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Guidelines for Diagnosis and Treatment of Chronic Gastritis in China (2022, Shanghai): An interpretation Wu Haotian, Fan Yuwen, Zhang Xiaolan Clinical Focus    2023, 38 (10): 926-930.   DOI: 10.3969/j.issn.1004-583X.2023.10.012 Abstract （696）   HTML （32）    PDF（pc） （843KB）（2252）       Knowledge map    Save In 2022, the Chinese Society of Gastroenterology has referred the research and guidelines associated with chronic gastritis at home and abroad in recent years, formulated a total of 53 recommendations on the epidemiology, clinical manifestations, endoscopic and laboratory diagnosis, treatment principles, outcomes and prognosis, and unsolved problems at home and abroad, and published the Guidelines for Diagnosis and Treatment of Chronic Gastritis in China (2022, Shanghai). This article interprets the updates and highlights of this guideline. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (8): 743-748.   DOI: 10.3969/j.issn.1004-583X.2023.08.012 Abstract （257）   HTML （2）    PDF（pc） （896KB）（922）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (12): 1146-1149.   DOI: 10.3969/j.issn.1004-583X.2023.12.016 Abstract （174）   HTML （6）    PDF（pc） （875KB）（646）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (2): 188-192.   DOI: 10.3969/j.issn.1004-583X.2024.02.018 Abstract （254）   HTML （9）    PDF（pc） （847KB）（356）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (10): 935-939.   DOI: 10.3969/j.issn.1004-583X.2024.10.012 Abstract （131）   HTML （6）    PDF（pc） （803KB）（227）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (7): 654-657.   DOI: 10.3969/j.issn.1004-583X.2024.07.013 Abstract （222）   HTML （6）    PDF（pc） （853KB）（221）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (4): 372-376.   DOI: 10.3969/j.issn.1004-583X.2025.04.014 Abstract （81）   HTML （3）    PDF（pc） （988KB）（205）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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The risk prediction models for pneumonia in patients with intracerebral hemorrhage: A systematic review Liu Jinteng, Liu Xingyu, Huang Lumei, Pan Hailong Clinical Focus    2025, 40 (1): 5-13.   DOI: 10.3969/j.issn.1004-583X.2025.01.001 Abstract （133）   HTML （4）    PDF（pc） （976KB）（194）       Knowledge map    Save Objective To systematically analyze and evaluate the risk prediction model for pneumonia in patients with intracerebral hemorrhage (ICH). Methods Articles reporting risk prediction model for pneumonia in ICH patients published prior to February 2023 were searched in the online databases of Pubmed, Web of Science, Embase, The Cochrane Library, Scopus, Ovid Medline, CNKI (China National Knowledge Infrastructure), WanFang Data, VIP and CBM (Chinese Biomedical Literature Database). Two researchers were independently responsible for screening literature and extracting data. The quality of the literature included in this study was rigorously evaluated, and both the risk of bias and adaptability were assessed in accordance with the Transparent Reporting of a Multivariable Prediction Model for Individal Prognosis or Diagnosis(TRIPOD), and the Prediction Model Risk of Bias Assessment Tool(PROBAST). Results A total of 12 relevant studies were included, involving 7 registered studies, 1 ovarian case-control study, 3 single-center case-control studies, and 1 retrospective cohort study. Logistic regression and machine learning were used for modeling. Eight studies were validated internally, 2 studies were only validated externally, and 2 studies were validated both. The area under the receiver operating characteristic curve of the model was 0.740-0.920. The range of predictors in the 12 studies ranged from 4 to 11, and the common predictors were the age, the National Institutes of Health Stroke Scale score, the Glasgow Coma Scale score, dysphagia, smoking, chronic obstructive pulmonary disease, and nasogastric tube feeding. Model calibration was performed in 9 studies and not in 3 studies. The model was mainly presented in the form of risk score, risk calculation formula and nomogram. The included studies exhibited moderate quality and a high risk of bias. Conclusion The current model for predicting the risk of pneumonia in ICH patients demonstrates good predictive ability, and the predictive factors are relatively easy to obtain. However, there are also significant defects and high bias. In future research, it is recommended that researchers adhere to the TRIPOD guideline and PROBAST statement when conducting prediction model studies. It is important to summarize the advantages and disadvantages of existing models and to conduct external verification, thus developing a risk prediction model for pneumonia in ICH patients with excellent predictive performance and ease of use. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Interpretation of the Chinese Expert Consensus on Gastrointestinal Endoscopic Treatment of Obesity Su Miao, Wang Sashuang, Zhao Dongqiang Clinical Focus    2025, 40 (4): 366-371.   DOI: 10.3969/j.issn.1004-583X.2025.04.013 Abstract （60）   HTML （1）    PDF（pc） （468KB）（187）       Knowledge map    Save Obesity is a chronic disease that increases the risk of cardiovascular and metabolic disorders. Current treatment methods for obesity mainly include lifestyle interventions, pharmacotherapy, and surgical procedures. Traditional lifestyle interventions result in a poor long-term compliance, and pharmacotherapy is often associated with side effects or weight regain. Although surgical procedures can lead to significant weight loss, they are limited by the invasiveness, high complication risks, and irreversibility. In recent years, endoscopic bariatric therapy has emerged as a safer and more effective treatment option due to its reversibility, minimal invasiveness, and cost-effectiveness. To standardize this approach in China, the National Clinical Medical Research Center for Digestive Diseases, in collaboration with experts in this field, developed the Chinese Expert Consensus on Gastrointestinal Endoscopic Treatment of Obesity. This article reviewed the key points of the consensus, aiming to enhance the understanding of endoscopic bariatric therapy among both healthcare providers and patients. The goal is to advance and refine endoscopic bariatric therapy while promoting academic exchange and expanding awareness of minimally invasive treatment options in China. Reference | Related Articles | Metrics | Comments（0）

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Interpretation for the third edition of WHO Operational Handbook on Tuberculosis, Module 6: Tuberculosis and Comorbidities Zeng Jian, Wang Xiaomin, Fang Mutong, Lu Shuihua Clinical Focus    2025, 40 (3): 270-274.   DOI: 10.3969/j.issn.1004-583X.2025.03.014 Abstract （74）   HTML （1）    PDF（pc） （871KB）（176）       Knowledge map    Save Tuberculosis (TB) is a major global public health challenge, and its interaction with a variety of comorbidities like mental disorder, HIV infection and diabetes significantly affects the prognosis of patients. In January 2025, the World Health Organization (WHO) released the third edition of the WHO Operational Handbook on Tuberculosis, Module 6: Tuberculosis and Comorbidities, which systematically integrated the management strategy of TB and comorbidities. Based on the three core comorbidities of mental and substance-use disorders, human immunodeficiency virus (HIV) infection and diabetes, this paper interprets the key recommendations for the operation manual including screening tools, comprehensive treatment approach, and preventive measures. it aims to provide evidence-based guidance for clinical practice and optimize the whole process management of TB patients. Reference | Related Articles | Metrics | Comments（0）

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Interpretation of the Guidelines for the Assessment and Clinical Practice of Behavioral and Psychological Symptoms of Dementia 2025 Gao Yan, Qu Shuo, Li Yang, Qiu Huiqing, He Sha, Ma Xiaowei Clinical Focus    2025, 40 (5): 389-393.   DOI: 10.3969/j.issn.1004-583X.2025.05.001 Abstract （76）   HTML （4）    PDF（pc） （826KB）（172）       Knowledge map    Save Currently, more than 55 million people suffer from dementia worldwide. Alzheimer's disease (AD) is the most common diagnostic cause of dementia, accounting for 50%-70% of all dementia cases. In March 2025, the Canadian Coalition for Seniors' Mental Health (CCSHM) released the Guidelines for the Assessment and Clinical Practice of Behavioral and Psychological Symptoms of Dementia 2025, targeting on the assessment and management of BPSD in AD patients. The present article focused on the five major symptoms of BPSD, including agitation, depression, anxiety, mental symptoms and potential risk sexual behavior manifestations, as well as the the reduction of antipsychotics and psychotropic drugs. Through interpreting key suggestions in the guideline, three aspects of diagnostic criteria, evaluation methods and treatment measures were discussed to provide references for clinical treatment of BPSD and optimizing the whole-process management of BPSD symptoms in AD patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (9): 842-846.   DOI: 10.3969/j.issn.1004-583X.2024.09.015 Abstract （249）   HTML （11）    PDF（pc） （905KB）（165）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (11): 1034-1037.   DOI: 10.3969/j.issn.1004-583X.2023.11.014 Abstract （158）   HTML （3）    PDF（pc） （842KB）（154）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical efficacy of individualized vestibular rehabilitation in the treatment of vestibular neuritis Zhang Xiuling, Zhang Li, Chen Jinxiang Clinical Focus    2025, 40 (3): 227-230.   DOI: 10.3969/j.issn.1004-583X.2025.03.006 Abstract （87）   HTML （2）    PDF（pc） （856KB）（154）       Knowledge map    Save Objective To investigate the clinical efficacy of individualized vestibular rehabilitation program in the treatment of vestibular neuritis. Methods Seventy-six patients with vestibular neuritis who visited the outpatient department from June 2020 to June 2023 were randomly divided into the control group and experimental group. Routine medication was given to patients of both groups. Based on physical examination, vestibular function examination, and subjective scale scores, the impairment of the vestibulo-ocular reflex (VOR) pathway and vestibular spinal reflex (VSR) pathway were assessed in patients of the experimental group, and thus managed by individualized vestibular rehabilitation plans. After three months of treatment, the various examination indicators and clinical treatment effects of the two groups were compared. Results The clinical indicators of both groups significantly improved compared to before treatment. Compared with those of the control group, patients in the experimental group had significantly better improvements in indicators such as Romberg test (ROM), directional preference (DP), video head impulse test (vHIT) gain, dizziness handicap inventory (DHI), and Berg balance scale (BBS) score (P<0.05). The clinical treatment effective was significantly higher in the experimental group than that of the control group (97.37% vs 81.57%, P<0.05). An individualized rehabilitation treatment provided a superior effective outcome to patients with VSR pathway damage. Conclusion Accurately developing individualized vestibular rehabilitation plans based on clinical examination results of patients with vestibular neuritis has significant effects and advantages in improving subjective scores, symptoms and signs, objective indicators of vestibular function. It is worth further promotion. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (11): 1048-1052.   DOI: 10.3969/j.issn.1004-583X.2023.11.017 Abstract （110）   HTML （2）    PDF（pc） （864KB）（151）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical application of GEMOX combined with target-immunity therapy in patients with advanced biliary tract cancer Wu Xiaomin, Fang Yipeng, Zhang Zhen, Zhang Ye, Jin Cheng Clinical Focus    2024, 39 (5): 408-412.   DOI: 10.3969/j.issn.1004-583X.2024.05.004 Abstract （296）   HTML （6）    PDF（pc） （1116KB）（150）       Knowledge map    Save Objective To evaluate the clinical efficacy and safety of gemcitabine and oxaliplatin (GEMOX) combined with target-immunity therapy (lenvatinib and programmed cell death 1 [PD-1] monoclonal antibody) in patients with advanced biliary tract cancer (BTC). Methods Twenty-four patients with advanced BTC received GEMOX combined with target-immunity therapy visited Integrative Oncology Department or Hepatobiliary Surgery Department of our hospital from January 2015 to January 2024 were recruited. The primary end points were set as overall survival (OS) and progression-free survival (PFS), and the secondary end points were objective response rate (ORR), disease control rate (DCR) and safety. The safety and overall clinical efficacy of GEMOX combined with target-immunity therapy regimen on advanced BTC were comprehensively evaluated via tumor marker indexes (carcinoembryonic antigen [CEA], carbohydrate antigen 125 [CA125], CA199), adverse reactions rates, quality of life scores, imaging indicators, and other data. Results None of the 24 patients had complete remission (CR). ORR was 33.3% (8/24, 8 patients had PR), DCR was 66.7% (16/24; 8 patients had SD and 8 patients had PD, respectively), median OS was 13 months and median PFS was 8 months. After treatment, the levels of CA199 were significantly lower than those before treatment (P<0.05). The incidence of adverse events in 24 patients were rash (14/24, 58.3%), leucopenia (22/24, 91.6%), anemia (20/24, 83.3%). One patient had serious adverse events and withdrew from treatment, one patient died of biliary obstruction with infection during treatment. Conclusion GEMOX combined with target-immunity therapy regimen is safe and effective in the treatment of advanced BTC, it may be used clinically. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (6): 564-569.   DOI: 10.3969/j.issn.1004-583X.2025.06.015 Abstract （24）   HTML （1）    PDF（pc） （938KB）（149）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Longitudinal cohort study of oral health status and cognitive function in the elderly: A meta-analysis Wang Lin, Wang Ting, Pu Xiaolan, Ju Mei Clinical Focus    2024, 39 (8): 677-683.   DOI: 10.3969/j.issn.1004-583X.2024.08.001 Abstract （221）   HTML （7）    PDF（pc） （1364KB）（145）       Knowledge map    Save Objective To explore the correlation between oral health status and the risk of cognitive dysfunction by meta-analysis. Methods Cohort studies on the correlation between oral health status and cognitive function from inception to August 2023 were searched in PubMed, Web of Science, EMBASE, Scopus, Chinese National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), Wanfang, VIP and Duxiu databases. Two reviewers independently screened literatures, extracted data and evaluated the quality of included studies. Meta-analysis was performed using RevMan 5.3 and Stata 17.0 software. Results A total of 34 cohorts were included. The results of meta-analysis showed that the risk of cognitive impairment in the elderly with poor oral health status was significantly higher than that in the elderly with good oral health status (RR=1.31, 95%CI 1.18-1.46, P<0.01). The results of subgroup analysis showed that there were significant differences in periodontitis disease, posterior occlusal support, dentition status, and tooth loss (P<0.05), but there was no significant difference in the oral frailty (RR=1.32, 95%CI 0.96-1.81, P=0.09). There was no significant difference in the risk of oral health status and cognitive impairment in the subgroup with a follow-up time>10 years (RR=1.01, 95%CI 0.83-1.23, P=0.90), but a significant difference was detected in the subgroup with a follow-up time ≤10 years (RR=1.48, 95%CI 1.32-1.67, P<0.001). There was no significant difference in the risk of oral health status and cognitive impairment in the moderate quality subgroup (RR=1.05, 95%CI 0.91-1.20, P=0.51), but a significant difference was detected in the high quality subgroup (RR=1.35, 95%CI 1.21-1.51, P<0.01). Conclusion Oral health status is associated with the risk of cognitive dysfunction. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (1): 90-96.   DOI: 10.3969/j.issn.1004-583X.2025.01.015 Abstract （101）   HTML （5）    PDF（pc） （1062KB）（141）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (1): 76-81.   DOI: 10.3969/j.issn.1004-583X.2025.01.012 Abstract （111）   HTML （3）    PDF（pc） （863KB）（130）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Risk prediction model for readmission of chronic obstructive pulmonary disease: A systematic review Zhu Jieyun, Gao Min, Huang Chunli, Pan Dongzan, Wang Qiaoyan, Lu Zhao Clinical Focus    2024, 39 (9): 773-779.   DOI: 10.3969/j.issn.1004-583X.2024.09.001 Abstract （227）   HTML （10）    PDF（pc） （597KB）（130）       Knowledge map    Save Objective To systematically evaluate the risk for readmission in patients with chronic obstructive pulmonary disease (COPD) and provide references for the construction and optimization of prediction model.Methods The literatures on the risk prediction model for COPD readmission were independently screened in China National Knowledge Infrastructure (CNKI), VIP, WanFang Data, Cochrane Library, PubMed, Embase databases from database inception to November 22, 2023 by two researchers. After extracting data, the bias risk and applicability of the models were evaluated using the PROBAST tool. Results Twelve cohort studies representing 21 models were finally included. Eleven studies reported the area under a receiver operator characteristic (ROC) curve (AUC) and one study for the C-index. The AUC ranged from 0.603 to 0.917, with AUC>0.7 for 16 models. Six studies conducted model calibration and eight studies for internal or external validation. The overall applicability of the 12 studies was good, but with a high risk of bias, mainly in the analysis domain. The included studies had significant differences in the predictive factors, with the most common predictive factors of lung function indicators, Charlson comorbidity index, times of hospitalization due to a history of acute exacerbation during the previous year, eosinophil levels, and inhaled drug therapy. Conclusion The performance of the included models varied greatly, with good applicability but high risk of bias. Due to the incomplete screening method, and there were significant differences in predictive factors of the included studies. Future prediction models should focus on lung function, Charlson comorbidity index, times of hospitalization due to a history of acute exacerbation during the previous year, eosinophil levels, and inhaled drug therapy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Efficacy and safety of sotagliflozin in the treatment of type 2 diabetes mellitus: A meta-analysis Yue Jianghong, Wang Heng, Cai Gang, Zhang Xuanming, Peng Xi Clinical Focus    2024, 39 (7): 581-592.   DOI: 10.3969/j.issn.1004-583X.2024.07.001 Abstract （207）   HTML （13）    PDF（pc） （3483KB）（127）       Knowledge map    Save Objective To evaluate the efficacy and safety of sotagliflozin in the treatment of type 2 diabetes mellitus (T2DM). Methods Randomized controlled trials (RCTs) involving sotagliflozin versus placebo (or other oral hypoglycemic agents) in the treatment of T2DM pulished before October 31, 2023 were retrieved in PubMed, Embase, Web of science, Medline, Cochrane Library, the North American Clinical Trial Register, CNKI, Wanfang, VIP, SinoMed and other databases. The extracted Valid data were performed for quality evaluation, and a meta-analysis was conducted using RevMan 5.3 software. Results Fourteen RCTs representing 16, 959 patients were included. The results of meta-analysis showed: In terms of efficacy, compared with the control group, sotagliflozin group presented significantly decreased glycated hemoglobin (HbA1c, MD=-0.45, 95%CI[-0.58, -0.33]; P<0.01) and fasting blood glucose (FBG, MD=-0.66, 95%CI[-1.01, -0.31]; P=0.0002) and 2-h postprandial glucose (2hPG, MD=-1.01, 95%CI[-1.58, -0.44]; P=0.0005), and improved compliance rate of HbA1c <7% (RR=1.88, 95%CI[1.64, 2.15], P<0.01). Compared with control group, sotagliflozin group had decreased systolic blood pressure (SBP, MD=-2.13, 95%CI[-2.81, -1.45], P<0.01) and body mass (BM, MD=-1.40, 95%CI[-1.63, -1.17], P<0.01), but there was no statistical significance in reducing diastolic blood pressure (DBP). In terms of safety, the incidence of hypoglycemic events was similar between the sotagliflozin group and the control group (RR=1.00, 95%CI[0.92, 1.09], P=0.97). However, the incidence of adverse reactions was significantly lower in sotagliflozin group (RR=0.92, 95%CI [0.88, 0.96], P<0.01). Subgroup analysis according to different doses of sotagliflozin showed that compared with the control group, sotagliflozin 200 mg and 400 mg groups could significantly reduce the HbA1c and FBG, improve the compliance rate of HbA1c<7%, and reduce SBP, BM and other indexes (P<0.05), and without increasing the risk of hypoglycemia events (P>0.05). Conclusion Sotagliflozin can significantly reduce HbA1c, FBG, 2hPG, SBP, and BM in T2DM patients without increasing the risk of hypoglycemia or the incidence of adverse reactions. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (12): 1125-1130.   DOI: 10.3969/j.issn.1004-583X.2024.12.012 Abstract （97）   HTML （5）    PDF（pc） （907KB）（123）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Association of urinary transferrin with new-onset cardiovascular disease in type 2 diabetes mellitus Ma Jiannan, Tao Jie, Sang Dasen, Wu Shouling, Zhang Qi Clinical Focus    2024, 39 (8): 700-705.   DOI: 10.3969/j.issn.1004-583X.2024.08.004 Abstract （140）   HTML （8）    PDF（pc） （1135KB）（116）       Knowledge map    Save Objective To explore the correlation between urinary transferrin to urinary creatinine ratio (uTRF/Cr) and new onset cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). Methods A total of 8 163 T2DM patients who participated in the 6th health examination in Kailuan and underwent urinary transferrin and urinary creatinine detection were recruited. Subjects were divided into the first group (n=2 721), the second group (n=2 721), and the third group (n=2 721) based on baseline uTRF/Cr. The effects of uTRF/Cr on the risk of CVD were analyzed by multivariate Cox regression model. Results The baseline age of the study population was (60.46±9.96) years, with 78.30% of males, and 0.24(0.16-0.47) mg/mmol of baseline uTRF/Cr. The median follow-up time was 3.85(3.43-4.22) years, with 411(6.79%) of CVD events occurred. The cumulative incidence of total CVD events in the first, second and third groups was 3.81%, 4.65%, and 7.29%, respectively. After adjusting for relevant influencing factors, the risk of total CVD events in the second and third groups of uTRF/Cr was 1.12(95%CI 0.86-1.46) times and 1.52(95%CI 1.18-1.97) times that in the first group, respectively. Conclusion Increased uTRF/Cr is an independent risk factor for CVD in T2DM populations, and the risk of CVD increases with increased uTRF/Cr, even before the onset of macroalbuminuria. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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A case report of adult MOGAD and literature review Zhong Yuan, Meng Fenglei Clinical Focus    2025, 40 (1): 70-75.   DOI: 10.3969/j.issn.1004-583X.2025.01.011 Abstract （100）   HTML （4）    PDF（pc） （1403KB）（116）       Knowledge map    Save Objective To discuss the clinical manifestations, magnetic resonance imaging (MRI) features, MOG-IgG testing, diagnostic criteria, treatment and prognosis of myelin oligodendrocyte glycoprotein (MOG)-associated disease (MOGAD). Methods We reported a case of adult MOGAD, and reviewed relevant literatures. Results A 38-year-old female presented with headache and blurred vision in both eyes for three days. She had a history of prodromal fever. The head MRI showed lesions and enhancement in the thalamus, basal ganglia, cerebral peduncle, and brainstem. Serum and cerebrospinal fluid antibody testing showed a weak positive MOG IgG at a 1:10 ratio in both serum and cerebrospinal fluid. She was diagnosed with MOGAD, mainly manifested as optic neuritis and brainstem encephalitis. The combination therapy of corticosteroid and rituximab was given, and the patient's symptoms were completely disappeared at the 4-month follow-up. Conclusion MOGAD is a rare, antibody-mediated infl ammatory demyelinating disorder of the central nervous system (CNS) with cardinal features of optic neuritis, myelitis, brainstem encephalitis, cerebral cortical encephalitis (often with seizures) and acute disseminated encephalomyelitis. New diagnostic criteria for MOGAD have recently been proposed by an international panel of experts in 2023. MOG-IgG detection is the key to diagnosing MOGAD. There is no clear guideline for MOGAD treatment. About 50% of patients will experience a recurrence. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Comparative study on the clinical efficacy of different antiviral drugs in the treatment of COVID-19 Wu Wanfeng, Wang Yunyun, Yang Daokun Clinical Focus    2025, 40 (2): 147-152.   DOI: 10.3969/j.issn.1004-583X.2025.02.009 Abstract （146）   HTML （1）    PDF（pc） （860KB）（116）       Knowledge map    Save Objective To explore the clinical efficacy of different antiviral drugs in the treatment of Coronavirus Disease 2019 (COVID-19). Methods A total of 456 COVID-19 patients admitted to Jincheng People's Hospital from February 2023 to June 2023 were selected for the study. According to the random number method, they were randomly divided into group A (treated with azvudine, n=152), group B (treated with nirmatrelvir/ritonavir, n=152) and group C (treated with simnotrelvir/ritonavir, n=152). The clinical efficacy, symptom and sign recovery time, mortality, lung imaging, complete blood count (white blood cell count [WBC], absolute neutrophil count [ANC], and lymphocyte count [LYC]), CT values (mRNA levels) of the ORF1ab and N genes, and adverse events were observed. Results There were no significant differences in the clinical efficacy, symptom and sign recovery time, CT values of the ORF1ab and N genes, mortality, time required for lung imaging improvement, and negative conversion time of nucleic acid testing among groups A, B and C (P>0.05). After treatment, WBC and ANC significantly decreased, and LYC significantly increased in all the three groups, although intergroup comparisons did not show significant differences (P>0.05). The total incidence of adverse events was 15.12%(23/152) in group A, 16.44%(25/152) in group B, and 13.80% (21/152) in group C. There was no significant difference in the total incidence of adverse events among groups A, B and C (P>0.05). Conclusion Azvudine, nirmatrelvir/ritonavir, and simnotrelvir/ritonavir have significant antiviral effects against COVID-19, although leading to some adverse events and medication restrictions. Therefore, when using the above drugs in clinical practice, the specific conditions and medication risks of patients should be fully considered, and a strict compliance and medication guidance are essential, aiming to ensure patient's safety and efficacy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Efficacy and safety of anticoagulant therapy in patients with cirrhosis: A meta-analysis Su Rui, Wang Cunkai, Wang Dingxin, Cai Conghui, Zhang Jian, Hou Hongtao, Bai Yun Clinical Focus    2025, 40 (4): 293-303.   DOI: 10.3969/j.issn.1004-583X.2025.04.001 Abstract （97）   HTML （11）    PDF（pc） （1999KB）（115）       Knowledge map    Save Objective To investigate the efficacy and safety of anticoagulant therapy and prophylactic anticoagulant therapy in cirrhosis patients with or without portal vein thrombosis (PVT). Methods Literature searchs were conducted using PubMed, Cochrane, Embase, Web of Science, CNKI, Wanfang, and VIP databases, and relevant references were also reviewed. The included literatures were assessed for quality and data extraction. A meta-analysis was conducted using Revman5.3 and Stata14.0. Results Twenty-three eligible articles were included in 3423 retrieved articles. In patients with cirrhosis and PVT, the PVT recanalization rate in the anticoagulant therapy group was significantly higher than that of the non-anticoagulant group (OR=3.39, 95%CI: 2.59-4.44, P<0.001), without an increase in adverse events. The PVT recanalization rate of direct oral anticoagulants (DOAC) was significantly higher than that of traditional anticoagulants (OR=39.49, 95%CI: 9.65-161.68, P<0.001), and the rate of major bleeding was significantly lower than that of traditional anticoagulants (OR=0.35, 95%CI: 0.13-0.97, P=0.04). In patients with cirrhosis without PVT, the rate of PVT formation in the prophylactic anticoagulation group was significantly lower than that of non-anticoagulant group (OR=0.15, 95%CI: 0.05-0.43, P<0.001), with no difference of bleeding between groups (OR=1.96, 95%CI: 0.72-5.30, P=0.19), but the all-cause mortality rate in the prophylactic anticoagulation group was significantly lower (OR=0.51, 95%CI: 0.43-0.60, P<0.001). Conclusion Anticoagulant therapy can treat or prevent PVT in patients with cirrhosis and is a relatively safe treatment. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Cortical “ribbon sign” on DWI in adults: A case report and literature review Zhang Yingqiu, Zhang Jin, Ge Shihao, Chen Junmin Clinical Focus    2024, 39 (9): 821-824.   DOI: 10.3969/j.issn.1004-583X.2024.09.010 Abstract （152）   HTML （3）    PDF（pc） （1059KB）（114）       Knowledge map    Save Objective To investigate the clinical characteristics of cortical “ribbon sign” on diffusion-weighted imaging (DWI). Methods The clinical data, relevant examination data, and imaging data of a case of cortical “ribbon sign” were analyzed, and relevant literatures were reviewed. Results The patient was admitted to the hospital due to involuntary grasping of objects with a walking instability for 10 days, and aggravated for 2 days. Brain imaging examination showed cortical “ribbon sign”, manifesting as a high signal intensity along the cerebral sulcus on T1-weighted imaging, DWI and fluid-attenuated inversion recovery sequence. The increase in signal intensity was pronounced on DWI sequence, reflecting the cytotoxic edema of the cerebral cortex. Symptomatic treatment was performed. The patient's symptoms gradually worsened and died about half a year later. Conclusion Cortical ribbon sign is a typical imaging change of laminar necrosis of the cerebral cortex, usually observed in vascular, infectious, metabolic, and toxic nerve system diseases. A deep mining of the pathogenesis and causes of cortical ribbon sign favors the clinical diagnosis and differentiation diagnosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2023, 38 (8): 757-762.   DOI: 10.3969/j.issn.1004-583X.2023.08.015 Abstract （233）   HTML （2）    PDF（pc） （942KB）（114）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2024, 39 (9): 861-864.   DOI: 10.3969/j.issn.1004-583X.2024.09.019 Abstract （196）   HTML （9）    PDF（pc） （897KB）（113）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Effect of serum s100A4 levels on polycystic ovary syndrome in patients with polycystic ovary syndrome Ren Yumei, Zhang Qiu, Hu Honglin Clinical Focus    2023, 38 (12): 1078-1085.   DOI: 10.3969/j.issn.1004-583X.2023.12.004 Abstract （159）   HTML （5）    PDF（pc） （1026KB）（111）       Knowledge map    Save Objective To detect serum S100A4 levels in patients with polycystic ovary syndrome (PCOS) and explore the effects of S100A4 on the development. Methods One hundred twenty-nine women of childbearing age with PCOS were enrolled into PCOS group from December 2021 to June 2023 at the Department of Endocrinology of the First Affiliated Hospital of Anhui Medical University, and 47 healthy women of childbearing age with regular menstrual cycles and no hyperandrogenemia, who underwent routine medical examinations at the hospital in the same period, were as the normal control group (NC group). According to the levels of body mass index (BMI) and glucose metabolism, the PCOS group was assigned into PCOS-over BIM group, PCOS-normal BIM group, PCOS-normal glucose metabolism group and PCOS-abnormal glucose metabolism group, respectively. The general data, S100A4 levels, and other biochemical indicators were collected, and the differences of clinical data between groups were compared. Results The serum S100A4 level of PCOS group was significantly higher than that of the NC group ( P<0.01). There was a significant difference in serum S100A4 levels amongNC group, PCOS-normal BIM group and PCOS-over BIM group ( P<0.01), which was significantly higher in the latter two groups than that of NC group ( P<0.05). There was a significant difference in serum S100A4 levels among NC group, PCOS-normal glucose metabolism group and PCOS-abnormal glucose metabolism group( P<0.01), which was significantly higher in the latter two groups than that of NC group ( P<0.05). Spearman related analysis results showed that serum S100A4 levels were negative correlation with homeostasis model assessment- β (HOMA-β) and positively correlated with low-density lipoprotein cholesterol (LDL-C) ( P<0.05). Multi-factor logistic regression analysis showed that S100A4 was the influencing factor for the occurrence of PCOS in women of childbearing age ( O R=1.046, 95% C I: 1.015-1.078, P<0.05). The area under receiver operating characteristic (ROC) curve for serum S100A4 levels predicting PCOS was 0.681, and its optimal cutoff value was 0.176 ng/ml ( P<0.01). Conclusion The increase in serum S100A4 in PCOS patients was related to obesity, insulin resistance, and abnormal lipid metabolism, and involving the development of PCOS. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (3): 275-280.   DOI: 10.3969/j.issn.1004-583X.2025.03.015 Abstract （80）   HTML （3）    PDF（pc） （884KB）（108）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Analysis of risk factors for refractory Mycoplasma pneumoniae pneumonia in children Yu Zeyu, Lin Xi, Chen Zhanghua, Yang Wei, Chen Zhimin, Zhang Hai Clinical Focus    2024, 39 (1): 43-46.   DOI: 10.3969/j.issn.1004-583X.2024.01.007 Abstract （167）   HTML （2）    PDF（pc） （921KB）（106）       Knowledge map    Save Objective To analyze risk factors for refractory M y c o p l a s m a p n e u m o n i a e pneumonia (RMPP) in children. Methods A total of 67 children with RMPP who were admitted in the Department of Paediatrics, Luoyuan County Hospital from January 2020 to September 2023 were enrolled in the case group. During the same period, 134 children with common M y c o p l a s m a p n e u m o n i a e pneumonia and complete clinical data were selected in the control group. Children in both groups were initially treated with macrolide antibiotics. Univariate and multivariate logistic regression analyses were used to analyze the risk factors for RMPP in children. The predictive potentials of risk factors for RMPP in children were assessed by plotting the receiver operating characteristic (ROC) curves. Results Decreased albumin, decreased platelet count, heat peak≥40 ℃, lactate dehydrogenase≥500 U/L, and lobar pneumonia changes on pulmonary imaging were risk factors for RMPP in children. The area under the curve (AUC) and cut-off value of risk factors were as follows: albumin<40 g/L (AUC=0.765, 95% C I=0.803-0.901), lactate dehydrogenase≥500 U/L (AUC=0.753, 95% C I=0.772-0.877), platelet count<120×109/L (AUC=0.821, 95% C I:0.761-0.868), heat peak≥40 ℃ (AUC=0.750, 95% C I: 0.685-0.807), and lobar pneumonia changes on pulmonary imaging (AUC=0.541, 95% C I: 0.469-0.611). Conclusion RMPP should be alerted in children with albumin<40 g/L, platelet count<120×109/L, heat peak≥40 ℃, lactate dehydrogenase≥500 U/L, and lobar pneumonia changes on pulmonary imaging. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Trilaciclib combined with chemotherapy in the treatment of extensive-stage small cell lung cancer: A case report and literature review Wang Yinfeng, Li Manxiang Clinical Focus    2025, 40 (4): 355-359.   DOI: 10.3969/j.issn.1004-583X.2025.04.011 Abstract （63）   HTML （2）    PDF（pc） （1512KB）（105）       Knowledge map    Save Objective To study the effect of trilaciclib combined with chemotherapy on extensive small cell lung cancer (ES-SCLC). Methods A case of ES-SCLC patient treated with trilaciclib combined with chemotherapy in the First Affiliated Hospital of Xi'an Jiaotong University was retrospectively reviewed, and the related literatures were reviewed. Results The 56-year-old female patient was diagnosed with ES-SCLC of the left lung, large airway stenosis, and type I respiratory failure. She developed severe myelosuppression after receiving rescue chemotherapy, and gradually recovered after 11 days of drug administration and blood transfusion. After 5 cycles of chemotherapy combined with trilaciclib, severe myelosuppression was not reported, and chemotherapies were successfully completed. Conclusion The administration of trilaciclib within 4 h before chemotherapy in ES-SCLC patients can effectively reduce the degree of bone marrow suppression, shorten the duration of bone marrow suppression, and increase the tolerance to chemotherapy drugs without adverse impacts on the efficacy, suggesting clinical promotion. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (6): 570-576.   DOI: 10.3969/j.issn.1004-583X.2025.06.016 Abstract （26）   HTML （2）    PDF（pc） （970KB）（104）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Clinical Focus    2025, 40 (4): 381-384.   DOI: 10.3969/j.issn.1004-583X.2025.04.016 Abstract （48）   HTML （3）    PDF（pc） （363KB）（103）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Systematic review and meta-analysis of contrast-enhanced ultrasound in diagnosing hepatic echinococcosis Pu Wutao, Xiao Yixin, Tuo Li, Kailibinuer·Muti , Fan Xueting, Chong Le Clinical Focus    2025, 40 (3): 197-204.   DOI: 10.3969/j.issn.1004-583X.2025.03.001 Abstract （116）   HTML （10）    PDF（pc） （2209KB）（103）       Knowledge map    Save Objective To systematically evaluate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in diagnosing hepatic echinococcosis. Methods By searching keywords combined with free words, articles reporting CEUS in diagnosing hepatic echinococcosis published before June 2023 were searched in the databases, including Pubmed, EMBASE, Cochrane Library, CBM, CNKI, Wanfang and CQVIP. According to the inclusion and exclusion criteria, eligible articles were screened. Data of general information, true positive, false positive, false negative, and true negative were extracted from the included articles. Using the QUADAS-2 tools to assess the included studies. Meta-disc1.4 and RevMan5.4 software were used for meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were calculated. The diagnostic odds ratio(OR) and area under the SROC curve (AUC) were calculated. Stata14.0 software was used to draw the Galbraith plot to perform heterogeneity analysis on the research data. Results According the inclusion and exclusion criteria, 7 articles were included with 348 patients. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic OR and AUC of CEUS in diagnosing hepatic echinococcosis was 0.96 (95%CI 0.92-0.98), 0.88(95%CI 0.79-0.93), 5.73 (95%CI 1.24-26.58), 0.07 (95%CI 0.03-0.18), 95.32(95%CI 22.02-412.60), and 0.9767, respectively. According to the pooled sensitivity, specificity and AUC, CEUS had a high diagnostic efficacy in diagnosing hepatic echinococcosis. The Galbraith plot showed that all articles were distributed on both sides of the solid red effect line and within the green confidence interval range, indicating no overall heterogeneity in this study. Conclusion CEUS has a high efficacy in the diagnosis of hepatic echinococcosis and can serve as a new method for clinical diagnosis of hepatic echinococcosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Construction of a nomogram to predict the risk of lung metastasis in extremity osteosarcomas based on the SEER database and its validation Wang Zhuangzhuang, Ren Huan, Liu Yanting, Tian Chunlei, Ai Wenbing Clinical Focus    2024, 39 (5): 413-419.   DOI: 10.3969/j.issn.1004-583X.2024.05.005 Abstract （166）   HTML （3）    PDF（pc） （1206KB）（103）       Knowledge map    Save Objective To construct a nomogram to predict the risk of lung metastasis in patients with extremity osteosarcomas. Methods Clinical data of 1 610 extremity osteosarcoma patients were acquired from the National Cancer Institute’s Surveillance, Epidemiology, and End Results database from 2010 to 2020. The data were assigned into the training dataset and validation dataset at a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for the occurrence of lung metastasis in patients with extremity osteosarcomas. A nomogram to predict risk factors for lung metastasis in patients with extremity osteosarcomas was then constructed based on the results of multivariate logistic regression analysis. Its performance was assessed by the receiver operating characteristic curve, calibration curve, and decision curve analysis (DCA). Results Logistic regression analysis showed that advanced T staging, lymph node metastasis, refusal of surgery and treatment of radiotherapy and chemotherapy were independent risk factors for lung metastases in patients with extremity osteosarcomas (P<0.05). The area under the curve of the nomogram in predicting lung metastasis of extremity osteosarcomas was 0.801 and 0.640 in the training dataset and validation dataset, respectively. The calibration curve and DCA showed the good accuracy and a high net benefit over a wide range of probability thresholds, respectively. Conclusion We created a nomogram to predict lung metastasis in patients with extremity osteosarcomas, showing high accuracy and feasibility. It assists orthopedists to make a faster and more reliable prediction and provide an individualized treatment. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Risk factors for constipation in patients with chronic kidney disease in Gansu province: a single-center study Pu Qian, Cheng Gang, Dao Jiecao, Qi Zizhao, Dou Lele, Zhao Junfang, Zhang Wenjun, Guo Caixia, Wang Yingying Clinical Focus    2025, 40 (1): 44-53.   DOI: 10.3969/j.issn.1004-583X.2025.01.007 Abstract （110）   HTML （3）    PDF（pc） （1033KB）（102）       Knowledge map    Save Objective To investigate the prevalence of constipation among patients with chronic kidney disease (CKD) in Gansu province, and to analyze potential risk factors. Methods CKD patients in the Department of Nephrology and Dialysis Center & Clinical Medical School of the Second Hospital, Lanzhou University were surveyed by a constipation questionnaire developed according to the Rome III criteria during the two periods of July 2022 to August 2022, and January 2023 to February 2023 via the WJX platform. At the same time, demographics, hemodialysis-related data, laboratory parameters, and use of drugs such as iron and phosphorus binders were collected. Results Totally 279 adult CKD patients older than 18 years were enrolled, including 191 hemodialysis patients and 88 non-dialysis patients. The prevalence of constipation in CKD stage 1-2, 3-4, and 5 patients was 36.2%, 45.8%, and 29.8%, respectively. Univariate Logistic regression analysis showed that primary diabetic nephropathy (OR=4.694, 95% CI 1.436-15.350, P=0.011) was a significant risk factor for constipation in non-dialysis patients. High serum triglyceride (TG) (OR=1.493, 95% CI 1.082-2.060, P=0.015) was a risk factor for constipation in CKD patients receiving hemodialysis. The risk factors for constipation in CKD patients included the use of phosphorus binding agents (OR=1.669, 95% CI 1.001-2.784, P=0.049) and use of iron agents (OR=1.745, 95% CI 1.047-2.909, P=0.033), high serum glucose (Glu)(OR=1.070, 95% CI 1.008-1.135, P=0.026) and TG (OR=1.254, 95% CI 1.017-1.546, P=0.034). Multivariate Logistic regression showed that female (OR=3.258, 95% CI 1.022-10.386, P=0.046) and diabetic nephropathy (OR=13.863, 95% CI 1.815-105.901, P=0.011) were independent risk factors for constipation in non-dialysis patients. In addition, diabetic nephropathy (OR=2.137, 95% CI 1.015-4.499, P=0.046) was a risk factor for constipation in CKD patients. Conclusion Diabetic nephropathy is an independent risk factor for constipation in CKD patients. The female gender represents an independent risk factor for constipation in non-dialysis patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Evidence summary of the application of the diary method in adult ICU patients Wang Yu, Peng Lili, Shi Yao, Du Yunhong, Duan Yuliang, Wang Li Clinical Focus    2024, 39 (9): 780-786.   DOI: 10.3969/j.issn.1004-583X.2024.09.002 Abstract （159）   HTML （4）    PDF（pc） （1158KB）（101）       Knowledge map    Save Objective To systematically screen, evaluate, summarize and extract the optimal evidence for the application of the diary method in adult patients in the intensive care unit (ICU), so as to provide evidence-based basis for the implementation of the diary method in ICU. Methods All the evidence on the application of the diary to adult ICU patients were searched in relevant professional websites and databases at home and abroad, including the guidelines, evidence summary, expert consensus, systematic reviews, clinical decisions, etc. The retrieval time was from the establishment of the database to January 25, 2024. Two researchers independently conducted literature screening, quality evaluation, data extraction, classification and evidence summary according to the topic. Results A total of 13 articles were included, with 1 expert consensus, 2 guidelines and 10 systematic reviews. The optimal evidence for the application of diary method in ICU adult patients was formed, including 8 dimensions (application cognition, application effect, target population, writers, diary content, writing notes, application guidance and diary management) and 32 pieces of evidence. Conclusion Medical staff should carefully select appropriate evidence according to the corresponding clinical situation, and a multidisciplinary team cooperation should be carried out to yield the optimal individualized evidence practice of the diary method in ICU. Table and Figures | Reference | Related Articles | Metrics | Comments（0）