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (2): 172-176.   DOI: 10.3969/j.issn.1004-583X.2024.02.015 Abstract （234）   HTML （7）    PDF（pc） （876KB）（44）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (2): 188-192.   DOI: 10.3969/j.issn.1004-583X.2024.02.018 Abstract （232）   HTML （9）    PDF（pc） （847KB）（356）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (1): 80-83.   DOI: 10.3969/j.issn.1004-583X.2024.01.015 Abstract （230）   HTML （8）    PDF（pc） （860KB）（60）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Meta-analysis of clinical significance of serum total bilirubin level in inflammatory bowel disease Chen Xiaotian, Huo Lijuan Clinical Focus    2023, 38 (8): 677-685.   DOI: 10.3969/j.issn.1004-583X.2023.08.001 Abstract （230）   HTML （1）    PDF（pc） （2559KB）（58）       Knowledge map    Save Objective To systematically evaluate the clinical significance of serum total bilirubin (STB) in patients with inflammatory bowel disease (IBD). Methods Case-control studies on the correlation between STB and IBD published from their inception to November 2022 were searched in online databases, including the PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, Wanfang, and Chinese Biomedical Databases (CBM). The quality of recruited articles was assessed using the Newcastle-Ottawa Scale (NOS). RevMan 5.4.1 and Stata13.1 were used for data analysis. Results A total of 14 articles, involving 6067 participants in 18 case-control studies (2972 in IBD group and 3905 in control group) were enrolled in this meta-analysis. STB was significantly lower in IBD patients than that of controls (SMD=-0.80, 95%CI:-0.99, -0.61, P<0.01). STB level in the active stage of IBD was significantly lower than that in remission stage (SMD=-0.76, 95%CI:-1.33, -0.19, P=0.009). STB decreased with the increase of IBD severity (mild vs moderate: SMD=-0.35, 95%CI:-0.52,-0.18, P<0.01; moderate vs severe: SMD=-0.59, 95%CI:-0.78, -0.39, P<0.01; mild vs severe: SMD=-0.88, 95%CI:-1.10, -0.66, P<0.01). STB level was negatively correlated with erythrocyte sedimentation rate (ESR) (r=-0.41, 95%CI:-0.45, -0.35, P<0.01), C-reactive protein (CRP) (r=-0.37, 95%CI:-0.48, -0.26, P<0.01) and clinical score (r=-0.54, 95%CI:-0.70, -0.39; P<0.01), and positively correlated with hemoglobin (Hb)(r=0.45, 95%CI:0.40, 0.50; P<0.01). The risk of IBD in patients with low-level STB within the normal range was 3.15 times higher than that of patients with high-level STB (OR=3.15, 95%CI:2.24, 4.44, P<0.01). Conclusion Low-level STB within the normal range is correlated with the increased risk, disease activity and severity of IBD, which may have reference values for clinical evaluation of IBD. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Colonic telangiectasia combined with bleeding: A case report and literature review Ren Huaijing, Tao Jianan, Ma Zhenqi, Wang Xuehong Clinical Focus    2024, 39 (2): 155-159.   DOI: 10.3969/j.issn.1004-583X.2024.02.011 Abstract （228）   HTML （9）    PDF（pc） （1034KB）（38）       Knowledge map    Save Objective To explore the clinical characteristics and diagnostic and therapeutic strategies of colonic telangiectasia. Methods A retrospective analysis was conducted on the clinical data of a patient with colonic telangiectasia who presented with repeated gastrointestinal bleeding and anemia, and relevant literature was reviewed. Results A 56-year-old female patient presented with recurrent black stools and alternating fresh bloody stools. Colonoscopy showed extensive network-like, dendritic, and spider nevus-like capillary dilation in multiple locations around the mucosa from the cecum to the descending colon, with the maximum of approximately 5mm × 5mm. She was finally diagnosed with colonic telangiectasia. Conclusion Colonic telangiectasia, also known as colonic vascular dysplasia, is more common in elderly patients. It is mostly asymptomatic, and gastrointestinal bleeding is an occasional symptom. Electronic colonoscopy is an important diagnostic method for colonic telangiectasia, and lesions are more common in the right colon. Asymptomatic patients do not require treatment, and those with concurrent bleeding may consider medications or local hemostasis under endoscopy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (6): 572-576.   DOI: 10.3969/j.issn.1004-583X.2024.06.016 Abstract （222）   HTML （6）    PDF（pc） （844KB）（21）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Meta-analysis of expression and clinical significance of HER-2 in hepatocellular carcinoma Tao Jianan, Li Wenqian, Ma Xiuwen, An Qi, Wang Xuehong Clinical Focus    2023, 38 (12): 1067-1072.   DOI: 10.3969/j.issn.1004-583X.2023.12.002 Abstract （221）   HTML （8）    PDF（pc） （1341KB）（40）       Knowledge map    Save Objective To systematically evaluate the relationship between the expression of human epidermal growth factor receptor-2 (HER-2) and clinicopathologic featurests in hepatocellular carcinoma (HCC). Methods Case-control studies regarding the expression of HER-2 in HCC were searched from PubMed, CNKI, Wanfang database and VIP database from establishment of the database to May 2023. Literature screening, data extraction and risk-of-bias assessment were independently performed by two researchers. Meta-analysis was performed using Revman5.3 software. Results Thirty one case-control studies representing 2558 patients were included. Meta-analysis showed that the positive rate of HER-2 in HCC cases was significantly higher than that in control cases (54.3% vs 50.5%, O R=1.87, 95% C I: 1.13-3.10, P=0.01). The expression of HER-2 in HCC cases in age ( O R=0.48, 95% C I: 0.25-0.94, P=0.03), differentiation degree( O R=2.61, 95% C I: 1.84-3.69, P<0.01), tumor diameter ( O R=1.93, 95% C I: 1.25-2.98, P=0.003), blood metastases ( O R=5.42, 95% C I: 3.15-9.31, P<0.01), clinical stage ( O R=2.02, 95% C I: 1.39-2.94, P=0.0003), portal vein invasion ( O R=1.73, 95% C I: 1.11-2.72, P=0.02) and serum HBsAg ( O R=2.22, 95% C I:1.55-3.18, P<0.01) were statistically significant. Conclusion HER-2 is differentially expressed in HCC, and its expression level is related to clinicopathological features of HCC, suggesting a important role in the pathogenesis of HCC, and which can provide a higher level of evidence for the diagnosis and molecular targeted therapy of HCC in the future. However, the evidence for its quantity and quality remains limited, the results need to be verified by more high-quality studies. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (3): 274-278.   DOI: 10.3969/j.issn.1004-583X.2024.03.014 Abstract （221）   HTML （4）    PDF（pc） （847KB）（41）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (3): 284-288.   DOI: 10.3969/j.issn.1004-583X.2024.03.016 Abstract （221）   HTML （2）    PDF（pc） （830KB）（59）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Risk assessment of pancreatic cancer in patients with type 2 diabetes mellitus treated with sitagliptin: A meta-analysis of randomized controlled trials Zhu Chenglou, Wu Qiong, Da Mingxu Clinical Focus    2023, 38 (12): 1061-1066.   DOI: 10.3969/j.issn.1004-583X.2023.12.001 Abstract （220）   HTML （17）    PDF（pc） （1492KB）（52）       Knowledge map    Save Objective To evaluate the risk of pancreatic cancer (PC) in patients with type 2 diabetes mellitus (T2DM) who are treated with sitagliptin. Methods Articles reporting the risk of PC in T2DM patients treated with sitagliptin published before July 10, 2022 were searched in the online databases, including EMBASE, MEDLINE, the Cochrane Library, PubMed. STATA 12.0 software was used for meta-analysis. Two investigators were independently responsible for article screen, data collection and quality assessment. Results A total of 11 randomized controlled trials involving 33, 360 T2DM patients were identified. Meta-analysis using a fixed-effect model showed that sitagliptin treatment did not significantly increase the risk of PC in T2DM patients ( R R=0.74, 95% C I: 0.45-1.21, P=0.225). Subgroup analyses showed that the monotherapy ( R R=0.82, 95% C I: 0.39-1.71, P=0.600) and combination regimen of sitagliptin ( R R=0.68, 95% C I: 0.35-1.31, P=0.244) did not significantly increase the risk of PC in T2DM patients. Conclusion Sitagliptin treatment is not associated with the increase in the risk of PC. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (7): 658-663.   DOI: 10.3969/j.issn.1004-583X.2024.07.014 Abstract （219）   HTML （7）    PDF（pc） （1030KB）（44）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (2): 177-182.   DOI: 10.3969/j.issn.1004-583X.2024.02.016 Abstract （213）   HTML （9）    PDF（pc） （895KB）（29）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Effect of acceptance and commitment therapy on mental health and quality of life in cancer patients: A meta-analysis Gong Caifang, Zhao Junyu, You Chuan Clinical Focus    2024, 39 (2): 101-107.   DOI: 10.3969/j.issn.1004-583X.2024.02.001 Abstract （212）   HTML （20）    PDF（pc） （1514KB）（36）       Knowledge map    Save Objective To systematically evaluate the effect of acceptance and commitment therapy (ACT) on the mental health and quality of life of cancer patients. Methods Randomized clinical trials (RCTs) reporting the influence of ACT on mental health and quality of life in cancer patients were searched in the CBM, WanFang, CNKI, VIP, PubMed, Cochrane Library, Web of Science and EMbase databases, and the retrieval time was from the time of building the database to November 2022. Literature screening based on inclusion and exclusion criteria, quality assessment and data extraction were performed by two investigators. A meta-analysis was conducted using Revman5.4 software. Results A total of 14 RCTs representing 1,063 cancer patients were enrolled. Meta-analysis results showed that ACT significantly improved anxiety (SMD=-1.04, 95%CI [-1.19, -0.89], P<0.01), depression (SMD=-0.73, 95%CI[ -0.88, -0.59], P<0.01), psychological flexibility (MD=-2.17, 95%CI[-2.77, -1.57], P<0.01) and quality of life in cancer patients (MD=5.27, 95%CI [3.57, 6.98], P<0.01). Conclusion ACT can relieve anxiety and depression, improve psychological flexibility and quality of life, and positively promoting physical and mental health of cancer patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (8): 757-762.   DOI: 10.3969/j.issn.1004-583X.2023.08.015 Abstract （209）   HTML （2）    PDF（pc） （942KB）（50）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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IgG4-related diseases characterized by increased IgE level and eosinophil count with multiple lymphadenopathy: A case report Song Jialiang, Jiang Yingjie, Kong Ruina, Cai Qing, Gao Jie Clinical Focus    2024, 39 (1): 57-60.   DOI: 10.3969/j.issn.1004-583X.2024.01.010 Abstract （208）   HTML （4）    PDF（pc） （1086KB）（33）       Knowledge map    Save Objective To explore the clinical features and treatment of immunoglobulin G4 (IgG4)-related diseases characterized by increased immunoglobulin E (IgE) level and eosinophilic count with multiple lymphadenopathy. Methods The clinical data, diagnosis and treatment process of a patient with IgG4-related disease characterized by increased IgE level and eosinophilic count with multiple lymphadenopathy were retrospective analyzed, and related literatures were reviewed. Results A 24-year-old male patient was admitted with the enlargement of bilateral inguinal lymph nodes for more than 2 years. The clinical manifestations, IgG4 test and pathology results suggested the diagnosis of IgG4-related disease. The therapeutic regimen was 20 mg prednisone orally once a day and 5 mg Tofacitinib citrate tablets orally twice a day. The dosage was adjusted according to the blood test and ultrasound results, and the symptoms of the patient were significantly improved at the final follow-up visit. Conclusion IgG4-related diseases are often characterized by significantly elevated serum IgG4 levels and lump-like lesions. Increased IgE level and eosinophil count are rarely observed in cases of IgG4-related diseases, although their important roles have been recently identified. Glucocorticoids are the first-line drugs, and targeted drugs like Tofacitinib may have potential therapeutic effects on IgG4-related diseases, which expand the new idea of the treatment. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1135-1139.   DOI: 10.3969/j.issn.1004-583X.2023.12.014 Abstract （205）   HTML （5）    PDF（pc） （884KB）（46）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (1): 84-87.   DOI: 10.3969/j.issn.1004-583X.2024.01.016 Abstract （201）   HTML （8）    PDF（pc） （859KB）（42）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Correlation between serum uric acid, homocysteine and cystatin C levels with motor symptoms and cognitive function in Parkinson's disease patients Wang Jiuxue, Li Na, Jin Wei, Wang Shuo, Chang Yajun, Wang Tianjun Clinical Focus    2024, 39 (2): 125-129.   DOI: 10.3969/j.issn.1004-583X.2024.02.005 Abstract （197）   HTML （9）    PDF（pc） （869KB）（35）       Knowledge map    Save Objective To investigate the correlation between serum uric acid (UA), homocysteine (HCY) and cystatin C (Cys C) with motor symptoms and cognitive function in Parkinson's disease (PD) patients. Methods A total of 200 PD patients admitted to Hebei General Hospital from January 2019 to August 2022 were enrolled. They were divided into tremor-dominant (TD) group(n=104) and non-tremor-dominant (NTD) group(n=96) according to first-onset motor symptoms. In addition, the PD patients were grouped also into cognitive normal(PD-CN) group(n=118) and cognitive impairment (PD-CI) group(n=82) according to Montreal Cognitive Assessment. The levels of serum UA, HCY and Cys C of the PD patients were compared. Multivariate logistic regression was used to analyze the risk factors of tremor and cognitive dysfunction in PD patients. Results The patients in TD group had significantly higher serum UA levels, significantly lower Hcy and Cys C levels compared with those of the NTD group (P<0.05). The results from multiple logistic regression analysis showed that UA, HCY, and Cys C were independent risk factors for tremor in PD patients. The patients in the PD-CN group pesented significantly higher serum UA levels, significantly lower HCY and Cys C levels relative to those of the PD-CI group (P<0.05). The results from multivariate logistic regression analysis verifyed that UA, HCY, and Cys C were independent risk factors for cognitive dysfunction in PD patients (P<0.05). Conclusion The serum levels of UA, HCY, and Cys C in PD patients are correlated with motor symptoms and cognitive function. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (7): 668-672.   DOI: 10.3969/j.issn.1004-583X.2023.07.015 Abstract （197）   HTML （1）    PDF（pc） （848KB）（150）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (9): 842-846.   DOI: 10.3969/j.issn.1004-583X.2024.09.015 Abstract （194）   HTML （9）    PDF（pc） （905KB）（52）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (10): 944-948.   DOI: 10.3969/j.issn.1004-583X.2023.10.016 Abstract （194）   HTML （4）    PDF（pc） （860KB）（32）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）