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Adrenocorticotropic hormone combined with magnesium sulfate therapy for infantile epileptic spasms syndrome:a real-world study

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World Journal of Pediatrics 2024年第8期20卷 834-847页

作者： Wen He Qiu-Hong Wang Jiu-Wei Li Yang-Yang Wang Xiao-Mei Luo Lin Wan Jing Wang Xiu-Yu Shi Wei-Hua Zhang Fang Fang Li-Ping Zou senior Department of Pediatrics the Seventh Medical Center of Chinese PLA General HospitalDepartment of Pediatricsthe First Medical Center of Chinese PLA General HospitalBeijing 100853China Department of Neurology Beijing Children’s HospitalCapital Medical UniversityBeijingChina Center of Epilepsy Beijing Institute for Brain DisordersBeijing 100069China

Background Infantile epileptic spasms syndrome(IESS)is a serious disease in infants,and it usually evolves to other epilepsy types or syndromes,especially refractory or super-refractory focal *** adrenocorticotropic hormone(ACTH)is one of the first-line and effective treatment plans for IESS,it has serious side effects and is not sufficiently *** A retrospective study of the clinical outcomes of ACTH combined with magnesium sulfate(MgSO4)therapy for IESS in two hospital centers was *** major outcome of the single and combined treatment was evaluated by changes in seizure frequency and improvements in hypsarrhythmia electroencephalography(EEG).To reduce the confounding bias between the two groups,we used SPSS for the propensity score matching(PSM)*** We initially recruited 1205 IESS patients from two Chinese hospitals and treated them with ACTH combined with MgSO4 and ACTH *** 1005 patients were enrolled in the treatment(ACTH combined with MgSO4:744,ACTH:261),and both treatment plans had a more than 55%response ***,compared to patients treated with ACTH alone,those patients treated with ACTH combined with MgSO4 had better performance in terms of the seizure frequency and hypsarrhythmia *** PSM,the two groups also showed significant differences in responder rate[70.8%(95%confidence interval,CI)=66.7%–74.8%)vs.53.8%(95%CI=47.4%–60.2%),P3 months(P<0.05).In addition,the overall incidence of adverse reactions in the ACTH combined with MgSO4 group was much lower than that in the ACTH group(31.4%vs.63.1%,P<0.001).During the treatment,only

关键词： Adrenocorticotropic hormone Clinical trial Infantile epileptic spasms syndrome Magnesium sulfate Real-world study

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Cost-Effectiveness Analysis of Renalof® versus Extracorporeal Shockwave Lithotripsy (ESWL) for the Treatment of Kidney Stones ≤ 1 cm in Nicaragua

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Health 2024年第7期16卷 674-687页

作者： Mélida M. Aguilar Chamorro Sergio Vargas Collado Leslie Pérez Ruíz David Márquez Soriano Jorge Luis Soriano García Clínica senior Managua Nicaragua Centro de Inmunología Molecular Havana Cuba Catalysis S.L. Madrid Spain

Objectives: To assess the efficiency in terms of cost-effectiveness (CE) of oral Renalof® treatment versus extracorporeal shockwave lithotripsy (ESWL) in the treatment of kidney stones ≤ 1 cm in Nicaragua. Methods: A cost-effectiveness economic evaluation was carried out based on the results obtained in the randomised, prospective, observational, single-blind, prospective, phase 2 clinical trial. Cost-effectiveness and the incremental cost-effectiveness ratio (ICER) were calculated. Economic data were obtained from the Economics Department of Clínica senior in Managua, Nicaragua. The monetary cost was expressed in US dollars (USD). Results: Treatment with Renalof® yielded a CE of $1,323.08/% remission, while ESWL was $9,498.54/% remission. The ICER shows that, in order to achieve a high percentage of kidney stone remission with ESWL, an extra $4,734.70 per patient must be invested. Conclusions: The use of Renalof® is shown to be a more cost-effective option than ESWL. It is recommended for the treatment of kidney stones ≤ 1 cm in size.

关键词： Economic Evaluation Pharmacoeconomics Renalof® Extracorporeal Shockwave Lithotripsy Kidney Stones

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Analysis of Phenotypes Associated with Deficiency of PAX6 Haplotypes in Chinese Aniridia Families

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Current Medical Science 2024年第4期44卷 820-826页

作者： Xiao-lu HAO Ran CHEN Wei LIU Bao-ke HOU Ling-hui QU Zhao-hui LI Da-jiang WANG Xin JIN Hou-bin HUANG senior Department of Opthalmology the Third Medical Center of Chinese PLA General HospitalBeijing100039China Bolin Eye Care Group Beijing100098China Department of Ophthalmology Hainan Hospital of Chinese PLA General HospitalSanya572000China Department of Ophthalmology the 74th Army Group HospitalGuangzhou510318China

Objective To examine the clinical phenotype and genetic deficiencies present in Chinese aniridia families with PAX6 haplotype *** A comprehensive questionnaire and ophthalmological assessments were administered to both affected patients and unaffected *** clinical feature analysis included the evaluation of visual acuity,intraocular pressure,slit-lamp anterior segment examination,fundus photography,and spectral domain optical coherence *** identify the mutation responsible for aniridia,targeted next-generation sequencing was used as a beneficial *** A total of 4 mutations were identified,consisting of two novel frameshift mutations(c.314delA,p.K105Sfs*33 and c.838_845dup AACACACC,p.S283Tfs*85),along with two recurring nonsense mutations(c.307C>T,p.R103X and c.619A>T,p.K207*).Complete iris absence,macular foveal hypoplasia,and nystagmus were consistent in these PAX6 haplotype-deficient Chinese aniridia families,while corneal lesions,cataracts,and glaucoma exhibited heterogeneity both among the families and within the same *** In our study,two novel PAX6 mutations associated with aniridia were identified in Chinese families,which expanded the phenotypic and genotypic spectrum of PAX6 *** also analyzed the clinical characteristics of PAX6 haplotype deficiency in Chinese aniridia families.

关键词： aniridia PAX6 mutation haplotype deficiency phenotype genotype

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Tissue-resident macrophages exacerbate lung injury after remote sterile damage

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Cellular & Molecular Immunology 2024年第4期21卷 332-348页

作者： Hanhui Zhong Jingjing Ji Jinling Zhuang Ziying Xiong Pengyun Xie Xiaolei Liu Jundi Zheng Wangli Tian Xiaoyang Hong Jing Tang The Department of Anesthesiology Affiliated Hospital of Guangdong Medical UniversityZhanjiangGuangdongChina The Department of Critical Care Medicine General Hospital of Southern Theater Command of PLAGuangzhouChina The Department of Respiratory Medicine Guangdong Provincial Hospital of Integrated Chinese and Western MedicineFoshanChina Pediatric Intensive Care Unit Senior Department of Pediatricsthe Seventh Medical Center of PLA General HospitalBeijingChina

Remote organ injury,which is a common secondary complication of sterile tissue damage,is a major cause of poor prognosis and is difficult to ***,we report the critical role of tissue-resident macrophages in lung injury after trauma or stroke through the inflammatory *** found that depleting tissue-resident macrophages rather than disrupting the recruitment of monocyte-derived macrophages attenuated lung injury after trauma or *** findings revealed that the release of circulating alarmins from sites of distant sterile tissue damage triggered an inflammatory response in lung-resident macrophages by binding to receptor for advanced glycation end products(RAGE)on the membrane,which activated epidermal growth factor receptor(EGFR).Mechanistically,ligand-activated RAGE triggered EGFR activation through an interaction,leading to Rab5-mediated RAGE internalization and EGFR phosphorylation,which subsequently recruited and activated P38;this,in turn,promoted RAGE translation and trafficking to the plasma membrane to increase the cellular response to RAGE ligands,consequently exacerbating *** study also showed that the loss of RAGE or EGFR expression by adoptive transfer of macrophages,blocking the function of RAGE with a neutralizing antibody,or pharmacological inhibition of EGFR activation in macrophages could protect against trauma-or stroke-induced remote lung ***,our study revealed that targeting the RAGE-EGFR signaling pathway in tissue-resident macrophages is a potential therapeutic approach for treating secondary complications of sterile damage.

关键词： tissue-resident macrophage RAGE remote sterile damage

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Acupuncture reduces sedative and anaesthetic consumption and improves pain tolerance in patients undergoing colonoscopy: aMeta-analysis

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Journal of Traditional Chinese Medicine 2024年

作者： WANG Bingyu JIN Fangfang GAO Jiawei YANG Liuxin ZHANG Yali YUAN Xingxing ZHANG Yang School of Graduate Studies，Heilongjiang University of Chinese Medicine Department of Gastroenterology， Heilongjiang Academy of Traditional Chinese Medicine Department of Zhang Yali senior Traditional Chinese Medicine Expert Studio， Heilongjiang Academy of Traditional Chinese Medicine Department of Gastroenterology， the First Affiliated Hospital of Heilongjiang University of Chinese Medicine

OBJECTIVE: To evaluate the effects of acupuncture anesthesia on the consumption of sedatives and anesthetics， pain， and time consumption in patients undergoing colonoscopy， thus providing evidence that acupuncture anesthesia should be extended to endoscopists and ***: Four English and four Chinese databases were searched for randomised controlled trials of acupuncture anaesthesia in patients undergoing colonoscopy， published from database inception to 1 March 2023. Outcomes were consumption of sedatives and anaesthetics， pain tolerance， visual analog scale(VAS) score， the meantime consumption of examination， satisfaction， and adverse reactions. RESULTS: Thirty-one randomized controlled trials with a total of 4790 participants were included. Results showed that acupuncture anaesthesia significantly reduced consumption of sedatives and anaesthetics[9 studies， n = 944， standardized mean difference (SMD)= -0.82， 95% CI(-1.31， -0.33)， P = 0.001]， VAS score [9 studies， n = 1790， mean difference (MD)= -1.13， 95% CI(-1.70， -0.57)， P＜0.001]， meantime consumption [21 studies， n= 3799， MD = -2.09， 95% CI(-3.15， -1.03)， P＜0.001]and adverse reactions of colonoscopy [7 studies， n = 738， odds ratio (OR) = 0.17， 95% CI (0.10， 0.28)， P＜0.001]. Acupuncture also significantly improved pain tolerance [14 studies， n= 1661， OR = 7.05， 95% CI(3.79， 13.12)， P＜0.001]， while no beneficial effects were found for satisfaction[7 studies， n = 843， SMD = 0.02， 95% CI(-0.38， 0.43)， P = 0.91]. CONCLUSION: Acupuncture has beneficial effects on patients undergoing colonoscopy， particularly in reducing consumption of sedatives and anaesthetics， alleviating pain， shorteningthe time consumption of examination and preventing adverse events. As an alternative， effective， inexpensive， and accessible approach， acupuncture anaesthesia should be extended to endoscopists and anaesthesiologists.

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Standard-definition White-light,High-definition White-light versus Narrow-band Imaging Endoscopy for Detecting Colorectal Adenomas:A Multicenter Randomized Controlled Trial

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Current Medical Science 2024年第3期44卷 554-560页

作者： Chang-wei DUAN Hui-hong ZHAI Hui XIE Xian-zong MA Dong-liang YU Lang YANG Xin WANG Yu-fen TANG Jie ZHANG Hui SU Jian-qiu SHENG Jun-feng XU Peng JIN Chinese PLA General Hospital and Medical School Beijing100853China Department of Gastroenterology Xuanwu HospitalCapital Medical UniversityBeijing100053China Department of Gastroenterology The Seventh Medical Center of Chinese PLA General HospitalBeijing100700China senior Department of Gastroenterology The First Medical Center of Chinese PLA General HospitalBeijing100853China

Objective This study aimed to compare the performance of standard-definition white-light endoscopy(SD-WL),high-definition white-light endoscopy(HD-WL),and high-definition narrow-band imaging(HD-NBI)in detecting colorectal lesions in the Chinese *** This was a multicenter,single-blind,randomized,controlled trial with a non-inferiority *** undergoing endoscopy for physical examination,screening,and surveillance were enrolled from July 2017 to December *** primary outcome measure was the adenoma detection rate(ADR),defined as the proportion of patients with at least one adenoma *** associated factors for detecting adenomas were assessed using univariate and multivariate logistic *** Out of 653 eligible patients enrolled,data from 596 patients were *** ADRs were 34.5%in the SD-WL group,33.5%in the HD-WL group,and 37.5%in the HD-NBI group(P=0.72).The advanced neoplasm detection rates(ANDRs)in the three arms were 17.1%,15.5%,and 10.4%(P=0.17).No significant differences were found between the SD group and HD group regarding ADR or ANDR(ADR:34.5%vs.35.6%,P=0.79;ANDR:17.1%vs.13.0%,P=0.16,respectively).Similar results were observed between the HD-WL group and HD-NBI group(ADR:33.5%vs.37.7%,P=0.45;ANDR:15.5%vs.10.4%,P=0.18,respectively).In the univariate and multivariate logistic regression analyses,neither HD-WL nor HD-NBI led to a significant difference in overall adenoma detection compared to SD-WL(HD-WL:OR 0.91,P=0.69;HD-NBI:OR 1.15,P=0.80).Conclusion HD-NBI and HD-WL are comparable to SD-WL for overall adenoma detection among Chinese *** can be concluded that HD-NBI or HD-WL is not superior to SD-WL,but more effective instruction may be needed to guide the selection of different endoscopic methods in the *** study’s conclusions may aid in the efficient allocation and utilization of limited colonoscopy resources,especially advanced imaging technologies.

关键词： standard-definition white-light endoscopy high-definition white-light endoscopy narrow-band imaging colonoscopy colorectal cancer screening adenoma detection rate

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Analysis of Information Leadership and Digital Campus Management Strategy

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Journal of Educational Theory and Management 2024年第2期8卷 11-15页

作者： Fang Liu Wei Li Lanzhou Wenyuan senior High School Lanzhou730050China Beijing Chuanzhiboke Education Technology Co. Ltd.Beijing100096China

In the information age,the development of schools needs to be integrated with information education,and the principal,as the leader of the school,has a positive significance for the development of the ***,in the process of school informatization development,principals should continuously improve their informatization leadership,and take digitalization as the guide to build schools,accelerate the construction and improvement of campus management,and then promote the school to continuously optimize the overall management and business processes under the immersion of digital *** on this,this paper is based on information leadership and digital campus,and explores the way to improve the information leadership of principals based on the construction of digital campus.

关键词： Informatization Leadership Digital campus management

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Development of an Information-Based Leadership Evaluation Index System for School Management Teams:A Comprehensive Approach

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Journal of Contemporary Educational Research 2024年第4期8卷 35-40页

作者： Wei Li Fang Liu Beijing Chuanzhiboke Education Technology Co. Ltd.Beijing 100096China Lanzhou Wenyuan senior High School Lanzhou 730050Gansu ProvinceChina

In the context of educational informatization reform,there are many uncertain factors in the process of education *** optimize the educational environment so that it can be effectively combined with information technology,teachers need to change their teaching ideas,strengthen the school’s own adaptability to informatization,and promote the development of informatization construction in *** a branch of information leadership,the management team should establish an evaluation index system for information leadership in order to ensure the construction of school informatization,so as to provide a boost for the integration of school resources and information *** on the overview and connotation of information-based leadership of the management team,this paper explores the construction of an evaluation index system of information-based leadership of the school management team,aiming to provide references for the research of relevant personnel in the future.

关键词： School management team Information-based leadership Evaluation index system

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Clinical significance,molecular characterization,and immune microenvironment analysis of coagulation-related genes in clear cell renal cell carcinoma

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Cancer Innovation 2024年第1期3卷 29-49页

作者： Weihao Chen Xupeng Zhao Yongliang Lu Hanfeng Wang Xiyou Wang Yi Wang Chen Liang Zhuomin Jia Wei Ma Department of Urology The Third Medical Center of PLA General HospitalBeijingChina School of Medicine Nankai UniversityTianjinChina Medical Service Department The PLA General HospitalBeijingChina senior Department of Otolaryngology-Head&Neck Surgery The Sixth Medical Center of PLA General HospitalBeijingChina

Background:Numerous studies have revealed a tight connection between tumor development and the coagulation ***,the effects of coagulation on the prognosis and tumor microenvironment(TME)of clear cell renal cell carcinoma(ccRCC)remain poorly ***:We employed the consensus clustering method to characterize distinct molecular subtypes associated with coagulation ***quently,we examined variations in the overall survival(OS),genomic profiles,and TME characteristics between these *** develop a prognostic coagulation-related risk score(CRRS)model,we utilized the least absolute shrinkage and selection operator Cox regression and stepwise multivariate Cox regression *** also created a nomogram to aid in the clinical application of the risk score,evaluating the relationships between the CRRS and the immune microenvironment,responsiveness to immunotherapy,and targeted *** clinical significance of PLAUR and its biological function in ccRCC were also further ***:There were significant differences in clinical features,prognostic stratification,genomic variation,and TME characteristics between the two coagulation-related *** established and validated a CRRS using six coagulation-related genes that can be employed as an effective indicator of risk stratification and prognosis estimation for ccRCC *** variations in survival outcomes were observed between the high-and low-risk *** nomogram was proficient in predicting the 1-,3-,and 5-year ***,the CRRS emerged as a novel tool for evaluating the clinical effectiveness of immunotherapy and targeted treatments in ***,we confirmed upregulated PLAUR expression in ccRCC samples that was significantly correlated with poor patient *** knockdown notably inhibited ccRCC cell proliferation and ***:Our data suggested that CRRS may be employed as a reliable predictive biomarker that can pro

关键词： clear cell renal cell carcinoma coagulation immunotherapy risk score tumor immune microenvironment

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Plasma metabolites and risk of myocardial infarction:a bidirectional Mendelian randomization study

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Journal of Geriatric Cardiology 2024年第2期21卷 219-231页

作者： Dong-Hua LI Qiang WU Jing-Sheng LAN Shuo CHEN You-Yi HUANG Lan-Jin WU Zhi-Qing QIN Ying HUANG Wan-Zhong HUANG Ting ZENG Xin HAO Hua-Bin SU Qiang SU Department of Cardiovascular Medicine Minzu Hospital of Guangxi Zhuang Autonomous RegionGuangxiChina senior Department of Cardiology the Sixth Medical CenterChinese PLA General HospitalBeijingChina Library of Graduate School Chinese PLA General HospitalBeijingChina Department of Cardiology Jiangbin Hospital of Guangxi Zhuang Autonomous RegionGuangxiChina Health Management Institute the Second Medical CenterChinese PLA General HospitalBeijingChina

BACKGROUND Myocardial infarction(MI)is a critical cardiovascular event with multifaceted etiology,involving several genetic and environmental *** is essential to understand the function of plasma metabolites in the development of MI and unravel its complex *** This study employed a bidirectional Mendelian randomization(MR)approach to investigate the causal relationships between plasma metabolites and MI *** used genetic instruments as proxies for plasma metabolites and MI and conducted MR analyses in both directions to assess the impact of metabolites on MI risk and vice *** addition,the large-scale genome-wide association studies datasets was used to identify genetic variants associated with plasma metabolite(1400 metabolites)and MI(20,917 individuals with MI and 440,906 individuals without MI)*** variance weighted was the primary method for estimating causal *** estimates are expressed as beta coefficients or odds ratio(OR)with 95%*** We identified 14 plasma metabolites associated with the occurrence of MI(P<0.05),among which 8 plasma metabolites[propionylglycine levels(OR=0.922,95%CI:0.881–0.965,P<0.001),gamma-glutamylglycine levels(OR=0.903,95%CI:0.861–0.948,P<0.001),hexadecanedioate(C16-DC)levels(OR=0.941,95%CI:0.911–0.973,P<0.001),pentose acid levels(OR=0.923,95%CI:0.877–0.972,P=0.002),X-24546 levels(OR=0.936,95%CI:0.902–0.971,P<0.001),glycine levels(OR=0.936,95%CI:0.909–0.964,P<0.001),glycine to serine ratio(OR=0.930,95%CI:0.888–0.974,P=0.002),and mannose to trans-4-hydroxyproline ratio(OR=0.912,95%CI:0.869–0.958,P<0.001)]were correlated with a decreased risk of MI,whereas the remaining 6 plasma metabolites[1-palmitoyl-2-arachidonoyl-GPE(16:0/20:4)levels(OR=1.051,95%CI:1.018–1.084,P=0.002),behenoyl dihydrosphingomyelin(d18:0/22:0)levels(OR=1.076,95%CI:1.027–1.128,P=0.002),1-stearoyl-2-docosahexaenoyl-GPE(18:0/22:6)levels(OR=1.067,95%CI:1.027–1.109,P=0.001),alpha-ketobutyrate levels(OR=1.108,95%

关键词： infarction alterations diagnosis

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