This study was aimed to investigate the effects of the introplasmic interferon-γ level in circulating T cell of patients with aplastic anemia (AA) and its clinical significance. The interferon-γ level before and after immuno-suppressive therapy was monitored by flow cytometry. The results indicated that the higher interferon-γ level was detected in 28 out of 50 AA patients, detected rate was 56%. The effective rate of immunosuppressive therapy for AA patients with higher interferon-γ level was up to 85.7% (24/28). The decrease of interferon-γ level in these patients positively correlated with hemogram recovery to normal level and obviously earlier than hematologic remission. It is concluded that the immunosuppressive therapy shows better efficacy for AA patients with high interferon-γ level, moreover the change of interferon-γ level is earlier than hematologic change, that is important for predicting the therapeutic efficacy and relapse of disease.
Happiness is the continuous joy that people experience when they are satisfied with their lives long term, and is the ultimate goal pursued by all citizens. In this study, we investigate the relationship between education, income, and happiness in the migrant population in China. Using 1,31,186 individuals in the 2012 China Migrants Dynamic Survey (CMDS) as research samples, the estimated results of ordinal logistic regression show that education, including secondary education and higher education, has a significant and direct impact on individual happiness, and that the impact of education on happiness can also be mediated by income as an intermediary mechanism. In addition, factors such as gender, flow distance, flow time, employment status, type of housing, number of children, degree of preference for the city, and degree of discrimination by locals have obvious effects on happiness. This work provides important insights for countries seeking to implement an active education policy in order to increase economic income and thus achieve the development goal of universal happiness among their citizens.
all sensitivity and specificity of a PPI test were 80% (95% confidence interval [CI], 71%-87%) and 74% (95% CI, 64%-83%), respectively, compared with 19% (95% CI, 12%-29%) and 77% (95% CI, 62%-87%), respectively, in the placebo group. The PPI test showed a significant higher discriminative power, with a summary diagnostic odds ratio of 19.35 (95% CI, 8.54-43.84) compared with 0.61 (95% CI, 0.20-1.86) in the placebo group. The impact of the prevalence of GERD and treatment duration on the accuracy of the test could not be determined because of the lack of an adequate number of studies. Conclusion: The use of PPI treatment as a diagnostic test for detecting GERD in patients with NCCP has an acceptable sensitivity and specificity and could be used as an initial approach by primary care physicians to detect GERD in selected patients with NCCP. Arch Intern Med. 2005;165:1222-1228
Introduction Pension insurance is an essential safeguard for the quality of life and health of older adults because it provides a stable and dependable source of income after retirement. China has constructed a multi-level social security system to accommodate the diverse needs of older adults, and offers various levels of pension insurance to maximize their interests. Methods This study uses propensity score matching and ordinary least squares techniques to analyze 7,359 data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) in order to explore the relationship between different pension insurance categories and the health of older individuals. Results The research findings reveal that advanced insurances greatly benefit the health of older adults more than basic pension insurances, and the findings pass the robustness test. In addition, the effect was found to be heterogeneous, depending on the location of retirement and the marital status of older adults.Our findings suggest that both material and non-material consumption may be potential mechanisms by which pension insurance affects the health of older adults, providing new evidence for the causal mechanism between pension insurance and the health of older adults. Discussion This study expands the scope of research on the health effects of pension insurance by covering a large representative sample across the country. The results show the important impact of the level of pension insurance on the health of older adults and can contribute to the development of social policies to promote the physical and mental health of older adults.
Gastroesophageal reflux disease (GERD) is common in patients with noncardiac chest pain (NCCP). Results of studies evaluating the accuracy of a proton pump inhibitor (PPI) treatment as a diagnostic test for GERD-related NCCP have varied. We evaluated the overall accuracy of this modality.
Methods
We searched the PubMed, MEDLINE, EMBASE, CINAHL, and Cochrane databases to May 2004 and included randomized, placebo-controlled studies evaluating the accuracy of findings from PPI testing in the diagnosis of GERD in patients with NCCP. The GERD diagnosis was confirmed by results of endoscopy and/or 24-hour esophageal pH monitoring. A summary diagnostic odds ratio and summary receiver operating characteristic curve analysis were used to estimate the overall accuracy and to explore any contributing factors.
Results
Six studies met the inclusion criteria. The overall sensitivity and specificity of a PPI test were 80% (95% confidence interval [CI], 71%-87%) and 74% (95% CI, 64%-83%), respectively, compared with 19% (95% CI, 12%-29%) and 77% (95% CI, 62%-87%), respectively, in the placebo group. The PPI test showed a significant higher discriminative power, with a summary diagnostic odds ratio of 19.35 (95% CI, 8.54-43.84) compared with 0.61 (95% CI, 0.20-1.86) in the placebo group. The impact of the prevalence of GERD and treatment duration on the accuracy of the test could not be determined because of the lack of an adequate number of studies.
Conclusion
The use of PPI treatment as a diagnostic test for detecting GERD in patients with NCCP has an acceptable sensitivity and specificity and could be used as an initial approach by primary care physicians to detect GERD in selected patients with NCCP.
Objective: To explore the clinical and laboratory features of multiple myeloma(MM) . Methods: Clinical and labortory data of 82 previously untreated patients with MM were analyzed. Results: In MM subgroup A and B, patients with Bence Jones pro-teinuria were 20% and 51. 9% , respectively( P 0. 01), patients of stage El were 67. 3% and 92. 6% , respectively( P 0. 05), patients with serum p2-MG56 mg/L were 43. 8% and 87. 5%, respectively(P 0. 01), and patients with serum Ca2. 98 mmol/L were 5. 5% and 25. 9%, respectively( P 0. 025). In the groups of combinding plasmablast with immature plasmacyte and combinding intermediate with mature plasmacyte, patients with Hb level 85g/L were 82. 4% and 40% respectively( P 0. 025), patients with serum p2-MG 6 mg/L were 87. 5% and 20% respectively( P 0. 005), and patients with^30% bone marrow plasma-cell (BMPC) were 76. 5% and 32. 0% respectively( P 0. 025) . Elder patients( 65 years) among the groups of complete or partial response, improvement and disease progression were 30% , 32. 6% and 37. 5% respectively! P 0. 05). Conclusion: Patients with IgA myeloma have hyperviscosity more usually than patients with IgG myeloma. Thrombocytopenia is rare in early phase of myeloma; The incidence of hypercalcemia was low. Renal insufficiency was more common in patients with Bence Jones proteinuria, stage HI, hypercalcemia and increased serumb2-MG. Lower Hb, higher b2-MG level and higher BMPC were more common in the group of combingding plasmablast with immature plasmacyte.
Treatments consisting of dexamethasone with a 5‐HT3 receptor antagonist (5‐HT3RA) or metoclopramide are commonly used for controlling delayed chemotherapy‐induced nausea and vomiting (CINV). We evaluated systematically the efficacy of these treatments for preventing delayed CINV. We undertook a meta‐analysis of studies that met the following entry criteria: randomized clinical trials comparing dexamethasone and a 5‐HT3RA versus dexamethasone alone or dexamethasone with metoclopramide for preventing delayed CINV; same prophylactic treatment must be used for acute CINV. A comprehensive literature search was conducted. Of 54 potentially useful studies, eight reports met the criteria and were analyzed. The overall total protection from delayed CINV was similar between patients receiving a 5‐HT3RA combined with dexamethasone (53.2%, 454/853) and dexamethasone alone (53.3%, 450/844), yielding a relative risk (RR) of 1.03 (95% CI 0.97–1.09). Similar efficacy between the two treatment groups was also observed for preventing delayed nausea [RR 1.03 (95% CI 0.98–1.09)] and vomiting [RR 1.03 (95% CI 0.99–1.07)]. No significant difference in the efficacy of preventing delayed CINV was observed between patients receiving dexamethasone combined with either a 5‐HT3RA or metoclopramide. We conclude that treatments consisting of dexamethasone and a 5‐HT3RA or metoclopramide have similar efficacy to dexamethasone alone for preventing delayed CINV.
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