Progression of anti-mycoplasma drug therapy in children with refractory mycoplasma pneumonia

The incidence of refractory mycoplasma pneumoniae pneumonia (RMPP) in children is increasing year by year, and the disease is progressing rapidly. It is accompanied by serious complications and legacy effects, seriously affecting the quality of life of children. The selection, dosage, and course of anti-MP drugs in children with RMPP have brought a lot of troubles to pediatric hospitals. In the present study, the characteristics, usage and dosage, drug resistance mechanism, and treatment progress of anti-MP drugs for the treatment of RMPP in children were reviewed. Collectively, our findings provided ideas for the treatment of children with RMPP using anti-MP drugs.     

Documento de consenso de poliquistosis renal autosómica dominante del grupo de trabajo de enfermedades hereditarias de la Sociedad Española de Nefrología. Revisión 2020

Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent cause of genetic renal disease and accounts for 6–10% of patients on kidney replacement therapy (KRT).Very few prospective, randomized trials or clinical studies address the diagnosis and management of this relatively frequent disorder. No clinical guidelines are available to date. This is a revised consensus statement from the previous 2014 version, presenting the recommendations of the Spanish Working Group on Inherited Kidney Diseases, which were agreed to following a literature search and discussions. Levels of evidence mostly are C and D according to the Centre for Evidence-Based Medicine (University of Oxford). The recommendations relate to, among other topics, the use of imaging and genetic diagnosis, management of hypertension, pain, cyst infections and bleeding, extra-renal involvement including polycystic liver disease and cranial aneurysms, management of chronic kidney disease and KRT and management of children with ADPKD. Recommendations on specific ADPKD therapies are provided as well as the recommendation to assess rapid progression.     

不同方法治疗进展期胃癌临床疗效观察

【摘要】 目的 探讨不同方案治疗进展期胃癌的临床疗效及不良反应。方法 选取66例进展期胃癌,分观察组及对照组,各33例,观察组行SOX(替吉奥+奥沙利铂)化疗,对照组给予FOX(奥沙利铂+亚叶酸钙+氟尿嘧啶),比较两组临床疗效、不良反应及生存时间。结果〓观察组临床有效率为28/33,84.9%,对照组为24/33,72.7%,二者差异无统计学意义(?字2=1.451,P>0.05);观察组治疗期间出现的毒副作用主要表现为中性粒细胞降低、血小板减少、胃肠道反应、肝功能异常、食欲下降等;观察组与对照组中位生存期分别为29.27±7.15个月和17.84±4.58个月,差异具有统计学意义(t=7.733,P<0.05)。结论〓替吉奥+奥沙利铂治疗进展期胃癌患者临床可取得较好的疗效。     

The Natural Progression of Parkinson's Disease in a Small Cohort with 15 Drug-na?ve Patients

Background:

The studies of the natural progression of Parkinson''s disease (PD) in Chinese populations have been lacking. To address this issue and obtain a preliminary data, we conducted a PD progression assessment in 15 adults with de novo PD from a nutritional intervention trial (NIT) cohort in Lin County China.

Methods:

Using the Copiah County screening questionnaire and United Kingdom Parkinson''s Disease Society Brain Bank diagnostic criteria, we surveyed the available NIT cohort members in 2000 and diagnosed 86 patients as PD. In 2010, we resurveyed all PD patients and confirmed definite PD diagnosis in 15 cases with the rest of them being dead (54); having probable (10) PD or vascular Parkinsonism (3); refusing to participate (2); or being away (2). In both surveys, we used Hoehn and Yahr (HY) scale and assessed the disease progression. Unified Parkinson''s Disease Rating Scale (UPDRS) was added to the second survey.

Results:

In 2010, the average disease duration for 15 definite PD patients was 13.6 ± 7.3 years. Over a 10-year time span, 9 out of 15 patients remained at the same HY stage while the remaining 6 progressed. Rigidity (47% vs. 100%; P = 0.002) and postural instability (7% vs. 47%; P = 0.005) worsened significantly. The mean UPDRS motor scores in 2010 were 39.4 ± 23.7.

Conclusions:

Overall worsening of motor function in PD seems to be the rule in this untreated cohort, and their rate of progression seemed to be slower than those reported in the western populations.     

Clinical outcomes of people living with human immunodeficiency virus (HIV) with diffuse large B-cell lymphoma (DLBCL) in Shanghai,China

Background:Numerous studies have focused on lymphoma among patients infected with human immunodeficiency virus (HIV). However, little is known about the treatment options and survival rate of lymphoma in the Chinese people living with HIV (PLHIV). Our study aimed to investigate the prognosis and compare outcome of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH-R) with standard cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab(R-CHOP) as front line therapy for PLHIV with diffuse large B-cell lymphoma (DLBCL) receiving modern combined antiretroviral therapy (cART).Methods:A retrospective analysis evaluating PLHIV with DLBCL was performed in Shanghai Public Health Clinical Center from July 2012 to September 2019. The demographic and clinical data were collected, and overall survival (OS) and progression-free survival (PFS) analyses of patients receiving R-CHOP or DA-EPOCH-R therapy were performed by Kaplan-Meier analysis. Additionally, a Cox multiple regression model was constructed to identify related factors for OS.Results:A total of 54 eligible patients were included in the final analysis with a median follow-up of 14 months (interquartile range [IQR]: 8–29 months). The proportion of high international prognostic index (IPI) patients was much larger in the DA-EPOCH-R group (n = 29) than that in the R-CHOP group (n = 25). The CD4 cell counts and HIV RNA levels were not significantly different between the two groups. The 2-year OS for all patients was 73%. However, OS was not significantly different between the two groups, with a 2-year OS rate of 78% for the DA-EPOCH-R group and 66% for the R-CHOP group. Only an IPI greater than 3 was associated with a decrease in OS, with a hazard ratio of 5.0. The occurrence of grade 3 and 4 adverse events of chemotherapy was not significantly different between the two groups.Conclusions:Outcomes of R-CHOP therapy do not differ from those of DA-EPOCH-R therapy. No HIV-related factors were found to be associated with the OS of PLHIV in the modern cART era.     

单侧良性蝶窦病变的CT及MRI影像表现特点分析

目的分析单侧良性蝶窦病变的CT及MRI影像表现特点。方法回顾性分析2017年5月至2018年5月我院耳鼻喉科诊治的20例鼻内镜手术后病理证实单侧良性蝶窦病变患者临床资料,均行CT及MRI检查,评估其影像学特征。结果 20例单侧良性蝶窦病变患者中,7例为蝶窦囊肿,CT见蝶窦内呈圆形/卵圆形密度均匀的软组织密度影,其中蝶窦腔膨胀者骨质吸收减少,MRI呈长T1、长T2不规则球形影;7例为真菌性蝶窦炎,CT见其蝶窦内呈不规则点片状钙化斑、云絮状影,毛玻璃样改变,MRI见蝶窦内混杂信号,炎症片状渗出影,真菌结节T2WI低信号;4例为蝶窦脑脊液鼻漏,CT发现蝶窦中单纯软组织密度影,MRI上有线状高信号影将脑脊液高信号影及鼻窦内高信号液体影相连,脑组织、鼻黏膜呈明显低信号;内翻性乳头状瘤2例,CT见蝶窦中软组织不均匀密度影,MRI上肿物不均匀强化,条索样或"脑回征"。结论 CT及MRI可为单侧良性蝶窦病变的诊断及治疗提供全面影像信息,其中CT对病变周围骨质改变、MRI对病变侵袭范围分别有较好显示效果,两者联合对病变有较高的鉴别价值。