Chinese Patients Research Articles

Childhood-onset versus adult-onset Takayasu arteritis: A study of 239 patients from China

Objective: We aimed to compare clinical features, vascular involvement, disease activity, and management between Chinese patients with childhood-onset Takayasu arteritis (cTAK) and adult-onset Takayasu arteritis (aTAK).Methods: In total, 239 patients with TAK from the pediatric and adult rheumatology departments of two tertiary care centers were retrospectively evaluated. Data on demographic characteristics, laboratory results, disease activity, vascular involvement, and management regimens were collected and compared between the cTAK and aTAK patients.Results: In total, 85 cTAK and 154 aTAK patients were enrolled. There was a significant difference in the female/male ratio between the cTAK and aTAK groups (2.3:1 vs. 10.8:1, P < 0.001). Fever, hypertension, arrhythmia, and heart failure were more frequent in the cTAK group. The median Indian Takayasu Clinical Activity Score-scores were significantly higher in the cTAK group compared to the aTAK group (5 vs. 3, P = 0.004). The prevalence of supra-aortic artery involvement was significantly higher in the aTAK group than in the cTAK group (P < 0.05). The rate of involvement of coronary and renal arteries was significantly lower in the aTAK group than in the cTAK group (P < 0.05). Compared to the aTAK patients, the cTAK patients were more likely to be treated with biological agents (76.5% vs. 9.1%, P < 0.001).Conclusion: cTAK patients had more severe disease and inflammation. Coronary and renal artery involvement was more common among cTAK patients, whereas supra-aortic artery involvement was more common in aTAK patients increasing their risk of cerebral infarction. Biologics were used more frequently in cTAK patients.

A-212 Retrospective Review of Mycosis Fungoides and Sézary Syndrome in Chinese Patients at a Hong Kong Tertiary Center

A-212 Retrospective Review of Mycosis Fungoides and Sézary Syndrome in Chinese Patients at a Hong Kong Tertiary Center

A critical review on phytochemicals as antiviral medications for SARS-CoV-2 virus infection.

A pandemic of acute respiratory infection, which was specified as coronavirus disease 2019, was instigated by a different strain of the virulent coronavirus SARS-CoV-2 that first appeared in late 2019. Since viral infections spread fast and there is presently no effective treatment, the use of plants with a long history of use in treating these infections has been explored regularly. The pandemic of coronavirus disease 2019 (COVID-19) has brought to light the dearth of medications with approval to treat acute viral illnesses. Because of this, the illness had a high fatality rate. The mortality rate was initially quite high and varied according to the patient's geographic location. For instance, among Chinese patients, the rate was 3·6%, whereas 1·5% of COVID-19-related deaths were documented outside of China. As of 2020, India has a 1.4% case fatality rate (CFR) of COVID-19 mortality, compared to 2.8% in Brazil and 1.8% in the USA. Many studies are being conducted to create pharmaceutical compounds specifically targeting important SARS-CoV-2 proteins. Several drug discovery initiatives are being undertaken to find powerful inhibitors by combining biochemical assay and computer-aided drug design techniques. Although plant-derived compounds have not had much success in the dominion of antivirals, plants are, however, believed to be a limitless supply of medications for a variety of diseases and clinical conditions. The scientific foundation required for developing novel natural source medications is provided by the chemical characterization and analysis of plant components. Most viral infections treated by ethnobotanical applications and historical literature on ayurveda, and traditional medicine are generally attributed to phytochemicals, which are compounds derived from medicinal plants. In this review, we have described the application of vascular plant-derived chemicals, such as tannins, polyphenols, alkaloids, and flavonoids, as antivirals, especially for managing COVID-19. This article discusses novel bioactive compounds and their molecular structures that target the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as prospective candidates for anti-coronavirus disease drugs. Moreover, to confirm the effectiveness of the phytochemicals that have demonstrated antiviral activity, clinical trials would need to be conducted in addition to the preclinical research that has already been done. To ensure spectacular findings, more applications of the compound would need to be studied to fully understand the effects of those phytochemicals whose clinical usefulness has already been established.

Long-Term Kidney Outcome of Lupus Nephritis by Renal Response Status

IntroductionLimited evidence exists that clinical trial treatment response criteria predict long-term outcomes in Asian patients with lupus nephritis (LN). MethodsThis retrospective analysis of prospectively collected data from the Hong Kong Queen Mary Hospital Cohort categorized adults with biopsy-proven LN (Class III, IV, V, or mixed [III±V, IV±V]) after standard treatment for 2 years (2Y) post biopsy and immunosuppression induction according to modified primary efficacy renal response (mPERR: estimated glomerular filtration rate [eGFR] ≥60 ml/min/1.73 m2 or ≤20% below biopsy value AND urine protein:creatinine ratio [uPCR] ≤0.7) and modified complete renal response (mCRR; eGFR ≥90 ml/min/1.73 m2 or ≤10% below biopsy value AND uPCR ≤0.5). Associations between 2Y mPERR/mCRR status and long-term kidney survival and mild chronic kidney disease (CKD) or worse (Stage ≥3) were assessed. ResultsOf the 176 Chinese patients, 64.2% achieved mPERR and 43.8% achieved mCRR at 2Y post biopsy. After mean follow-up of 15.3 years, significantly higher proportions of mPERR and mCRR responders versus non-responders achieved long-term kidney survival (mPERR: 85.8% vs 71.4%; p=0.029; mCRR: 92.2% vs 71.7%; p<0.001). mPERR and mCRR achievement was associated with adjusted risk reductions for kidney non-survival of 60% (p=0.034) and 86% (p<0.001), respectively. Adjusted risk for mild CKD or worse (Stage ≥3) was 82% (p=0.013) and 87% (p=0.012) lower for mPERR and mCRR responders, respectively, versus non-responders. ConclusionsIn Chinese patients with LN, mPERR and mCRR at 2Y post biopsy predict superior long-term kidney outcomes and lower CKD progression risk.

PRRC2A rs114580964 Variant as an Independent Predictor of Poor Kidney Prognosis in Chinese Patients with Lupus Nephritis

PRRC2A rs114580964 Variant as an Independent Predictor of Poor Kidney Prognosis in Chinese Patients with Lupus Nephritis

Improved Fatigue Management in Primary Sjögren's Syndrome: A Retrospective Analysis of the Efficacy of Methotrexate in Chinese Patients.

To assess the efficacy of methotrexate (MTX) and hydroxychloroquine (HCQ) in improving fatigue symptoms in patients with primary Sjögren's syndrome (pSS). A single-center retrospective study was conducted on pSS patients experiencing fatigue symptoms. All patients received either MTX, HCQ, or a combination of MTX + HCQ for a period of six months. Clinical efficacy was measured using the European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), fatigue severity scale (FSS), and visual analog scale (VAS) score. These measures were assessed at baseline and at 1, 2, 3, and 6 months. A total of 86 pSS patients with fatigue symptoms were enrolled (27 received MTX, 29 received HCQ, and 30 received MTX + HCQ). Patients receiving MTX and MTX + HCQ showed significant improvements at 6th month in ESSDAI, ESSPRI, FSS, FACIT-F, and VAS scores (all P < 0.01) compared with baseline. Repeated-measures analysis of variance revealed that patients treated with MTX and MTX + HCQ experienced significant improvements in ESSDAI, FSS, FACIT-F, and VAS scores (all P < 0.01) from baseline to the 6th month. The HCQ group did not show significant improvement in FSS, FACIT-F, and VAS scores (all P > 0.05), although their ESSDAI and ESSPRI scores did improve significantly (all P < 0.01). Patients in the MTX group showed the most improvement in mean changes of ESSDAI score, FSS score, FACIT-F score, and VAS score from baseline to the 6th month. And patients received MTX treatment significantly had more fatigue remission numbers (all P < 0.05). In clinical practice, methotrexate is more effective than hydroxychloroquine in improving fatigue symptoms, as measured by patient-reported fatigue scales (FSS, FACIT-F, and VAS scores) in patients with pSS.

Prevalence and risk factors of low bone mineral density in Chinese Han male patients with alcohol dependence.

To investigate the prevalence of low bone mineral density (BMD) along with its possible risk factors in male Han Chinese patients with alcohol dependence (AD). This retrospective, cross-sectional study included male patients with AD, classified into normal and low BMD groups according to bone densitometry T scores. Demographic and alcohol-related data, and routine laboratory parameters were compared between the two groups. Binary logistic regression analysis was employed to evaluate risk factors associated with low BMD, and correlations between the T-score and demographic, alcohol-related, and routine laboratory data were evaluated. Among a total of 107 patients with AD included in the study, the prevalence of low BMD was 70.09% (75/107). Patients with low BMD were older, consumed more alcohol daily, and had higher lactate dehydrogenase (LDH) and lower Ca2+ levels than patients with normal BMD. Regression analysis revealed that increased daily alcohol intake, low serum Ca2+ levels, high serum LDH levels, and comorbid hypertension was related to low BMD in patients with AD. Further correlation analysis revealed a positive association between T-score and serum Ca2+ levels. Increased daily alcohol intake, low serum Ca2+ levels, high serum LDH levels, and comorbid hypertension may be risk factors for low BMD.

Cerebral small vessel disease was associated with the prognosis in ischemic stroke with atrial fibrillation.

The purpose of this study was to explore the relationship between atrial fibrillation (AF), cerebral small vessel disease (CSVD), and ischemic stroke. Data were extracted from China's Third National Stroke Registry (CNSR-III), which registered 15,166 patients in China. A total of 12,180 ischemic stroke patients were included excluding those diagnosed with TIA or without MRI. Logistic regression was to explore the relationship between AF, CSVD, and poor functional outcomes at 12-month follow-up. Cox regression is to explore AF, CSVD, and stroke recurrence as well as all-cause mortality at 12-month follow-up. The average age was 62.40 ± 11.22 years old, and 8362 (68.65%) were men at baseline. Patients with AF had an increased risk of stroke recurrence and all-cause mortality at 12-month follow-up. Those with AF and CSVD imaging such as lacunes, white matter hyperintensity (WMH), and the presence of cerebral microbleeds (CMBs) had an increased risk of poor prognosis. And those with both AF and CSVD burden had an increased risk of worse prognosis at 12-month follow-up. Among Chinese patients with acute ischemic stroke, those with AF were associated with a higher risk of 12-month mortality and stroke recurrence. When AF was combined with some CSVD imaging features such as lacunes, WMH, presence of CMBs or burdens, the 12-month poor prognosis worsened.

A novel mutation in the BTB domain impairs transcriptional repression function of KCTD1 leading to syndromic microtia

Microtia is a common birth defect affecting the external ears and encompasses a spectrum of congenital anomalies of the auricle. For some of the microtia-associated syndromes, the additional abnormalities are not easily observed or with variable expressivity. Identifying pathogenic mutations through genetic testing is of great help in recognizing these highly heterogeneous syndromes in clinical practice. We reported a novel de novo KCTD1 mutation in a Chinese patient with congenital microtia. It expands the mutational spectrum of KCTD1 and provide an additional scalp‐ear‐nipple patient with typical and atypical clinical presentations. The identified mutation in the BTB domain impairs the suppressive activity of the AP-2 transcription factor family and may impact on maintaining the finely tuned activity of WNT pathway, which directs stem cell development in ectoderm patterning and craniofacial development. Due to the variable expressive clinical phenotypes of syndromic microtia, genetic molecular testing could be of great help in the definite diagnosis.

Correlation between PKD1 Mutation Type and Height-Adjusted Total Kidney Volume in Chinese Patients with ADPKD: Genotype-Phenotype Analysis

Correlation between PKD1 Mutation Type and Height-Adjusted Total Kidney Volume in Chinese Patients with ADPKD: Genotype-Phenotype Analysis

S1372 Prospective, Multicenter, Single-Armed Observational Study to Evaluate the Safety of Vedolizumab in the Chinese Patients with Inflammatory Bowel Disease: Interim Analysis of Safety Results

S1372 Prospective, Multicenter, Single-Armed Observational Study to Evaluate the Safety of Vedolizumab in the Chinese Patients with Inflammatory Bowel Disease: Interim Analysis of Safety Results

Feasibility of intraoperative assessment of STAS in pathologic stage 1 lung adenocarcinomas in Chinese patients

BackgroundIntraoperative assessment of tumor spread through air spaces (STAS) in early-stage lung adenocarcinomas (ADC) has been proposed to stratify patients for surgical management. However, data on the accuracy and reproducibility of detecting STAS on frozen sections (FS) and the prognostic value of STAS on FS remain limited and contradictory. MethodsWe conducted a retrospective study on the feasibility of intraoperative assessment of STAS by comparing the STAS patterns identified on FS and permanent sections from 524 patients diagnosed with pathologic stage 1 lung ADC. We also evaluated the association between STAS with patients’ clinicopathological characteristics and their postoperative survival outcomes. ResultsSTAS was identified in 117 out of 524 patients (22.3%) on permanent sections. Patients with STAS identified on permanent sections experienced shorter progression-free survival (PFS; P=0.042) and overall survival (OS; P=0.005) compared to those without. STAS was identified in 87 out of 509 patients on FS. Patients with STAS detected on FS also had shorter PFS (P=0.01) and OS (P<0.001) than those without. Compared to permanent sections, STAS detection on FS yielded 66.73% (74/111) sensitivity, 96.7% (385/398) specificity, 85.1% (74/87) positive predictive value, 91.2% (385/422) negative predictive value, and 90.2% (459/509) overall agreement. The kappa coefficient was 0.688 (P < 0.001). ConclusionsOur results from a large series of Chinese patients with stage 1 lung ADC indicated that STAS was associated with poorer survival outcomes on both FS and permanent sections. FS is a highly specific method for assessing STAS in stage 1 lung ADC, but caution is warranted regarding false-positive results.

Self-management behavior preferences and influencing factors in Chinese patients with recurrent gout: A qualitative study

ObjectiveThis study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve self-management preferences. MethodsA total of 10 patients with recurrent gout were recruited from the gout specialist outpatient clinic at a tertiary hospital in Shenyang, Liaoning Province, China. Semi-structured interviews were conducted with these patients, and the Kawakita Jiro (KJ) method was used to analyze the interview data. ResultsAfter four rounds of screening by five researchers, 35 codes were selected from an initial 132. After three rounds of discussion and induction, the KJ method identified seven domains of self-management behavior preferences in patients with recurrent gout: 1) extensive knowledge of gout, yet difficulty in distinguishing between accurate and inaccurate information; 2) a passive attitude of “no pain, no management”; 3) the challenge of changing entrenched daily habits; 4) the optimistic but unrealistic belief of “self-delusion”; 5) a tendency to seek medical attention late due to hopelessness of cure and familiarity with recurrences; 6) preference for analgesics for gout recurrences while neglecting long-term urate-lowering therapy (ULT); and 7) gout-related stigma. ConclusionThe results of this study showed that the self-management behavior of patients with recurrent gout could be improved, especially in the aspects of medical seeking behavior, medication compliance, daily management and emotional management. At the same time, we found that gout stigma, difficulty in distinguishing true and false knowledge of gout and negative attitude of “ignoring pain” were significantly associated with self-management behavior.

A comparison of measurement properties between EORTC QLU-C10D and FACT-8D in patients with hematological malignances

ObjectiveTo perform a comparison of the measurement properties of two cancer-specific Multi-Attribute Utility Instruments (MAUIs), EORTC QLU-C10D and FACT-8D, in Chinese patients with hematologic malignancies (HM).MethodsWe conducted a longitudinal study on patients with HM in China, using QLU-C10D and FACT-8D at baseline and follow-up (3–4 months from baseline). We assessed: (i) convergent validity using Spearman’s rank correlation test (r) with EQ-5D-5L; (ii) clinical-groups validity by differentiating cancer stages, overall health assessment (OHA), Eastern Cancer Oncology Group (ECOG) performance status, and mental health status. We also examined clinical validity with effect size (ES) and relative efficiency (RE); (iii) responsiveness to changes in patient self-perception using receiver operating characteristics (ROC) curves and area under the curves (AUC); and (iv) agreement using intraclass correlation coefficients (ICC) and visualized with Bland-Altman plot.ResultsAmong the 308 patients with HM at baseline, 131 completed the follow-up survey. Agreement between the two measures was high (ICC = 0.76). Both measures were highly correlated with EQ-5D-5 L and significantly differentiated (p < 0.001) among groups categorized by cancer stage, OHA performance status, and mental health. ESs for QLU-C10D were numerically higher for cancer stage, OHA, and performance status (ES = 0.53–1.49), whereas ES was higher for FACT-8D and mental health status (ES = 1.35). Responsiveness was higher for QLU-C10D (AUC = 0.84) compared to FACT-8D (AUC = 0.78).ConclusionBoth QLU-C10D and FACT-8D are valid cancer-specific MAUIs for evaluating patients with HM. However, scholars should consider their slight differences in focus when choosing between the two measures.

Exploring the decision-making experience of elderly diabetes patients regarding their health-seeking behaviour: a descriptive qualitative study

BackgroundDiabetes has emerged as a critical global public health issue. The burden of diabetes is escalating in developing countries, including China. For individuals with diabetes, making informed and rational decisions...

EP.04E.05 Prevalence and Characterization of MET Overexpression in Chinese NSCLC Patients: A Retrospective Real-World Analysis

EP.04E.05 Prevalence and Characterization of MET Overexpression in Chinese NSCLC Patients: A Retrospective Real-World Analysis

Extensive pedunculated fibrolipoma of the buttocks that had accompanied the patient for 50 years: a rare case report.

Lipomas are the most prevalent benign soft-tissue tumours, however, pedunculated fibrolipoma in the buttock is rare. Here, the case of a Chinese male patient in his early 70s with a 50-year history of a growing pedunculated fibrolipoma on his right buttock is presented. The attending physician and the registered nurse collaborated on a treatment plan, leading to a successful resection with rhomboid flap transfer. The operation went smoothly, and with continued home care and follow-ups, the patient recovered well, without complications. At 4 months post-surgery, the incision had healed perfectly, boosting the patient's psychological state and allowing him to resume his daily activities unhindered.

Guidelines for diagnosis,treatment and prevention of clostridium difficile infection in China(2024)

Clostridium difficile infection(CDI) is an intestinal infection caused by Clostridium difficile,characterized by clinical symptoms such as fever,abdominal pain,watery diarrhea,and loose stools. Mild cases present with diarrhea,while severe cases can progress to pseudomembranous colitis,often accompany by complications such as toxic megacolon,intestinal perforation,and septic shock. CDI is a significant cause of complications and mortality,especially among elderly patients,and is one of the most common hospital-acquired infections. The purpose of this guideline is to provide guidance on the diagnosis,treatment,and prevention of CDI,covering a total of 20 clinical questions across three domains: diagnosis,treatment,and prevention. The guideline was developed by a collaborative effort of a guideline expert group and a guideline working group. The guideline expert group consists of 37 clinical experts in 18 specialties related to the diagnosis and treatment of CDI and healthcare associated infection control. This guideline was developed using the internationally recognized GRADE method. It includes evidence evaluation and recommendation grading. It categorizes the quality of evidence into four levels: high,medium,low and very low. When formulating recommendations,it considers factors such as the balance of benefits and harms of intervention,quality of evidence,values and preferences,as well as cost and resource consumption. The recommendations are classified into strong and weak recommendations(conditional recommendations). The target audience of this guideline includes Chinese doctors and patients.

Investigation of Core Symptoms during Hemodialysis Period in Chinese Middle-Aged and Young Patients on Maintenance Hemodialysis: A Network Analysis

Investigation of Core Symptoms during Hemodialysis Period in Chinese Middle-Aged and Young Patients on Maintenance Hemodialysis: A Network Analysis

Effectiveness of Preoperative Intrahepatic Portal Venous Classification System in Guiding Preoperative Surgical Decisions and Predicting Hypotensive Effects After Meso-rex Bypass for Children With EHPVO

BackgroundThe categorization of intrahepatic portal venous system (IHPS) patterns using wedged hepatic venous portography (WHVP) has proven to be an effective tool in the preoperative evaluation of Rex recessus and in identifying pediatric patients with extrahepatic portal vein obstruction (EHPVO) who are suitable for meso-Rex bypass (MRB). Despite this classification system being proposed a decade ago, its clinical application remains underutilized. MethodsA single-center retrospective study of 182 children with EHPVO was conducted between October 2014 and July 2023 when MRB was attempted. Data on demographics, etiology, imaging examinations, procedures, and follow-up were collected for 161 patients included. Two interventional radiologists used deVille’s method to classify patients into types A to E based on WHVP imaging, with interobserver agreement analyzed. Associations between IHPS patterns and surgical outcomes following MRB were investigated. ResultsTwo radiologists had a high level of agreement on identifying IHPS patterns and suitable patients for MRB. Of the 161 cases, 130 were type A, 10 were type B, 5 were type C, 7 were type D, and 9 were type E. One hundred and forty-five patients with types A, B and C underwent successful MRB, showing feasibility for 90% of patients. Children categorized as types A and B experienced more significant benefits than type C, including intraoperatively decreased portal vein pressure, esophageal/gastric varices relief, decreased portal venous collaterals and a lower rate of bypass occlusion after one year. The surgical outcomes of patients with types A and B were not influenced by the diameter of the Rex recessus as suggested by WHVP. ConclusionsThe majority of pediatric patients with EHPVO in mainland China have opportunities to receive successful MRB. There are potential differences in the etiology of Chinese and Western patients. The IHPS classification system aids in guiding preoperative surgical decisions and predicting hypotensive effects after MRB. Type C patients should be carefully chosen for MRB.