BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explor...BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explore the effects of Zhibai dihuang pills and gonadotropin-releasing hormone analogue(GnRHa)on growth and ovarian function in girls with precocious puberty.METHODS The clinical data of 84 adolescent girls with precocious puberty and rapidly progressive puberty from February 2017 to August 2023 were retrospectively analyzed.Girls were divided into a control group and an observation group,with 42 cases in each group.The control group received diet intervention combined with GnRHa treatment,while the observation group received diet intervention combined with Zhibai dihuang pills+GnRHa treatment.Outcomes such as clinical efficacy,growth indicators,ovarian function,and adverse reactions were compared between the two groups.RESULTS The observation group showed superior clinical efficacy compared to the control group(P<0.05).Prior to the intervention,no significant differences were found in growth or ovarian function between the groups(P>0.05).Post-intervention,the observation group exhibited significantly lower rates in growth,height,and bone age,along with reduced levels of progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone compared to the control group(P<0.05).The incidence of adverse reactions was similar across both groups(P>0.05).CONCLUSION Combining Zhibai dihuang pills with GnRHa and dietary intervention effectively improves growth,enhances ovarian function,and minimizes adverse reactions in adolescent girls with precocious and rapidly progressive puberty.展开更多
White paper emphasizes national unity and stability are the "lifeblood" for Xinjiang’s development The Chinese Government on September 21 published a white paper on development and progress in northwest Ch...White paper emphasizes national unity and stability are the "lifeblood" for Xinjiang’s development The Chinese Government on September 21 published a white paper on development and progress in northwest China’s展开更多
It is possible and clinically relevant to distinguish between slow and rapid progressive spermatozoa in basic semen analysis. This is discussed in light of the different purposes of semen analysis for the subfertile c...It is possible and clinically relevant to distinguish between slow and rapid progressive spermatozoa in basic semen analysis. This is discussed in light of the different purposes of semen analysis for the subfertile couple and the male patient. The two groups of progressive spermatozoa should be distinguished to help ensure that pertinent information available in the semen sample is not neglected.展开更多
Rationale:Coexistence of anti-glomerular basement membrane(anti-GBM)disease with anti-neutrophil cytoplasmic antibody(ANCA)in a case of glomerulonephritis is often identified as a"double-positive"disease.Int...Rationale:Coexistence of anti-glomerular basement membrane(anti-GBM)disease with anti-neutrophil cytoplasmic antibody(ANCA)in a case of glomerulonephritis is often identified as a"double-positive"disease.Interestingly,the majority of"double positive"ANCA is myeloperoxidase(MPO)-ANCA and some of the MPO-ANCA positive cases showed intrarenal arteritis,suggesting an ANCA-associated kidney lesion.Proteinase 3-ANCA positive diseases are also rarely reported.Patients positive for all three antibodies,i.e.,triple-positive patients,are extremely rare.Patient's Concern:A 53 year-old female presented with anasarca and oliguria of 2 months'duration.Diagnosis:Pauci-immune type renal limited crescentic glomerulonephritis positive for MPO-ANCA,proteinase 3-ANCA,and anti-GBM antibody(triple-positive).Interventions:Intravenous high dose cyclophosphamide,oral azathioprine,intravenous methylprednisolone,and plasma exchange as per British Health Professionals in Rheumatology Guidelines.Outcomes:After one-month follow-up,anasarca and proteinuria were lessened,serum creatinine was normalized,titers of MPO-ANCA levels were decreased,and anti-GBM antibody levels were normalized.Lessons:Triple-positive renal limited vasculitis is rare and response to combined immunosuppressive therapy and plasma exchange can contribute to successful remission.展开更多
As a traditional precious Chinese herbal medicine,Anoectochilus roxburghii has the cooling and detoxifying effects,and can nourish yin to reduce pathogenic fire,and has anti-inflammatory and analgesic effects. In this...As a traditional precious Chinese herbal medicine,Anoectochilus roxburghii has the cooling and detoxifying effects,and can nourish yin to reduce pathogenic fire,and has anti-inflammatory and analgesic effects. In this paper,we summarized the research progress in detail about the biological characteristics,resource distribution,composition,medicinal value and rapid seedling breeding technology concerning the rare Chinese herbal medicine A. roxburghii,in order to provide a reference for the in-depth study and rational development and utilization of A.roxburghii.展开更多
BACKGROUND Human immunodeficiency virus(HIV)-associated dementia(HAD)is a subcortical form of dementia characterized by memory deficits and psychomotor slowing.However,HAD often presents with symptoms similar to those...BACKGROUND Human immunodeficiency virus(HIV)-associated dementia(HAD)is a subcortical form of dementia characterized by memory deficits and psychomotor slowing.However,HAD often presents with symptoms similar to those of Creutzfeldt-Jakob disease(CJD),particularly in patients with acquired immune deficiency syndrome(AIDS).CASE SUMMARY We report the case of a 54-year-old male who exhibited cognitive dysfunction and secondary behavioral changes following HIV infection and suspected prion exposure.The patient was diagnosed with HIV during hospitalization and his cerebrospinal fluid tested positive for 14-3-3 proteins.His electroencephalogram showed a borderline-abnormal periodic triphasic wave pattern.Contrast-enhanced magnetic resonance imaging revealed moderate encephalatrophy and demyelination.Initially,symptomatic treatment and administration of amantadine were pursued for presumed CJD,but the patient’s condition continued to deteriorate.By contrast,the patient’s condition improved following anti-HIV therapy.This individual is also the only patient with this prognosis to have survived over 4 years.Thus,the diagnosis was revised to HAD.CONCLUSION In the diagnostic process of rapidly progressive dementia,it is crucial to rule out as many potential causes as possible and to consider an autopsy to diminish diagnostic uncertainty.The 14-3-3 protein should not be regarded as the definitive marker for CJD.Comprehensive laboratory screening for infectious diseases is essential to enhance diagnostic precision,especially in AIDS patients with potential CJD.Ultimately,a trial of diagnostic treatment may be considered when additional testing is not feasible.展开更多
BACKGROUND The protective effect of tracheal stents is reported to relieve airway obstruction and reduce side effects of rapid progression of malignant tracheoesophageal fistula(MTEF)after immunotherapy in this case w...BACKGROUND The protective effect of tracheal stents is reported to relieve airway obstruction and reduce side effects of rapid progression of malignant tracheoesophageal fistula(MTEF)after immunotherapy in this case with 10 mo follow-up.CASE SUMMARY Two kinds of silicone stents were placed in the main airway of a 58-year-old male to relieve the airway obstruction caused by advanced esophageal carcinoma.The patient then received four doses of toripalimab.Subsequently,rapid,progressive deterioration of the original fistula was found.Although the fistula enlarged rapidly after immunotherapy,it remained covered completely,and likely because of this,his condition remained stable.Therefore,immunotherapy could be continued to treat the primary tumor.Despite these efforts,the patient died of the advancement of his esophageal cancer.CONCLUSION Appropriately-sized tracheal stent placement combined with immune checkpoint inhibitors may improve the quality of life and survival of patients with MTEF.展开更多
The origin,introduction,cultivation,active ingredients,use and advances in propagation methods of Adansonia digitata are reviewed in this paper,with focus on the rapid propagation techniques of plant tissues,to provid...The origin,introduction,cultivation,active ingredients,use and advances in propagation methods of Adansonia digitata are reviewed in this paper,with focus on the rapid propagation techniques of plant tissues,to provide theoretical basis for seedling breeding and promotion of A.digitata.展开更多
Aim:For many years,systemic treatment of metastatic Renal Cell Carcinoma(mRCC)was based on sequential targeted agent monotherapies.In this real-life case series,we evaluated easily accessible clinical factors useful f...Aim:For many years,systemic treatment of metastatic Renal Cell Carcinoma(mRCC)was based on sequential targeted agent monotherapies.In this real-life case series,we evaluated easily accessible clinical factors useful for disease course prediction.Methods:We exploited patients'clinical pathological characteristics and systemic treatment outcomes in a real-world population of 365 mRCC patients who received sequential monotherapies in the targeted therapy era,and we identified an early progressors subpopulation,resistant to first-line VEGFR-TKI monotherapy in less than 6 months.Results:Early progressors(n=124)show a far worse OS compared with patients progressing beyond the sixth month of therapy(13.5 vs.44.8 months,P-value<0.0001,HR=0.41,95%CI:0.29-0.53).However,these patients did not show far worse performance in second and third-line settings compared to first-line responders.In the univariate analysis,IMDC risk class,sarcomatoid features,and Systemic Inflammation Index(SII)were correlated with first-line therapy Progression-Free Survival(PFS1).In multivariate analysis,variables correlated with first-line outcome were IMDC risk class,histotype,and number of metastatic sites at the diagnosis.Conclusion:Real-world data can contribute to developing easy-to-use prognostic factors associated with refractory disease that could support clinicians in identifying the most appropriate treatment strategy for each patient.展开更多
文摘BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explore the effects of Zhibai dihuang pills and gonadotropin-releasing hormone analogue(GnRHa)on growth and ovarian function in girls with precocious puberty.METHODS The clinical data of 84 adolescent girls with precocious puberty and rapidly progressive puberty from February 2017 to August 2023 were retrospectively analyzed.Girls were divided into a control group and an observation group,with 42 cases in each group.The control group received diet intervention combined with GnRHa treatment,while the observation group received diet intervention combined with Zhibai dihuang pills+GnRHa treatment.Outcomes such as clinical efficacy,growth indicators,ovarian function,and adverse reactions were compared between the two groups.RESULTS The observation group showed superior clinical efficacy compared to the control group(P<0.05).Prior to the intervention,no significant differences were found in growth or ovarian function between the groups(P>0.05).Post-intervention,the observation group exhibited significantly lower rates in growth,height,and bone age,along with reduced levels of progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone compared to the control group(P<0.05).The incidence of adverse reactions was similar across both groups(P>0.05).CONCLUSION Combining Zhibai dihuang pills with GnRHa and dietary intervention effectively improves growth,enhances ovarian function,and minimizes adverse reactions in adolescent girls with precocious and rapidly progressive puberty.
文摘White paper emphasizes national unity and stability are the "lifeblood" for Xinjiang’s development The Chinese Government on September 21 published a white paper on development and progress in northwest China’s
文摘It is possible and clinically relevant to distinguish between slow and rapid progressive spermatozoa in basic semen analysis. This is discussed in light of the different purposes of semen analysis for the subfertile couple and the male patient. The two groups of progressive spermatozoa should be distinguished to help ensure that pertinent information available in the semen sample is not neglected.
文摘Rationale:Coexistence of anti-glomerular basement membrane(anti-GBM)disease with anti-neutrophil cytoplasmic antibody(ANCA)in a case of glomerulonephritis is often identified as a"double-positive"disease.Interestingly,the majority of"double positive"ANCA is myeloperoxidase(MPO)-ANCA and some of the MPO-ANCA positive cases showed intrarenal arteritis,suggesting an ANCA-associated kidney lesion.Proteinase 3-ANCA positive diseases are also rarely reported.Patients positive for all three antibodies,i.e.,triple-positive patients,are extremely rare.Patient's Concern:A 53 year-old female presented with anasarca and oliguria of 2 months'duration.Diagnosis:Pauci-immune type renal limited crescentic glomerulonephritis positive for MPO-ANCA,proteinase 3-ANCA,and anti-GBM antibody(triple-positive).Interventions:Intravenous high dose cyclophosphamide,oral azathioprine,intravenous methylprednisolone,and plasma exchange as per British Health Professionals in Rheumatology Guidelines.Outcomes:After one-month follow-up,anasarca and proteinuria were lessened,serum creatinine was normalized,titers of MPO-ANCA levels were decreased,and anti-GBM antibody levels were normalized.Lessons:Triple-positive renal limited vasculitis is rare and response to combined immunosuppressive therapy and plasma exchange can contribute to successful remission.
基金Supported by Special Chinese Herbal Medicine Breeding Project of Provincial Department of Science and Technology(2016C02058)Key Provincial Research and Development Project(2017C02019)
文摘As a traditional precious Chinese herbal medicine,Anoectochilus roxburghii has the cooling and detoxifying effects,and can nourish yin to reduce pathogenic fire,and has anti-inflammatory and analgesic effects. In this paper,we summarized the research progress in detail about the biological characteristics,resource distribution,composition,medicinal value and rapid seedling breeding technology concerning the rare Chinese herbal medicine A. roxburghii,in order to provide a reference for the in-depth study and rational development and utilization of A.roxburghii.
文摘BACKGROUND Human immunodeficiency virus(HIV)-associated dementia(HAD)is a subcortical form of dementia characterized by memory deficits and psychomotor slowing.However,HAD often presents with symptoms similar to those of Creutzfeldt-Jakob disease(CJD),particularly in patients with acquired immune deficiency syndrome(AIDS).CASE SUMMARY We report the case of a 54-year-old male who exhibited cognitive dysfunction and secondary behavioral changes following HIV infection and suspected prion exposure.The patient was diagnosed with HIV during hospitalization and his cerebrospinal fluid tested positive for 14-3-3 proteins.His electroencephalogram showed a borderline-abnormal periodic triphasic wave pattern.Contrast-enhanced magnetic resonance imaging revealed moderate encephalatrophy and demyelination.Initially,symptomatic treatment and administration of amantadine were pursued for presumed CJD,but the patient’s condition continued to deteriorate.By contrast,the patient’s condition improved following anti-HIV therapy.This individual is also the only patient with this prognosis to have survived over 4 years.Thus,the diagnosis was revised to HAD.CONCLUSION In the diagnostic process of rapidly progressive dementia,it is crucial to rule out as many potential causes as possible and to consider an autopsy to diminish diagnostic uncertainty.The 14-3-3 protein should not be regarded as the definitive marker for CJD.Comprehensive laboratory screening for infectious diseases is essential to enhance diagnostic precision,especially in AIDS patients with potential CJD.Ultimately,a trial of diagnostic treatment may be considered when additional testing is not feasible.
基金Supported by National Natural Science Foundation of China,No. 81973784
文摘BACKGROUND The protective effect of tracheal stents is reported to relieve airway obstruction and reduce side effects of rapid progression of malignant tracheoesophageal fistula(MTEF)after immunotherapy in this case with 10 mo follow-up.CASE SUMMARY Two kinds of silicone stents were placed in the main airway of a 58-year-old male to relieve the airway obstruction caused by advanced esophageal carcinoma.The patient then received four doses of toripalimab.Subsequently,rapid,progressive deterioration of the original fistula was found.Although the fistula enlarged rapidly after immunotherapy,it remained covered completely,and likely because of this,his condition remained stable.Therefore,immunotherapy could be continued to treat the primary tumor.Despite these efforts,the patient died of the advancement of his esophageal cancer.CONCLUSION Appropriately-sized tracheal stent placement combined with immune checkpoint inhibitors may improve the quality of life and survival of patients with MTEF.
基金Supported by Natural Science Foundation of Hainan Province(317205)Key Research and Development Project of Hainan Province(ZDYF2016065)
文摘The origin,introduction,cultivation,active ingredients,use and advances in propagation methods of Adansonia digitata are reviewed in this paper,with focus on the rapid propagation techniques of plant tissues,to provide theoretical basis for seedling breeding and promotion of A.digitata.
文摘Aim:For many years,systemic treatment of metastatic Renal Cell Carcinoma(mRCC)was based on sequential targeted agent monotherapies.In this real-life case series,we evaluated easily accessible clinical factors useful for disease course prediction.Methods:We exploited patients'clinical pathological characteristics and systemic treatment outcomes in a real-world population of 365 mRCC patients who received sequential monotherapies in the targeted therapy era,and we identified an early progressors subpopulation,resistant to first-line VEGFR-TKI monotherapy in less than 6 months.Results:Early progressors(n=124)show a far worse OS compared with patients progressing beyond the sixth month of therapy(13.5 vs.44.8 months,P-value<0.0001,HR=0.41,95%CI:0.29-0.53).However,these patients did not show far worse performance in second and third-line settings compared to first-line responders.In the univariate analysis,IMDC risk class,sarcomatoid features,and Systemic Inflammation Index(SII)were correlated with first-line therapy Progression-Free Survival(PFS1).In multivariate analysis,variables correlated with first-line outcome were IMDC risk class,histotype,and number of metastatic sites at the diagnosis.Conclusion:Real-world data can contribute to developing easy-to-use prognostic factors associated with refractory disease that could support clinicians in identifying the most appropriate treatment strategy for each patient.
