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Objective:To establish a 180-day mortality predictive score based on frailty syndrome in elderly sepsis patients [elderly sepsis score (ESS)].Methods:A prospective study for sepsis patients aged 60 years and above who were admitted to a medical intensive care unit of the General Hospital of Southern Theatre Command from January 1st, 2018 to December 31st, 2018 was conducted. Univariate analysis was performed on 19 independent variables including gender, age, body mass index (BMI), tumor, charlson comorbidity index (CCI), activity of daily living (ADL), instrumental activity of daily living (IADL), mini-mental state examination (MMSE), geriatric depression scale (GDS), clinical frail scale (CFS), sequential organ failure assessment (SOFA), Glasgow coma scale (GCS), acute physiology and chronic health evaluation (APACHEⅡ, APACHEⅣ), modified NUTRIC score (MNS), multiple drug resistance (MDR), mechanical ventilation (MV), continuous renal replacement therapy (CRRT) and palliative care. Continuous independent variables were converted into classified variables. Multivariate binary regression analysis of risk factors was conducted to screen independent risk factors which affecting 180-day mortality in elderly sepsis patients. Then a 180-day mortality predictive score was established, and the discrimination of the mortality of patients using CFS, SOFA, GCS, APACHEⅡ, APACHEⅣ, MNS scores were compared.Results:A total of 257 patients were enrolled, with a 180-day mortality of 60.7%. Univariate analysis showed that age, tumor, CCI, ADL, IADL, MMSE, CFS, SOFA, GCS, APACHEⅡ, APACHEⅣ, MNS, MDR, MV, CRRT, palliative care were risk factors of 180-day mortality in elderly sepsis patients [age: odds ratio ( OR) = 1.027, 95% confidence interval (95% CI) was 1.005-1.050, P = 0.018; tumor: OR =2.001, 95% CI was 1.022-3.920, P = 0.043; CCI: OR = 1.193, 95% CI was 1.064-1.339, P = 0.003; ADL: OR = 0.851, 95% CI was 0.772-0.940, P = 0.001; IADL: OR = 0.894, 95% CI was 0.826-0.967, P = 0.005; MMSE: OR = 0.962, 95% CI was 0.937-0.988, P = 0.004; CFS: OR = 1.303, 95% CI was 1.089-1.558, P = 0.004; SOFA: OR = 1.112, 95% CI was 1.038-1.191, P = 0.003; GCS: OR = 0.918, 95% CI was 0.863-0.977, P = 0.007; APACHEⅡ: OR = 1.098, 95% CI was 1.053-1.145, P < 0.001; APACHEⅣ: OR = 1.032, 95% CI was 1.020-1.044, P < 0.001; MNS: OR = 1.315, 95% CI was 1.159-1.493, P < 0.001; MDR: OR = 2.029, 95% CI was 1.197-3.437, P = 0.009; MV: OR = 6.408, 95% CI was 3.480-11.798, P < 0.001, CRRT: OR = 2.744, 95% CI was 1.529-4.923, P = 0.001, palliative care: OR = 5.760, 95% CI was 2.177-15.245, P < 0.001]. By binary regression analysis, CFS stratification ( OR = 1.934, 95% CI was 1.267-2.953, P = 0.002), MV ( OR = 4.531, 95% CI was 2.376-8.644, P < 0.001), CRRT ( OR = 2.471, 95% CI was 1.285-4.752, P = 0.007), palliative care ( OR = 6.169, 95% CI was 2.173-17.515, P = 0.001) were independent risk factors of 180-day mortality in elderly patients with sepsis. The model of "ESS = 0.660×CFS stratification+1.511×MV+0.905×CRRT+1.820×palliative care" was established. Receiver operating characteristic curve (ROC curve) analysis showed that the area under the ROC curve (AUC) for predicting 180-day mortality by ESS was 0.785 (95% CI was 0.730-0.834, P < 0.001). When the best cut-off value was 2.2 points, its sensitivity was 78.9%, specificity was 70.3%, the positive predictive value was 80.4%, and the negative predictive value was 68.3%. Simplified ESS was defined as "0.5×CFS stratification+1.5×MV+1×CRRT+2×palliative care". ROC curve analysis showed that AUC for predicting 180-day mortality by simplified ESS was 0.784 (95% CI was 0.729-0.833, P < 0.001). When the best cut-off value was 2.0 points, sensitivity was 76.9%, specificity was 70.3%, the positive predictive value was 80.0%, and the negative predictive value was 66.4%. Compared with CFS, SOFA, GCS, APACHEⅡ, APACHEⅣ and MNS, ESS had a significant difference in discriminating 180-day mortality in elderly patients with sepsis (AUC was 0.785 vs. 0.607, 0.607, 0.600, 0.664, 0.702, 0.657, 95% CI: 0.730-0.734 vs. 0.537-0.678, 0.537-0.677, 0.529-0.671, 0.598-0.730, 0.638-0.766, 0.590-0.725, all P < 0.05). Conclusions:CFS, MV, CRRT, and palliative care are independent risk factors of 180-day mortality in elderly patients with sepsis. We established ESS based on these risk factors. The ESS model has good discrimination and can be used as a reference and assessment tool for prediction and treatment guidance in elderly patients with sepsis.
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PURPOSE: To explore the effects of biodegradable magnesium alloy stents (BMAS) on remodeling of vein graft (VG) anastomotic restenosis. MATERIALS AND METHODS: To establish a VG restenosis model, seventy two New Zealand rabbits were randomly divided into three groups according to whether a stent was implanted in the graft vein or not. BMASs and 316L stainless steel stents were implanted in BMAS and 316L groups, respectively, while no stent was implanted in the no-treatment control group (NC group). Loss of lumen diameter in the graft vein was measured in all three groups. Upon harvesting VG segments to evaluate intimal proliferation and re-endothelization, the degradation and biological safety of the stents were observed to explore the effects of BMAS on VG remodeling. RESULTS: Model establishment and stent implantation were successful. The BMAS reduced lumen loss, compared with the control group (0.05±0.34 mm vs. 0.90±0.39 mm, p=0.001), in the early stage. The neointimal area was smaller in the BMAS group than the 316L group after 4 months (4.96±0.66 mm2 vs. 6.80±0.69 mm2, p=0.017). Re-endothelialization in the BMAS group was better than that in the 316L group (p=0.001). Within 4 months, the BMAS had degraded, and the magnesium was converted to phosphorus and calcium. The support force of the BMAS began to reduce at 2–3 months after implantation, without significant toxic effects. CONCLUSION: BMAS promotes positive remodeling of VG anastomosis and has advantages over the conventional 316L stents in the treatment of venous diseases.
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Rabbits , Alloys , Calcium , Magnesium , Phosphorus , Stainless Steel , Stents , Transplants , VeinsABSTRACT
Background Immediately ocular rinsing is a key step for the prevention of eye tissue damage after acute chemical bums.A good ophthalmic rinsing solution can neutralize chemical substance and improve the prognosis of patients.Objective This study attempted to evaluate the therapeutic effect of self-made citric aciddisodium hydrogen phosphate buffer and citric acid-disodium hydrogen phosphate-potassium chloride buffer on corneal chemical burns in mice.Methods Citric acid-disodium hydrogen phosphate buffer solution (solution 1) and citric acid-disodium hydrogen phosphate-potassium chloride buffer solution (solution2) with the pH 7.4 were prepared.One hundred and twenty clean male C57 mice aged 6-8 weeks were randomized to two groups,and filter papers containing 1 mol/L H2SO4 or 0.15 mol/L NaOH were attached to the central corneas of the right eyes to create the acid or alkali burning models.Then the eyes were immediately rinsed by 40 ml solution 1,tap water or solution 2 according to the grouping and the model eyes without rinsing served as the control group.The corneal opacity was examined by slit lamp microscope and scored in 3,7 and 14 days after modeling.The percentages of corneal fluorescein staining,corneal neovascularization and corneal ulcer were analyzed.The study protocol was approved by Experimental Animal Ethic Commission of Second Military Medical University.Results In the corneal acid burning models,the number of eye with corneal opacity scored 1 in the solution 1 group,tap water group and solution 2 group was significantly more than that in the non-rinsing group in 3,7 and 14 days after modeling (all at P＜0.01);In 3 days after modeling,the numbers of eye scored 1 were more in the solution 1 group than those in the tap water group and solution 2 group (x2 =11.000,P =0.001;x2 =4.000,P =0.046).There were no differences in the eye number of different corneal opacity scores in 14 days after acid burning (all at P＞0.05).In 3,7 and 14 days after corneal alkali burning,the number of eyes with corneal opacity scored 1-2 was significantly increased in the solution 1 group,tap water group and solution 2 group compared with non-rinsing group (all at P＜0.01).The percentage of corneal ulcer in the solution 1 group,tap water group and solution 2 group was 7％,27％ and 13％,respectively,which was significantly lower than 73％ in the non-rinsing group (P =0.000,0.027,0.003),and no significant differences were seen in various time points after corneal alkali burning (all at P＞O.05).Corneal neovascularization occurred in 50％ mice in non-rinsing group in 14 days after acid burning.However,no neovascularization was seen in the mice of the solution 1 group,tap water group and solution 2 group in both acid and alkali burning mice.Conclusions Citric aciddisodium hydrogen phosphate buffer (pH 7.4) appears to be an effective emergency rinsing solution for corneal chemical burns and the rinsing solution with or without potassium chloride is not obviously affected to the prognosis of corneal chemical burns in the mice.
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OBJECTIVE:To investigate the clinical efficacy of levodopa combined with comprehensive therapy for ametropic amblyopia children and teenagers and its effeets on pattern visual evoked potential(P-VEP)and visual function. METHODS:70 pa-tients(80 eyes)with ametropic amblyopia were randomly divided into observation group(35 cases,40 eyes)and control group(35 cases,38 eyes). Control group received comprehensive therapy as wearing correctional glasses,occlusion therapy and visual stimu-lation training;observation group additionally received levodopa 0.125(d1-3)-0.25 g/time,bid,on the basis of control group for 6 months. Therapeutic efficacy,P-VEP,Visual sensitivity and visual function were compared between two groups,and the occur-rence of ADR was recorded. RESULTS:The effective rate of observation group(92.50%)was significantly higher than that of con-trol group(76.32%),with statistical significance(P0.05). CONCLUSIONS:Levodopa combined with comprehensive therapy can improve the function of visual central neurons,and improve visual acuity and binocular stereo vision functions so as to improve therapy efficacy.
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Objective To evaluate the association between matrix metalloproteinase‐1 (MMP‐1)‐1 607 bp 1G/2G and matrix metalloproteinase‐3(MMP‐3)‐1 171 bp 5A/6A polymorphisms in promoter regions and susceptibility to ovarian cancer by Meta‐a‐nalysis .Methods Case‐control studies with regards of relationship between MMP‐1‐1 607 bp 1G/2G ,MMP‐3‐1 171 bp 5A/6A pol‐ymorphisms in promoter regions and susceptibility to ovarian cancer were searched in electronic databases .Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the association between polymorphisms and susceptibility .RevMan5 .0 software was applied for data analysis .Results Eight studies ,containing 5 studies for MMP‐1 and 3 studies for MMP‐3 ,were selected .For MMP‐1‐1 607 bp 1G/2G ,OR(95% CI)=0 .95 (0 .74-1 .21) ,P=0 .67 under 1G/1G :1G/2G+2G/2G model ,OR(95% CI)=0 .93 (0 .70-1 .23) ,P=0 .60 under 1G/1G :2G/2G model ,OR(95% CI)=0 .99 (0 .87-1 .14) ,P=0 .91 under 1G :2G model;for MMP‐3‐1 171 bp 5A/6A ,OR(95% CI)=0 .97(0 .68-1 .38) ,P=0 .85 under 5A/5A+5A/6A :6A/6A model .Overall ,there was statisti‐cal significance .Conclusion It is still not confirmed that significant association between the MMP‐1‐1 607 bp 1G/2G and MMP‐3‐1 171 bp 5A/6A polymorphisms in promoter regions and susceptibility to ovarian cancer exists in current literature .
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Objective To investigate the influence of serum containing Qingre Chubi Decoction ( QCD) on the THP-1 cell viability and the release of interleukin 1 beta ( IL-1β) stimulated by monosodium urate crystals in vitro. Methods The cultured human monocyte THP-1 strain were divided into blank serum group, model control group, and high-, middle- and low-concentration ( volume fraction being 20%, 10%, 5%) QCD-containing serum groups. Except for the blank serum group , the other groups were all given 500 mg/L of monosodium urate crystals. On culturing hour 0, 12, 24 and 48, THP-1 cell viability was tested by methy1 thiazolyl tetrazolium celorimetry ( MTS) method. On culturing hour 48, the content of IL-1β in the supernatant of THP-1 cells was detected by enzyme-linked immunosorbent assay ( ELISA) . Results The THP-1 cell viability in various groups was increased along with the prolongation of culturing time. The THP-1 cell viability in the model control group was increased as compared with that in the blank serum group at different time points (P<0.05 or P<0.01) . And the content of IL-1β in the model control group was increased significantly as compared with that in the blank serum group on culturing hour 48 (P<0.01) . The THP-1 cell viability in various QCD-containing serum groups on culturing hour 12 and 24, and in high- and middle-concentration QCD-containing serum group on culturing hour 48 was decreased significantly as compared with that of the model control group at the same time point ( P<0.05 or P<0.01) . The content of IL-1β in various serum containing QCD groups was markedly decreased as compared with that in the model control group on culturing hour 48 ( P<0.01) . Conclusion Serum containing QCD can inhibit the viability of THP-1 cells stimulated by monosodium urate crystals, and the possible mechanism is related with the inhibition of IL-1 release.
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Objective To evaluate the association of angiotensin (AGT ) gene M235T polymorphism with essential hypertension (EH) .Methods The literatures examining the association of the M 235T polymorphisms with EH were selected in electronic data-bases .Using RevMan5 .0 ,heterogeneity and pooled effect sizes were calculated .Results Totally ,29 articles ,with 5 971 cases and 6 443 controls were finally included in this study .The odds ratio (OR) value of TT+ TM∶MM genotype was 1 .13 (95% CI 1 .00-1 .25 ,P=0 .04) in worldwide populations .Subgroup analysis showed that the OR values of TT ∶MM genotype were 1 .13 (95% CI 0 .90-1 .42 ,P=0 .28) in subjects published before 2008 and 1 .29(95% CI 0 .94-1 .75 ,P=0 .11) in those after 2008(year of 2008 included) .The OR values of T ∶M in Han population was 1 .24 (95% CI 1 .01-1 .53 ,P=0 .04) .Conclusion TT+ TM genotype of the M235T polymorphisms is associated with EH in worldwide populations ,and T allele is also correlated with EH in Han popu-lation .
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Denoising is an important issue for medical image processing. Based on the analysis of the Non-local means algorithm recently reported by Buades A, et al. in international journals we herein propose adapting it for PET image denoising. Experimental de-noising results for real clinical PET images show that Non-local means method is superior to median filtering and wiener filtering methods and it can suppress noise in PET images effectively and preserve important details of structure for diagnosis.
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Humans , Algorithms , Artifacts , Artificial Intelligence , Image Processing, Computer-Assisted , Methods , Positron-Emission Tomography , MethodsABSTRACT
Objective To evaluate the surgical effect for congenital nystagmus (CN) with an abnormal head position in all three axes of a predominant head turn. Design Retrospective case series. Participants 11 patients with horizontal nystagmus and abnormal head position treated in Xingtai Eye Hospital during 2003-2008. All had an abnormal head position in all three axes with a predomi-nant head turn. Methods Recession of the yoke muscles responsible for the slow phase of nystagmus (one medial rectus of 6mm, and one lateral rectus 8 mm), and simultaneously resection of the yoke muscles responsible for the fast phase of nystagmus (the other lateral rectus 9 mm, and medial rectus 7 mm) were performed. The follow-up was from 6 to 20 months. Main Outcome Measures The visual acuity of both eyes in primary position, the degree of head turn, chin elevation or depression, head tilt. Results At the last follow-up, the all 11 patients undergoing the operation for CN gained two or more lines of Snellen acuity with both eyes in primary position for be-ing corrected best. The postoperative mixed head position of 9 cases got disappear or ≤ 10°. Of 1 case developed overcorrection of the head turn. 1 case has the head turn of ≤15°, and 1 case remained the head turn of 25°. Conclusion Recessions and resections of the horizontal yoke rectus muscles in nystagmus with blockage position, when the head turn predominates over the vertical and torsional components, are effective in diminishing the abnormal head position on all three axes, and improve the visual acuity with both eyes in primary position. (Ophthalmol CHN, 2009, 18: 275-278)
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Objective To investigate the clinical efficacy of kidney-tonifying and blood-activating therapy on puberty polycystic ovarian syndrome(PCOS).Methods Thirty-one PCOS patients were randomly allocated into 2 groups:16 patients(TCM group)received kidney-tonifying and blood-activating Fuke No.5 Prescription combined with herbal medicine based on the menstrual cycle,and 15 patients(WM group)received oral administration of western medicine of diane-35.Changes of clinical symptoms and signs,B-ultrasonic results and serum hormones levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),testosterone(T)and estrogen(E2)were examined before treatment,after treatment for 3 menstrual cycles and on the 3rd cycle after suspension.Results The menstuation and ovulation,serum sexual hormones(except FSH and E2)levels,and B-ultrasonic indexes(except the volume of uterus)were obviously improved in the two groups after treatment for 3 menstrual cycles(P0.05 compared with those before treatment),but remained at the levels after treatment for 3 menstrual cycles(P
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ive] To observe the effects of Shengjiang Capsule (SC) on gastric evacuation and to study its mechanism. [Methods] Eight-week-old SD rats were randomly allocated to five groups. Group A served as normal control, and Group B were treated with high dosage of SC, Group C with low dosage of SC, Group D with Zhike Baizhu Decotion and Group E with cisapride. After ten days of treatment, gas tric evacuation of rats was detected by isotope tracing method, erythrocyte-acetycholinesterase activity by micro-hydroxylamine method and plasma motilin (Mot) and somatostatin (SS) levels by radioimmunoas-say. [Results] Thirty-minute gastric evacuation rate was (51.44?.38)%, (40.82 + 7.24)% and (40.22?.16)% in Group B, Group C and Group D respectively, which was higher than that in Group A [ (33.18?.32)%]. Erythrocyte-acetycholinesterase activity, Mot and SS levels were (0.856?.128) umol/h, (124.26?5.94) ng/L and (39.42?.96) ng/L, and (0.726?.164 ) umol/h, (119.86 ?9.38) ng/L and (38.33 ?.64) ng/L in Group B and Group C respectively, which were higher than those in Group A [ (0.576 ?.150)/umol/h, (91.28 + 26.84) ng/L and (28.22 ?7.68)ng/L]. [Conclusion] SC can promote gastric evacuation, and its mechanism may be re lated to the increase of the cholinergic nerve function and plasma Mot and SS levels.