Establishment of risk prediction model for acute myocardial infarction in elderly patients with hyperuricemia / 中华老年医学杂志

Objective:To establish a risk prediction model of acute myocardial infarction(AMI)in elderly patients with hyperuricemia(HUA).Methods:A total of 148 elderly patients with HUA in Shanghai Fourth People's Hospital Affiliated to Tongji University for prospective study from March 2020 to March 2021 were divided into AMI group and non-AMI group according to whether they were complicated with AMI.The baseline data of patients were recorded at admission and compared between the two groups.Multivariate Logistic regression analysis was used to examine the risk factors for AMI in elderly patients with HUA.And AMI risk prediction model was established.The ROC curves were plotted.Using the ROC curve, the prediction efficiency of AMI risk prediction model was evaluated.Results:Among 148 elderly patients with HUA, 22 cases(14.86%)had AMI.The proportion of smoking history in AMI group was higher than non-group( χ2=6.192, P=0.013). The diastolic blood pressure, systolic blood pressure, fasting blood glucose(FPG), low density lipoprotein cholesterol(LDL-C), serum uric acid(SUA)and homocysteine(Hcy)were statistically significantly higher in AMI group than in non-AMI group( U=1.973, 2.652, 2.016, 1.364, 2.151, 2.973, 5.972, P=0.049, 0.008, 0.044, 0.032, 0.003, <0.001). The multiple Logistic regression analysis showed that smoking history, high DBP, high SBP, high FPG, high LDL-C, high SUA and high Hcy were risk factors for AMI in elderly HUA patients( OR=3.120, 1.072, 1.887, 2.358, 3.365, 1.031, 3.773, P=0.016, 0.001, <0.001, 0.008, 0.028, 0.001, <0.001). By substituting the risk factor index and the regression coefficient into the Logistic regression equation formula, the obtained final fitting equation was: AMI=1.138×smoking history(no=0, yes=1)+ 0.070×DBP+ 0.635×SBP+ 0.858×FPG+ 1.213×low density lipoprotein+ 0.030×SUA+ 1.328×Hcy.The ROC curve was drawn and showed that the AUC of forecast value of AMI risk prediction model in predicting the risk of AMI in elderly HUA patients was 0.847, >0.80, which had certain predictive value.Hosmer-Leme show goodness of fit test χ2=5.743, P=0.676, P>0.05, the model had good correction ability and satisfactory fitting. Conclusions:AMI in elderly hyperuricemia patients are affected by multiple risk factors.The AMI risk prediction model is established via combining with multiple risk factors.The model has certain efficiency in predicting the occurrence of AMI in elderly patients with hyperuricemia.

Effect of adipose-derived mesenchymal stem cells (ADSC) on the T cell immune status of allergic rhinitis mouse model / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the regulation of adipose-derived mesenchymal stem cells (ADSC) on helper T cells and regulatory T cells in allergic rhinitis(AR) mouse model and the underlying mechanisms.</p><p><b>METHODS</b>Using random number table, 60 Balb/c mice were divided into 6 groups (represented by: sensitized/challenged/treated ), they were the experimental group 1(OVA/OVA/high dose ADSC), the experimental group 2(OVA/OVA/low dose ADSC), the experimental group 3(OVA/OVA/PBS), the experimental group 4(OVA/OVA/0), the control group 1(PBS/PBS/0) and the control group 2(0/0/0). The mouse ADSC were isolated and cultured through conventional method, and AR mouse model was built with OVA and aluminum. The mice were injected with high (3×10(6)), low (1×10(6)) ADSC respectively labeled by CM-Dil for 3 consecutive days via tail-vein injection and sacrificed 48 hours later. Finally, levels of IL-4, IL-6, IL-10 and IFN -γ in serum were examined by ELISA; expressions of the four cytokines in spleen were examined by q RT-PCR; migration of ADSC to mouse model nasal mucosa were observed through fluorescence microscope; eosinophil infiltration were observed by the nasal HE staining.</p><p><b>RESULTS</b>Mouse ADSC was isolated, cultured and identified successfully. There was significant difference in symptom scores of AR models (compared with 0/0/0 group, P<0.01). The IL-4 and IL-6 levels of OVA/OVA/high ADSC group were significantly lower than OVA/OVA/0 group (group 1: (17.95±7.78), (27.51±5.93) pg/ml; group 4: (56.82±9.12), (70.03±7.22) pg/ml), the IFN-γ and IL-10 levels increased significantly (group 1: (367.74±13.79), (417.10±72.40) pg/ml; group 4: (199.46±11.25), (122.50±15.57) pg/ml) in serum. These differences were statistically significant(P<0.01). Compared with OVA/OVA/low ADSC group, the IL-4 and IL-6 levels decreased significantly (group 1: (17.95±7.78), (27.51±5.93) pg/ml; group 2: (41.57±12.27), (56.21±9.23)pg/ml) of OVA / OVA / high ADSC group, and the IFN-γ and IL-10 increased significantly (group 1: (367.74±13.79), (417.10±72.40)pg/ml; group 2: (281.77±30.41), (203.45±87.10) pg/ml). These differences were statistically significant(P<0.01). At the same time, the corresponding changes observed at the levels of the cytokines' mRNA. ADSC labeled by CM-Dil could migrate to the mouse nasal mucosa. OVA/OVA/high ADSC group showed the more red fluorescence than the OVA/OVA/low ADSC group. The eosinophils in nasal mucosa of the two groups reduced compared with the normal control.</p><p><b>CONCLUSION</b>ADSC injected via tail-vein can migrate to nasal mucosa and play non-specific immune effects, that may to effect the releases of some cytokines then to regulate the Th1/Th2 imbalance and the function of Treg cell, finally that be dose-related in a certain extent.</p>

The role of Nods like receptors in the patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore role of Nods (nucleotide-binding oligomerization domain Nod Like receptors) kind of pattern recognition receptors (PRR) in patients with allergic rhinitis.@*METHOD@#The mRNA and protein of Nod1, Nod2 of Nalp3 were analyzed in the turbinate mucosa of patients with allergic rhinitis, nasal septum deviation (NSD) nasal mucosa of patients and nasal polyp mucosa with Real-Time RT-PCR, Western blot and immunohistochemistry respectively, and Nod1 expression changes was explored in PBMC with wad explored Western-blot and then the level of IL-4, IL-6, IL-10, IFN-γ were detected in serum of AR after desensitization treatment.@*RESULT@#These Nods like receptors, mainly found in nasal mucosa epithelial cells, glandular epithelium and inflammatory cells (e. g. plasma cells, eosinophils), were expressed in the nasal mucosa tissues. In AR group, Nod1 (mRNA and protein) expression were lower than NSD group (P0.05.@*CONCLUSION@#Nod1, Nod2 and Nalp3 expression were seen in the two groups,and the Nod1 expression in allergic rhinitis group was lower than other two groups, while, the Nalp3 was higher than other two groups. It showed Nod1, Nalp3 may be involved in the pathogenesis of allergic rhinitis. Expression of Nod1 in PBMC reduced after sublingual desensitization treatment. Besides, the change of Nod1 was negatively correlated with the change of IL-10 in PBMC. So,it seemed that Nod1 may regulate IL-10 changes and be involved in sublingual desensitization therapy.

Role of Nods like receptors in the patients with nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and role of a new pattern-recognition receptors (PRR), nucleotide binding oligomerization domain (Nod) like receptors (NLRs), in the patients with nasal polyps and nasal septum normal control group.@*METHOD@#The expressions of Nod1, Nod2 and Nalp3 mRNA and protein were explored with real-time RT-PCR, Western-Blot and immunohistochemistry respectively.@*RESULT@#The protein levels of Nod1, Nod2 and Nalp3 were expressed in nasal polyp and the control, but the expression of Nod1 and Nalp3 in nasal polyps were higher than those in control. No significant difference of Nod2 was seen between the two groups. And then, there was no significant difference of Nod1, Nod2, Nalp3 mRNA between two groups with Real-time RT-PCR.@*CONCLUSION@#The expression of Nod1 and Nalp3 are increased in nasal polyp tissues and maybe a etiological factors in the formation of nasal polyps.

Effect of nasal epithelial lining prognosis and turnover changed by vesicles molecular immuno-pathology after nasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe Effect of nasal epithelial lining prognosis and turnover changed by vesicles molecular immuno-pathology after nasal endoscopic surgery.@*METHOD@#Forty patients (80 sides) with chronic nasal polyps in accordance with the EPOS standard after endoscopic sinus surgery were randomly divided into treatment group and control group according to weather scraping the vesicles. Compared the speed of epithelialization of nasal cavity mucosa in the two groups. Observed the pathological features of vesicles through HE staining and transmission electron microscopy. Divided the treatment group into 1-3 weeks group, 6-8 weeks group and 11-14 weeks group. And make the inferior turbinate mucosa and nasal polyps during surgery the control group. Compared the level of vascular endothelial growth factor(VEGF) and transforming growth factor beta1 (TGF beta1) between the groups.@*RESULT@#Vesicles were divided into mild groups and moderate to severe groups according to the sizes and amonts. Vesicles in moderate to severe groups were faster epithelialization than the mild groups, 1.5 weeks shortened on average (P < 0.05). There wes no significant difference between the two groups in mild group. The level of TGF beta1 in the nasal polyps, 1-3 weeks group and 6-8 weeks group were significantly higher than the inferior turbinate mucosa and 11-14 weeks group (P < 0.05). The level of VEGF in the nasal polyps, 6-8 weeks group were significantly higher than the inferior turbinate mucosa, 1-3 weeks group and 11-14 weeks group (P < 0.05). Vesicles were displayed discontinuous basal membranes, interstitial edama, infiltration of inflammatory cells, increased pathological glands, abnormal microtubule structure, reduction of mitochondrials.@*CONCLUSION@#Vesicles is a dynamic process, which may predict the increased levels of inflammatory factors (VEGF and TGF beta1) and contribute to some of the patheologic changes observed in nasal polyps. The level of VEGF and TGF beta1 in vesicles after endoscopic sinus surgery can be used as indicators of prognosis. Treating the moderate to severe vesicles after surgery is benefit to the epithelium of the nasal mucosa.

Nosocomial Bacterial Infection in Patients with Systemic Lupus Erythematosus:An Analysis of Clinical Features and Risk Factors / 中华医院感染学杂志

OBJECTIVE To investigate the clinical features and risks factors of nosocomial bacterial infection in patients with systemic lupus erythematosus(SLE).METHODS Five hundred and ninety-seven patients with SLE were classed into two groups,the group of nosocomial bacterial infection and the control group according to the results of bacteriological examinations.A comparison was performed between the two groups.RESULTS According to the infection sites,36% occurred in the respiratory tract and lungs,29.0% in the urinary tract,19.9% in the blood system and 15.1% in other tissues and organs.From them,75.8% onsets of nosocomial bacterial infection were chronic or insidious.The pathogens of nosocomial bacterial infection were mostly opportunistic,45.6% were G-bacilli,40.9% G+cocci and 13.9% were other bacteria.The eight major risk factors included lung disease,the more than 3 damaged organs or systems,plasma albumin under 30 g/L,long application of large dose glucocorticoid(GC),treatment of super-dose GC,therapeutic alliance of GC and cytotoxic immunosuppressant usage,use of broad-spectrum antibiotics before hospitalization and the time in hospital over 3 weeks.CONCLUSIONS The respiratory tract and lungs are the commonest site of nosocomial bacterial infection in patients with SLE.Most of the pathogens may be opportunistic of G-bacilli and G+cocci.The clinical features are untypical.It may decrease the incidence of the nosocomial bacterial infection to diminish by decreasing dose and the course of GC treatment after the patient's condition improved,select prudently application of super-dose GC,therapeutic alliance of GC and cytotoxic immunosuppressants,cautiously use of broad-spectrum antibiotics and shorten the duration of hospitalization.

Clinical analysis of 41 cases with the late onset of systemic lupus erythematosus / 中华老年医学杂志

Objective To investigate the clinical manifestations and laboratory findings of patients with the late onset systemic lupus erythematosus(LOSLE) and the elderly onset SLE. Methods Forty one patients with SLE onset beyond the age of 50 years(including 20 patients SLE onset beyond the age of 60 years) were identified and compared with 41 patients who had SLE onset before the age of 50 (General SLE). Patients in the group of general SLE were selected by 1 to 1 individual matching according to sex, course of diseases, date of admission. The presenting clinical features, laboratory findings, incidence rate of complication, efficacy of glucocorticoid and the prognosis of patients in two groups of LOSLE and general SLE were compared and analyzed. In addition, 20 cases of elderly onset SLE were also compared and analyzed. Results There were significant differences in symptoms between groups of LOSLE and General SLE. The LOSLE group had less occurrence of rash (39 0% vs 73 2%, P