CLINICAL EVALUATION OF MONOCLONAL ANTIBODIES AGAINST ALDOLASE-A IN THE DIAGNOSIS OF HEPATO-CELLULAR CARCINOMA

Serum ALD-A of 57 patients with HCC and 43 of other diseases were measured by ALD-A-McAb linked with 425I-staphylococcus A protein. The results showed that the ALD-A in patient with HCC was significantly elevated as compared with controls and that in patients with cholangiocarcinoma, gastrointestinal cancer without hepatic metastasis, cirrhosis. CAH and benign GI diseases. There was no statistical difference between ALD-A in patients with HCC and that in cases of cirrhosis with liver failure and that in cases of metastatic liver carcinoma. It was noted that diagnostic sensitivity of ALD-A in AFP (+) HCC was 73.9% and that in AFP (-) HCC was 81.8% 1-6 patients with HCC were treated by hepatic arterial embolization combined with chemotherapy. ALD-A in patients after the treatment decreased significantly than that before treatment, furthermore, advantages of the method are discussed.

Clinical evaluation of Xive implants 3-year after placement

Objective： The main purpose of this retrospective study is to evaluate clinical outcomes of Xive implants 3-year after insertion. Methods： 219 Xive implants were placed in 139 patients and their clinical effects were evaluated using the Albrektsson Standard. Results：The 3-year survival rate of the Xive implants is 97.26%（213/2 1 9）. Eleven cases of immediate implants and 15 cases of implant insertion after maxillary sinus lifting all succeeded. The failure ratio is 6/219（2.74%） with failures resulting from excess bone loss in the implant region, peri-implant mucosal inflammation or continuous pain caused by some unknown reasons. Conclusion： Xive implants are clinically effective for the restoration of missing teeth. Immediate implant and implant following maxillary sinus lifting were also successful.

Clinical Evaluation after Introduction of Stem Cell Supernatant Biocell Shot 65 by Electroporation

Objectives: The objective of this study is clinical evaluation after introduction of stem cell supernatant Biocell Shot 65 by electroporation. Background: There is a clinical report of psoriasis treatment by umbilical cord blood-derived stem cells, in which there was a beneficial result. These clinical results are the result of cord blood-derived cell growth factors. The umbilical cord blood-derived stem cell culture supernatant contains a high amount of TGF-β, PDGA, etc., and promotes wound healing. In addition, we suppose that the supernatant has the esthetic effect of improving skin condition, thus, we planned to make a clinical evaluation. However, it is difficult to set judgement criteria, and human judgement tends to be subjective. Therefore, in this study, as a new clinical evaluator, we used an AI skin diagnostic device with learning function. Methods: Stem cell culture supernatant Biocell Shot 65 was used as an introduction solution. After it was applied to the full faces of four patients, electroporation with BeBe pinocchio DM-5 SUPER DX Plus promoted infiltration deep in the keratinized layer. The patients were all healthy women in their forties. This procedure was performed every two weeks for three months. Wrinkles, fine lines around eyes, stains, pores, and 4V, which is considered as one diagnostic criteria, were evaluated at baseline and after each procedure with the skin diagnostic device HiMirror-Professional. In this study, macroscopic findings were not examined. Results: In all four patients, 4V did not change remarkably. Patient 1 showed improvement after the procedure in wrinkles, fine lines around eyes, stains, and pores. Patient 2 revealed improvement only in fine lines around eyes, but did not show improvement in other items. Patient 3 improved in wrinkles, stains, and pores only after the second procedure, but did not show improvement in the other procedures. Patient 4 improved in all items except 4V after the fourth procedure. In addition, when the mean values of all the patients were plotted and compared before and after each procedure, there was a trend toward improvements after the fifth procedure. Conclusion: In addition to application of supernatant culture to the skin, introduction of the solution to the skin by electroporation might improve stains, wrinkles, and pores. Our evaluation was performed with a facial diagnostic device three months after the start of the procedure.

Clinical evaluation of timing of endovascular embolization treatment for intracranial aneurysm

Objective To evaluate the effects of endovascular embolization treatment for intracranial aneurysms in different time. Methods The clinical data of 165 cases of ruptured intracranial aneurysm treated by endovascular treatment were analysed retrospectively. The patients were divided into 3 groups accrodding to

Retrospective cytological evaluation of indeterminate thyroid nodules according to the British Thyroid Association 2014 classification and comparison of clinical evaluation and outcomes

The cytology of 130 indeterminate nodules （Thy 3） was retrospectively reviewed according to the British Thyroid Association 2014 classification. Nodules were divided into Thy 3a （atypical features） and Thy 3f （follicular lesion） categories. Histology was available as a reference for 97 nodules. Pre-surgical evaluations comprised biochemical tests, color-Doppler ultrasonogrephy （US）, semi-quantitative elastography-US （USE）, contrast-enhanced US （CEUS）, and mutation analysis from cytological slides. Thyroid malignancy was the final diagnosis for 19% of surgically- treated nodules. No statistically significant difference in the risk of malignancy was found between Thy 3a （26%） and Thy 3f （14%） nodules. Histology of the Thy 3a and Thy 3f nodules showed a higher incidence of Hurtle cell adenomas in Thy 3f （29%） than in Thy 3a （3%） nodules （P=0.01）. The only pre-surgical difference concerned the BRAF V600E mutation, which was positive in some Thy 3a but not in any Thy 3f nodules （P=0.04）. Receiver-operating characteristic （ROC） analysis was used to obtain cut-off values from US （score）, USE （ELX 2/1 strain index）, and CEUS （time-to- peak index and peak index） data. The cut-off values were similar for Thy 3a and Thy 3f nodules. Data showed that malignancy can be suspected if the US score is 〉2, ELX 1/2 strain index 〉1, time-to-peakindex 〉1, and peak index 〈1. In a sub-group of 24 revised nodules （12 Thy 3a and 12 Thy 3f） with histology as a reference, the diagnostic power of cumulative pre-surgical analysis by means of US, USE, and CEUS showed high positive and negative predictive values （83% and 100%, respectively） for the presence of malignancy in Thy 3a and Thy 3f nodules. In conclusion, in our series of revised Thy 3 nodules, malignancy was low and displayed no significant differences between Thy 3a and Thy 3f categories. The use of cut-offs based on histology as a reference could reduce surgery. Our data support the conviction that, in mutation-negative Thy 3a and Thy 3f nodules, observation should be the first choice when not all instrumental results are suspect.

ALTERATIONS OF THE PERCENTAGE OF LYMPHOCYTES IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND CLINICAL EVALUATION

In order to investigate the human immunological response to acute myocardial infarction (AMI), lymphocyte cells of peripheral vein blood withdrawn from patients with AMI were continuously and quantitatively assayed by flow cytometry method (FCM). The correlation between the alterations of immunological function and clinical course was analyzed. MATERIAL AND METHODS Thirty-one samples were collected from peripheral vein blood of hospitalized patients with AMI in the author’s institution. The patients were aged from 39 to 81 years, ( 26 men and 5 women ). Samples withdrawn from 14 healthy adults served as normal control.

Evaluation of Clinical Outcomes of ses Stent in Patients with Coronary Artery Disease After Intracoronary Stenting in Small Vessels

Background:Limited data are available for sirolimus-eluting stent(SES,Cypher)implantation in patients with coronary artery disease in small vessels.The clinical longtermoutcomes of SES in patients with coronary artery disease after intracoronary stenting in small vessels has not been yet evaluated.

Evaluation of the Sensitivity and Specificity of the New Clinical Diagnostic and Classification Criteria for Kashin-Beck Disease,an Endemic Osteoarthritis,in China

This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease （KBD） using six clinical markers： flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling.

Acute optic neuritis: a clinical paradigm for evaluation of neuroprotective and restorative strategies?

What makes the acute optic neuritis model unique in an era of trials for neuroprotective and myelin repair agents？Acute optic neuritis（AON）is a common,and often the earliest manifestation of central nervous system（CNS）inflammatory demyelinating disorders like multiple sclerosis （MS） and neuromyelitis optica （NMO）.

Prospects for the future of clinical efficacy evaluation of traditional Chinese medicine——Emphasis on original theory and clinical practice

Traditional Chinese medicine(TCM)clinical efficacy evaluation runs through the development of TCM and has been progressing so far.With the introduction of evidence-based medicine(EBM)in recent 20 years,TCM clinical efficacy evaluation has developed rapidly,accumulated research and experience,improved the quality and standardization of research,but also gradually found deep-seated deficiencies.In 2019,the China Center for Evidence-based Traditional Chinese Medicine(CCEBTCM)was established,and TCM was included in the 11th revision of the International Statistical Classification of Diseases(ICD-11).In above opportunities for TCM clinical efficacy evaluation,it is necessary to face up to the previous deficiencies,so that the TCM clinical efficacy evaluation can truly reflect the actual clinical practice characteristics,including TCM clinical problems,TCM thinking and TCM diagnosis&treatment mode.Based on the summary and analysis of past research,development concepts are proposed in this article.On the one hand,original concepts of TCM should be confidently paid more attention to the design and implementation of TCM clinical efficacy evaluation to be close to TCM clinical practice.On the other hand,it is necessary to consolidate the foundation of TCM clinical practice before evaluating efficacy.Evaluated object built on TCM ontology knowledge should be demonstrated based on clinical practice,and unknown evaluated object combined with new methods,technologies and concepts should be maturely integrated in clinical practice firstly.

Comparison of Clinical Effects of Au-Pt Based and Ni-Cr Based Porcelain Crowns

Objective To compare the long-term clinical effects of two kinds of crowns and bridges made of porcelain fused to Au-Pt alloy and Ni-Cr alloy. Methods A total of 131 teeth (64 patients) were rehabilitated using porcelain-fused-to-metal crowns, among which 59 were rehabilitated with Au-Pt alloy metal ceramic crown and 72 with Ni-Cr alloy metal ceramic crown. The porcelain fracture, shade, marginal adaptation, gingival discoloration, and gingival status after finishing restoration and 36 months of follow-up were evaluated. Results After 36 months of restoration, porcelain fused to Au-Pt alloy crown showed better clinical effects than porcelain fused to Ni-Cr alloy crown in shade, marginal adaptation, gingival discoloration, as well as gingival status (all P<0.05). Conclusion The Au-Pt alloy ceramic crown is superior to Ni-Cr alloy ceramic crown in long-term clinical effects.

Establishment and Clinical Application of Multidisciplinary Collaborative Rapid Rehabilitation Nursing Pathway in Perioperative Period of Brucellosis Spondylitis

Objective: To study the establishment and clinical application of multidisciplinary collaborative rapid rehabilitation nursing model in patients with brucellosis spondylitis during the perioperative period. Method: From January 2009 to January 2013, 39 patients diagnosed with brucellosis spondylitis were treated with focal clearance combined with posterior pedicle internal fixation. Nursing was randomly divided into 2 groups: 19 cases of routine nursing as the control group (group A);20 cases of implementation of the nursing path as the intervention group (group B). In the intervention group, analgesic nursing plan, daily activity ability training path, medication compliance and health education path were used to effectively intervene on the evaluation parameters affecting rapid recovery and clinical efficacy (VAS score, daily activity ability mastery, Oswestry disability index and medication Morisky-Green index). The nursing effect and clinical evaluation of the two groups were compared. Results: As time went by, VAS pain score, mastery of daily activity ability, Oswestry disability index and medication compliance between the two groups at the same time point were significantly different (P Conclusions: The nursing path of brucellosis spondylitis is positively correlated with rapid recovery and clinical efficacy. Compared with routine nursing, it has a significant effect on accelerating postoperative rehabilitation and clinical efficacy.

Attitudes of Nursing Faculty Members and Graduates towards the Objective Structured Clinical Examination (OSCE)

The aim of this study was to evaluate the attitudes of faculty and graduates of college of nursing towards Objective Structured Clinical Examination (OSCE) as a valid and reliable method of clinical competency assessment in nursing ten years after its inception. Core nursing courses are based on instructional teaching methods and “hands-on” approach to impact cognitive, psychomotor skills and clinical judgments. Different clinical competency assessment methods are used globally;however, most of them are subjective. A descriptive survey using 16-item five-point likert scale questionnaire was conducted. The study sample consisted of 140 participants: 20 faculty members, 27 graduates of the Bachelor of Science in Nursing (BSN) Degree and 93 graduates of the Associate Degree of Nursing (ADN) programs with OSCE experience during their training. Data collection was carried out between October and November 2015. Eighty percent of faculty members, 74% of BSN and 62.3% of ADN graduates agreed that OSCE represented an objective evaluation method for psychomotor skills. Majority of the graduates perceived their OSCE experience positively although stressful. However, they have suggested the introduction of trial/mock OSCE prior to each exam to minimize the stress associated with it. In conclusion, there appears to be no single “gold-standard” assessment tool for clinical competency. OSCE assesses student nurses’ psychomotor skills in a non-clinical environment, therefore without risks to real patients. In combination with other assessment methods in the clinical settings, OSCE will provide a more comprehensive student psychomotor skill evaluation. OSCE experiences gave new nursing graduates confidence to work as registered nurses in health care settings.

Status and Development Trend of Evaluation of Post-Marketing Traditional Chinese Medicines in China

Evaluation of traditional Chinese medicines after the market has achieved fruitful results after years of development.The real-world research concept has been first proposed by Chief Researcher Xie Yanming in 2010 and to 2020 with the approval of the National Medical Products Administration to use real-world evidence to support drug development and review in 2020.Real-world data application and transformation continue to cause heated discussions in the industry.Real-world research concepts have been added new motivation into the evaluation of Chinese medicines after they are marketed.The development of the Chinese patent medicine industry is facing unprecedented opportunities and challenges.

Study on psychological resilience and associated influencing factors in lung cancer patients with bone metastases

BACKGROUND Evaluating the psychological resilience of lung cancer(LC)patients helps understand their mental state and guides future treatment.However,there is limited research on the psychological resilience of LC patients with bone me-tastases.AIM To explore the psychological resilience of LC patients with bone metastases and identify factors that may influence psychological resilience.METHODS LC patients with bone metastases who met the inclusion criteria were screened from those admitted to the Third Affiliated Hospital of Wenzhou Medical University.The psychological scores of the enrolled patients were collected.They were then grouped based on the mean psychological score:Those with scores lower than the mean value were placed in the low-score group and those with scores equal to or greater than the mean value was placed in the high-score group.The baseline data(age,gender,education level,marital status,residence,monthly income,and religious beliefs),along with self-efficacy and medical coping mode scores,were compared.RESULTS This study included 142 LC patients with bone metastases admitted to our hospital from June 2022 to December 2023,with an average psychological resilience score of 63.24±9.96 points.After grouping,the low-score group consisted of 69 patients,including 42 males and 27 females,with an average age of 67.38±9.55 years.The high-score group consisted of 73 patients,including 49 males and 24 females,with a mean age of 61.97±5.00 years.χ2 analysis revealed significant differences between the two groups in education level(χ2=6.604,P=0.037),residence(χ2=12.950,P=0.002),monthly income(χ2=9.375,P=0.009),and medical coping modes(χ2=19.150,P=0.000).Independent sample t-test showed that the high-score group had significantly higher self-efficacy scores(t=3.383,P=0.001)and lower age than the low-score group(t=4.256,P<0.001).Furthermore,multivariate logistic regression hazard analysis confirmed that self-efficacy is an independent protective factor for psychological resilience[odds ratio(OR)=0.926,P=0.035,95%confidence interval(CI):0.862-0.995],while age(OR=1.099,P=0.003,95%CI:1.034-1.169)and medical coping modes(avoidance vs confrontation:OR=3.767,P=0.012,95%CI:1.342-10.570;resignation vs confrontation:OR=5.687,P=0.001,95%CI:1.974-16.385)were identified as independent risk factors.A predictive model based on self-efficacy,age,and medical coping modes was developed.The receiver operating characteristic analysis showed an area under the curve value of 0.778(95%CI:0.701-0.856,P<0.001),indicating that the model has good predictive performance.CONCLUSION LC patients with bone metastases are less psychologically resilient than the general population.Factors such as self-efficacy,age,and medical coping modes influence their psychological resilience.Patients with low self-efficacy,old age,and avoidance/resignation coping modes should be closely observed.

Comparison of different diagnostic methods in infants with Cholestasis

AIM: To evaluate different methods in differentiating idiopathic neonatal hepatitis from biliary atresia. METHODS: Sixty-five infants with cholestatic jaundice and final diagnosis of idiopathic neonatal hepatitis and biliary atresia were studied prospectively from September 2003 to March 2006. A thorough history and physical examination were undertaken and the liver enzymes were examined. All cases underwent abdominal ultrasonography, hepatobiliary scintigraphy, and percutaneous liver biopsy. The accuracy, sensitivity, specificity and predictive values of these various methods were compared. RESULTS: There were 34 girls and 31 boys, among them 46 subjects had idiopathic neonatal hepatitis (age, 61 ± 17 d) and 19 had biliary atresia (age, 64 ± 18 d). The mean age at onset of jaundice was significantly lower in cases of biliary atresia when compared to idiopathic neonatal hepatitis cases (9 ± 13 d vs 20 ± 21 d; P = 0.032). The diagnostic accuracy of different methods was as follows: liver biopsy, 96.9%; clinical evaluation, 70.8%; ultrasonography, 69.2%; hepatobiliary scintigraphy, 58.5%; and liver enzymes, 50.8%.CONCLUSION: Our results indicate that clinical evaluation by an experienced pediatric hepatologist and a biopsy of the liver are considered as the most reliable methods to differentiate idiopathic neonatal hepatitis and biliary atresia.

A comprehensive review of research progress in Chinese medicines for primary liver cancer treatment

Primary liver cancer seriously threatens human health,affects the quality of life,and has a high mortality rate.Traditional Chinese medicine(TCM)has long been used in the prevention,treatment,and adjuvant treatment of primary liver cancer.Clinical trials were conducted in recent years to evaluate the efficacy and safety of TCM.The mechanism of action of TCM in primary liver cancer treatment also received extensive attention.This study summarizes the common monomial Chinese herbal medicines and their components,formulae,and the proprietary Chinese medicines used to treat primary liver cancer.Common medicines include Chansu(Bufonis venenum),Kushen(Sophorae flavescentis radix),Renshen(Ginseng radix et rhizoma),and Jianghuang(Curcumae longae rhizoma).This study also reviewed the literature on liver cancer treatment using TCM.The results confirmed the safety and efficacy of TCM in liver cancer treatment.The possible mechanisms involved are also listed,including influencing the cell cycle,inducing cancer cell apoptosis and autophagy,inhibiting cancer cell angiogenesis and metastasis,regenerating the microenvironment and DNA methylation,and regulating the innate immune response.For primary liver cancer patients who often have a long disease course,Chinese herbal medicine often plays a role in protecting and conditioning the body.Research aimed at finding more traditional Chinese herbal medicines and their mechanisms of action should be promoted.This study aimed to provide a scientific reference for further research and the rational clinical application of TCM for primary liver cancer treatment.

Formulation of a CITE metric for evaluating the clinical implications of medical studies and their originating hospitals in China

Background:The number of medical research publications by Chinese clinical investigators has risen substantially,contributing to 14.63%of the global total in 2019;however,their tangible impact on clinical decisionmaking remains limited.Various evaluation methods have been developed to measure hospital research competence in China,such as Fudan University's China hospital ranking and Science and Technology Evaluation Metrics(STEM)ranking,which predominantly focuses on factors such as academic reputation,volume of publications and patents,and research resources.However,composite indices may not fully capture the actual clinical value generated by medical research.To address this gap,we introduced the“Clinical Influence and Timeliness Evaluation(CITE)”metric to assess both the clinical importance of a given medical research study and the clinical influence of the hospital where it originated.The methodology used relies on the premise that influential medical research would be referenced in clinical guidelines,which serve as critical resources for clinicians.Methods:The CITE metric was applied for 78,636 medical studies concerning chronic obstructive pulmonary disease(COPD)published between 2000 and 2020 and referenced in both Chinese and international clinical guidelines for COPD.Specific indexes and formulas were derived to quantify the clinical weight of a medical research study(W)and its timeliness(T),enabling a dynamic assessment of the clinical value of each study and the overall contribution of a particular hospital.Results:In this analysis,we incorporated 499 hospitals in China and quantitatively identified their dynamic clinical influence in COPD from 2000 to 2020.Our findings offer objective and targeted evaluation metrics by focusing on clinical relevance and recognizing the collaborative nature of medical research.Conclusion:The CITE metric provides an innovative method to gauge the true impact of medical research in China,with potential applications across different medical specialties.CITE can serve as a useful tool for understanding the relationship between research input and practical clinical outcomes,ultimately promoting more clinically relevant research endeavors.

Meta-analyses in the wonderl and of neurology

Meta-analyses are often misused and underused in neurology. This editorial provides some comments on the role of meta-analyses in neurological research.Recently, a huge increase in the number of metaanalyses and systematic reviews has been observed in neurological journals. The major strengths of metaanalyses are the increase of statistical power. However, as for any other investigative tool, meta-analytic research is a research method itself which can produce severe shortcomings. Specifically, the issues of search terms, time periods of published studies, databases used for searching, the definitions of inclusion and exclusion criteria for papers(which greatly affect clinical heterogeneity), publication bias; and the statistical methods used, dramatically influence the results of metaanalyses. The main problem of meta-analyses is that they cannot be expected to overcome the limitations of the studies they include(the so-called "garbage in,garbage out" phenomenon). Furthermore, most systematic reviews in the neurological literature lead to the unsatisfying and clinically frustrating statement "further studies are needed". However it is much more frustrating to see how the gaps in scientific knowledge identified by meta-analyses have not been translated into serious efforts to fill them. Besides their role in evaluating efficacy and tolerability of drugs, meta-analyses may be used to assess diagnostic values of debatable clinical findings, as they represent powerful tools to try to answer questions not posed by individual studies and to settle controversies arising from conflicting claims.

Posturodynamic 6 Test: A New Scoring Method for Effective Communication of Results

Background: Posturodynamic 6 (PDN-6) is a clinical assessment of posture that merges the Clinical Posturodynamic Test and the Pelvic Maintain Test. Current scoring system does not fulfill all our needs and requirements mostly because the same numeric score might reflect 28 different possible combinations of postural dysfunction in terms of anatomic region and laterality. Objective: We propose a new scoring method for the PDN-6 that would not change the clinical methods for the PDN-6 assessment. Specifically, new scoring method would clearly indicate specific patterns of postural dysfunction while still enabling statistical analyses. Methods: We developed a new scoring method for the PDN-6 without changing the instrument’s clinical procedures. We qualitatively assessed the validity of the new scoring system to detail specific patterns of postural dysfunction in terms of anatomic region and laterality. Results: New scoring method successfully deals with limitations of the previous scoring method. The new method enables clinicians to differentiate among 2 or more patients who might have very different patterns of postural dysfunction while still having the same numeric score using the previous scoring. The new scoring method provides quantitative data that are easily translated in terms of anatomic region and laterality for the postural dysfunctions that are present. Patient behavioral improvements are quantified, documented and interpreted with a change in score, and the exact nature of the improvements can be determined in terms of anatomic location and laterality. Rash analyses can also be used for statistical analyses. Conclusion: PDN-6 new scoring method provides quantitative data that provide more specific information about a patient’s postural deficits and any changes in their postural dysfunction over time without changing the clinical assessment methods.