吉林省流通麦冬质量评价研究

目的:考察吉林省内麦冬的质量现状。方法:参照《中华人民共和国药典》2015年版一部"麦冬药材"检测标准进行常规质量检验,并进行二氧化硫残留量探索性研究。结果:45份麦冬样品中仅55.6%符合麦冬检验标准,44.4%的样品不合格,且部分样品存在熏硫现象。结论:当前吉林省内流通使用的麦冬总体质量较差。     

Whole‐exome sequencing suggests multiallelic inheritance for childhood‐onset Ménière's disease

The genetic background of Ménière's disease (MD) was studied in one patient with childhood‐onset MD and his grandfather affected with middle age–onset MD. Whole‐exome sequencing was performed and the data were compared to 76 exomes from unrelated subjects without MD. Thirteen rare inner ear expressed variants with pathogenic estimations were observed in the case of childhood‐onset MD. These variants were in genes involved in the formation of cell membranes or the cytoskeleton and in genes participating in cell death or gene‐regulation pathways. His grandfather shared two of the variants: p.Y273N in HMX2 and p.L229F in TMEM55B. HMX2 p.Y273N was considered the more likely candidate for MD, as the gene is known to affect both hearing and vestibular function. The variant in the HMX2 gene may affect inner ear development and structural integrity and thus might predispose to the onset of MD. As there was a significant difference in onset between the patients, an accumulation of defects in several pathways is probably responsible for the exceptionally early onset of the disease, and the genetic etiology of childhood‐onset MD is most likely multifactorial. This is the first molecular genetic study of childhood‐onset MD.     

Prognosis of unrecognized coeliac disease as regards mortality: A population-based cohort study

Background and aim. Clinically diagnosed coeliac disease patients carry an increased risk of mortality. As coeliac disease is markedly underdiagnosed, we aimed to quantify the risk of mortality in subjects with unrecognized and thus untreated coeliac disease.

Method. Blood samples from 6,987 Finnish adults were drawn in 1978–80, and sera were tested for immunoglobulin A (IgA)-class tissue transglutaminase antibodies (Eu-tTG) in 2001. Positive sera were further analysed for endomysial (EMA) and tissue transglutaminase antibodies by another test (Celikey tTG). EMA- and Celikey tTG-positive cases were compared to negatives as regards mortality in up to 28 years of surveillance, yielding a total follow-up of 147,646 person years. Dates and causes of death were extracted from the nation-wide database.

Results. Altogether 74 (1.1%) of the participants were EMA- and 204 (2.9%) Celikey tTG-positive. The age- and sex-adjusted relative risk of overall mortality was not increased in either EMA (0.78, 95% CI 0.52–1.18) or Celikey tTG (1.19, 95% CI 0.99–1.42) -positive subjects. However, antibody-positive cases evinced a tendency to die from lymphoma, stroke, and diseases of the respiratory system.

Conclusions. The prognosis of unrecognized coeliac disease was good as regards overall mortality, which does not support screening of asymptomatic coeliac disease cases.     

Study of the economic burden and influencing factors on stroke patients in Central China in the post-epidemic era

The economic burden of disease is the main burden of disease for patients, and experts and scholars have done various studies from different perspectives on various types of diseases. In the present study, we focused on the basic situation of hospitalization cost of stroke patients in Hunan Province and analyzed the factors affecting the hospitalization cost of stroke patients. A retrospective random sample of 7270-case home data of patients discharged from several hospitals in Hunan Province with diagnoses of ICD-10 codes I60 to I64 from 2019 to 2021 was used to analyze the patient’s hospitalization costs and the influencing factors. The univariate analysis was used to eliminate irrelevant factors, and multiple linear regression analysis was performed on the effective factors. Patients’ medical costs are increasing year by year, with drug costs accounting for a high proportion of patients’ hospitalization costs. The ranking of the total effect factors of hospitalization costs was as follows: the number of days of hospitalization, the level of the institution, the disease subtype, gender, the type of participation, and age. It was recommended to strengthen the scientific and rational use of drugs, improve medical technology and service level, do a good job in early screening and prevention of diseases, realize the hierarchical diagnosis and treatment system, play an active role in community hospitals, use medical resources rationally, develop scientific and rational treatment plans, shorten the number of days of hospitalization, control costs effectively, strengthen publicity and education, and form healthy and good living habits to shorten the number of days of hospitalization. The number of days of hospitalization should be shortened.     

Distinct distal myopathy phenotype caused by VCP gene mutation in a Finnish family

Inclusion body myopathy with Paget disease and frontotemporal dementia (IBMPFD) is caused by mutations in the valosin-containing protein (VCP) gene. We report a new distal phenotype caused by VCP gene mutation in a Finnish family with nine affected members in three generations. Patients had onset of distal leg muscle weakness and atrophy in the anterior compartment muscles after age 35, which caused a foot drop at age 50. None of the siblings had scapular winging, proximal myopathy, cardiomyopathy or respiratory problems during long-term follow-up. Three distal myopathy patients developed rapidly progressive dementia, became bedridden and died of cachexia and pneumonia and VCP gene mutation P137L (c.410C > T) was then identified in the family. Late onset autosomal dominant distal myopathy with rimmed vacuolar muscle pathology was not sufficient for exact diagnosis in this family until late-occurring dementia provided the clue for molecular diagnosis. VCP needs to be considered in the differential diagnostic work-up in patients with distal myopathy phenotype.     

Outcomes of HER2-positive early breast cancer patients in the pre-trastuzumab and trastuzumab eras: a real-world multicenter observational analysis. The RETROHER study

Addition of trastuzumab to adjuvant chemotherapy has dramatically reduced the risk of recurrence and has become the standard of care for human epidermal growth factor receptor 2 (HER2)-positive early breast cancer patients. Since most data on trastuzumab benefits come from clinical trials, conducted in selected patient populations, we performed a retrospective analysis of HER2-positive early breast cancer patients treated in the “pre-trastuzumab” and “trastuzumab” eras, with the aim to determine patients' outcomes in real-world practice. 925 consecutive HER2-positive breast cancer patients treated with adjuvant chemotherapy in ten Italian oncologic centers were identified. Patients who had received adjuvant chemotherapy alone (cohort A, 352 patients), and patients who had received adjuvant chemotherapy followed or combined with trastuzumab (cohort B, 573 patients) were analyzed. Relapse rate at 3 years, relapse-free survival, and overall survival were significantly more unfavorable in the cohort A than in the cohort B (p < 0.0001). In multivariate analysis, factors related to relapse were younger age, advanced stage at diagnosis, absence of hormonal and of trastuzumab therapy. The benefit derived from the addition of trastuzumab was independent of nodal status and hormonal receptors expression. A subgroup analysis including 163 “triple positive” tumors with high levels of estrogen and progesterone receptor (TP50) suggested that addition of trastuzumab to adjuvant chemotherapy and hormonal therapy did not translate into better outcomes. In our analysis, trastuzumab benefit was confirmed in all but a small subset of TP50 tumors subgroups. In this subset further investigations are needed.     

Antioxidant Activities of the Chloroform Extract of Solanum trilobatum

A chloroform extract from the anticancer herb Solanum trilobatum (CST) (Nadkarni, 1979) was analyzed and compared with reference antioxidants for its in vitro antioxidative properties such as scavenging of α,α-diphenyl-β-picryl hydrazyl (DPPH) and superoxide radicals, protection to deoxyribose degradation, reducing power, as well as inhibition of lipid peroxidation. Preliminary phytochemical analysis of CST by silica gel thin-layer chromatography showed the presence of simple phenols, phenolic acids, isoflavones, xanthones, and lignans. The antioxidative effect of CST was found to be concentration dependent to a certain extent and then leveled off with further increase in concentration. The IC₅₀ for each antioxidative reaction studied was calculated. When compared to the reference antioxidant butylated hydroxytoluene (BHT), CST exhibited less scavenging effect on DPPH radicals and reducing power but a better superoxide radical scavenging effect. From a comparison of the hydroxyl radical scavenging effect of CST with catechin, it seemed that CST was four-times more effective than catechin. CST was also able to prevent the formation of ·OH-induced malondialdehyde (MDA) in rat liver homogenate.     

Breast cancer patients receiving postoperative radiotherapy: Distress, depressive symptoms and unmet needs of psychosocial support

Background and purpose

The diagnosis and treatment of breast cancer can cause considerable psychological consequences, which may remain unrecognized and untreated. In this study, the prevalence of depressive symptoms and distress, and unmet needs for psychosocial support were assessed among breast cancer patients receiving postoperative radiotherapy.

Material and methods

Out of 389 consecutive patients, 276 responded and comprised the final study group. Depressive symptoms were assessed with the Beck Depression Inventory. Distress was measured with the Distress Thermometer. Hospital records of the patients were examined for additional information.

Results

Nearly one third of patients (32.1%) displayed depressive symptoms, and more than a quarter of patients (28.4%) experienced distress. Younger age (p = 0.001) and negative hormone receptor status (p = 0.008) were independent factors associated with distress. One quarter of the patients expressed an unmet need for psychosocial support, which was independently associated with depressive symptoms and/or distress (p = 0.001) and younger age (p = 0.006).

Conclusions

During radiotherapy for breast cancer, the staff should have awareness of the higher risk of depression and distress in their patients and should consider screening tools to recognise distress and depressive symptoms. Special attention should be paid to younger patients.     

Comparative Enzyme Immunoassay of Matrix Metalloproteinases-2, -7, -9 and Their Tissue Inhibitor-2 in Tumors and Plasma of Patients with Gastric Cancer

The content of matrix metalloproteinases (MMP) -2, -7, and -9 was significantly higher in tumors in comparison with the adjacent histologically intact gastric mucosa in 80, 70, and 72% patients with gastric cancer, respectively, the increase in the level of MMP tissue inhibitor-2 (TIMP-2) detected in 61% tumors was insignificant. Only plasma level of MMP-7 was elevated in primary patients in comparison with the control and positively correlated with the expression of this protein in the tumor. The concentration of MMP-7 was maximum in the blood of patients with tumor invasion in lymph vessels. These data suggest MMP-7 as a possible serological marker of gastric cancer.