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Perioperative neurocognitive disorders(PND)is a common complication after surgery or anesthesia, especially in elderly patients.The effects and mechanism of body temperature on PND are still controversial.In this paper, the relationship between body temperature and PND and its possible mechanism of action were discussed based on some research results of perioperative body temperature management in elderly patients, aiming at suggesting the significance of body temperature management in preventing PND.
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Objective@#The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT)features for outcome prediction in patients with coronavirus disease (COVID-19). @*Materials and Methods@#The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitalswere retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in thetraining cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in thevalidation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, ordeath. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. Anomogram was constructed based on the combination of clinical and CT features, and its prognostic performance wasexternally tested in the validation group. The predictive value of the combined model was compared with models built on theclinical and radiological attributes alone. @*Results@#Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohortexperienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67–6.71;p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04–0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03–4.48;p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76–0.88),and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82–0.96). The combinedmodel provided the best performance over the clinical or radiological model (p < 0.050). @*Conclusion@#Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverseoutcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predictingadverse outcomes of patients with COVID-19.
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Objective To explore the values of shear wave elastography (SWE) and ultrasonic grading in liver grafts from brain death donor (DBD).Methods Liver grafts of 39 DBD cases were examined preoperatively by ultrasonography (US) and SWE.Blood samples were tested preoperatively.Based upon early allograft function of liver recipients,the donors were classified into early allograft dysfunction (EAD) and early allograft function normal (non-EAD) groups.The SWE/ US grading results of EAD group were compared with those of non-EAD group.Receiver operating curve (ROC) was employed for analyzing the diagnostic accuracy of SWE/US grading in EAD.Results The SWE value of EAD group was significantly higher than that of non-EAD group [(6.65 ± 2.69)vs.(3.50 ± 1.27) kPa,P＜0.05].Ultrasonic grading of EAD group was also significantly higher than that of non-EAD group (P＜0.05).The area under ROC curve (AUROC) of SWE in EAD was 0.939,optimal cut-off value 4.56 kPa,AUROC of ultrasonic grading 0.806 (P =0.003) and optimal cut-off value level 3.5.Conclusions SWE quantifies fibrosis in liver grafts of DBD with a high diagnostic accuracy.There are significant correlations between EAD after liver transplantation and SWE value of liver grafts and ultrasonic grading.SWE and ultrasonic grading may improve the assessments of liver grafts of DBD.
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Shear wave elastography (SWE) is used to quantitatively analyze the hardness of the tissue by Young's modulus.The hardness of the tissue is visualized in the form of color coding to distinguish the benign and malignant tissue detected.SWE has higher sensitivity,accuracy and specificity compared with traditional color doppler,which is more objective than elastography,safer,cheaper and simpler than MRI.SWE has a good application prospect in the diagnosis,clinical staging and curative effect monitoring of cervical cancer.
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<p><b>OBJECTIVE</b>To study the estrogen-like action mechanism of Menoprogen on ovariectomized female rats.</p><p><b>METHOD</b>Ovariectomized rat model (OVX) was established and estradiol (17beta-estradiol, E2) was used as positive control. The uterine coefficient and serum E2 level were determined after administration of Menoprogen for 2 weeks. The uterine vascular endothelial growth factor (VEGF), water channel protein (aquaporin, AQP), estrogen receptor (ER), progesterone receptor (PR) and the expression of proto-oncogenes (c-jun, c-fos) were observed by immunohistochemical method. Yeast two-hybrid assay was applied to detect the existence of components combining with ERalpha or ERbeta in Menoprogen.</p><p><b>RESULT</b>Both Menoprogen and E2 could significantly elevate the uterine coefficient of OVX rats, increase the level of serum E2 and up-regulate the expressions of VEGF, AQP2 as well as AQP5 in uterus. E2, not as E2 Menoprogen couldn't promote the expressions of ERalpha, PR, c-jun and c-fos in OVX rat uterus. And yeast two-hybrid assay showed no components combining with ERalpha or ERbeta in Menoprogen.</p><p><b>CONCLUSION</b>Menoprogen has estrogen-like effect, and can be used to treat menopause syndrome. The risk of estrogen-mediated endometrial cancer is low for this treatment because its mechanism is different from estrogen-like substances.</p>