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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    2022, 37 (7): 653-657.   DOI: 10.3969/j.issn.1004-583X.2022.07.014 Abstract （1504）   HTML （5）    PDF（pc） （886KB）（1329）       Knowledge map    Save 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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Effects of dual coping intervention on coping ability and marital adjustment of young adult patients with breast cancer and their spouses Gu Jiahua, Wu Qi Clinical Focus    2022, 37 (9): 822-826.   DOI: 10.3969/j.issn.1004-583X.2022.09.011 Abstract （682）   HTML （1）    PDF（pc） （855KB）（613）       Knowledge map    Save Objective To explore the effect of dual coping intervention on coping ability and marital adjustment of young adult patients with breast cancer and their spouses. Methods The young ault postoperative patients with breast cancer and their spouses (n=80 pairs), who visited the Department of Breast, the International Peace Maternity & Child Health Hospital of China welfare institute (June 2021 to September 2021) were randomized to recevie conventional care (control group, n=40 pairs) or dual coping intervention + conventional care (observation group, n=40 pairs) for 4 months, aiming to compare intergroup coping ability and marital adjustment.Results Before intervention, the two groups had insignificant differences in the total scores and dimension scores of the dyadic coping inventory (DCI) scale and Locke-Wollance marital adjustment scale (LWMAS) (all P>0.05); after intervention, the observation group had significantly higher total scores and dimension scores of DCI scale and LWMAS than the control group (all P<0.05).Conclusion Dual coping intervention can improve the coping ability and marital adjustment of young adult patients with breast cancer and their spouses, which contributes to the improvements in marital quality and happiness. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1146-1149.   DOI: 10.3969/j.issn.1004-583X.2023.12.016 Abstract （160）   HTML （6）    PDF（pc） （875KB）（598）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2022, 37 (8): 748-752.   DOI: 10.3969/j.issn.1004-583X.2022.08.014 Abstract （501）   HTML （10）    PDF（pc） （884KB）（574）       Knowledge map    Save Table and Figures | 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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Long-term effect of hypoglossal nerve stimulation in the treatment of obstructive sleep apnea hypopnea syndrome: A meta analysis Sun Ying, Yu Qin Clinical Focus    2022, 37 (8): 677-684.   DOI: 10.3969/j.issn.1004-583X.2022.08.001 Abstract （401）   HTML （0）    PDF（pc） （2009KB）（259）       Knowledge map    Save Objective To explore the long-term effect of hypoglossal nerve stimulation (HGNS) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Through the systematic search of China knowledge Network database, Wanfang database, VIP database, Chinese biomedical literature database, Pubmed, Embase, Cochrane Library, the article published by domestic and foreign scholars regarding HGNS, untill to March 2022, were collected. The literatures were screened and extracted by two evaluators independently and the quality of the literatures was evaluated by NOS scale, Meta analysis was carried out by stata12.0 software. Results A total of 12 cohort studies with 776 patients were included. The posttreatment 6-month sleep apnea hypopnea index, (AHI, mean difference [SMD]=-1.47, 95% CI 95% confidence interval [95%CI]-1.68-1.25, P=0.000), oxygen desaturation index (ODI, SMD=-0.77,CI: -0.95--0.58, P=0.000), epworth scale score (ESS, SMD=-1.00, CI: -1.16--0.84, P=0.000), functional qutcomes of sleep questionnaire (FQSQ, SMD=1.10, CI: 0.92~1.28, P=0.000), AHI in 12 months after operation (SMD=-1.250, CI:-1.39--1.10, P=0.000), ODI (SMD=-0.874, CI:-1.114--0.634, P=0.001) and FQSQ (SMD=1.10, CI: 0.96-1.22, P=0.000) were significantly improved than those before treatment. Conclusion Hypoglossal nerve stimulation is effective in the treatment of OSAHS. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2022, 37 (8): 759-763.   DOI: 10.3969/j.issn.1004-583X.2022.08.016 Abstract （285）   HTML （0）    PDF（pc） （898KB）（248）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (10): 935-939.   DOI: 10.3969/j.issn.1004-583X.2024.10.012 Abstract （108）   HTML （6）    PDF（pc） （803KB）（225）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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A network meta-analysis of SGLT2 inhibitors on cardiovascular outcomes in patients with type 2 diabetes Wang Runqing, Wang Qian, Liao Jianxiong Clinical Focus    2022, 37 (12): 1061-1073.   DOI: 10.3969/j.issn.1004-583X.2022.12.001 Abstract （399）   HTML （3）    PDF（pc） （3529KB）（193）       Knowledge map    Save Objective Type 2 diabetes is a chronic disease and heart failure is a common complication of type 2 diabetes, and large studies have demonstrated the role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in improving cardiovascular outcomes of patients with type 2 diabetes. In this paper, the efficacy effects of five different SGLT2i were indirectly compared by systematic evaluation. Methods PubMed, Web of science, Cochrane Library, CNKI, WanFang, and VIP databases were searched to collect relevant literature with a search time frame of build to July 2022. Two researchers independently screened the literature and extracted the corresponding data, using the composite outcome of heart failure hospitalization and cardiovascular death as the primary outcome indicator, with heart failure hospitalization, cardiovascular death and all-cause death as secondary outcome indicators, and a network meta-analysis was performed using Stata 16.0 as well as the network program package. Results A total of 340 publications were retrieved, eligible 11 publications representing 62 904 patients were included. The five intervention methods were involved, namely: empagliflozin, sotagliflozin, dapagliflozin, ertugliflozin and canagliflozin. There were no statistically significant differences (P>0.05) between the five different SGLT2i in altering the composite outcomes of heart failure hospitalization and cardiovascular death, cardiovascular death, heart failure hospitalization and all-cause death in patients with type 2 diabetes. All five different SGLT2i significantly improved heart failure hospitalization outcomes in patients with type 2 diabetes compared to placebo. There was a statistically significant difference between empagliflozin and sotagliflozin in improving the composite outcome of heart failure hospitalization and cardiovascular death. No significant difference between placebo and the five different SGLT2i in improving the outcome of cardiovascular death or all-cause death. Conclusion There was a trend towards a more significant benefit of empagliflozin and sotagliflozin improving the composite outcome of heart failure hospitalization and cardiovascular death and heart failure hospitalization outcome in type 2 diabetic patients, while for cardiovascular death or all-cause death outcome, there was no statistically significant difference between the five different SGLT2i and placebo, and the exact mechanisms and causes still need to be explored and validated in large studies. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (11): 1034-1037.   DOI: 10.3969/j.issn.1004-583X.2023.11.014 Abstract （132）   HTML （3）    PDF（pc） （842KB）（154）       Knowledge map    Save 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    2022, 37 (10): 957-960.   DOI: 10.3969/j.issn.1004-583X.2022.10.016 Abstract （396）   HTML （2）    PDF（pc） （835KB）（147）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2022, 37 (8): 753-758.   DOI: 10.3969/j.issn.1004-583X.2022.08.015 Abstract （307）   HTML （2）    PDF（pc） （889KB）（143）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Effect of semaglutide on total myocardial ischemic burden and serum inflammatory factors in patients with type 2 diabetes mellitus complicated with coronary heart disease Wang Wenqi, Zhang Tao Clinical Focus    2022, 37 (11): 996-1000.   DOI: 10.3969/j.issn.1004-583X.2022.11.006 Abstract （468）   HTML （1）    PDF（pc） （817KB）（141）       Knowledge map    Save Objective To investigate the effects of semaglutide, a once-weekly glucagon-like peptide-1 receptor agonist (GLP-1RA), on total myocardial ischemic burden and inflammatory factors in patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD). Methods From June 2021 to June 2022, totally 96 patients with T2DM and CHD admitted to the First Affiliated Hospital of Jinzhou Medical University were retrospectively recruited. They were randomized 1∶1 to the conventional treatment group and the semaglutide treatment group. Patients in the conventional treatment group were treated with standard hypoglycemic, hypotensive, lipid-regulating, and antiplatelet medications. According to blood glucose target, insulin glargine was applied and adjusted. Semaglutide injection 1.0 mg subcutaneously, once a week, was additionally given to those in the semaglutide treatment group. The clinical manifestations, body mass index (BMI), blood pressure, fasting blood glucose (FPG), blood lipids, glycosylated hemoglobin A1c (HbA1c) and other indicators were observed in the two groups before and 3 months after treatment, and the total myocardial ischemia burden and serum inflammation indicators were detected. Results One case was lost to follow-up in both groups. At the end of the trial, clinical symptoms, FPG, blood lipid and HbA1c were significantly improved in the both groups. BMI and low-density lipoprotein cholesterol (LDL-C) in the semaglutide treatment group were significantly decreased than those in the conventional treatment group. The dosage of insulin glargine and incidence of hypoglycemia were significantly lower in the semaglutide treatment group than in the conventional treatment group. The total load of myocardial ischemia was significantly reduced in the both groups and the effect of semaglutide treatment group was better than that of the coventional treatment group. The serum levels of high sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in the semaglutide treatment group were significantly decreased than those in the conventional treatment group. Conclusion Semaglutide provides clinical benefits to T2DM patients by lowering glucose, regulating lipid and reducing body weight. It delays the progression of coronary atherosclerosis in patients with T2DM and CHD, and improves myocardial ischemia and prognosis by inhibiting inflammatory response and reducing total myocardial ischemic load. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2022, 37 (11): 1044-1047.   DOI: 10.3969/j.issn.1004-583X.2022.11.015 Abstract （491）   HTML （7）    PDF（pc） （796KB）（138）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Mycoplasma pneumoniae infection in Chengdu in 2021: An epidemiological study Zhang Dawei, Li Xin, Sun Guifeng Clinical Focus    2023, 38 (3): 237-240.   DOI: 10.3969/j.issn.1004-583X.2023.03.007 Abstract （379）   HTML （3）    PDF（pc） （814KB）（138）       Knowledge map    Save Objective To explore the epidemic characteristics and changing trend of mycoplasma pneumoniae (MP) infection in Chengdu in 2021, thus providing references for clinical practice.Methods A total of 10,012 patients in Chengdu, Sichuan Province with respiratory tract infection and examined with a passive agglutination assay for detecting MP antibodies (MP-Ab) in 2021 were recruited. The differences in MP infections of different age groups, male or female patients and at different seasons were observed.Results Totally 3084/10,012 (30.80%) MP-positive samples were detected. Stratified by the sex, the positive rate of MP infection in male patients was significantly lower than that of females (25.84% vs 36.12%, χ2=124.00, P<0.05). The positive rate of MP in juveniles was significantly higher than that in adults and middle-aged and elderly people (43.53% vs 33.83%, 14.03%, χ2=790.13, P<0.05). The positive rate of MP increased with aging in patients of 0-18 years. The highest and lowest positive rate of MP in minors were detected in those aged 15-17 years (61.61%) and infants younger than 1 year (4.08%), respectively. A significant difference in the positive rate of MP was detected in age groups of minors (χ2=388.27, P<0.05). Stratified by the season, the highest and lowest positive rate of MP were detected in autumn (33.67%) and summer (27.01%), respectively. No significant difference was detected in the positive rate of MP between winter and spring (χ2=1.16, P>0.05), which was significantly different between summer and autumn (χ2=28.23, P<0.05). November was the month with the highest positive rate of MP in the whole year (35.85%), and the lowest was February (21.79%). Conclusion The positive rate of MP in female is higher than that in male. Preschool children, school-age children and adolescents are susceptible populations of MP infection. In autumn and the alternating seasons of autumn and winter (i.e., September to December), MP infection is highly prevalent. MP is one of the important pathogens causing respiratory tract infection in Chengdu in 2021. Targeted prevention and control measures should be taken for susceptible populations according to the epidemiological characteristics of MP infection. Meanwhile, health education should be strengthened to prevent and control the spread of MP infection. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Correlations between sleep disorder and cognitive function in elderly patients with mild cognitive impairment Li Zhongmei, Ran Li, Jiang Yi, Guo Zhiwei, Mu Qiwen Clinical Focus    2022, 37 (7): 607-611.   DOI: 10.3969/j.issn.1004-583X.2022.07.004 Abstract （422）   HTML （0）    PDF（pc） （877KB）（138）       Knowledge map    Save Objective To explore the sleep disorders (SD) in elderly patients with mild cognitive impairment (MCI) and corresponding correlations with cognitive function. Methods A total of 171 eligible patients with MCI in a community located in Nanchong, Sichuan from November 2018 to January 2019 were included. The overall sleep conditions of patients was assessed by the Pittsburgh sleep quality index (PSQI). The enrolled patients were divided into MCI with SD group (MCI-SD group) and MCI without SD group (MCI-NSD group) according to scoring results. Montreal cognitive assessment-basic (MoCA-B), mini-mental status examination (MMSE), auditory verbal learning test (AVLT), Boston naming test (BNT), animal verbal fluency test (AFT), trail making test (TMT) were applied to evaluate the overall cognition, memory, language and executive function of MCI patients, and the differences in overall cognitive function and cognitive domain between two groups were comparatively analyzed. Results SD was found in 70 (40.9%) out of 171 MCI patients, and the differences in the gender, age and education level between two groups were not statistically significant (all P>0.05), while the differences in the sleep quality, time of sleep onset, sleep duration, sleep efficiency, night sleep disorders, hypnotic drug and daytime function were statistically significant (all P<0.05). Compared to the MCI-NSD group, MoCA-B, MMSE, and BNT scores of MCI-SD group were significantly lowered, and the total time spent on TMT-A was significantly increased (all P<0.05). The time to fall asleep in the MCI-SD group was negatively correlated with the total score of MMSE and positively correlated with the total time spent in TMT-A; the sleep efficiency was negatively correlated with total scores of MMSE; total scores of PSQI were negatively correlated with total scores of MoCA-B and MMSE and were positively correlated with the total time spent in TMT-A. The total time spent on BNT and TMT-A was considered to be an independent risk factor for MCI patients complicated with SD (all P<0.05). Conclusion MCI patients are found to have higher incidence of SD, and long-term sleep disorder may lead to or aggravate the decline of cognitive dysfunction, especially the impacts on language naming and executive function may be more significant. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2022, 37 (9): 838-841.   DOI: 10.3969/j.issn.1004-583X.2022.09.015 Abstract （350）   HTML （3）    PDF（pc） （839KB）（137）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Correlation between the gene polymorphisms of interleukin and the susceptibility to pneumonoconiosis: A systematic review and meta-analysis Zheng Ling, Su Jingying, Wu Dinghui, Yao Xiangyang Clinical Focus    2023, 38 (1): 5-19.   DOI: 10.3969/j.issn.1004-583X.2023.01.001 Abstract （286）   HTML （1）    PDF（pc） （1735KB）（134）       Knowledge map    Save Objective To investigate the correlationbetween the genepolymorphisms of interleukin and the susceptibility to pneumonoconiosis. Methods Literatures reporting the correlation between the gene polymorphisms of interleukin and the susceptibility to pneumonoconiosis in the PubMed, the Cochrane Library, Embase, CNKI, Wanfang Data, Weipu Database (VIP), and Chinese Biomedical Database (CBM) and other databases, which were published from the establishment of the databases to January 8, 2022 were screened.Two researchers independently extracted data and assessed the risk of bias. Using RevMan 5.2 and Stata 14.0, allelic model, dominant model, recessive model, co-dominant models (2 models), and over-dominant model were used in the meta-analysis on the correlation between interleukin-associated gene polymorphisms and susceptibility to pneumoconiosis. Results A total of 29 eligiblestudies, involving 5 315 pneumoconiosis cases and 5 332 controls were included in the current study. There were 8 literatures reporting the IL-1β-511C/T polymorphism, and the data revealed that the recessive model (OR=1.57, 95%CI=1.06-2.33, P=0.024), and co-dominant model (TT vs CC) (OR=1.80, 95%CI=1.03-3.13, P=0.039) of the IL-1β-511C/T polymorphism were significantly correlated with the susceptibility to pneumonoconiosis. There were 6 literatures reporting the IL-1RA+2018T/C polymorphism, and the data revealed that the allele model(OR=1.65, 95%CI=1.21-2.27, P=0.002), dominant model(OR=1.65, 95%CI=1.11-2.46, P=0.013), recessive model(OR=2.14, 95%CI=1.50-3.06, P=0.000), and co-dominant model (TT vs CC) (OR=2.29, 95% CI=1.58-3.32, P=0.000) of the IL-1RA+2018T/C polymorphism were significantly correlated with the susceptibility to pneumonoconiosis. There were 4 literatures reporting the IL-1α-889C/T polymorphism, and the data revealed that the dominant model(OR=1.75, 95%CI=1.02-3.01, P=0.042), and co-dominant model (CT vs CC)(OR=1.79, 95%CI=1.21-2.636, P=0.004) of the IL-1α-889C/T polymorphism were significantly correlated with the susceptibility to pneumonoconiosis. There were 3 literatures reporting the IL-1α +4845G/T polymorphism, and the data revealed that the allele model(OR=1.59, 95%CI=1.03-2.56, P=0.038) of the IL-1α+4845G/T polymorphism was significantly correlated with the susceptibility to pneumonoconiosis. There were 4 literatures reporting the IL-6 -634C/G polymorphism, and the data revealed that the allele model(OR=0.60, 95%CI=0.47-0.75), dominant model(OR=0.47, 95% CI=0.35-0.64), co-dominant model(OR=0.63, 95%CI=0.42-0.94) (OR=0.36, 95%CI=0.24-0.54) and over-dominant model (OR=2.51, 95%CI=1.71-3.69) of the IL-6 -634C/G polymorphism were significantly correlated with the susceptibility to pneumonoconiosis. There were 2 literatures reporting the IL-8 -781C/T, IL-8-Met31Arg T/G and IL-8 -251A/T polymorphisms, and the data revealed their significant correlation with thesusceptibility to pneumonoconiosis. There was no significant correlation between IL-1β +3953C/T, IL-6 -174G/C and IL-10 -592A/C polymorphisms with the susceptibility topneumoconiosis. Conclusion IL-1RA +2018T/C and IL-6 -634 C/G polymorphisms were significantly correlated with the susceptibility to pneumoconiosis. IL-1α +4845G/T, IL-1β -511C/T and IL-1α -889C/T polymorphisms may be correlated with the susceptibility to pneumoconiosis. IL-1β +3953C/T and IL-6 -174G/C were not correlated with the susceptibility to pneumoconiosis. Our findings should be further validated in multi-center studies with a large sample size. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Predicting the risk by FIB-4 on hepatocellular carcinoma in patients with chronic liver disease: A meta-analysis He Chao, Huang Shaobin Clinical Focus    2022, 37 (9): 779-784.   DOI: 10.3969/j.issn.1004-583X.2022.09.002 Abstract （252）   HTML （0）    PDF（pc） （1460KB）（132）       Knowledge map    Save Objective To systematically evaluate the value of fibrosis-4 (FIB-4) in predicting future hepatocellular carcinoma (HCC) in patients with chronic liver disease (CLD).Methods We searched PubMed, Web of Science, Wan-fang and CNKI databases for relevant literatures of FIB-4 predicting HCC risk in CLD patients, and selected eligible literatures according to the including and excluding criteria. Revman 5.3 software was used to perform statistical analyses.Results A total of 35 articles with 94, 569 CLD patients were included. Meta-analysis results showed that high baseline FIB-4 predicted high HCC risk in CLD patients (HR=1.57, 95%CI: 1.41-1.75, P<0.01). Post-treatment high FIB-4 (HR=2.40, 95%CI: 1.74-3.32, P<0.01) was associated with high risk of future HCC in patients with chronic hepatitis B or hepatitis C virus. Conclusion FIB-4 is useful in predicting future HCC in CLD patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Effects of common cardiovascular drugs on the risk of COVID-19 infection and poor prognosis Zhou Zihan, Cui Wei Clinical Focus    2022, 37 (10): 869-888.   DOI: 10.3969/j.issn.1004-583X.2022.10.001 Abstract （280）   HTML （1）    PDF（pc） （1215KB）（131）       Knowledge map    Save Cardiovascular disease is the most-common complication of coronavirus disease 2019 (COVID-19). During the COVID-19 pandemic, the safety and efficacy of common cardiovascular drugs such as anti-hypertensive, lipid-lowering, antiplatelet, anticoagulant, hypoglycemic and antiarrhythmic drugs have remained controversial that required improved consensuses. With the increase of global cases of COVID-19 and the occurrence of the second wave of infection, it is urgent to reveal the effects of cardiovascular disease drugs on COVID-19 patients. This study aims to summarize the relationship between common cardiovascular drugs and the risk of COVID-19 infection and poor prognosis, thus providing references for medications in COVID-19 patients with cardiovascular diseases. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Comparative analysis on pathological results of preoperative & postoperative colorectal intraepithelial neoplasia and early colorectal cancer endoscopic therapies Shi Yujuan, Wang Jing, Xu Ping Clinical Focus    2023, 38 (1): 55-59.   DOI: 10.3969/j.issn.1004-583X.2023.01.007 Abstract （708）   HTML （0）    PDF（pc） （850KB）（130）       Knowledge map    Save Objective To provide reference for the improved pathological diagnosis of lesions of the tissues by exploring pathological differences of preoperative and postoperative endoscopic polypectomy for colorectal intraepithelial neoplasia and early colorectal cancer. Methods One hundred and twenty nine patients receiving both biopsies and surgeries based on the inclusion and exclusion criteria were selected as study samples, the specimen data and preoperative pathology biopsy data of 129 patients diagnosed with high-grade colorectal intraepithelial neoplasia or early colorectal cancer patients under endoscopic mucosal resection (EMR)/ endoscopic submucosal dissection (ESD) were retrospectively analyzed, differences in preoperative and postoperative pathological results were compared, and the risk factors associated with pathological differences in preoperative and postoperative endoscopic therapies were analyzed. Differences in the accuracy of pathological biopsies and EMR/ESD samples of patients with different parts (ascending colon, transverse colon, descending colon, sigmoid colon, rectum), lesion morphology (pedicled, sessile and lateral developmental morphology), maximum diameter of lesions, gender and age were observed. Results The diagnostic accordance rate of the postoperative pathological diagnosis of preoperative colonoscopy biopsies and endoscopic EMR/ESD therapies was 17.1% (22/129), the number of postoperative pathological ascending and descending lesions of endoscopic therapies amounted to 103 cases (79.8%) and 4 cases (3.1%), respectively, the mild-severity judgment rate of sites was 82.4%, 80.0%, 85.7%, 80.9% and 76.7%, respectively, and differences weren’t statistically significant (P>0.05). The results of single-factor Logistic regression analysis showed that the phenomenon of mild-severity judgments on preoperative biopsies was more obvious in patients with pedunculated polyps, and difference was statistically significant (P<0.05), while difference in mild-severity judgment rate for preoperative biopsies was not statistically significant for the lesion site, maximum diameter, sex, and age (P>0.05). Conclusion Both the preoperative pathological biopsy diagnosis and postoperative EMR/ESD pathological diagnosis with low compliance rate provide certain basis for selection on endoscopic follow-up and surgical treatment. Patients with pedunculated polyps are vulnerable to mild severity judgment for preoperative biopsies. Therefore, patients with pedunculated polyps are subject to intraepithelial neoplasia diagnose via biopsies, EMR/ESD surgery is supported to be selected based on the conditions in combination with narrow band imaging and magnifying endoscopy technique, and necessities for follow-up treatment and endoscopic follow-up time are supported to be determined by combining the pathological diagnosis on postoperative specimens. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Analysis of one-year follow-up results of ≥75-year-old atrial fibrillation inpatients with high CHA2DS2-VASc score Zhang Fang, Zhang Yichao, Jia Xinwei, Li Jianlong, Chen Chunhong Clinical Focus    2023, 38 (2): 117-120.   DOI: 10.3969/j.issn.1004-583X.2023.02.003 Abstract （257）   HTML （1）    PDF（pc） （823KB）（122）       Knowledge map    Save Objective Atrial fibrillation (AF) is a common arrhythmia that increases the risk of ischemic stroke with age. It is a prospective study to analyze the prognosis of ≥75-year-old AF patients with high CHA2DS2-VASc scores, and to explore the risk factors. Methods A total of 196 elderly patients older than 75 years with high CHA2DS2-VASc scores who were hospitalized in the Department of Cardiology, Affilated Hospital of Hebei University, from December 2015 to November 2017 were recruited, including 90 in the AF group and 106 in the non-AF group. A 1-year follow-up was performed, the primary endpoint events of all-cause death, heart failure (HF), and ischemic stroke were recorded. Data processing was performed using the SPSS19.0 statistical software package. Results ①There were 31 deaths (15.8%) at 1-year follow-up. The incidence of all-cause death, stroke and HF in AF group was significantly higher than that in non-AF group (P <0.05). ②Age and history of heart failure were independent risk factors for death and HF in elderly patients older than 75 years with high CHA2DS2-VASc scores. ③Female gender and hypertension were independent risk factors for stroke at 1-year follow-up in elderly patients older than 75 years with high CHA2DS2-VASc scores. Conclusion Elderly patients (≥75 years old) with high CHA2DS2-VASc scores have a poor prognosis, and those combined with AF have a worse prognosis. Sex and age are the independent risk factors for assessing the prognosis. As an independent risk factor, HF has a significant power, and active control can significantly improve the prognosis. Our prospective and observational study provides some theoretical basis for the current clinical treatment of such patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Rebamipide in the treatment of nonsteroidal anti-inflammatory drug-associated intestinal disease: A meta-analysis Wang Tengyan, He Yajun, Shu Jianchang Clinical Focus    2022, 37 (8): 685-690.   DOI: 10.3969/j.issn.1004-583X.2022.08.002 Abstract （310）   HTML （0）    PDF（pc） （1695KB）（120）       Knowledge map    Save Objective To evaluate the clinical efficacy of Rebamipide in the treatment of nonsteroidal anti-inflammatory drugs (NSAIDs)-associated intestinal disease. Methods PubMed, MedLine, Embase, The Cochrane Library, China Biomedical Literature Database (CBM), CNKI and Wanfang Data were searched for randomized controlled trials(RCTs)in the treatment of NSAIDs-associated bowel diseases. Set a time limit for each database to be built until January 2021. According to the evaluation criteria recommended by the Cochrane system evaluation guide manual, the quality of the included study was evaluated, and Review Manager 5.3 software was used for Meta analysis after entering the main outcome indicators of the literatures. Results Finally, eligible 6 RCTs were included, with a total of 255 subjects; 3 articles mainly observed the number of cases of intestinal injury after treatment with Rebamipide, and all of them could extract effective data; the effective data could be extracted from 4 articles focused the number of intestinal mucosal erosion after treatment, 3 articles observed the number of intestinal mucosal ulcers after treatment with extracted effective data. The results of Meta analysis showed that the number of intestinal injuries (OR=0.34, 95%CI: 0.15-0.75, P<0.05), intestinal mucosal erosion(MD=-4.71, 95%CI:-6.40 to -3.02, P<0.05) and intestinal mucosal ulcers (MD =-0.45, 95% CI: -0.89 to -0.01, P<0.05) decreased significantly in the Rebamipide group as compared to the routine regimen group. Conclusion Rebamipide has advantages in the prevention and treatment of NSAIDs-associated intestinal disease and can reduce intestinal injury in patients who take NSAIDs drugs for a long time. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (1): 88-92.   DOI: 10.3969/j.issn.1004-583X.2023.01.015 Abstract （349）   HTML （6）    PDF（pc） （857KB）（119）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Exploration path on integrating red doctor’s spirit into curricular ideology of medical humanities course Wang Jingwei, Ji Yunfei, Zhou Di Clinical Focus    2022, 37 (10): 938-941.   DOI: 10.3969/j.issn.1004-583X.2022.10.011 Abstract （339）   HTML （0）    PDF（pc） （831KB）（116）       Knowledge map    Save The red doctor’s spirit, formed in the Revolutionary War Time, and it is the specific embodiment of Jinggangshan spirit and Yan'an Spirit in medical and health undertakings. It includes the connotation of “political firmness, saving the dying and healing the wounded, hard work and selfless dedication”. The red doctor’s spirit still has its significance in the new era. It not only provided spiritual strength in the COVID-19 period, but also will play a guiding role in the post epidemic era. Integrating the red doctor’s spirit into the medical humanities course will help medical students establish lofty ideals, beliefs and value pursuit. It is the need to explore the path of integration in order to help students internalize and externalize the connotation of the red doctor’s spirit into their mind and action. This paper will suggest that we could use the mode of selecting teaching forms according to the connotation of red doctor’s spirit, so as to cultivate the medical humanistic quality of firm belief, life first, great medical skill & sincerity and shared common destiny. Reference | Related Articles | Metrics | Comments（0）

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Prognostic value of procalcitonin to platelet ratio in patients with fever with thrombocytopenia syndrome Yang Jinqiang, Zhang Renmin Clinical Focus    2023, 38 (4): 346-351.   DOI: 10.3969/j.issn.1004-583X.2023.04.010 Abstract （229）   HTML （0）    PDF（pc） （936KB）（109）       Knowledge map    Save Objective To investigate the value of procalcitonin/platelet ratio(PCT/PLT) in evaluating the prognosis of Severe fever with thrombocytopenia syndrome(SFTS). Methods A total of 156 SFTS patients diagnosed in Weihai Central Hospital from January 1, 2020 to January 1, 2022 were collected andassigned into death group and survival group according to the prognosis. the basic data and laboratory indicators of the two groups were compared, the independent risk factors affecting the prognosis of SFTS were screened by univariate and binomial multiple Logistic regression, and the value of different influencing factors on the prognosis of SFTS was evaluated by the area under the receiver operating characteristic(ROC) curve, sensitivity, specificity, accuracy.Results Activated partial thromboplastin time, thrombin time, D-dimer, alanine aminotransferase, serum creatinine, lactate dehydrogenase, aspartate aminotransferase, blood urea nitrogen, activated partial thromboplastin time/platelet, neutrophil count, neutrophil lymphocyte ratio, creatine kinase isoenzyme, procalcitonin, PCT/PLT, as well as the proportion of patients whose nucleic acid quantity were higher than the optimal reference value in the death group was significantly higher than those in the survival group(P<0.05). The proportion of patients with Ca2+, PLT, lymphocyte count higher than the optimal reference value was significantly lower than that in the survival group(P<0.05). Univariate and binomial multiple Logistic regression showed that age, thrombin time, aspartate aminotransferase, lymphocyte count, PCT/PLT, and viral nucleic acid quantification were independent risk factors for the prognosis of SFTS. The best reference value of PCT/PLT was 0.005, and the AUC was 0.828(0.757-0.898). When PCT/PLT was greater than 0.005, the risk of death was increased by 30 times, the sensitivity was 87.1%, and the specificity was 78.4%. Conclusion PCT/PLT can be used as a clinical indicator to evaluate the prognosis of patients with SFTS. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Unilateral biportal endoscopy versus microendoscopic discectomy for degenerative lumbar spinal stenosis: A meta-analysis Shen Tianyu, Bai Gang, Chen Rui, Xiang Zhicheng, Zhu Hao, Shang Hui Clinical Focus    2022, 37 (8): 691-698.   DOI: 10.3969/j.issn.1004-583X.2022.08.003 Abstract （424）   HTML （0）    PDF（pc） （2175KB）（108）       Knowledge map    Save Objective To provide instructions to clinical decision-making by comparing the efficacy of unilateral biportal endoscopic(UBE) and microendoscopic discectomy (MED) in treating degenerative lumbar spinal stenosis(LSS). Methods Chinese and English study papers on UBE and MED for degenerative LSS were respectively searched in PubMed, Web of Science,Cochrane Library,Embase,Wanfang Database,CNKI,VIP,China Biologicl Medicine (CBM) and other databases, and controlled clinical studies on UBE and MED therapies with the search duration starting from the setup of databases to March 2020 were collected. The study documents were subject to the screening, quality evaluation and data extraction based on the inclusion and exclusion criteria. RevMan 5.4 and Stata15.1 software were applied for meta-analysis on the extracted data. The operation duration, blood loss, visual analogue scake (VAS) score of back and leg pain in the last follow-up, disability index (ODI), complication rates, postoperative dural distension, and intraoperative blood loss were included as comparator. Results Finally, 10 study papers (3 randomized controlled trials (RCTs) and 7 non-randomized controlled trials (N-RCTs)) involving a total of 880 patients were included, and 407 UBE cases and 473 MED cases were noted. The meta-analysis results showed that differences in the degree of dura extension, operation duration, intra-operative blood loss and ODI between groups weren't statistically significant. Compared with MED group, the lower VAS scores of the back pain in the last follow-up [MD=-0.18,95%CI(-0.31,-0.05),P=0.006] and leg pain [MD=-0.15,95%CI(-0.27,-0.04),P=0.008] as well as higher incidence rate of complications[OR=0.54,95%CI(0.31,0.94),P=0.03] were noted in UBE group. Conclusion Both UBE and MED are both effective treatments of degenerative LSS, MED is found to be superior to UBE in reducing the complications, while UBE is advantageous in improving VAS scores of the post-operative back pain, and overall consideration should be taken in the selection on surgery program. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Relationship between uric acid and prognosis of Chinese patients with acute ischemic stroke: A meta analysis Wang Huixin, Zhao Fangqing, Zhang Xinyan, Hou Xiaowen Clinical Focus    2022, 37 (9): 785-790.   DOI: 10.3969/j.issn.1004-583X.2022.09.003 Abstract （363）   HTML （0）    PDF（pc） （1334KB）（108）       Knowledge map    Save Objective The meta analysis method was applied to comprehensively and systematically evaluate relations between uric acid and prognosis of Chinese patients with acute ischemic stroke.Methods PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP and Wanfang databases were searched by computer system to collect case-control studies on relation between the level of uric acid and prognosis of patients with acute ischemic stroke in Chinese from database establishment to February 2022. The Meta analysis was performed using STATA 16 software. Results Thirteen literatures representing a total of 11, 046 study subjects (n=8, 016 in the good prognosis group, and n=3 030 in the poor prognosis group) were included in the meta-analysis. The results showed that the uric acid level of patients in the good prognosis group was higher than that of poor prognosis group [WMD=18.44 μmol/L, 95%CI(3.20, 33.68), P<0.05]. The results of sensitivity analysis and publication bias test showed that the study results were stable and reliable.Conclusion The level of uric acid in Chinese may be related to the prognosis of patients with acute ischemic stroke, and the higher level of uric acid in Chinese patients may have a better prognosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Meta-analysis of risk factors for pancreatic pseudocyst in acute pancreatitis Ma Mingfu, Wei Zhiguo, He Tieying Clinical Focus    2023, 38 (4): 293-301.   DOI: 10.3969/j.issn.1004-583X.2023.04.001 Abstract （99）   HTML （2）    PDF（pc） （2010KB）（107）       Knowledge map    Save Objective To evaluate the risk factors of pancreatic pseudocysts in acute pancreatitis using a meta-analysis system, providing evidence based medical evidence for the prevention and treatment of pancreatic pseudocyst. Methods All relevant literature included in Medline database, Embase, Cochrane Library, web of science, CNKI, CBM, Wanfang database and VIP database from the establishment to November 2022 were first searched. The literature were then screened according to the inclusion and exclusion criteria. The Newcastle-Ottawa Scale (NOS) was used for quality evaluation. Review Manager 5.4 and Stata 14 software were applied for meta-analysis. Publication bias was evaluated by Funnel plot. Results A total of 14 articles were finally included. Meta-analysis results showed that male OR=3.94, 95%CI=(2.12-7.31), P<0.01; diabetes history OR=2.62, 95%CI=(2.04-3.36), P<0.01; CT severity index (CTSI) OR=1.5, 95%CI=(1.31-1.72), P<0.01; serum albumin level OR=0.88, 95%CI=(0.83-0.92), P<0.01; previous drinking history OR=4.36, 95%CI=(2.77-6.88), P<0.01; previous history of pancreatitis OR=2.73, 95%CI=(1.15-6.51), P<0.01; the differences were statistically significant. Conclusion Male, diabetes history, CTSI, serum albumin level, previous drinking history, and previous history of pancreatitis were associated with acute pancreatitis complicated with pancreatic pseudocyst. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (5): 459-464.   DOI: 10.3969/j.issn.1004-583X.2023.05.014 Abstract （153）   HTML （2）    PDF（pc） （921KB）（107）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (2): 175-180.   DOI: 10.3969/j.issn.1004-583X.2023.02.014 Abstract （380）   HTML （1）    PDF（pc） （1948KB）（106）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Analysis of risk factors for refractory Mycoplasma pneumoniae pneumonia in children Yu Zeyu, Lin Xi, Chen Zhanghua, Yang Wei, Chen Zhimin, Zhang Hai Clinical Focus    2024, 39 (1): 43-46.   DOI: 10.3969/j.issn.1004-583X.2024.01.007 Abstract （145）   HTML （2）    PDF（pc） （921KB）（105）       Knowledge map    Save Objective To analyze risk factors for refractory M y c o p l a s m a p n e u m o n i a e pneumonia (RMPP) in children. Methods A total of 67 children with RMPP who were admitted in the Department of Paediatrics, Luoyuan County Hospital from January 2020 to September 2023 were enrolled in the case group. During the same period, 134 children with common M y c o p l a s m a p n e u m o n i a e pneumonia and complete clinical data were selected in the control group. Children in both groups were initially treated with macrolide antibiotics. Univariate and multivariate logistic regression analyses were used to analyze the risk factors for RMPP in children. The predictive potentials of risk factors for RMPP in children were assessed by plotting the receiver operating characteristic (ROC) curves. Results Decreased albumin, decreased platelet count, heat peak≥40 ℃, lactate dehydrogenase≥500 U/L, and lobar pneumonia changes on pulmonary imaging were risk factors for RMPP in children. The area under the curve (AUC) and cut-off value of risk factors were as follows: albumin<40 g/L (AUC=0.765, 95% C I=0.803-0.901), lactate dehydrogenase≥500 U/L (AUC=0.753, 95% C I=0.772-0.877), platelet count<120×109/L (AUC=0.821, 95% C I:0.761-0.868), heat peak≥40 ℃ (AUC=0.750, 95% C I: 0.685-0.807), and lobar pneumonia changes on pulmonary imaging (AUC=0.541, 95% C I: 0.469-0.611). Conclusion RMPP should be alerted in children with albumin<40 g/L, platelet count<120×109/L, heat peak≥40 ℃, lactate dehydrogenase≥500 U/L, and lobar pneumonia changes on pulmonary imaging. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2022, 37 (10): 946-949.   DOI: 10.3969/j.issn.1004-583X.2022.10.013 Abstract （413）   HTML （1）    PDF（pc） （827KB）（103）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Congenital insensitivity to pain with anhidrosis: A case report and literature review Pang Shu, Zhang Mingkai, Bai Hongmei, Wu Yongdong Clinical Focus    2023, 38 (1): 64-67.   DOI: 10.3969/j.issn.1004-583X.2023.01.009 Abstract （243）   HTML （3）    PDF（pc） （1078KB）（102）       Knowledge map    Save Objective To investigate the clinical characteristics, diagnosis and treatment of congenital insensitivity to pain with anhidrosis. Methods The clinical data and gene detection results of a patient with congenital insensitivity to pain with anhidrosis in our hospital was analyzed retrospectively. The related literature were reviewed and summarized. Results A 10-year-old female patient had rough skin, repeated fractures and swelling of the left knee joint for 3 years. The clinical features are rough skin, insensitivity to pain, oral ulcer, absence of finger (toe) nail, Charcot joint of left knee, slight valgus of left knee, repeated falls and fractures, and repeated fever. The results of gene sequencing indicated that the patient had a homozygous variation of C.575-19G>A of NTRK1 gene. She was diagnosed as congenital insensitivity to pain with anhidrosis. Conclusion There are various clinical manifestations of congenital insensitivity to pain with anhidrosis, and there is no radical cure. Prevention and treatment of complications is the main method to improve the survival rate of these patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (4): 381-384.   DOI: 10.3969/j.issn.1004-583X.2023.04.018 Abstract （339）   HTML （5）    PDF（pc） （808KB）（102）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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One case of neuromyelitis optica with positive antithyroid antibody and literature review Wang Zijia, Wang Jiuxue, Wang Tianjun Clinical Focus    2023, 38 (3): 264-267.   DOI: 10.3969/j.issn.1004-583X.2023.03.013 Abstract （176）   HTML （0）    PDF（pc） （957KB）（101）       Knowledge map    Save Objective To investigate the correlation between antithyroid antibodies (ATAbs) and neuromyelitis optica (NMO). Methods The clinical data and antibody detection results of one NMO patient with positive ATAbs were retrospectively analyzed, and the related literatures were reviewed. Results The patient, 61 years old female, left limb numbness for 10 days, aggravation for 3 days. The results of cerebrospinal fluid and serum indicated that aquaporin-4 immunoglobulin G (AQP4-IgG)-positive in cerebrospinal fluid and serum was 1∶1 and 1∶100, respectively. The diagnosis was NMO. Conclusion NMO and thyroid-related diseases are often associated, and more studies are needed to draw definite conclusions about their relationship. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2022, 37 (12): 1137-1141.   DOI: 10.3969/j.issn.1004-583X.2022.12.014 Abstract （414）   HTML （1）    PDF（pc） （852KB）（101）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）