Clinical characteristics and microbiological tests analysis of 18 patients with Talaromyces marneffei infection / 中国热带医学

@#Abstract:Objective　To investigate the clinical characteristics and early diagnostic methods of patients with Talaromyces marneffei infection, so as to reduce the mortality of patients. Methods The clinical characteristics and microbiological analysis data including fungal culture, smear examination and mass spectrometry were collected from 18 patients with Talaromyces marneffei infection in the Department of Respiratory Medicine, Department of Tuberculosis, and Department of Critical Respiratory Medicine in Fuzhou Pulmonary Hospital from January 2017 to December 2021, and descriptive analysis was conducted. Results　All the 18 patients were confirmed to be infected with Talaromyces marneffei by conventional culture and matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MS). The main infection sites of 18 patients with Talaromyces marneffei infection were lungs and lymph nodes, and the patients were accompanied by clinical manifestations such as cough, sputum and fever. The imaging features such as patchy shadows, mediastinal lymph node shadows and nodular shadows were common. Microbiological testing showed a statistically significant difference between smear and culture with a higher positive culture rate (χ2=13.74, P<0.05). The positive rate of blood culture in microbiological test was 60.0% (9/15), the positive rate of bronchial lavage fluid culture was 26.7% (4/15), the positive rate of sputum culture was 5.6% (1/18), one case each of pus, bone marrow, pleural fluid and cerebrospinal fluid was positive for culture and the other cases were negative, one case of sputum and one case of pus were positive for smear and the rest were negative. Colony characteristics showed that the colony morphology was mycelial phase at 25 ℃, producing red pigment, and the branching pattern of the penicillus was seen microscopically as monoverticillate or biverticillate; At 35 ℃, the yeast phase appeared at the initial stage, and then the mycelium phase changed after 5-6 days; the yeast phase was observed at 37 ℃, and yeast-like cells were seen under the microscope. All 18 patients with Talaromyces marneffei infection got better after using antifungal drugs. Compared with non-HIV patients with Talaromyces marneffei infection, leukopenia and anemia were common in HIV patients with Talaromyces marneffei infection, and the differences were statistically significant (P<0.05). 　Conclusions The infection of Talaromyces marneffei can be divided into localized type and disseminated type, which usually invade the lungs, skin, lymph nodes and other places. The main manifestations of patients are fever, cough, phlegm and other atypical symptoms. At present, the diagnosis of Talaromyces marneffei infection is mostly based on the fungal culture test, and the application of MALDI-TOF MS method can effectively shorten the diagnosis time of Talaromycosis marneffei. Clinical characteristics combined with microbiological analysis provide an objective basis for early diagnosis of patients with Talaromyces marneffei infection, and timely use of antifungal therapy can improve the prognosis of patients.

Arthroscopic treatment of schatzker type III tibial plateau fractures with hydroxylapatite rods: 6-month follow-up / 中国组织工程研究

BACKGROUND: The clinical treatment of Schatzker III tibial plateau fracture is different, including internal fixation, external fixation and arthroscopy. OBJECTIVE: To investigate the effect and influencing factors of arthroscopic treatment of Schatzker type III tibial plateau fracture with nano hydroxylapatite rod. METHODS: Totally 36 cases of Schatzker type III tibial plateau fractures admitted to Hebei Provincial People’s Hospital from July 2017 to July 2019 were enrolled, including 25 males and 11 females, aged 20-57 years. Among them, 18 patients in the observation group received minimally invasive arthroscopic hydroxylapatite rod implantation and 18 patients in the control group received conventional open plate and screw fixation. After 6 months of follow-up, complications and fracture healing time were recorded. Pain was assessed by visual analogue scale score. Knee function was assessed by HSS score. Excellent and good rate was assessed by Lysholm score. The effects of single factors such as age, sex, combined meniscus and ligament injuries, operation time and intraoperative blood loss in the observation group on the efficacy of the postoperative knee joint were analyzed by single factor analysis. The trial was approved by the Ethics Committee of Hebei Provincial People’s Hospital. RESULTS AND CONCLUSION: (1) The incidence rate of postoperative complications such as deep venous thrombosis and traumatic arthritis in the observation group was lower than that in the control group (P < 0.05). (2) The healing time of the observation group was shorter than that of the control group (P < 0.05). The excellent and good rate of clinical treatment was higher in the observation group than that of the control group (P < 0.05). (3) The visual analogue scale scores of the observation group were lower than those of the control group at 1 day, 1 week, 1 and 3 months after operation (P < 0.05). The HSS scores of knee joint function in 1, 3 and 6 months after operation were higher in the observation group than those in the control group (P < 0.05). (4) The single factor analysis showed that the postoperative effect of patients with age < 50 years was better than that of patients with age ≥ 50 years (P < 0.05). (5) The results showed that the minimally invasive treatment of Schatzker type III tibial plateau fracture with nano hydroxyapatite rod under arthroscope could promote fracture healing, alleviate pain and promote joint function recovery, in which the age was an independent factor affecting the postoperative effect.

Diagnostic Utility of Interferon-Gamma Release Assay in Tuberculous Lymphadenitis / 中国医学科学杂志(英文版)

Objective The aim of this study was to evaluate the diagnostic performance of T-SPOT.TB for tuberculous lymphadenitis. Methods Suspected tuberculous lymphadenitis patients between September 2010 and September 2018 who had both peripheral blood T-SPOT.TB test and lymph node biopsy were retrospectively enrolled in this study. The cutoff value of T-SPOT.TB test for peripheral blood was set as 24 spot forming cell (SFC)/10 6 periphreral blood monocyte cell (PBMC) according to the instruction of testing kits. The gold standard for diagnosis of TBL was the combination of microbiology results, histopathology results and patient's response to anti-TB treatment. Diagnostic efficacy of T-SPOT.TB was evaluated, including sensitivity, specificity, accuracy, predictive values, and likelihood ratio. Results Among 91 patients who met the inclusion criteria, we excluded 8 cases with incomplete clinical information and 6 cases who lost to follow-up. According to the gold standard, there were 37 cases of true TBL (9 confirmed TBL and 28 probable TBL), 30 cases of non-TBL, and 10 cases of clinically indeterminate diagnosis who were excluded from the final analyses. The T-SPOT.TB tests yielded 43 cases of positive response and 24 cases of negative response. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of peripheral blood T-SPOT.TB for diagnosing TBL were 89.2%, 66.7%, 79.1%, 76.7%, 83.3%, 2.68 and 0.16, respectively. The number of SFCs of T-SPOT.TB in TBL patients [432(134-1264)/10 6 PBMCs] was higher than that in non-TBL patients [0 (0-30) /10 6PBMCs] with a significant difference (Z=-5.306, P <0.001). Conclusion T-SPOT.TB is a rapid and simple diagnostic test for TBL with a high sensitivity and negative predictive value.

Establishment of the Mathematical Model for PMI Estimation Using FTIR Spec-troscopy and Data Mining Method / 法医学杂志

Objective To analyse the relationship between Fourier transform infrared （FTIR） spectrum ofrat's spleen tissue and postmortem interval （PMI） for PMI estimation using FTIR spectroscopy combinedwith data mining method. Methods Rats were sacrificed by cervical dislocation, and the cadavers were placed at 20 ℃. The FTIR spectrum data of rats' spleen tissues were taken and measured at different time points. After pretreatment, the data was analysed by data mining method. Results The absorption peak intensity of rat's spleen tissue spectrum changed with the PMI, while the absorption peak position was unchanged. The results of principal component analysis （PCA） showed that the cumulative contribution rate of the first three principal components was 96%. There was an obvious clustering tendency for the spectrum sample at each time point. The methods of partial least squares discriminant analysis （PLS- DA） and support vector machine classification （SVMC） effectively divided the spectrum samples with different PMI into four categories （0-24 h, 48-72 h, 96-120 h and 144-168 h）. The determination coefficient （R2） of the PMI estimation model established by PLS regression analysis was 0.96, and the root mean square error of calibration （RMSEC） and root mean square error of cross validation （RMSECV） were 9.90 h and 11.39 h respectively. In prediction set, the R2 was 0.97, and the root mean square error of prediction （RMSEP） was 10.49 h. Conclusion The FTIR spectrum of the rat's spleen tissue can be effectively analyzed qualitatively and quantitatively by the combination of FTIR spectroscopy and data mining method, and the classification and PLS regression models can be established for PMI estimation.

Medicolegal analysis of 193 homicide cases in a district of Weinan,Shaanxi Province of China from 2007 to 2016 / 复旦学报（医学版）

Objective To summarize the key points of forensic medicine appraisal by retrospectively analyzing the scene.Methods The data of 193 homicide cases in a district of Weinan from 2007 to 2016 were collected and analyzed.Results The majority of the criminal suspect and victims was male,aged 21-40 years old,local,farmers and primary school educational level.Infringement was the majority criminal motivation (52.8％).The most common injuries tools were sharp instruments (63.8 ％);multiple parts damage accounted for 32.1 ％;mechanical injury induced hemorrhagic shock and craniocerebral injury were the most common causes of death in these cases (87.0％).Conclusions The demographic characteristics of suspects,criminal motivation,injury instruments,distribution of injuries and cause of death in the district of Weinan showed similar general characteristics,which could provide experience and reference for detecting homicide cases in the future.

Heparin-derived oligosaccharide inhibits vascular intimal hyperplasia in balloon-injured carotid artery / 中国天然药物

The aims of the present study were to determine the effects of heparin-derived oligosaccharides (HDOs) on vascular intimal hyperplasia (IH) in balloon-injured carotid artery and to elucidate the underlying mechanisms of action. An animal model was established by rubbing the endothelia within the common carotid artery (CCA) in male rabbits. The rabbits were fed a high-cholesterol diet. Arterial IH was determined by histopathological changes to the CCA. Serum lipids were detected using an automated biochemical analysis. Expressions of mRNAs for vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), vascular cell adhesion molecule-1 (VCAM-1), monocyte chemoattractant protein-1 (MCP-1), scavenger receptor class B type I (SR-BI), and ATP-binding cassette transporter A1 (ABCA-1) were analyzed using reverse transcription polymerase chain reaction assays. Expressions of VEGF, VCAM-1, MCP-1, SR-BI and ABCA-1 proteins were analyzed by Western blotting. Enzyme-linked immunosorbent assays were used to quantify expression levels of VEGF and bFGF. Our results showed that administration of HDO significantly inhibited CCA histopathology and restenosis induced by balloon injury. The treatment with HDOs significantly decreased the mRNA and protein expression levels of VEGF, bFGF, VCAM-1, MCP-1, and SR-BI in the arterial wall; however, ABCA-1 expression level was elevated. HDO treatment led to a reduction in serum lipids (total cholesterol, triglycerides, high-density and low-density lipoproteins). Our results from the rabbit model indicated that HDOs could ameliorate IH and underlying mechanism might involve VEGF, bFGF, VCAM-1, MCP-1, SR-BI, and ABCA-1.

Analysis and comparison about musculoskeletal ultrasonoLranhv and x-rav of knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To analyze and compare the characteristics of musculoskeletal ultrasonography and X-ray of knee osteoarthritis, and to investigate the advantages of them.</p><p><b>METHODS</b>According to the inclusion and exclusion criteria, 57 cases (66 knees) were collected from February 2015 to May 2015. Among them, there were 48 females and 9 males with an average age of (58.9 +/- 9.8) years old (ranged, 41 to 78 years old). The main symptoms included unilateral or bilateral knee pain and locked joints explicit areas of tender points. The mean course of disease was (13.6 +/- 3.0) months. The results of musculoskeletal ultrasound and X-ray examinations were analyzed.</p><p><b>RESULTS</b>According to Kellgren-Lawrence classification of knee joint on the X-ray: the musculoskeletal ultrasound results of patients with I degree synovial hyperplasia in 9 cases, joint effusion in 20 cases, meniscal disease in 13 cases, patellar pad inflammation in 5 cases, and patellar lesion in 8 cases. The musculoskeletal ultrasound results of patients with III degree: synovial hyperplasia in 20 cases,joint effusion in 31 cases, meniscal disease in 22 cases, patellar pad inflammation in 16 cases and patellar lesion in 17 cases. The musculoskeletal ultrasound results of patients with III degree: synovial hyperplasia in 6 cases,joint effusion in 6 cases, meniscal disease in 7 cases, patellar pad inflammation in 7 cases and patellar lesion in 5 cases.</p><p><b>CONCLUSION</b>The musculoskeletal ultrasound can detect the pathological changes of knee soft tissue sensitively, provide an accurate location of lesions,and find lesions early. The musculoskeletal ultrasound should be applicated in the diagnosis of knee osteoarthritis.</p>

Study about Traditional Chinese Medicine syndrome of adolescent neck pain / 中国骨伤

<p><b>OBJECTIVE</b>To preliminarily research the formular about the Traditional Chinese Medicine (TCM) syndrome of adolescent neck pain.</p><p><b>METHODS</b>An observation table of adolescent neck pain syndromes was formulated,and 1 397 patients with adolescent neck pain were investigated to establish a database of adolescent neck pain. The Descriptive Statistical Analysis and Hierarchical Cluster Analysis were performed by statistical software.</p><p><b>RESULTS</b>Totally 60 TCM symptoms was clustered into 4 TCM syndromes by Hierarchical Cluster Analysis. The expert panel of TCM syndromes preliminarily formulate 4 TCM syndromes of adolescent neck pain by analyzing the result of Cluster Analysis and discussing their clinical experience.</p><p><b>CONCLUSION</b>Adolescent neck pain is a category of Tendon Trauma's Bi-syndrome of TCM. Ying, Wei, Qi and blood block caused by exopathy, strains, and internal injury is considered as the main pathogenesis of adolescent neck pain. Base on statistical result and expert's opinions, 4 TCM syndromes about adolescent neck pain were formulated: cold-dampness syndrome, dampness-heat blockage syndrome, liver-stagnation and spleen-deficiency syndrome, Qi and Yin deficiency of both heart and kidney syndrome.</p>

Di-syllabic Tone in Hearing-impaired Children and Normal-hearing Children Aged 3~5 Years / 中国康复理论与实践

@#Objective To compare the di-syllabic tone between hearing-impaired children and normal-hearing children. Methods 120 hearing-impaired children and 36 normal-hearing children aged 3~5 years were asked to read aloud 32 word with 16 kinds of di-syllabic tone. Results All the normal-hearing children read all the words correctly, and the hearing-impaired children faulted in pronouncing as their peers. The correct incidence improved in 4-year old hearing-impaired children compared with that of the 3-year old, but it was not significant different between the 4- and the 5- year old. There was not significant difference of the high and level tone between the hearing-impaired children and normal-hearing children. However, the rising, falling- rising and falling tones were significantly different between the two groups. Conclusion The hearing-impaired children aged 3~5 years delay to speech words with di-syllabic tone, especially for those with rising, falling-rising and falling tones.

Minimally invasive perventricular device closure of ventricular septal defect: a comparative study in 80 patients / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the efficacy of minimally invasive perventricular device closure of ventricular septal defect (VSD).</p><p><b>METHODS</b>Between September 2011 and February 2013, we collected 40 patients who underwent perventricular closure via a small lower sternal incision (minimally invasive group), aged 15.5±3.5 years (12 months to 32 years) with a body weight of 24.2±7.5 kg (10.8-58.0 kg). The mean size of VSD was 5.6±0.5 mm (2-14 mm). Another 40 patients were included as the surgical group, receiving the conventional surgical repair of VSD. The device of the minimally invasive group was released under the guidance of transesophageal echocardiography. Success rate, cardiac indicators, and clinical outcomes of the 2 groups were compared.</p><p><b>RESULTS</b>The patients in the surgical group and those in the minimally invasive group showed similar results in success rate (both 97.5%). The procedure time, intensive care unit stay, hospital stay, and postoperative recovery time in the minimally invasive group were significantly shorter than those in the surgical group (58±21 minutes versus 145±26 minutes, 2±1 days versus 8±3 days, 5±1 days versus 16±6 days, 3±1 days versus 90±20 days, all P<0.05). The minimally invasive group had a higher incidence of conduction anomalies (17.5% versus 2.5%, P<0.05). In the follow-up period of 3-12 months, there was no new residual shunt, noticeable aortic regurgitation, significant arrhythmias, or device failure except for new complications in the surgical group.</p><p><b>CONCLUSIONS</b>The success rate of minimally invasive perventricular device closure of VSD under transesophageal echocardiography guidance is similar to that of conventional surgical repair, but the short-term outcomes of the minimally invasive approach is much better. Long-term follow-up is necessary to confirm the effectiveness of this technique.</p>

Presepsin as a novel sepsis biomarker / 世界急诊医学杂志（英文）

BACKGROUND:In 2004, a new biomarker sCD14-subtypes (presepsin) was found and its value was shown in the diagnosis and evaluation of sepsis. This article is a brief overview of the new biomarker. DATA SOURCES:A literature search using multiple databases was performed for articles, especially meta-analyses, systematic reviews, and randomized controlled trials. RESULTS:Compared with other markers, presepsin seems to have a better sensitivity and specificity in the diagnosis of sepsis. Presepsin as a biom1arker is not only suitable for the early diagnosis of sepsis, but also for the assessment of its severity and prognosis. CONCLUSIONS:Presepsin has a higher sensitivity and specificity in the diagnosis of sepsis as a new biomarker, and is a predictor for the prognosis of sepsis. More importantly, preseptin seems to play a crucial role as a supplemental method in the early diagnosis of sepsis. Since there is no multicenter study on the relationship between presepsin and sepsis, further studies on the clinical values of presepsin are needed.

Study on antagonistic effect of liangxue huayu recipe on endoplasmic reticulum stress-induced L02 hepatocyte apoptosis and its mechanism / 中国中药杂志

Endoplasmic reticulum stress (ERS) is a new pathway inducing cell apoptosis that has been discovered in recent years. This study focused on the protective effect of Liangxue Huayu recipe (LHR) on tumor necrosis factor-alpha (TNF-alpha) and D-GalN-induced hepatocyte apoptosis. It found that TNF-alpha and D-GalN could obviously inhibit hepatocyte proliferation, induce cell apoptosis, and significantly increase free calcium ions in cytoplasms, as well as protein expressions of ERS apoptosis-related signal molecules phosphorylated PERK, phosphorylated elF2alpha, cleaved Caspase-12, GRP78 and CHOP. After the administration of LHR of different concentrations, compared with the TNF-alpha/GalN injury group, LHR could significantly alleviated L02 hepatocyte proliferation, decreased cell apoptosis, inhibited growth of intracytoplasmic free calcium content, and gradually reduced the protein expressions of phosphorylated PERK, phosphorylated elF2alpha, cleaved Caspase-12, GRP78 and CHOP. These findings indicated that LHR has the inhibitory effect on TNF-alpha and D-GalN-induced hepatocyte apoptosis. Its mechanism may be related to down-regulation of ERS apoptosis-related signal molecules phosphorylated PERK, phosphorylated elF2alpha, cleaved Caspase-12, GRP78 and CHOP that maintain calcium homeostasis in endoplasmic reticulum.

Predicting value of serum soluble ST2 and interleukin-33 for risk stratification and prognosis in patients with acute myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acute myocardial infarction (AMI) is a common cardiac emergency with high mortality. Serum soluble ST2 (sST2) is a new emerging biomarker of cardiac diseases. The present study is to investigate the predictive value of sST2 and interleukin-33 (IL-33) for risk stratification and prognosis in patients with AMI.</p><p><b>METHODS</b>Fifty-nine patients with AMI, whose chief complaint was chest pain or dyspnea, were selected for our study. Physical examination, chest radiograph, electrocardiograph (ECG), biomarkers of myocardial infarction, NT-proBNP, echocardiography and other relevant examinations were performed to confirm the diagnosis of AMI. Thirty-six healthy people were chosen as the control group. Serum samples from these subjects (patients within 24 hours after acute attack) were collected and the levels of sST2 and IL-33 were assayed by enzyme-linked immuno-sorbent assay (ELISA) kit. The follow-up was performed on the 7th day, 28th day, 3rd month and 6th month after acute attack. According to the follow-up results we defined the end of observation as recurrence of AMI or any causes of death.</p><p><b>RESULTS</b>Median sST2 level of the control group was 9.38 ng/ml and that of AMI patients was 29.06 ng/ml. Compared with the control group, sST2 expression in the AMI group was significantly different (P < 0.001). In contrast, the IL-33 level showed no significant difference between the two groups. Serum sST2 was a predictive factor independent of other variables and may provide complementary information to NT-proBNP or GRACE risk score. IL-33 had no relationship to recurrence of AMI. Both sST2 and the IL-33/sST2 ratio were correlated with the 6-month prognosis; areas under the ROC curve were 0.938 and 0.920 respectively.</p><p><b>CONCLUSIONS</b>Early in the course (<24 hours) of AMI, sST2 usually increases markedly. The increase of sST2 has an independent predictive value for the prognosis in AMI patients and provides complementary information to NT-proBNP or GRACE risk score. The IL-33/sST2 ratio correlates with the 6-month prognosis of AMI patients. However, there is no significant relationship between IL-33 and the prognosis of AMI patients.</p>

Mortality and morbidity of acute hypoxemic respiratory failure and acute respiratory distress syndrome in infants and young children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acute hypoxemic respiratory failure (AHRF) often develops acute respiratory distress syndrome (ARDS), and its incidence and mortalities in critically ill pediatric patients in China were 2% and 40% respectively. This study aimed at prospectively investigating incidence, causes, mortality and its risk factors, and any relationship to initial tidal volume (V(T)) levels of mechanical ventilation, in children £5 years of age with AHRF and ARDS.</p><p><b>METHODS</b>In 12 consecutive months in 23 pediatric intensive care units (PICU), AHRF and ARDS were identified in those requiring > 12 hour intratracheal mechanical ventilation and followed up for 90 days or until death or discharge. ARDS was diagnosed according to the American-European Consensus definitions. The mortality and ventilation free days (VFD) were measured as the primary outcome, and major complications, initial disease severity, and burden were measured as the secondary outcome.</p><p><b>RESULTS</b>In 13 491 PICU admissions, there were 439 AHRF, of which 345 (78.6%) developed ARDS, resulting in incidences of 3.3% and 2.6%, and corresponding mortalities of 30.3% and 32.8% respectively along with 8.2 and 6.7 times of relative risk of death in those with pneumonia (62.9%) and sepsis (33.7%) as major underlying diseases respectively. No association was found in V(T) levels during the first 7 days with mortality, nor for V(T) at levels < 6, 6 - 8, 8 - 10, and > 10 ml/kg in the first 3 days with mortality or length of VFD. By binary Logistic regression analyses, higher pediatric risk of mortality score III, higher initial oxygenation index, and age < 1 year were associated with higher mortality or shorter VFD in AHRF.</p><p><b>CONCLUSIONS</b>The incidence and mortalities of AHRF and ARDS in children £5 years were similar to or lower than the previously reported rates (in age up to 15 years), associated with initial disease severity and other confounders, but causal relationship for the initial V(T) levels as the independent factor to the major outcome was not found.</p>

Clinical characteristics and prognosis of heart failure with normal left ventricular ejection fraction in elderly patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The term heart failure with normal ejection fraction (HFNEF) is often used to describe the syndrome of heart failure with normal ejection fraction. Based on the previous studies, HFNEF has a significant morbidity and mortality and is associated with a similar prognosis to heart failure with reduced ejection fraction (HFREF). The present study aimed to investigate the clinical characteristics and prognosis of HFNEF in elderly patients.</p><p><b>METHODS</b>Consecutive elderly patients (≥ 60 years old) hospitalized for the first episode of heart failure (HF) in Beijing Hospital from January 2003 to December 2009 were retrospectively recruited. Three hundred and ten patients with HF were eligible for our study. As recently recommended, a cut-off value of 50% was used to distinguish HFNEF (LVEF ≥ 50%) from HFREF (LVEF < 50%). Data were retrospectively obtained from hospital records and databases. Follow-up data were obtained by telephone and from hospital records. For every eligible patient, the clinical characteristics and prognosis were collected and compared between the HFNEF and HFREF groups.</p><p><b>RESULTS</b>Patients with HFNEF accounted for 54.5% of all cases of elderly patients with HF. Compared with HFREF, the elderly patients with HFNEF had a higher proportion of females (62.1% vs. 32.6%, P < 0.001), higher body mass index (BMI) ((24.9 ± 4.7) vs. (23.5 ± 4.0) kg/m(2), P = 0.011), higher systolic blood pressure at admission ((141.5 ± 22.6) vs. (134.3 ± 18.6) mmHg, P = 0.002), but lower hemoglobin levels ((118.3 ± 22.7) vs. (125.8 ± 23.8) g/L, P = 0.005). The incidence of coronary heart disease (43.2% vs. 65.2%, P < 0.001) and myocardial infarction (16.6% vs. 46.1%, P < 0.001) were significantly lower in elderly patients with HFNEF than in those with HFREF (P < 0.001). With a mean follow-up of 33.5 (0.5 - 93) months, 120 patients (38.7%) died, including 94 (30.3%) cardiac deaths. The HFNEF group had fewer deaths than the HFREF group at the end of the first follow-up (46/169 (27.2%) vs. 58/141 (41.1%)) and at the end of the second follow-up (56/169 (33.1%) vs. 64/141 (45.4%)). Kaplan-Meier survival analysis showed a significantly higher survival rate in elderly patients with HFNEF than those with HFREF (P = 0.021 for total mortality and P < 0.001 for cardiac mortality). Multiple Logistic regression analysis showed that LVEF < 50% was an independent risk factor for death in elderly patients with HF.</p><p><b>CONCLUSIONS</b>More than half of elderly patients with HF have a normal LVEF. The prognosis of the elderly patients with HFNEF is poor, though slightly better than the elderly patients with HFREF.</p>

Risk factors and warning signs of sudden cardiac death / 中国医学科学院学报

Sudden cardiac death (SCD) is the most common death mode. No test has been able to accurately predict SCD. This article reviews the risk factors and warning signs of SCD with an attempt to effectively prevent SCD events.

Analysis on pedestrian traffic injury among aged 0-14 years children in Guangzhou, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the characteristics of child pedestrian traffic injuries among aged 0-14 years old in Guangzhou city and to provide information on road, vehicle and human injuries in pedestrian.</p><p><b>METHODS</b>A database of all motor vehicle crashes involving child pedestrian traffic injury cases over a five-year period (2000-2004), was from the police department.</p><p><b>RESULTS</b>The annual pedestrian traffic injury rates on incidence, mortality and case fatality were 17.63/ 1,100,000, 1.78/ 100,000 and 10.07% respectively. Both incidence rate and mortality peaked in the 5-9 age group were 26.80/ 100,000 and 2.57/ 100,000, with case fatality peaked in the 0-4 age group (13.29%). For males, the incidence (20.98/ 100,000) and mortality (2.00/ 100,000) were higher than that in females (13.83/ 100,000, and 1.52/ 100,000). The main injured parts of body would include multi-areas (40.34%), head (26.75%) and lower limbs (21.53%). 10.07% of the cases died and 66.18% and 23.75% of them having had severe and slight injures. The major causes were due to drivers (57.50%) and pedestrians (33.47%) faults with top three responsible vehicles were cars (40.14%), two-wheeled motorcycles (34.38%) and vans (22.15%).</p><p><b>CONCLUSION</b>Data from pediatric pedestrian injury poses a threat to children and adolescents, data suggesting that it is important to change behaviors of both drivers and pedestrians.</p>

Expression of phosphorylated ERK1/2 induced by crocidolite fibers in BEAS-2B cells / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the characteristic of the signal transduction in BEAS cells induced by the crocidolite fibers.</p><p><b>METHODS</b>The human respiratory airway epithelial cells BEAS-2B were cultured in vitro. The final 100 microg/ml crocidolite concentration and lOnM of epidermal growth factor were cocultured with BEAS-2B cells for 30 minutes and 120 minutes. Phosphorylated ERKl/2 and MEKl/2 were detected by Western Blotting using specific antibodies.</p><p><b>RESULTS</b>A rapid phosphorylation expression of ERK1/2 (molecular weight at 44 kD and 42 kD, also called as p44 and p42) was observed by treatment of the BEAS-2B cells with 100 microg/ml crocidolite or 100 ng/ml EGF (the proven activator of the ERK signaling pathway) at 30 minutes. This phosphorylation could be still detected by incubation the cells at 2 hours. However no expression was changed for the total ERKl/2 expression at 30 minutes or 120 minutes. Treatment of BEAS cells with 100 microg/ml crocidolite fiber or 100 ng/ml EGF led to the rapid increased phosphorylation of MEK1/2 at 30 minutes; similarly, the overexpression of MEK1/2 could last 2 hours.</p><p><b>CONCLUSION</b>The crocidolite induces the MAPK (ERK1/2 and MEK1/2) phosphorylation within a shorter time. It indicates that the MAPKs signals are involved in the process of crocidolite induced damage.</p>

Significance of Serum Cardiac Troponin I and Creatine Phosphokinase-Isoenzyme-MB in Asphyxia Neonate / 实用儿科临床杂志

Objective To explore the value of cardiac troponin I (cTnI) and creatine phosphokinase-isoenzyme-MB (CK-MB) on early diagnosis of heart damage in asphyxia neonate.Methods A total of 47 cases of asphyxia neonates were divided into mild-asphyxia group( n=29 ) and severe-asphyxia group(n=18),and the levels of cTnI and CK-MB were quantitatively determinated by ELISA and enzyme kinetics, respectively.Results After birth for the first day, the serum levels of cTnI and enzymatic activities of CK-MB were all significantly higher in mild-asphyxia group[(2.25?0.54)?g/L,(223.4?23.5)U/L]and severe-asphyxia group[(4.25?0.83)?g/L,(256.3?21.8) U/L)]than those in control group(P_a0.05), however the results in severe-asphyxia group[(1.54?0.72)?g/L,(188.9?21.5)U/L]were significantly higher than those in control group (P_a