BACKGROUND The trend of prediabetes progressing to type 2 diabetes mellitus(T2DM)is prominent,and effective intervention can lead to a return to prediabetes.Exploring the factors influencing the outcome of prediabetes...BACKGROUND The trend of prediabetes progressing to type 2 diabetes mellitus(T2DM)is prominent,and effective intervention can lead to a return to prediabetes.Exploring the factors influencing the outcome of prediabetes is helpful to guide clinical intervention.The weight change in patients with prediabetes has not attracted much attention.AIM To explore the interaction between body weight and the factors affecting the progression of prediabetes to T2DM.METHODS We performed a retrospective analysis of 236 patients with prediabetes and 50 with normal glucose tolerance(NGT),and collected clinical data and follow-up results of all patients.Based on natural blood glucose outcomes,we classified 66 patients with progression to T2DM into the disease progression(DP)group,and 170 patients without progression to T2DM into the disease outcome(DO)group.We analyzed the factors that influenced prediabetes outcome and the influence of body weight on prediabetes blood glucose outcome by unconditional logistic regression.A general linear model(univariate)was used to analyze the interaction between body weight and independent influencing factors.RESULTS There were 98 cases of impaired fasting glucose(IFG),90 cases of impaired glucose tolerance(IGT),and 48 cases of coexistent IFG and IGT.The body weight,waist circumference,body mass index,fasting blood glucose,and 2 h plasma glucose of patients with IFG,IGT,and coexistent IFG and IGT were higher than those in patients with NGT(P<0.05).Logistic regression analysis showed that body weight,glycosylated hemoglobin,uric acid,fasting insulin,and homeostatic model assessment for insulin resistance were independent factors affecting progression of prediabetes to T2DM(P<0.05).Receiver operating characteristic curve analysis showed that the area under the curve predicted by the above indicators combined was 0.905[95%confidence interval(CI):0.863-0.948],which was greater than that predicted by each indicator alone.Logistic regression analysis with baseline body weight as an independent variable showed that compared with body weight 1,the odds ratio(95%CI)of body weight 3 was 1.399(1.142-2.126)(P=0.033).There was a multiplicative interaction between body weight and uric acid(β=1.953,P=0.005).CONCLUSION High body weight in patients with prediabetes is an independent risk factor for progression to T2DM,and the risk of progression is increased when coexisting with high uric acid level.展开更多
AIM To investigate the differences in family history of inflammatory bowel disease(IBD) and clinical outcomes among individuals with Crohn's disease(CD) residing in China and the United States.METHODS We performed...AIM To investigate the differences in family history of inflammatory bowel disease(IBD) and clinical outcomes among individuals with Crohn's disease(CD) residing in China and the United States.METHODS We performed a survey-based cross-sectional study of participants with CD recruited from China and the United States.We compared the prevalence of IBD family history and history of ileal involvement,CD-related surgeries and IBD medications in China and the United States,adjusting for potential confounders.RESULTS We recruited 49 participants from China and 145 from the United States.The prevalence of family history of IBD was significantly lower in China compared with the United States(China:4.1%,United States:39.3%).The three most commonly affected types of relatives were cousin,sibling,and parent in the United States compared with child and sibling in China.Ileal involvement(China:63.3%,United States:63.5%) and surgery for CD(China:51.0%,United States:49.7%) were nearly equivalent in the two countries.CONCLUSION The lower prevalence of familial clustering of IBD in China may suggest that the etiology of CD is less attributed to genetic background or a family-shared environment compared with the United States.Despite the potential difference in etiology,surgery and ileal involvement were similar in the two countries.Examining the changes in family history during the continuing rise in IBD may provide further insight into the etiology of CD.展开更多
Background Since early December 2019,the 2019 novel coronavirus disease(COVID-19)has caused pneumonia epidemic in Wuhan,Hubei province of China.This study aimed to investigate the factors affecting the progression of ...Background Since early December 2019,the 2019 novel coronavirus disease(COVID-19)has caused pneumonia epidemic in Wuhan,Hubei province of China.This study aimed to investigate the factors affecting the progression of pneumonia in COVID-19 patients.Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia.Methods Patients tested positive for the COVID-19 based on nucleic acid detection were included in this study.Patients were admitted to 3 tertiary hospitals in Wuhan between December 30,2019,and January 15,2020.Individual data,laboratory indices,imaging characteristics,and clinical data were collected,and statistical analysis was performed.Based on clinical typing results,the patients were divided into a progression group or an improvement/stabilization group.Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test.Categorical variables were analyzed using Chi-squared test or Fisher’s exact test.Logistic regression analysis was performed to explore the risk factors for disease progression.Results Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study.Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients(14.1%)had deteriorated,and 67 patients(85.9%)had improved/stabilized.The patients in the progression group were significantly older than those in the disease improvement/stabilization group(66[51,70]vs.37[32,41]years,U=4.932,P=0.001).The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group(27.3%vs.3.0%,χ^2=9.291,P=0.018).For all the 78 patients,fever was the most common initial symptom,and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group(38.2[37.8,38.6]vs.37.5[37.0,38.4]°C,U=2.057,P=0.027).Moreover,the proportion of patients with respiratory failure(54.5%vs.20.9%,χ^2=5.611,P=0.028)and respiratory rate(34[18,48]vs.24[16,60]breaths/min,U=4.030,P=0.004)were significantly higher in the progression group than in the improvement/stabilization group.C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group(38.9[14.3,64.8]vs.10.6[1.9,33.1]mg/L,U=1.315,P=0.024).Albumin was significantly lower in the progression group than in the improvement/stabilization group(36.62±6.60 vs.41.27±4.55 g/L,U=2.843,P=0.006).Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group(χ^2=16.01,P=0.001).Multivariate logistic analysis indicated that age(odds ratio[OR],8.546;95%confidence interval[CI]:1.628-44.864;P=0.011),history of smoking(OR,14.285;95%CI:1.577-25.000;P=0.018),maximum body temperature at admission(OR,8.999;95%CI:1.036-78.147,P=0.046),respiratory failure(OR,8.772,95%CI:1.942-40.000;P=0.016),albumin(OR,7.353,95%CI:1.098-50.000;P=0.003),and C-reactive protein(OR,10.530;95%CI:1.224-34.701,P=0.028)were risk factors for disease progression.Conclusions Several factors that led to the progression of COVID-19 pneumonia were identified,including age,history of smoking,maximum body temperature at admission,respiratory failure,albumin,and C-reactive protein.These results can be used to further enhance the ability of management of COVID-19 pneumonia.展开更多
AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their perspectives.METHODS: Patients with IBD, aged > 18 years, who had moved from paedia...AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their perspectives.METHODS: Patients with IBD, aged > 18 years, who had moved from paediatric to adult care within 10 years were identified through IBD databases at three tertiary hospitals. Participants were surveyed regarding demographic and disease specific data and their perspectives on the transition process. Survey response data were compared to contemporaneously recorded information in paediatric service case notes. Data were compared to a similar age cohort who had never received paediatric IBD care and therefore who had not undergone a transition process.RESULTS: There were 81 returned surveys from 46 transition and 35 non-transition patients. No statistically significant differences were found in disease burden, disease outcomes or adult roles and responsibilities between cohorts. Despite a high prevalence of mood disturbance (35%), there was a very low usage (5%) of psychological services in both cohorts. In the transition cohort, knowledge of their transition plan was reported by only 25/46 patients and the majority (54%) felt they were not strongly prepared. A high rate (78%) of discussion about work/study plans was recorded prior to transition, but a near complete absence of discussion regarding sex (8%), and other adult issues was recorded. Both cohorts agreed that their preferred method of future transition practices (of the options offered) was a shared clinic appointment with all key stakeholders.CONCLUSION: Transition did not appear to adversely affect disease or psychosocial outcomes. Current transition care processes could be optimised, with better psychosocial preparation and agreed transition plans.展开更多
BACKGROUND A limited number of studies have been conducted to test the magnitudes of the association between apparent treatment resistant hypertension(aTRH)and risk of cardiovascular disease(CVD).AIM To investigate th...BACKGROUND A limited number of studies have been conducted to test the magnitudes of the association between apparent treatment resistant hypertension(aTRH)and risk of cardiovascular disease(CVD).AIM To investigate the association between aTRH and risk of CVD and examine whether sex and age modify this association.METHODS We applied an observational analysis study design using data from the United States Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial(ALLHAT).ALLHAT recruited participants(n=25516)from 625 primary care settings throughout the United States,Canada,Puerto Rico,and United States Virgin Islands,aged 55 and older with hypertension and at least one additional risk factor for heart disease.aTRH was assessed from the year 2 visit.CVD event was defined as one of the following from the year 2 follow-up visit:Fatal or non-fatal myocardial infarction,coronary revascularization,angina,stroke,heart failure,or peripheral artery disease.Cox proportional hazards regression was used to examine the effect of aTRH on CVD risk.Potential modifications of sex and age on this association were examined on the multiplicative scale by interaction term and additive scale by joint effects and relative excess risk for interaction.RESULTS Of the total study participants(n=25516),5030 experienced a CVD event during a mean of 4.7 years follow-up.aTRH was associated with a 30%increase in risk of CVD compared to non-aTRH[hazards ratio(HR)=1.3,95%CI:1.19-1.42].Sex and age modified this relationship on both multiplicative and additive scales independently.Stratified by sex,aTRH was associated with a 64%increase in risk of CVD(HR=1.64,95%CI:1.43–1.88)in women,and a 13%increase in risk of CVD(HR=1.13,95%CI:1.01–1.27)in men.Stratified by age,aTRH had a stronger impact on the risk of CVD in participants aged<65(HR=1.53,95%CI:1.32–1.77)than it did in those aged≥65(HR=1.18,95%CI:1.05–1.32).Significant two-way interactions of sex and aTRH,and age and aTRH on risk of CVD were observed(P<0.05).The observed joint effect of aTRH and ages≥65 years(HR=1.85,95%CI:1.22–2.48)in males was less than what was expected for both additive and multiplicative models(HR=4.10,95%CI:3.63–4.57 and 4.88,95%CI:3.66–6.31),although three-way interaction of sex,age,and aTRH on the risk of CVD and coronary heart disease did not reach a statistical significance(P>0.05).CONCLUSION aTRH was significantly associated with an increased risk of CVD and this association was modified by both sex and age.Further studies are warranted to test these mechanisms.展开更多
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...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.展开更多
AIMTo evaluate the prevalence, risk factors and outcome of acute kidney injury (AKI) in very low birth weight (VLBW) infants. METHODSIn this retrospective study of VLBW infants, we analyzed the prevalence of AKI, ...AIMTo evaluate the prevalence, risk factors and outcome of acute kidney injury (AKI) in very low birth weight (VLBW) infants. METHODSIn this retrospective study of VLBW infants, we analyzed the prevalence of AKI, as defined by changes in serum creatinine and urine output, associated risk factors and outcomes.RESULTSA total of 293 VLBW infants (mean gestational age 28.7 wk) were included, of whom 109 weighed less than 1000 g at birth. The overall prevalence of AKI was 11.6% (22% in infants with a birth weight under 1000 g and 5.4% those heavier). A total of 19 (55%) affected infants died, with a mortality rate of 58% in infant less than 1000 g and 50% in those heavier. After adjusting for confounding variables, only necrotizing enterocolitis (NEC) remained associated with AKI, with odds ratio of 4.9 (95%CI: 1.9-18.6). Blood pressure and glomerular filtration rate (GFR) were not different between affected infants and the others upon discharge from hospital. A normal GFR was documented in all affected infants at one year of age.CONCLUSION Using Kidney Disease Improving Global Outcomes defnition of AKI, it occurred in over 10% of VLBW infants, more commonly in infants with lower birth weight. NEC was an independent associated risk factor. Renal function, as defined by GFR, was normal in all surviving affected infants 10 to 12 mo later.展开更多
Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE)....Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE).Methods:A total of 128 pediatric inpatients with echinococcosis at the People’s Hospital of Qinghai Province and the Clinical Research Institute of Echinococcosis of Qinghai Province between January 2016 and December 2021 were chosen as subjects.Demographic and clinical data were collected,and double data entry was executed using EpiData 3.02.Factors influencing the cure of echinococcosis were analyzed with echinococcosis cure as the dependent variable,employing statistical analysis via SPSS 19.0.Results:Of the cases,35.9%had CE,and 64.1%had AE.Both types were observed in patients of all ages,with the majority aged 13-18.The number of cysts and their sizes varied between CE and AE.Complications were prevalent,including liver,gallbladder,lung,and nutritional complications.Univariate analyses revealed significant differences in outcomes based on factors such as cyst size(for CE),liver function grade(for AE),hydatid hypersensitivity test,operation,and length of hospital stay(P<0.05).Conclusion:This comprehensive analysis of hospitalized cases sheds light on the clinical data of echinococcosis in children and adolescents in Qinghai Province.The findings contribute to a scientific foundation for formulating effective prevention and control measures tailored to this demographic,facilitating an improved understanding of echinococcosis in Qinghai province.展开更多
AIM:To correlate cyclooxygenase-2(COX-2)expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma(CRC).METHODS:Archival tumor samples were analyzed...AIM:To correlate cyclooxygenase-2(COX-2)expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma(CRC).METHODS:Archival tumor samples were analyzed using immunohistochemistry for COX-2 expression in 94 patients with CRC.Patients were diagnosed and treatedat the Departments of Surgery and Oncology,King Abdulaziz University Hospital,Saudi Arabia.RESULTS:Fifty-six percent of the tumors showed positive cytoplasmic COX-2 expression,whereas 44%of cases were completely COX-2-negative.There were no significant correlations between COX-2 expression and sex,age,grade or tumor location.However,COX-2 expression revealed a significant correlation with tumor stage(P=0.01)and distant metastasis(P=0.02),and a borderline association with lymph node involvement(P =0.07).Tumors with high COX-2 expression showed a higher recurrence rate than tumors with no expression(P<0.009).In univariate Kaplan-Meier survival analysis,there was a significant(P=0.026)difference in disease-free survival between COX-2-positive and negative tumors in favor of the latter.COX-2 expression did not significantly predict disease-specific survival,which was much shorter for COX-2-positive tumors.In multivariate(COX)models,COX-2 did not appear among the independent predictors of disease-free survival or disease-specific survival.CONCLUSION:COX-2 expression seems to provide useful prognostic information in CRC,while predicting the patients at high risk for recurrent disease.展开更多
AIM:To assess the reasons for,and factors associated with,patient-initiated changes in treating specialist in inflammatory bowel diseases(IBD).METHODS:Prospectively identified IBD patients(n = 256) with ≥ 1 encounter...AIM:To assess the reasons for,and factors associated with,patient-initiated changes in treating specialist in inflammatory bowel diseases(IBD).METHODS:Prospectively identified IBD patients(n = 256) with ≥ 1 encounter at a metropolitan hospital were surveyed,including whether they had changed treating specialist and why.Negative reasons included loss of confidence,disagreement,and/or personality clash with the specialist.RESULTS:Of 162 respondents,70(43%) had ever changed specialists;30/70(43%) for negative reasons,52/70(74%) in the preceding year.Patients with negative reasons for changing(n = 30) were younger(median,35.2 years vs 45.3 years),had higher IBD knowledge(median,5.0 years vs 4.0 years),yet had lower medication adherence and satisfaction scores(median,19.0 years vs 22.0 years,14.0 years vs 16.0 years respectively,Mann-Whitney tests,all P < 0.05),compared to all other responders(n = 132).Patients with a recent change(for any reason) were more likely to have Crohn's disease,currently active disease,previous bowel resection and recent hospitalization [OR 2.6,95% CI(1.3-5.4),2.2(1.0-4.7),5.56(1.92-16.67),2.0(1.3-3.0),eachP < 0.05].CONCLUSION:Changing specialist appears associated with patient-related(age,nonadherence) and contemporaneous disease-related factors(recent relapse) which,where modifiable,may enhance patient-doctor relationships and therefore quality of care.展开更多
In 2002,the National Kidney Foundation Kidney Disease Outcomes Quality Initiative(NKF KDOQI)instituted new guidelines that established a novel chronic kidney disease(CKD)staging paradigm.This set of guidelines,since u...In 2002,the National Kidney Foundation Kidney Disease Outcomes Quality Initiative(NKF KDOQI)instituted new guidelines that established a novel chronic kidney disease(CKD)staging paradigm.This set of guidelines,since updated,is now very widely accepted around the world.Nevertheless,the authoritative United States Preventative Task Force had in August 2012acknowledged that we know surprisingly little about whether screening adults with no signs or symptoms of CKD improve health outcomes and that we deserve better information on CKD.More recently,the American Society of Nephrology and the American College of Physicians,two very well respected United States professional physician organizations were strongly at odds coming out with exactly opposite recommendations regarding the need or otherwise for"CKD screening"among the asymptomatic population.In this review,we revisit the various angles and perspectives of these conflicting arguments,raise unanswered questionsregarding the validity and veracity of the NKF KDOQI CKD staging model,and raise even more questions about the soundness of its evidence-base.We show clinical evidence,from a Mayo Clinic Health System Renal Unit in Northwestern Wisconsin,United States,of the pitfalls of the current CKD staging model,show the inexactitude and unpredictable vagaries of current CKD prediction models and call for a more cautious and guarded application of CKD staging paradigms in clinical practice.The impacts of acute kidney injury on CKD initiation and CKD propagation and progression,the effects of such phenomenon as the syndrome of late onset renal failure from angiotensin blockade and the syndrome of rapid onset end stage renal disease on CKD initiation,CKD propagation and CKD progression to end stage renal disease all demand further study and analysis.Yet more research on CKD staging,CKD prognostication and CKD predictions are warranted.Finally and most importantly,cognizant of the very serious limitations and drawbacks of the NKF K/DOQI CKD staging model,the need to individualize CKD care,both in terms of patient care and prognostication,cannot be overemphasized.展开更多
BackgroundRevascularization and statin therapy are routinely used in the management of stable coronary artery disease. However, it is unclear whether the estimated high-density lipoprotein (HDL) particle size (eHD...BackgroundRevascularization and statin therapy are routinely used in the management of stable coronary artery disease. However, it is unclear whether the estimated high-density lipoprotein (HDL) particle size (eHDL-S), the ratio of HDL cholesterol (HDL-C) to apoprotein A-I (apoA-I), is associated with the clinical outcomes of diabetic patients with stablecoronary artery disease (CAD).MethodsWe per-formed a prospective cohort study of 328 patients diagnosed with stable CAD by coronary angiography. Patients were followed up for a mean duration of 12 months. The patients were divided into three groups by the tertiles of eHDL-S: low eHDL-S (〈 0.71,n= 118); interme-diate eHDL-S (0.71-0.79,n= 111); and high eHDL-S (〉 0.79,n= 99). The associations between the baseline eHDL-S and short-term out-comes were evaluated using the Kaplan-Meier method and Cox proportional regression.Results The low eHDL-S group had higher trig-lyceride, hemoglobin A1c, uric acid, and leukocyte count than the other groups. During the follow-up period, 47/328 patients experienced a pre-specified outcome. According to the Kaplan-Meier analysis, the incidence of pre-specified outcomes was lower in the high eHDL-S group (P = 0.04). However, eHDL-S was not independently associated with adverse outcomes in Cox proportional hazards regression (haz-ard ratio (HR): 0.23, 95% confidence interval (95% CI): 0.01-11.24,P = 0.493).ConclusionAlthough the eHDL-S was associated with inflammatory biomarkers, it was not independently associated with the short-term prognosis of diabetic patients with stable CAD in the era of revascularization and potent statin therapy.展开更多
In a retrospective study. liquid nitrogen preserved specimens from 50 women with primary breast cancer, who underwent surgery at the Beijing Institute for Cancer Research between June. 1986 and September, 1988, were i...In a retrospective study. liquid nitrogen preserved specimens from 50 women with primary breast cancer, who underwent surgery at the Beijing Institute for Cancer Research between June. 1986 and September, 1988, were investigated. All patients under this study were staged in TNM II or later, involved with axillary lymph node metastasis. and treated with systemic postoperative adjuvant chemotherapy. The median length of follow-up was 69 months. The expression of P-glycoprotein was investigated by means of immunohistochemistry, using a monoclonal antibody C219 specifically against P-glycoprotein and avidin -biotin peroxidase method. Posrtive staining for P-glycoprotein was found in 23(16%) of the 50 patients. The P-glycoprotein expression negative group fared better than the group that was P-glycoprotein posrtive in overall survival curves (p= 0. 0008 , by the generalized Wilcoxon test). The prognostic effect of P-glycoprotein expression remained statistically significant (p=0. 0007) after adjustment by multivariate analysis(Cox’s model)for other prognostic factors. It is demonstrated that P-glycoprotein expression is a significant and independent Predictor of postoperative survival in breast cancer patients. The results of the present study suggest that P-glycoprotein expression might also influence the bioiogical behavior of breast cancers.展开更多
BACKGROUND The exact definition of Acute kidney injury(AKI)for patients with traumatic brain injury(TBI)is unknown.AIM To compare the power of the“Risk,Injury,Failure,Loss of kidney function,and End-stage kidney dise...BACKGROUND The exact definition of Acute kidney injury(AKI)for patients with traumatic brain injury(TBI)is unknown.AIM To compare the power of the“Risk,Injury,Failure,Loss of kidney function,and End-stage kidney disease”(RIFLE),Acute Kidney Injury Network(AKIN),Creatinine kinetics(CK),and Kidney Disease Improving Global Outcomes(KDIGO)to determine AKI incidence/stage and their association with the inhospital mortality rate of patients with TBI.METHODS This retrospective study collected the data of patients admitted to the intensive care unit for neurotrauma from 2001 to 2012,and 1648 patients were included.The subjects in this study were assessed for the presence and stage of AKI using RIFLE,AKIN,CK,and KDIGO.In addition,the propensity score matching method was used.RESULTS Among the 1648 patients,291(17.7%)had AKI,according to KDIGO.The highest incidence of AKI was found by KDIGO(17.7%),followed by AKIN(17.1%),RIFLE(12.7%),and CK(11.5%)(P=0.97).Concordance between KDIGO and RIFLE/AKIN/CK was 99.3%/99.1%/99.3%for stage 0,36.0%/91.5%/44.5%for stage 1,35.9%/90.6%/11.3%for stage 2,and 47.4%/89.5%/36.8%for stage 3.The in-hospital mortality rates increased with the AKI stage in all four definitions.The severity of AKI by all definitions and stages was not associated with inhospital mortality in the multivariable analyses(all P>0.05).CONCLUSION Differences are seen in AKI diagnosis and in-hospital mortality among the four AKI definitions or stages.This study revealed that KDIGO is the best method to define AKI in patients with TBI.展开更多
The uremic symptoms of advanced chronic kidney disease(CKD)can severely impair physical function,psychological health and social life.Some patients,especially for the older,chose conservative kidney management(CKM)and...The uremic symptoms of advanced chronic kidney disease(CKD)can severely impair physical function,psychological health and social life.Some patients,especially for the older,chose conservative kidney management(CKM)and Traditional Chinese medicine(TCM)but not dialysis in this stage.To measure the patients-reported outcome(PRO)from these people,Advanced Chronic Kidney展开更多
Background Many patients have symptoms suggestive of coronary artery disease (CAD) and are often eval- uated with the use of diagnostic testing, although there are limited data from randomized trials to guide care.
OBJECTIVE:To evaluate the curative effect of external application of the Chinese drug,Sanjierupi Gao,on mastalgia caused by mammary gland hyperplasia.METHODS:This randomized,double-blinded,and placebo controlled study...OBJECTIVE:To evaluate the curative effect of external application of the Chinese drug,Sanjierupi Gao,on mastalgia caused by mammary gland hyperplasia.METHODS:This randomized,double-blinded,and placebo controlled study enrolled 260 patients with mammary gland hyperplasia from five hospitals.Patients were randomly and equally divided in-to a Sanjierupi Gao treatment group and a placebo control group.An adhesive plaster was applied to the most painful area on either breast for 7 h a day.Treatment lasted for two menstrual cycles without application during menstruation.Mastalgia was used as the main index of curative effect.The change before and after treatment in days of mastalgia,the time to alleviate pain,pain extent,and severe pain scores were observed.RESULTS:Compared to the control group,the treatment group had significantly fewer days of mastalgia(P<0.01),a significantly lower severe pain score(P<0.01),and significantly less subjective pain and tenderness(P<0.05 and P<0.01,respectively).Three days before the follow-up visit,the pain score in the treatment group was significantly lower than that in the control group(P<0.05).A non-parametric test was used to compare the time to alleviate mastalgia between the two groups and found no statistical difference(Z=0.313,P=0.754).CONCLUSION:Application of Sanjierupi Gao can decrease mastalgia duration in patients with mammary gland hyperplasia during menstruation and alleviate the extent of mastalgia.The time to alleviate pain is psychologically influenced.展开更多
基金The study was reviewed and approved by The First People’s Hospital of Wenling City(Approval No.KY-2019-1024-01).
文摘BACKGROUND The trend of prediabetes progressing to type 2 diabetes mellitus(T2DM)is prominent,and effective intervention can lead to a return to prediabetes.Exploring the factors influencing the outcome of prediabetes is helpful to guide clinical intervention.The weight change in patients with prediabetes has not attracted much attention.AIM To explore the interaction between body weight and the factors affecting the progression of prediabetes to T2DM.METHODS We performed a retrospective analysis of 236 patients with prediabetes and 50 with normal glucose tolerance(NGT),and collected clinical data and follow-up results of all patients.Based on natural blood glucose outcomes,we classified 66 patients with progression to T2DM into the disease progression(DP)group,and 170 patients without progression to T2DM into the disease outcome(DO)group.We analyzed the factors that influenced prediabetes outcome and the influence of body weight on prediabetes blood glucose outcome by unconditional logistic regression.A general linear model(univariate)was used to analyze the interaction between body weight and independent influencing factors.RESULTS There were 98 cases of impaired fasting glucose(IFG),90 cases of impaired glucose tolerance(IGT),and 48 cases of coexistent IFG and IGT.The body weight,waist circumference,body mass index,fasting blood glucose,and 2 h plasma glucose of patients with IFG,IGT,and coexistent IFG and IGT were higher than those in patients with NGT(P<0.05).Logistic regression analysis showed that body weight,glycosylated hemoglobin,uric acid,fasting insulin,and homeostatic model assessment for insulin resistance were independent factors affecting progression of prediabetes to T2DM(P<0.05).Receiver operating characteristic curve analysis showed that the area under the curve predicted by the above indicators combined was 0.905[95%confidence interval(CI):0.863-0.948],which was greater than that predicted by each indicator alone.Logistic regression analysis with baseline body weight as an independent variable showed that compared with body weight 1,the odds ratio(95%CI)of body weight 3 was 1.399(1.142-2.126)(P=0.033).There was a multiplicative interaction between body weight and uric acid(β=1.953,P=0.005).CONCLUSION High body weight in patients with prediabetes is an independent risk factor for progression to T2DM,and the risk of progression is increased when coexisting with high uric acid level.
基金Supported by (in part)Johns Hopkins Institute for Clinical and Translational Research,No.UL1TR001079
文摘AIM To investigate the differences in family history of inflammatory bowel disease(IBD) and clinical outcomes among individuals with Crohn's disease(CD) residing in China and the United States.METHODS We performed a survey-based cross-sectional study of participants with CD recruited from China and the United States.We compared the prevalence of IBD family history and history of ileal involvement,CD-related surgeries and IBD medications in China and the United States,adjusting for potential confounders.RESULTS We recruited 49 participants from China and 145 from the United States.The prevalence of family history of IBD was significantly lower in China compared with the United States(China:4.1%,United States:39.3%).The three most commonly affected types of relatives were cousin,sibling,and parent in the United States compared with child and sibling in China.Ileal involvement(China:63.3%,United States:63.5%) and surgery for CD(China:51.0%,United States:49.7%) were nearly equivalent in the two countries.CONCLUSION The lower prevalence of familial clustering of IBD in China may suggest that the etiology of CD is less attributed to genetic background or a family-shared environment compared with the United States.Despite the potential difference in etiology,surgery and ileal involvement were similar in the two countries.Examining the changes in family history during the continuing rise in IBD may provide further insight into the etiology of CD.
文摘Background Since early December 2019,the 2019 novel coronavirus disease(COVID-19)has caused pneumonia epidemic in Wuhan,Hubei province of China.This study aimed to investigate the factors affecting the progression of pneumonia in COVID-19 patients.Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia.Methods Patients tested positive for the COVID-19 based on nucleic acid detection were included in this study.Patients were admitted to 3 tertiary hospitals in Wuhan between December 30,2019,and January 15,2020.Individual data,laboratory indices,imaging characteristics,and clinical data were collected,and statistical analysis was performed.Based on clinical typing results,the patients were divided into a progression group or an improvement/stabilization group.Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test.Categorical variables were analyzed using Chi-squared test or Fisher’s exact test.Logistic regression analysis was performed to explore the risk factors for disease progression.Results Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study.Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients(14.1%)had deteriorated,and 67 patients(85.9%)had improved/stabilized.The patients in the progression group were significantly older than those in the disease improvement/stabilization group(66[51,70]vs.37[32,41]years,U=4.932,P=0.001).The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group(27.3%vs.3.0%,χ^2=9.291,P=0.018).For all the 78 patients,fever was the most common initial symptom,and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group(38.2[37.8,38.6]vs.37.5[37.0,38.4]°C,U=2.057,P=0.027).Moreover,the proportion of patients with respiratory failure(54.5%vs.20.9%,χ^2=5.611,P=0.028)and respiratory rate(34[18,48]vs.24[16,60]breaths/min,U=4.030,P=0.004)were significantly higher in the progression group than in the improvement/stabilization group.C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group(38.9[14.3,64.8]vs.10.6[1.9,33.1]mg/L,U=1.315,P=0.024).Albumin was significantly lower in the progression group than in the improvement/stabilization group(36.62±6.60 vs.41.27±4.55 g/L,U=2.843,P=0.006).Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group(χ^2=16.01,P=0.001).Multivariate logistic analysis indicated that age(odds ratio[OR],8.546;95%confidence interval[CI]:1.628-44.864;P=0.011),history of smoking(OR,14.285;95%CI:1.577-25.000;P=0.018),maximum body temperature at admission(OR,8.999;95%CI:1.036-78.147,P=0.046),respiratory failure(OR,8.772,95%CI:1.942-40.000;P=0.016),albumin(OR,7.353,95%CI:1.098-50.000;P=0.003),and C-reactive protein(OR,10.530;95%CI:1.224-34.701,P=0.028)were risk factors for disease progression.Conclusions Several factors that led to the progression of COVID-19 pneumonia were identified,including age,history of smoking,maximum body temperature at admission,respiratory failure,albumin,and C-reactive protein.These results can be used to further enhance the ability of management of COVID-19 pneumonia.
基金Supported by Alice Bennett received financial support during her research year from Abb Vie
文摘AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their perspectives.METHODS: Patients with IBD, aged > 18 years, who had moved from paediatric to adult care within 10 years were identified through IBD databases at three tertiary hospitals. Participants were surveyed regarding demographic and disease specific data and their perspectives on the transition process. Survey response data were compared to contemporaneously recorded information in paediatric service case notes. Data were compared to a similar age cohort who had never received paediatric IBD care and therefore who had not undergone a transition process.RESULTS: There were 81 returned surveys from 46 transition and 35 non-transition patients. No statistically significant differences were found in disease burden, disease outcomes or adult roles and responsibilities between cohorts. Despite a high prevalence of mood disturbance (35%), there was a very low usage (5%) of psychological services in both cohorts. In the transition cohort, knowledge of their transition plan was reported by only 25/46 patients and the majority (54%) felt they were not strongly prepared. A high rate (78%) of discussion about work/study plans was recorded prior to transition, but a near complete absence of discussion regarding sex (8%), and other adult issues was recorded. Both cohorts agreed that their preferred method of future transition practices (of the options offered) was a shared clinic appointment with all key stakeholders.CONCLUSION: Transition did not appear to adversely affect disease or psychosocial outcomes. Current transition care processes could be optimised, with better psychosocial preparation and agreed transition plans.
文摘BACKGROUND A limited number of studies have been conducted to test the magnitudes of the association between apparent treatment resistant hypertension(aTRH)and risk of cardiovascular disease(CVD).AIM To investigate the association between aTRH and risk of CVD and examine whether sex and age modify this association.METHODS We applied an observational analysis study design using data from the United States Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial(ALLHAT).ALLHAT recruited participants(n=25516)from 625 primary care settings throughout the United States,Canada,Puerto Rico,and United States Virgin Islands,aged 55 and older with hypertension and at least one additional risk factor for heart disease.aTRH was assessed from the year 2 visit.CVD event was defined as one of the following from the year 2 follow-up visit:Fatal or non-fatal myocardial infarction,coronary revascularization,angina,stroke,heart failure,or peripheral artery disease.Cox proportional hazards regression was used to examine the effect of aTRH on CVD risk.Potential modifications of sex and age on this association were examined on the multiplicative scale by interaction term and additive scale by joint effects and relative excess risk for interaction.RESULTS Of the total study participants(n=25516),5030 experienced a CVD event during a mean of 4.7 years follow-up.aTRH was associated with a 30%increase in risk of CVD compared to non-aTRH[hazards ratio(HR)=1.3,95%CI:1.19-1.42].Sex and age modified this relationship on both multiplicative and additive scales independently.Stratified by sex,aTRH was associated with a 64%increase in risk of CVD(HR=1.64,95%CI:1.43–1.88)in women,and a 13%increase in risk of CVD(HR=1.13,95%CI:1.01–1.27)in men.Stratified by age,aTRH had a stronger impact on the risk of CVD in participants aged<65(HR=1.53,95%CI:1.32–1.77)than it did in those aged≥65(HR=1.18,95%CI:1.05–1.32).Significant two-way interactions of sex and aTRH,and age and aTRH on risk of CVD were observed(P<0.05).The observed joint effect of aTRH and ages≥65 years(HR=1.85,95%CI:1.22–2.48)in males was less than what was expected for both additive and multiplicative models(HR=4.10,95%CI:3.63–4.57 and 4.88,95%CI:3.66–6.31),although three-way interaction of sex,age,and aTRH on the risk of CVD and coronary heart disease did not reach a statistical significance(P>0.05).CONCLUSION aTRH was significantly associated with an increased risk of CVD and this association was modified by both sex and age.Further studies are warranted to test these mechanisms.
文摘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.
文摘AIMTo evaluate the prevalence, risk factors and outcome of acute kidney injury (AKI) in very low birth weight (VLBW) infants. METHODSIn this retrospective study of VLBW infants, we analyzed the prevalence of AKI, as defined by changes in serum creatinine and urine output, associated risk factors and outcomes.RESULTSA total of 293 VLBW infants (mean gestational age 28.7 wk) were included, of whom 109 weighed less than 1000 g at birth. The overall prevalence of AKI was 11.6% (22% in infants with a birth weight under 1000 g and 5.4% those heavier). A total of 19 (55%) affected infants died, with a mortality rate of 58% in infant less than 1000 g and 50% in those heavier. After adjusting for confounding variables, only necrotizing enterocolitis (NEC) remained associated with AKI, with odds ratio of 4.9 (95%CI: 1.9-18.6). Blood pressure and glomerular filtration rate (GFR) were not different between affected infants and the others upon discharge from hospital. A normal GFR was documented in all affected infants at one year of age.CONCLUSION Using Kidney Disease Improving Global Outcomes defnition of AKI, it occurred in over 10% of VLBW infants, more commonly in infants with lower birth weight. NEC was an independent associated risk factor. Renal function, as defined by GFR, was normal in all surviving affected infants 10 to 12 mo later.
基金2021-2022 Qinghai Province“Kunlun Talents”Action Plan of Young and Middle-Aged Scientific and Technological Talents.
文摘Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE).Methods:A total of 128 pediatric inpatients with echinococcosis at the People’s Hospital of Qinghai Province and the Clinical Research Institute of Echinococcosis of Qinghai Province between January 2016 and December 2021 were chosen as subjects.Demographic and clinical data were collected,and double data entry was executed using EpiData 3.02.Factors influencing the cure of echinococcosis were analyzed with echinococcosis cure as the dependent variable,employing statistical analysis via SPSS 19.0.Results:Of the cases,35.9%had CE,and 64.1%had AE.Both types were observed in patients of all ages,with the majority aged 13-18.The number of cysts and their sizes varied between CE and AE.Complications were prevalent,including liver,gallbladder,lung,and nutritional complications.Univariate analyses revealed significant differences in outcomes based on factors such as cyst size(for CE),liver function grade(for AE),hydatid hypersensitivity test,operation,and length of hospital stay(P<0.05).Conclusion:This comprehensive analysis of hospitalized cases sheds light on the clinical data of echinococcosis in children and adolescents in Qinghai Province.The findings contribute to a scientific foundation for formulating effective prevention and control measures tailored to this demographic,facilitating an improved understanding of echinococcosis in Qinghai province.
基金Supported by Scientific Chair for Colorectal Cancer,King Abdul-Aziz University,Jeddah,Saudi Arabia
文摘AIM:To correlate cyclooxygenase-2(COX-2)expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma(CRC).METHODS:Archival tumor samples were analyzed using immunohistochemistry for COX-2 expression in 94 patients with CRC.Patients were diagnosed and treatedat the Departments of Surgery and Oncology,King Abdulaziz University Hospital,Saudi Arabia.RESULTS:Fifty-six percent of the tumors showed positive cytoplasmic COX-2 expression,whereas 44%of cases were completely COX-2-negative.There were no significant correlations between COX-2 expression and sex,age,grade or tumor location.However,COX-2 expression revealed a significant correlation with tumor stage(P=0.01)and distant metastasis(P=0.02),and a borderline association with lymph node involvement(P =0.07).Tumors with high COX-2 expression showed a higher recurrence rate than tumors with no expression(P<0.009).In univariate Kaplan-Meier survival analysis,there was a significant(P=0.026)difference in disease-free survival between COX-2-positive and negative tumors in favor of the latter.COX-2 expression did not significantly predict disease-specific survival,which was much shorter for COX-2-positive tumors.In multivariate(COX)models,COX-2 did not appear among the independent predictors of disease-free survival or disease-specific survival.CONCLUSION:COX-2 expression seems to provide useful prognostic information in CRC,while predicting the patients at high risk for recurrent disease.
文摘AIM:To assess the reasons for,and factors associated with,patient-initiated changes in treating specialist in inflammatory bowel diseases(IBD).METHODS:Prospectively identified IBD patients(n = 256) with ≥ 1 encounter at a metropolitan hospital were surveyed,including whether they had changed treating specialist and why.Negative reasons included loss of confidence,disagreement,and/or personality clash with the specialist.RESULTS:Of 162 respondents,70(43%) had ever changed specialists;30/70(43%) for negative reasons,52/70(74%) in the preceding year.Patients with negative reasons for changing(n = 30) were younger(median,35.2 years vs 45.3 years),had higher IBD knowledge(median,5.0 years vs 4.0 years),yet had lower medication adherence and satisfaction scores(median,19.0 years vs 22.0 years,14.0 years vs 16.0 years respectively,Mann-Whitney tests,all P < 0.05),compared to all other responders(n = 132).Patients with a recent change(for any reason) were more likely to have Crohn's disease,currently active disease,previous bowel resection and recent hospitalization [OR 2.6,95% CI(1.3-5.4),2.2(1.0-4.7),5.56(1.92-16.67),2.0(1.3-3.0),eachP < 0.05].CONCLUSION:Changing specialist appears associated with patient-related(age,nonadherence) and contemporaneous disease-related factors(recent relapse) which,where modifiable,may enhance patient-doctor relationships and therefore quality of care.
文摘In 2002,the National Kidney Foundation Kidney Disease Outcomes Quality Initiative(NKF KDOQI)instituted new guidelines that established a novel chronic kidney disease(CKD)staging paradigm.This set of guidelines,since updated,is now very widely accepted around the world.Nevertheless,the authoritative United States Preventative Task Force had in August 2012acknowledged that we know surprisingly little about whether screening adults with no signs or symptoms of CKD improve health outcomes and that we deserve better information on CKD.More recently,the American Society of Nephrology and the American College of Physicians,two very well respected United States professional physician organizations were strongly at odds coming out with exactly opposite recommendations regarding the need or otherwise for"CKD screening"among the asymptomatic population.In this review,we revisit the various angles and perspectives of these conflicting arguments,raise unanswered questionsregarding the validity and veracity of the NKF KDOQI CKD staging model,and raise even more questions about the soundness of its evidence-base.We show clinical evidence,from a Mayo Clinic Health System Renal Unit in Northwestern Wisconsin,United States,of the pitfalls of the current CKD staging model,show the inexactitude and unpredictable vagaries of current CKD prediction models and call for a more cautious and guarded application of CKD staging paradigms in clinical practice.The impacts of acute kidney injury on CKD initiation and CKD propagation and progression,the effects of such phenomenon as the syndrome of late onset renal failure from angiotensin blockade and the syndrome of rapid onset end stage renal disease on CKD initiation,CKD propagation and CKD progression to end stage renal disease all demand further study and analysis.Yet more research on CKD staging,CKD prognostication and CKD predictions are warranted.Finally and most importantly,cognizant of the very serious limitations and drawbacks of the NKF K/DOQI CKD staging model,the need to individualize CKD care,both in terms of patient care and prognostication,cannot be overemphasized.
文摘BackgroundRevascularization and statin therapy are routinely used in the management of stable coronary artery disease. However, it is unclear whether the estimated high-density lipoprotein (HDL) particle size (eHDL-S), the ratio of HDL cholesterol (HDL-C) to apoprotein A-I (apoA-I), is associated with the clinical outcomes of diabetic patients with stablecoronary artery disease (CAD).MethodsWe per-formed a prospective cohort study of 328 patients diagnosed with stable CAD by coronary angiography. Patients were followed up for a mean duration of 12 months. The patients were divided into three groups by the tertiles of eHDL-S: low eHDL-S (〈 0.71,n= 118); interme-diate eHDL-S (0.71-0.79,n= 111); and high eHDL-S (〉 0.79,n= 99). The associations between the baseline eHDL-S and short-term out-comes were evaluated using the Kaplan-Meier method and Cox proportional regression.Results The low eHDL-S group had higher trig-lyceride, hemoglobin A1c, uric acid, and leukocyte count than the other groups. During the follow-up period, 47/328 patients experienced a pre-specified outcome. According to the Kaplan-Meier analysis, the incidence of pre-specified outcomes was lower in the high eHDL-S group (P = 0.04). However, eHDL-S was not independently associated with adverse outcomes in Cox proportional hazards regression (haz-ard ratio (HR): 0.23, 95% confidence interval (95% CI): 0.01-11.24,P = 0.493).ConclusionAlthough the eHDL-S was associated with inflammatory biomarkers, it was not independently associated with the short-term prognosis of diabetic patients with stable CAD in the era of revascularization and potent statin therapy.
文摘In a retrospective study. liquid nitrogen preserved specimens from 50 women with primary breast cancer, who underwent surgery at the Beijing Institute for Cancer Research between June. 1986 and September, 1988, were investigated. All patients under this study were staged in TNM II or later, involved with axillary lymph node metastasis. and treated with systemic postoperative adjuvant chemotherapy. The median length of follow-up was 69 months. The expression of P-glycoprotein was investigated by means of immunohistochemistry, using a monoclonal antibody C219 specifically against P-glycoprotein and avidin -biotin peroxidase method. Posrtive staining for P-glycoprotein was found in 23(16%) of the 50 patients. The P-glycoprotein expression negative group fared better than the group that was P-glycoprotein posrtive in overall survival curves (p= 0. 0008 , by the generalized Wilcoxon test). The prognostic effect of P-glycoprotein expression remained statistically significant (p=0. 0007) after adjustment by multivariate analysis(Cox’s model)for other prognostic factors. It is demonstrated that P-glycoprotein expression is a significant and independent Predictor of postoperative survival in breast cancer patients. The results of the present study suggest that P-glycoprotein expression might also influence the bioiogical behavior of breast cancers.
文摘BACKGROUND The exact definition of Acute kidney injury(AKI)for patients with traumatic brain injury(TBI)is unknown.AIM To compare the power of the“Risk,Injury,Failure,Loss of kidney function,and End-stage kidney disease”(RIFLE),Acute Kidney Injury Network(AKIN),Creatinine kinetics(CK),and Kidney Disease Improving Global Outcomes(KDIGO)to determine AKI incidence/stage and their association with the inhospital mortality rate of patients with TBI.METHODS This retrospective study collected the data of patients admitted to the intensive care unit for neurotrauma from 2001 to 2012,and 1648 patients were included.The subjects in this study were assessed for the presence and stage of AKI using RIFLE,AKIN,CK,and KDIGO.In addition,the propensity score matching method was used.RESULTS Among the 1648 patients,291(17.7%)had AKI,according to KDIGO.The highest incidence of AKI was found by KDIGO(17.7%),followed by AKIN(17.1%),RIFLE(12.7%),and CK(11.5%)(P=0.97).Concordance between KDIGO and RIFLE/AKIN/CK was 99.3%/99.1%/99.3%for stage 0,36.0%/91.5%/44.5%for stage 1,35.9%/90.6%/11.3%for stage 2,and 47.4%/89.5%/36.8%for stage 3.The in-hospital mortality rates increased with the AKI stage in all four definitions.The severity of AKI by all definitions and stages was not associated with inhospital mortality in the multivariable analyses(all P>0.05).CONCLUSION Differences are seen in AKI diagnosis and in-hospital mortality among the four AKI definitions or stages.This study revealed that KDIGO is the best method to define AKI in patients with TBI.
基金supported by MOST/SATCM of the People's Republic of China grant2013BAI02B04
文摘The uremic symptoms of advanced chronic kidney disease(CKD)can severely impair physical function,psychological health and social life.Some patients,especially for the older,chose conservative kidney management(CKM)and Traditional Chinese medicine(TCM)but not dialysis in this stage.To measure the patients-reported outcome(PRO)from these people,Advanced Chronic Kidney
基金Funded by the National Heart,Lung,and Blood InstitutePROMISE Clinical Trials.gov number,NCT01174550
文摘Background Many patients have symptoms suggestive of coronary artery disease (CAD) and are often eval- uated with the use of diagnostic testing, although there are limited data from randomized trials to guide care.
基金Supported by a Demonstrative Project of Research into Specific Therapy and Technology of External Application in Traditional Chinese MedicineNational Sci-Tech Plan of the Ministry of Science and Technology in the 11th 5-Year Plan(2008BAI53B053)
文摘OBJECTIVE:To evaluate the curative effect of external application of the Chinese drug,Sanjierupi Gao,on mastalgia caused by mammary gland hyperplasia.METHODS:This randomized,double-blinded,and placebo controlled study enrolled 260 patients with mammary gland hyperplasia from five hospitals.Patients were randomly and equally divided in-to a Sanjierupi Gao treatment group and a placebo control group.An adhesive plaster was applied to the most painful area on either breast for 7 h a day.Treatment lasted for two menstrual cycles without application during menstruation.Mastalgia was used as the main index of curative effect.The change before and after treatment in days of mastalgia,the time to alleviate pain,pain extent,and severe pain scores were observed.RESULTS:Compared to the control group,the treatment group had significantly fewer days of mastalgia(P<0.01),a significantly lower severe pain score(P<0.01),and significantly less subjective pain and tenderness(P<0.05 and P<0.01,respectively).Three days before the follow-up visit,the pain score in the treatment group was significantly lower than that in the control group(P<0.05).A non-parametric test was used to compare the time to alleviate mastalgia between the two groups and found no statistical difference(Z=0.313,P=0.754).CONCLUSION:Application of Sanjierupi Gao can decrease mastalgia duration in patients with mammary gland hyperplasia during menstruation and alleviate the extent of mastalgia.The time to alleviate pain is psychologically influenced.