Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients...Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.展开更多
In today’s growing modern world environment,as human food activities are changing,it is affecting human health,thus leading to diseases like cancer.Cancer is a complex disease with many subtypes that affect human hea...In today’s growing modern world environment,as human food activities are changing,it is affecting human health,thus leading to diseases like cancer.Cancer is a complex disease with many subtypes that affect human health without premature treatment and cause death.So the analysis of early diagnosis and prognosis of cancer studies can improve clinical management by analyzing various features of observa-tion,which has become necessary to classify the type in cancer research.The research needs importance to organize the risk of the cancer patients based on data analysis to predict the result of premature treatment.This paper introduces a Maximal Region-Based Candidate Feature Selection(MRCFS)for early risk diagnosing using Soft-Max Feed Forward Neural Classification(SMF2NC)to solve the above pro-blem.The predictive model is based on a different relational feature learning model,which is possessed to candidate selection to reduce the dimensionality.The redundant features are processed marginal weight rates for observing similar features’variants and the absolute value.Softmax neural hidden layers are trained using the Sigmoid Activation Function(SAF)to create the logical condition for feed-forward layers.Further,the maximal features are introduced to invite a deep neural network con-structed on the Feed Forward Recurrent Neural Network(FFRNN).The classifier produces higher classification accuracy than the previous methods and observes the cancer detection,which is recommended for early diagnosis.展开更多
BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its effic...BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.展开更多
BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with ...BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.展开更多
Parkinson's disease has a negative impact on health-related quality of life in Parkinson's disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopam...Parkinson's disease has a negative impact on health-related quality of life in Parkinson's disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson's disease patients in nOrtheastern Sicily, Italy. Ninety Parkinson's disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi "Bonino-Pulejo" (Messina), were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale (UPDRS-Ⅲ) scores, the Parkinson Disease Questionnaire-39 Item scores (as a disease-specific measure of health-related quality of life), scores on the Short Form (36) Health Survey Questionnaire (as a generic measure), and answers to a brief checklist were recorded. A total of 85 Parkinson's disease patients (49% males and 51% females; mean age 70.8 ± 8.6 years mean UPDRS-Ⅲ 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years) completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.展开更多
Rare earth phosphate fertilizer (REPF) as base fertilizer (750 kg per hm2) was applied in the western area of China during the 'Tenth Five-Year Plan' , and the results show as follows: compared with calcium su...Rare earth phosphate fertilizer (REPF) as base fertilizer (750 kg per hm2) was applied in the western area of China during the 'Tenth Five-Year Plan' , and the results show as follows: compared with calcium superphosphate (CK), REPF increases crops yields for maize by 17.0% , for rice by 10.5% , for wheat by 24.2% , for potato by 18.5% , for cabbage by 16.3%, for Chinese cabbage by 16.4%, for beet by 6.5%; decreases the diseased plant rate for common smut of maize by 1.0%, for maize stalk rot by 1.2%, for wheat take-all disease by 7.8%, for wheat root rot by 3.2%, for potato blackleg disease by 1.4%, for potato late blight by 6.6%; increases the sugar content of beet by 0.9°S.展开更多
Background The clinical utility and safety of sargramostim has previously been reported in cancer,acute radiation syndrome,autoimmune disease,inflammatory conditions,and Alzheimer’s disease.The safety,tolerability,an...Background The clinical utility and safety of sargramostim has previously been reported in cancer,acute radiation syndrome,autoimmune disease,inflammatory conditions,and Alzheimer’s disease.The safety,tolerability,and mecha-nisms of action in Parkinson’s disease(PD)during extended use has not been evaluated.Methods As a primary goal,safety and tolerability was assessed in five PD patients treated with sargramostim(Leukine®,granulocyte-macrophage colony-stimulating factor)for 33 months.Secondary goals included numbers of CD4+T cells and monocytes and motor functions.Hematologic,metabolic,immune,and neurological evaluations were assessed during a 5-day on,2-day off therapeutic regimen given at 3μg/kg.After 2 years,drug use was discon-tinued for 3 months.This was then followed by an additional 6 months of treatment.Results Sargramostim-associated adverse events included injection-site reactions,elevated total white cell counts,and bone pain.On drug,blood analyses and metabolic panels revealed no untoward side effects linked to long-term treatment.Unified Parkinson’s Disease Rating Scale scores remained stable throughout the study while regulatory T cell number and function were increased.In the initial 6 months of treatment,transcriptomic and proteomic mono-cyte tests demonstrated autophagy and sirtuin signaling.This finding paralleled anti-inflammatory and antioxidant activities within both the adaptive and innate immune profile arms.Conclusions Taken together,the data affirmed long-term safety as well as immune and anti-inflammatory responses reflecting clinical stability in PD under the sargramostim treatment.Confirmation in larger patient populations is planned in a future phase II evaluation.展开更多
Objective:To evaluate the non-inferiority of pramipexole extended-release(ER)versus immediate-release(IR)in Chinese patients with Parkinson’s disease(PD)in a double-blind,randomized,parallel-group study.Methods:Subje...Objective:To evaluate the non-inferiority of pramipexole extended-release(ER)versus immediate-release(IR)in Chinese patients with Parkinson’s disease(PD)in a double-blind,randomized,parallel-group study.Methods:Subjects were Chinese patients with idiopathic PD with diagnosis≥2 years prior to trial,age≥30 years old at diagnosis,and Modified Hoehn and Yahr score 2-4 during‘on’-time.Subjects received treatment with pramipexole ER(n=234)or IR(n=239).Non-inferiority was based on the primary endpoint,the change from baseline to end of maintenance(week 18)in the UPDRS(Parts II+III)total score.Results:For the primary endpoint,the adjusted mean changes(standard error)of UPDRS Parts II+III at week 18 were−13.81(0.655)and−13.05(0.643)for ER and IR formulations,respectively,using ANCOVA adjusted for treatment and centre(fixed effect)and baseline(covariate).The adjusted mean between group difference was 0.8 for the 2-sided 95%CI(−1.047,2.566).Since the lower limit of the 2-sided 95%CI(−1.047)for treatment difference was higher than the non-inferiority margin of−4,non-inferiority between pramipexole ER and IR was demonstrated.The incidence of adverse events(AEs)was 68.8%in the ER arm and 73.6%in the IR arm with few severe AEs(ER:2.1%;IR:3.8%).Conclusion:Based on the UPDRS II+III score,pramipexole ER was non-inferior to pramipexole IR.The safety profiles of pramipexole ER and IR were similar.These results were based on comparable mean daily doses and durations of treatment for both formulations.展开更多
Objective:To study the relationship between sleep disturbances and symptoms in patients with Parkinson’s disease(PD).Methods:The Parkinson’s Disease Sleep Scale-Chinese Version(PDSS-CV)was used to evaluate the sleep...Objective:To study the relationship between sleep disturbances and symptoms in patients with Parkinson’s disease(PD).Methods:The Parkinson’s Disease Sleep Scale-Chinese Version(PDSS-CV)was used to evaluate the sleep disturbances of PD patients in a cross sectional study.The Unified Parkinson’s Disease Rating Scale(UPDRS)parts II-IV,and the Hoehn&Yahr(H&Y)stage were used to determine the level of motor function in PD and the severity of PD.The Spearman correlation and a multiple regression analysis were used to identify the relationship between sleep disturbances and symptoms of PD.The quantities derived from the UPDRS and the H&Y stage and disease duration were compared between groups of patients either with or without sleep disturbances identified by the PDSS.This study was conducted from December 2011 to March 2012 at the First Affiliated Hospital of Sun Yat-sen University,in Guangzhou.Results:A total of 136 PD patients were included in this study.The overall total PDSS score in PD patients was 107.58±23.35 points(range:30–146).There were significant differences in the disease duration,the H&Y stage,and the UPDRS section subscores between groups of patients either with or without sleep disturbances(Kruskal-Wallis Test,p<0.05).There were significant negative correlations between PDSS scores and the UPDRS subscores,the H&Y stage and the disease duration(Spearman correlation,p<0.05).The multiple regression analysis indicated that sleep disturbances identified by the PDSS were only associated with daily life activity,tremor intensity and clinical fluctuation(R2=0.22,F(3,132)=12.4,p<0.001).The correlations were also significant when the contribution of the other two factors was excluded using partial correlations.Conclusions:The level of daily life activity and the occurrences of tremor and clinical fluctuation are likely to be important factors that lead to PD patients’sleep disturbances.This study may elucidate an important clue for the relationship between sleep disturbances and PD symptoms.展开更多
Background:The benefit of systemic treatments in esophageal squamous cell carcinoma(ESCC)which has pro-gressed after chemotherapy is still uncertain and optimal regimens based on randomized trials have not yet been es...Background:The benefit of systemic treatments in esophageal squamous cell carcinoma(ESCC)which has pro-gressed after chemotherapy is still uncertain and optimal regimens based on randomized trials have not yet been established.We aimed to compare the efficacy of irinotecan plus S-1 with S-1 monotherapy in recurrent or metastatic ESCC patients who had resistance to platinum-or taxane-based chemotherapy.Methods:We conducted a prospective randomized,multicenter,open-label,phase 3 trial in 15 centers across China.Eligible patients were adults with histologically confirmed recurrent or metastatic ESCC,and were randomly assigned(ratio,1:1)to receive either irinotecan plus S-1(intravenous infusion of irinotecan[160 mg/m2]on day 1 and oral S-1[80-120 mg]on days 1-10,repeated every 14 days)or oral S-1 monotherapy(80-120 mg/day on days 1-14,repeated every 21 days)using a central computerized minimization procedure.The primary endpoint was progression-free survival(PFS).Results:Between December 23,2014 and July 25,2016,we screened 148 patients and randomly assigned 123 patients to receive either irinotecan plus S-1 regimen(n=61)or S-1 monotherapy(n=62).After a median follow-up of 29.2 months(95%confidence interval[CI]17.5-40.9 months),the median PFS was significantly longer in the irinotecan plus S-1 group than in the S-1 monotherapy group(3.8 months[95%CI 2.9-4.3 months]vs.1.7 months[95%CI 1.4-2.7 months],hazard ratio=0.58,95%CI 0.38-0.86,P=0.006).The objective response rates were 24.6%in the irinotecan plus S-1 group and 9.7%in the S-1 monotherapy group(P=0.002).The patients in the irinotecan plus S-1 group presented with increased rates of grade 3-4 leukopenia(16.4%vs.0%),neutropenia(14.8%vs.1.6%),and nausea(4.9%vs.0%).No significant difference in grade 3-4 diarrhea and no treatment-related deaths were observed in both groups.Conclusions: The combination of irinotecan with S-1 was similarly tolerable but significantly prolonged PFS compared to S-1 monotherapy as a second- or third-line treatment in patients with recurrent or metastatic ESCC.展开更多
This paper,based on data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS),reports on the health status of China’s elderly,and their needs for care and use of medical services.The proport...This paper,based on data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS),reports on the health status of China’s elderly,and their needs for care and use of medical services.The proportion of the elderly in 2018 who reported being satisfied with their current lives was 67.1%,a proportion signifi-cantly higher than that reported by CLHLS 2002.Some 73.1%of the elderly self-rated their health as good or fair.There were ten types of chronic diseases with prev-alence rates higher than 5%,among which hypertension was the most common,with 46.2%of survey respondents self-reporting suffering from it.The daily lives of some people suffering from chronic diseases were seriously affected.Most elderly people(93.2%)were able to complete without assistance all of the ADL items surveyed by CLHLS 2018,while 63.6%were able to do so with IADL items.Only 19.1%of the elderly reported that they were unable to perform at least one IADL item.Family members were still the main source of primary care.The satisfaction of the elderly with primary caregiver and helps they received was quite high.The data shows that the average weekly cost of care was RMB 651.1 yuan,with a median of RMB 180.0 yuan.The median hours children or grandchildren helped their elderly parents(grandparents)in the week prior to being interviewed was 0,and the mean value was 10.3 h.Because 86.5%of elderly survey respondents were covered by some type of medical insurance,more than half of the elderly had their medical expenses covered by insurance,and most elderly people had access to adequate medical services.展开更多
文摘Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.
文摘In today’s growing modern world environment,as human food activities are changing,it is affecting human health,thus leading to diseases like cancer.Cancer is a complex disease with many subtypes that affect human health without premature treatment and cause death.So the analysis of early diagnosis and prognosis of cancer studies can improve clinical management by analyzing various features of observa-tion,which has become necessary to classify the type in cancer research.The research needs importance to organize the risk of the cancer patients based on data analysis to predict the result of premature treatment.This paper introduces a Maximal Region-Based Candidate Feature Selection(MRCFS)for early risk diagnosing using Soft-Max Feed Forward Neural Classification(SMF2NC)to solve the above pro-blem.The predictive model is based on a different relational feature learning model,which is possessed to candidate selection to reduce the dimensionality.The redundant features are processed marginal weight rates for observing similar features’variants and the absolute value.Softmax neural hidden layers are trained using the Sigmoid Activation Function(SAF)to create the logical condition for feed-forward layers.Further,the maximal features are introduced to invite a deep neural network con-structed on the Feed Forward Recurrent Neural Network(FFRNN).The classifier produces higher classification accuracy than the previous methods and observes the cancer detection,which is recommended for early diagnosis.
文摘BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.
基金Supported by Basic scientific research industry of Heilongjiang Provincial undergraduate universities in 2019,No.2019-KYYWF-1213.
文摘BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.
基金supported by a grant from the Ministry of Health (Research for the Strategic Program 2007)
文摘Parkinson's disease has a negative impact on health-related quality of life in Parkinson's disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson's disease patients in nOrtheastern Sicily, Italy. Ninety Parkinson's disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi "Bonino-Pulejo" (Messina), were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale (UPDRS-Ⅲ) scores, the Parkinson Disease Questionnaire-39 Item scores (as a disease-specific measure of health-related quality of life), scores on the Short Form (36) Health Survey Questionnaire (as a generic measure), and answers to a brief checklist were recorded. A total of 85 Parkinson's disease patients (49% males and 51% females; mean age 70.8 ± 8.6 years mean UPDRS-Ⅲ 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years) completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.
基金Project supported by the National Important Tackling Researoh Foundation of China (2002BA315A-7)
文摘Rare earth phosphate fertilizer (REPF) as base fertilizer (750 kg per hm2) was applied in the western area of China during the 'Tenth Five-Year Plan' , and the results show as follows: compared with calcium superphosphate (CK), REPF increases crops yields for maize by 17.0% , for rice by 10.5% , for wheat by 24.2% , for potato by 18.5% , for cabbage by 16.3%, for Chinese cabbage by 16.4%, for beet by 6.5%; decreases the diseased plant rate for common smut of maize by 1.0%, for maize stalk rot by 1.2%, for wheat take-all disease by 7.8%, for wheat root rot by 3.2%, for potato blackleg disease by 1.4%, for potato late blight by 6.6%; increases the sugar content of beet by 0.9°S.
基金supported by National Institute of Neurological Disorders and Stroke Grant 5 R01NS034239-25 and private donations provided through the University of Nebraska Foundation.
文摘Background The clinical utility and safety of sargramostim has previously been reported in cancer,acute radiation syndrome,autoimmune disease,inflammatory conditions,and Alzheimer’s disease.The safety,tolerability,and mecha-nisms of action in Parkinson’s disease(PD)during extended use has not been evaluated.Methods As a primary goal,safety and tolerability was assessed in five PD patients treated with sargramostim(Leukine®,granulocyte-macrophage colony-stimulating factor)for 33 months.Secondary goals included numbers of CD4+T cells and monocytes and motor functions.Hematologic,metabolic,immune,and neurological evaluations were assessed during a 5-day on,2-day off therapeutic regimen given at 3μg/kg.After 2 years,drug use was discon-tinued for 3 months.This was then followed by an additional 6 months of treatment.Results Sargramostim-associated adverse events included injection-site reactions,elevated total white cell counts,and bone pain.On drug,blood analyses and metabolic panels revealed no untoward side effects linked to long-term treatment.Unified Parkinson’s Disease Rating Scale scores remained stable throughout the study while regulatory T cell number and function were increased.In the initial 6 months of treatment,transcriptomic and proteomic mono-cyte tests demonstrated autophagy and sirtuin signaling.This finding paralleled anti-inflammatory and antioxidant activities within both the adaptive and innate immune profile arms.Conclusions Taken together,the data affirmed long-term safety as well as immune and anti-inflammatory responses reflecting clinical stability in PD under the sargramostim treatment.Confirmation in larger patient populations is planned in a future phase II evaluation.
基金Boehringer lngelheim lnternational GmbH sponsored this study.
文摘Objective:To evaluate the non-inferiority of pramipexole extended-release(ER)versus immediate-release(IR)in Chinese patients with Parkinson’s disease(PD)in a double-blind,randomized,parallel-group study.Methods:Subjects were Chinese patients with idiopathic PD with diagnosis≥2 years prior to trial,age≥30 years old at diagnosis,and Modified Hoehn and Yahr score 2-4 during‘on’-time.Subjects received treatment with pramipexole ER(n=234)or IR(n=239).Non-inferiority was based on the primary endpoint,the change from baseline to end of maintenance(week 18)in the UPDRS(Parts II+III)total score.Results:For the primary endpoint,the adjusted mean changes(standard error)of UPDRS Parts II+III at week 18 were−13.81(0.655)and−13.05(0.643)for ER and IR formulations,respectively,using ANCOVA adjusted for treatment and centre(fixed effect)and baseline(covariate).The adjusted mean between group difference was 0.8 for the 2-sided 95%CI(−1.047,2.566).Since the lower limit of the 2-sided 95%CI(−1.047)for treatment difference was higher than the non-inferiority margin of−4,non-inferiority between pramipexole ER and IR was demonstrated.The incidence of adverse events(AEs)was 68.8%in the ER arm and 73.6%in the IR arm with few severe AEs(ER:2.1%;IR:3.8%).Conclusion:Based on the UPDRS II+III score,pramipexole ER was non-inferior to pramipexole IR.The safety profiles of pramipexole ER and IR were similar.These results were based on comparable mean daily doses and durations of treatment for both formulations.
基金This study was supported by grants from the Guangdong Natural Science Foundation(No.10151008901000187)the Guangdong Science and Technology Foundation(No.2010B080701107).
文摘Objective:To study the relationship between sleep disturbances and symptoms in patients with Parkinson’s disease(PD).Methods:The Parkinson’s Disease Sleep Scale-Chinese Version(PDSS-CV)was used to evaluate the sleep disturbances of PD patients in a cross sectional study.The Unified Parkinson’s Disease Rating Scale(UPDRS)parts II-IV,and the Hoehn&Yahr(H&Y)stage were used to determine the level of motor function in PD and the severity of PD.The Spearman correlation and a multiple regression analysis were used to identify the relationship between sleep disturbances and symptoms of PD.The quantities derived from the UPDRS and the H&Y stage and disease duration were compared between groups of patients either with or without sleep disturbances identified by the PDSS.This study was conducted from December 2011 to March 2012 at the First Affiliated Hospital of Sun Yat-sen University,in Guangzhou.Results:A total of 136 PD patients were included in this study.The overall total PDSS score in PD patients was 107.58±23.35 points(range:30–146).There were significant differences in the disease duration,the H&Y stage,and the UPDRS section subscores between groups of patients either with or without sleep disturbances(Kruskal-Wallis Test,p<0.05).There were significant negative correlations between PDSS scores and the UPDRS subscores,the H&Y stage and the disease duration(Spearman correlation,p<0.05).The multiple regression analysis indicated that sleep disturbances identified by the PDSS were only associated with daily life activity,tremor intensity and clinical fluctuation(R2=0.22,F(3,132)=12.4,p<0.001).The correlations were also significant when the contribution of the other two factors was excluded using partial correlations.Conclusions:The level of daily life activity and the occurrences of tremor and clinical fluctuation are likely to be important factors that lead to PD patients’sleep disturbances.This study may elucidate an important clue for the relationship between sleep disturbances and PD symptoms.
基金This study was supported by the National Key Basic Research Program of China(973 Program No.2015CB553902)
文摘Background:The benefit of systemic treatments in esophageal squamous cell carcinoma(ESCC)which has pro-gressed after chemotherapy is still uncertain and optimal regimens based on randomized trials have not yet been established.We aimed to compare the efficacy of irinotecan plus S-1 with S-1 monotherapy in recurrent or metastatic ESCC patients who had resistance to platinum-or taxane-based chemotherapy.Methods:We conducted a prospective randomized,multicenter,open-label,phase 3 trial in 15 centers across China.Eligible patients were adults with histologically confirmed recurrent or metastatic ESCC,and were randomly assigned(ratio,1:1)to receive either irinotecan plus S-1(intravenous infusion of irinotecan[160 mg/m2]on day 1 and oral S-1[80-120 mg]on days 1-10,repeated every 14 days)or oral S-1 monotherapy(80-120 mg/day on days 1-14,repeated every 21 days)using a central computerized minimization procedure.The primary endpoint was progression-free survival(PFS).Results:Between December 23,2014 and July 25,2016,we screened 148 patients and randomly assigned 123 patients to receive either irinotecan plus S-1 regimen(n=61)or S-1 monotherapy(n=62).After a median follow-up of 29.2 months(95%confidence interval[CI]17.5-40.9 months),the median PFS was significantly longer in the irinotecan plus S-1 group than in the S-1 monotherapy group(3.8 months[95%CI 2.9-4.3 months]vs.1.7 months[95%CI 1.4-2.7 months],hazard ratio=0.58,95%CI 0.38-0.86,P=0.006).The objective response rates were 24.6%in the irinotecan plus S-1 group and 9.7%in the S-1 monotherapy group(P=0.002).The patients in the irinotecan plus S-1 group presented with increased rates of grade 3-4 leukopenia(16.4%vs.0%),neutropenia(14.8%vs.1.6%),and nausea(4.9%vs.0%).No significant difference in grade 3-4 diarrhea and no treatment-related deaths were observed in both groups.Conclusions: The combination of irinotecan with S-1 was similarly tolerable but significantly prolonged PFS compared to S-1 monotherapy as a second- or third-line treatment in patients with recurrent or metastatic ESCC.
基金The data analyzed in this paper are from the Chinese Longitudinal Healthy Longevity Study(CLHLS)which was jointly supported by the National Natural Sciences Foundation of China(71490732)the National Key R&D Program of China(2018YFC2000400)the U.S.National Institute of Aging of the National Institute of Health(P01AG031719).
文摘This paper,based on data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS),reports on the health status of China’s elderly,and their needs for care and use of medical services.The proportion of the elderly in 2018 who reported being satisfied with their current lives was 67.1%,a proportion signifi-cantly higher than that reported by CLHLS 2002.Some 73.1%of the elderly self-rated their health as good or fair.There were ten types of chronic diseases with prev-alence rates higher than 5%,among which hypertension was the most common,with 46.2%of survey respondents self-reporting suffering from it.The daily lives of some people suffering from chronic diseases were seriously affected.Most elderly people(93.2%)were able to complete without assistance all of the ADL items surveyed by CLHLS 2018,while 63.6%were able to do so with IADL items.Only 19.1%of the elderly reported that they were unable to perform at least one IADL item.Family members were still the main source of primary care.The satisfaction of the elderly with primary caregiver and helps they received was quite high.The data shows that the average weekly cost of care was RMB 651.1 yuan,with a median of RMB 180.0 yuan.The median hours children or grandchildren helped their elderly parents(grandparents)in the week prior to being interviewed was 0,and the mean value was 10.3 h.Because 86.5%of elderly survey respondents were covered by some type of medical insurance,more than half of the elderly had their medical expenses covered by insurance,and most elderly people had access to adequate medical services.