Relação entre a Razão Nitrogênio Ureico/Creatinina e Prognóstico de Insuficiência Cardíaca em Todo o Espectro da Fração de Ejeção / Relationship between BUN/Cr and Prognosis of HF Across the Full Spectrum of Ejection Fraction

Resumo Fundamento Em pacientes com insuficiência cardíaca (IC), devido à relativa deficiência do volume sanguíneo, a ativação do sistema neuro-hormonal leva à vasoconstrição renal, que afeta o teor de nitrogênio ureico (NU) e creatinina (C) no organismo, sendo que NU e C são facilmente afetados por outros fatores. Portanto, a razão NU/C pode ser utilizada como mais um marcador para o prognóstico da IC. Objetivo Explorar o prognóstico do desfecho adverso da IC no grupo NU/C alta em comparação com o grupo NU/C baixa em todo o espectro da fração de ejeção. Métodos De 2014 a 2016, pacientes sintomáticos hospitalizados com IC foram recrutados e acompanhados para observar desfechos cardiovasculares adversos. Foram realizadas análise logística e a análise COX para determinar a significância. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados Na análise de regressão logística univariada, o grupo NU/C alta apresentou maior risco de desfecho adverso na insuficiência cardíaca com fração de ejeção reduzida (ICFEr) e insuficiência cardíaca com fração de ejeção preservada (ICFEp). A análise de regressão logística multivariada mostrou que o risco de morte cardíaca no grupo ICFEr foi maior do que no grupo NU/C baixa, enquanto o risco de morte por todas as causas foi significativo apenas em 3 meses (p<0,05) (Ilustração Central). O risco de morte por todas as causas no grupo NU/C alta no grupo ICFEP foi significativamente maior do que no grupo NU/C baixa em dois anos. Conclusão O grupo NU/C alta está relacionado ao risco de mau prognóstico da ICFEP, não sendo inferior ao valor preditivo da fração de ejeção do ventrículo esquerdo (FEVE).

Abstract Background In patients with heart failure (HF), due to the relative deficiency of blood volume, neurohormone system activation leads to renal vasoconstriction, which affects the content of blood urea nitrogen (BUN) and creatinine (Cr) in the body, while BUN and Cr are easily affected by other factors. Therefore, BUN/Cr can be used as another marker for the prognosis of HF. Objective Explore the prognosis of adverse outcome of HF in the high BUN/Cr group compared with the low BUN/Cr group across the full spectrum of ejection fraction. Methods From 2014 to 2016, symptomatic hospitalized HF patients were recruited and followed up to observe adverse cardiovascular outcomes. Logistic analysis and COX analysis were performed to determine significance. p-values <0.05 were considered statistically significant. Results In the univariate logistic regression analysis, the high BUN/Cr group had a higher risk of adverse outcome in heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Multivariate logistic regression analysis showed that the risk of cardiac death in the HFrEF group was higher than that in the low BUN/Cr group, while the risk of all-cause death was significant only in 3 months (p<0.05) (Central Illustration). The risk of all-cause death in the high BUN/Cr in the HFpEF group was significantly higher than that in the low BUN/Cr group at two years. Conclusion The high BUN/Cr group is related to the risk of poor prognosis of HFpEF, and is not lower than the predictive value of left ventricular ejection fraction (LVEF).

A study on weight of indicators for evaluating service capacity of maternal and child health care institution at county level / 预防医学

Objective To obtain the weight coefficient of indicators for evaluating the service capacity of maternal and child health care institution at county level.Methods Expert scoring method and CRITIC method were used to calculate the subjective weight coefficient and objective weight coefficient respectively,then comprehensive weight coefficient of each indicator was calculated.Results A total of 25 indicators were selected,among which the minimum comprehensive weight coefficient was 0.033 4 and the maximum was 0.050 4.The 5 lowest weight coefficient indicators were the proportion of financial subsidies accounted for general income (X12),number of equipment valued above 10,000 Yuan (X7),number of available beds (X6),annual person -time number of hospitalization (X22)and annual person -time number of outpatient and emergency treatment (X21).The 5 highest weight coefficient indicators were the outpatient expenditure each time (X25),mortality rate of pregnant and lying -in women (X18),proportion of medical expenditure accounted for total expenditure (X13),indicators of the average hospital stay each time (X9)and diagnosis coincidence rate of hospital admission and discharge (X19).Conclusion This weight coefficient of indicators focuses more on the public health service and the comprehensive weight coefficient calculated by combining subjective weighting method and objective weighting method is more reasonable.

The enhancement of DNA binding ability of a mutated E2 (A338V) protein of HPV-2 / 病毒学报

HPV-2 is a very common type of HPV which causes common warts. The E2 protein of virus can repress the activity of the viral early promoter through binding to the specific binding sites in viral LCR. Previously we reported that the repression of a mutated E2 protein of HPV-2 isolated from a patient with huge common wart on the viral early promoter was obviously decreased, and A338V mutation located at the C terminal DNA binding region of E2 protein. In this study, we expressed and purified the recombinant mutated and prototype E2 fusion proteins, both in the contexts of the C terminal and the full length, by prokaryotic expression system. The electrophoretic mobility shift assay showed E2 protein could bind to double-stranded DNA oligos labeled with biotin that covered two E2 binding sites. The DNA binding abilities of both C terminal and full-length mutated E2 proteins were stronger than the prototype analogs. This result indicates that the enhancement of the mutated E2 DNA binding ability may be the molecular mechanism for its impact on the activity of viral promoter, which correlates with the phenotype of extensive common wart.

Oral acute toxicity of (+)-usnic acid in mice and its cytotoxicity in rat cardiac fibroblasts / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the oral acute toxicity of of (+)-usnic acid in mice and assess its cytotoxicity in rat cardiac fibroblasts.</p><p><b>METHODS</b>The mice with acute poisoning of (+)-usnic acid at different doses by oral administration were observed for toxic manifestations, and the LD(50) was determined. The survival time and survival rate of the mice receiving different doses of (+)-usnic acid were observed. Cultured rat cardiac fibroblasts were inoculated with different concentrations of (+)-usnic acid, and the cell growth inhibition rate was estimated and the IC(50) determined using MTT assay.</p><p><b>RESULTS</b>Higher dose of (+)-usnic acid resulted in more obvious symptoms of poisoning and shorter survival time of the mice. The LD(50) of (+)-usnic acid in mice by oral administration was 388 mg/kg. The manifestations of poisoning such as apathism, pilomotor, chill, dyspnea, torpidity and anorexia was observed. Rat cardiac fibroblasts incubated with (+)-usnic acid showed obvious growth inhibition, which was positively correlated to the dose of (+)-usnic acid, and high dose of (+)-usnic acid caused severe cell injuries. The IC(50) of (+)-usnic acid in rat cardiac fibroblasts was 322 microg/ml.</p><p><b>CONCLUSION</b>(+)-usnic acid is a natural compound of low toxicity in mice, and low to medium dose of (+)-usnic acid dose not produce obvious cytotoxicity.</p>

Molecular epidemiological study on prevalence of human papillomaviruses in patients with common warts in Beijing area / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the circulation, distribution, and genomic diversity of HPVs in common warts in Beijing area of China.</p><p><b>METHODS</b>Forty eight patients with pathologically diagnosed common warts were screened for the presence of HPV with HPV type-specific PCR and direct sequencing analysis. The genomic diversity of HPVs prevalent in Chinese patients was analyzed based on LCR.</p><p><b>RESULTS</b>Forty one (85.5%) samples were positive for HPV DNA, 13 (31.7%)--HPV-57, 12 (29.3%)--HPV-1a, 7 (17%)--HPV-27 and 5(12.2%)--HPV-2a. Four cases were infected with two different HPV types, two (4.9%) with HPV-1a and HPV-27, one (2.4%) with HPV-1 and HPV-57 and one (2.4%) with HPV-27 and HPV-57. In contrast to the prevalence of single strain of novel HPV-57 variant and HPV-1 prototype, two HPV-2 and three HPV-27 novel variants were found to circulate in Beijing.</p><p><b>CONCLUSION</b>HPV-1, -2, -27 and -57 are predominantly prevalent in patients with common warts in Beijing.</p>

Inactivation of bacterial spores using low-temperature plasma / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of low-temperature plasma on inactivation of bacterial spores and explore the mechanism.</p><p><b>METHODS</b>Dielectric barrier discharge (DBD) was employed to generate the atmospheric low-temperature plasma for treatment of B.subtilis var. niger spores with the gas spacing of 3, 4 and 5 and treatment time intervals of 5, 10, 15, 20, 25, 30 and 35 s. The survived colonies was counted with plate counting method, and the killing log value (KLV) at different treatment times was calculated. The inactivation effect of electric field on B.subtilis var.niger spores was also investigated and the spores treated with low-temperature plasma were observed with transmission electron microscope.</p><p><b>RESULTS</b>With the gap spacing of 3, 4 and 5 mm, the KLV of low-temperature plasma on B.subtilis var.niger spores within 25, 30 and 35 s of exposure was more than 5. The germicidal effects of the electric field on B. subtilis var.niger spores were rather poor. Transmission electron microscopy demonstrated total destruction of the surface and interior structure of the spores by low-temperature plasma.</p><p><b>CONCLUSIONS</b>Low-temperature plasma is effective for inactivation of the bacterial spores with a time and dose dependence. The penetrating effect of charged particles and oxygenation effect of the reactive oxygen species might play a dominant role in plasma-induced bacterial spore inactivation, while the role of electric field is negligible.</p>

A new algorithm for ultrasound image speckle suppression / 中国医疗器械杂志

Ultrasound image has a lot of speckle noise, which brings great difficulties to the feature extraction, recognition and analysis. Especially in the edge extraction, the conventional extraction algorithms are difficult to achieve the desired results because of the speckle noise. To solve this problem, an algorithm based on the anisotropic diffusion equation is presented. The new algorithm combines the robust estimation and considers the characteristic of the speckle noise, so it can suppress the speckle noise effectively and be more robust, thus the edge details of the ultrasound image can be preserved even enhanced, which can provide effective safeguard for the following edge extraction. Furthermore, the paper proposes a new method to compute speckle scale coefficients automatically, which reduces the influence of the human beings, and enhances the stability of the algorithm.

Bactericidal activity of GLL-37, a novel derivative of the human antimicrobial peptide LL-37 / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To develop and investigate GLL-37, a substitution analogue of the human antimicrobial peptide LL-37 with anti-enzymatic degradation activity and improved efficacy.</p><p><b>METHODS</b>The bactericidal activities of LL-37 and newly developed GLL-37 against 6 Gram-negative and -positive bacteria were determined by Broth microdilution assays. The minimum inhibitory concentrations of LL-37 and GLL-37 against E.coli ATCC 25922 in different NaCl concentration medium were also detected. Both peptides were co-incubated with elastase, and then analyzed by PAGE electrophoresis and bactericidal activity determination.</p><p><b>RESULT</b>GLL-37 showed a stronger elastase resistance ability than LL-37, and was significantly more effective than LL-37 under high-salt condition.</p><p><b>CONCLUSION</b>The antimicrobial peptide GLL-37 derived form LL-37 has the potential as a new therapeutic agent for bacterial infections.</p>

Breast tumor classification based on serial grayscale ultrasound images / 中国医疗器械杂志

This paper proposes an algorithm of evaluating the compression depth, and then to extract four normalized mammary elasticity characteristic parameters with respect to the compression depth. The classification experiments show that these elasticity parameters have a good capability in determining whether the tumor is benign or malignant, and if combined with morphological parameters, the accuracy, sensitivity and specificity can be improved and increased to 95.19%, 98.82% and 92.16%, respectively.

Segmentation of the prostate ultrasound image based on an improved geodesic active contour model / 中国医疗器械杂志

In this paper, we propose that, the need of the costly re-initialization procedure can be completely eliminated by using the variation formulation, thus increasing the speed of computing operations. The edge detecting function in the geodesic active contour model is improved by incorporating a prior knowledge. The accuracy of the segmentation algorithm can be enhanced by using the minimal variance. Experimental results show that the proposed algorithm can segment the prostate ultrasound images effectively and avoid the problem of contour leakage.

Three domains filtering for medical ultrasound images denoising / 中国医疗器械杂志

A filtering algorithm is proposed to deal with the medical ultrasonic image series in video format, which uses the relativity in spatial domain, gray value domain and temporal domain simultaneously. For each frame image, the relativity in spatial domain and gray value domain is utilized to construct the adaptive neighborhood first. Then the spatial weighted and gray value weighted filtering is performed in this neighborhood. Finally, the temporal relativity between the adjacent frames is used to perform the temporal weighted filtering. All the weighted filtering in the three domains uses Gaussian kernel, thus the filtering sensitivity resulting from the threshold selection is reduced, and the stability of the algorithm is enhanced. As it can be seen from the experimental results, the three-domains filtering algorithm can suppress the noise effectively, and the edge details can be reserved well. So it is useful for the feature extraction, recognition and analysis.

Diagnosis of prostate cancer using SVM-based ultrasound images / 中国医疗器械杂志

This paper presents a computer-aided diagnosis method for prostate cancer detection using Trans-rectal ultrasound(TRUS) images. Firstly, statistical texture analysis is implemented in every ROI in segmented prostate images. From each ROI, grey level difference vector features, edge-frequency features and texture features in frequency domain are constructed. Then, the number of features is reduced using ANOVA statistics to select the optimal feature subset. Finally, SVM is applied to the selected subset for detecting the cancer regions. Experimental results show that the proposed algorithm can recognize and detect the cancer images effectively so as to supply essential information for a diagnosis.

Transcriptional repressive activity of mutated E2 protein of human papillomavirus 2 (HPV-2) variant / 病毒学报

Common warts are close associated with HPVs infection. In this study, we amplified and sequenced the LCR fragment and E2 gene of HPV-2 that infected the patient of extensive common wart with cutaneous horns, and we constructed the recombinant CAT-reporter plasmids pBLCAT-LCR containing HPV-2 prototype or variant LCR and mammalian expression plasmids pcDNA3. 1-E2 containing prototype or variant E2 ORF individually. The promoter activities of HPV-2 variant and the transcriptional repression activities of the mutated E2 protein were evaluated by transient transfection into HeLa cells. The results showed that there were several mutations in LCR and E2 gene of HPV-2 variant. Compared with the prototype, the viral early promoter activity of variant was significantly increased uder the control of LCR. Compared with the wild type E2 protein, the transcriptional repression activities of the mutated E2 protein was abolished partially. We speculate herein that increased promoter activities and decreased repression effect of the mutated E2 protein are linked, at least partially, with the clinical phenotypes of the uncommon huge common wart.

Brain CT texture classification with tree-structured wavelet transform / 中国医疗器械杂志

This paper proposes a tree-structured wavelet algorithm for brain CT texture feature extraction. This algorithm is used to analyse subimages automatically and to choose the optimum subimage for feature extraction. Experimental results show that this algorithm can improve the performance of brain CT texture feature extraction.

Segmentation of breast tumor ultrasound images based on an improved C-V model / 中国医疗器械杂志

This paper proposes an improved C-V model, which can avoid the step of re-initialization and simplify the formation of the initial level set function, thus the speed of segmentation can be accelerated greatly. Furthermore, based on the grayscale distribution characteristics of the breast tumor ultrasound images and on the hypothesis of piecewise constant in the C-V model, a semiautomatic segmentation flow has been presented, in which the rough contour is sketched first, and then a subimage would be obtained for the refined segmentation algorithm. This flow has improved not only the accuracy, but also the efficiency of the segmentation algorithm. The experiments show that the proposed algorithm could extract the contour of the breast tumor from the ultrasound images efficiently and accurately, which is fundamentally important for the following target feature extraction and analysis.

Analgesic effect of interleukin-2 in mouse models of spared nerve injury / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the analgesic effect of interleukin-2 (IL-2) in mice with spared nerve injury (SNI).</p><p><b>METHOD</b>IL-2 was intraperitoneally injected in mice with induced SNI, and von Frey Filaments test and cold plate test were carried out to accesses the analgesic effects of IL-2 and the effect of naloxone in antagonizing the effects of IL-2.</p><p><b>RESULTS</b>IL-2 produced analgesic effects against hyperalgesia and allodynia in mouse models of SNI, and the effect of IL-2 lasted for more than 24 h, showing a double-peak pattern in its action with the two peaks occurring at 30 and 105 min, respectively. The effect of IL-2 could be significantly antagonized by naloxone.</p><p><b>CONCLUSIONS</b>IL-2 has long-lasting analgesic effects in mouse models of SNI model, showing a double-peak pattern of its action. The analgesic effect of IL-2 is probably mediated by opiate receptor.</p>

Algorithm for automatic quantification of brain atrophy with computed tomography / 中国医疗器械杂志

In this paper, a new, fully-automatic method for the quantification of brain atrophy based on CT volume data is put forward by taking advantage of the characteristics of cerebral CT images in combination with the prior medical knowledge. This algorithm has been verified through the calculation of 2388 cases of normal and brain atrophy subjects.

Study on the relationship between level of CD58 expression in peripheral blood mononuclear cell and severity of HBV infection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>As one of the intercellular adhesion molecules, CD58 plays important roles in promotion of the adhesion between T cells and target cells, hyperplasia, activation of T cells and natural killer cells, and balance between Th1 and Th2. We studied the relationship between the levels of CD58 expression in peripheral blood mononuclear cells (PBMCs) and severity of HBV infection.</p><p><b>METHODS</b>The levels of CD58 mRNA in PBMCs were detected using quantitative reverse transcription PCR. The percentage of CD58 positive cells was detected by flow cytometry in patients and healthy controls.</p><p><b>RESULTS</b>The levels of CD58 mRNA and the percentage of CD58 positive cells in patients infected with HBV were significantly higher than that in the control. Based on severity of HBV infection, the patients were classified into four groups. The expression of CD58 increased significantly in an order from mild chronic, moderate chronic, severe chronic to severe hepatitis groups. The levels of CD58 mRNA and the percentage of CD58 positive cells in PBMCs from patients with HBV infection were both positively correlated with serum levels of ALT and AST.</p><p><b>CONCLUSION</b>The level of CD58 expression is related with the severity of HBV infection and the degree of liver damage.</p>

Effects of allogeneic hepatic nonparenchymal cell on the survival of grafted skin in mice / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of allogene hepatic nonparenchymal cell (NPC) on the survival of grafted skin in mice and its underlying mechanism.</p><p><b>METHODS</b>Sixty-five C(3)H and fifty-eight C(57)BL/6 mice were employed in the study. Twenty C(3)H mice were used as skin donor and forty as the source of hepatic NPC. The rest five served as the stimulators of mixed lymphocyte culture (MLC) before and on the 7th, 18th, 30th, and 60th day after NPC infusion with 1 at each time point. MLC was determined and expressed as count per minute (CPM). Fifty-eight C(57)BL/6 mice were further divided into experimental (E, n = 50) and control groups (C, n = 8). The mice in C group only underwent skin grafting without NPC infusion. The mice in E group received with 2 x 10(7) NPC via caudal vein, followed by peritoneal injection of cytoxan (200 mg/kg) 48 hours later; They were grafted with skin donated from C(3)H mice 18 days after injections. The survival time of the mice in the two groups was observed. The serum levels of interleukin-4, chimera and MLC in the two groups were determined before and on 7th, 18th, 30th, 60th days after NPC infusion, and micro-chimera were aslo assessed on the 1st and 3rd day after NPC infusion. Five mice were sacrificed at each time point.</p><p><b>RESULTS</b>The survival time of skin graft in E group (70.0 +/- 17.2 day) was obviously longer than that in C group. The serum levels of IL-4, chimera in E group were increased gradually, while MLC response decreased gradually. The serum IL-4 level reached 251.5 +/- 11.0 ng/L and splenic chimera level to 26.30 +/- 1.04% on the 60th day after NPC infusion.</p><p><b>CONCLUSION</b>The high levels of IL-4 and chimera might play important roles in inducing and maintaining immune tolerance.</p>

An investigation on staff's opinions on community health services in Ganzhou City / 中华全科医师杂志

Objective To investigate the knowledge and opinions of the staff in community health service centers.Methods Staff in Ganjiang,Jiefang and Nanwai community health service centers of Zhanggong District,Ganzhou City,Jiangxi Province were interviewed with questionnaire based on meeting by chance by trained interviewers about their opinions on 10 aspects of community health services.The data were evaluated by score method and factors influencing the score were studied with logistic regression analysis.Results Generally,the staff's evaluation for community health services was high,satisfying with colleagues' cooperation,professional training and service capacities in 95.96% ,90.91% and 88.88% of them,respectively.But their satisfaction with personal income and staff' s income was poor(24.24% and 43.43%).Staff for logistics were not so satisfied with their personal income.Staff for logistics and senior staff were not so active in their professional training.Conclusions The staff in community health service centers could better understand community health services with satisfaction.Incentive mechanism for the staff in community health services should be introduced with optimized management system to increase staff's income and sustain its stable development.