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Objective:To investigate the effect of preoperative hemoglobin (Hb) level on the risk of developing acute kidney injury (AKI) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).Methods:A retrospective study was conducted. The hospitalized patients diagnosed with AMI who underwent PCI from May 2015 to May 2020 in the department of cardiology in the Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University were enrolled. According to the serum creatinine (SCr) level before and after interventional therapy, the patients were divided into an AKI group and a non-AKI group. The difference in patients' Hb levels between the AKI and non-AKI groups was compared. Univariate and multivariate Logistic regression analyses were used to analyze the effects of Hb levels on the risk of AKI after interventional therapy in patients with AMI. Kaplan-Meier survival curve was used to evaluate the effects of Hb levels on patients with AMI in all-cause death in the hospital.Results:A total of 922 AMI patients were enrolled in this study, of which 165 patients (17.9%) developed AKI. Compared with the non-AKI group, female patients in the AKI group had a higher proportion [35.8% (59/165) vs. 26.9% (204/757)], older (age: 69.78±14.56 vs. 66.61±13.44), with a lower rate of smoking [42.4% (70/165) vs. 51.7% (391/757)] and a higher prevalence of hypertension [73.3% (121/165) vs. 63.5% (481/757)], however, the patients in AKI group also had a worse cardiac function [the proportion of Killip grade 3 or above was higher: 33.9% (56/165) vs. 13.9% (105/757)], lower Hb level (g/L: 127.61±22.18 vs. 132.79±19.45), and there were less patients using angiotensin converting enzyme inhibitor/angiotensin Ⅱreceptor blocker [ACEI/ARB, 60.0% (99/165) vs. 74.5% (564/757)] and more patients using diuretics [24.8% (41/165) vs. 17.7% (134/757)] in AKI group, the differences were statistically significant (all P < 0.05). Compared with non-AKI group, patients in AKI group had a longer operation time [operation time > 60 minutes: 4.2% (7/165) vs. 1.5% (11/757)] and received more contrast media during the operative procedure [contrast media > 100 mL: 16.4% (27/165) vs. 3.6% (27/757)], the individuals had a higher rate of intra-operative hypotension [16.4% (27/165) vs. 8.2% (62/757)], and more patients were implanted more than 2 stents [8.5% (14/165) vs. 3.6% (27/757), all P < 0.05]. Univariate Logistic regression analysis suggested that each 1 g/L increase in preoperative Hb level was associated with a 1.2% decrease in the risk of postoperative AKI [odds ratio ( OR) = 0.988, 95% confidence interval (95% CI) was 0.980-0.996, P = 0.003]. Meanwhile, for every 1 standard deviation increase in preoperative Hb level, the risk of postoperative AKI decreased by 22.1% ( OR = 0.779, 95% CI was 0.661-0.918, P = 0.003). The patients were divided into low, medium and high concentration groups according to Hb levels (Hb levels were < 110 g/L, 110-150 g/L, ≥ 150 g/L, respectively), and multivariate Logistic regression analysis showed that the risk of AKI was significantly reduced in the high concentration group compared with that in the low concentration group ( OR = 0.463, 95% CI was 0.241-0.888, P = 0.020). The Kaplan-Meier survival curve analysis indicated that the short term survival after coronary intervention in AMI patients with low Hb concentration was significantly lower than that in patients with medium and high Hb concentration (Log-Rank: χ2= 23.215, P < 0.001). Conclusions:Preoperative lower Hb level is an independent risk factor for postoperative AKI in AMI patients. AMI patients with lower Hb levels have an increased risk of all-cause mortality within 1 month after AMI.
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Objective:To develop and validate a clinical prediction model for the risk of malignant ventricular arrhythmia in patients with acute myocardial infarction (AMI) during hospitalization, and evaluate the effect of the prediction model.Methods:A retrospective study was conducted. A total of 2 649 patients with AMI admitted to cardiology department of Changzhou No.2 People's Hospital of Nanjing Medical University from December 2012 to August 2020 were enrolled. The clinical characteristics including gender, age, medical history, discharge diagnosis, vital signs during hospitalization, electrocardiogram characteristics at admission, laboratory examination indexes, interventional treatment, drug usage, malignant ventricular arrhythmias [mainly included sustained ventricular tachycardia (VT), ventricular flutter or ventricular fibrillation (VF)], and death were recorded. All patients were divided into two groups according to whether VT/VF occurred during their hospitalization. Independent risk factors for VT/VF during hospitalization were evaluated by multivariate Logistic regression analysis, and a clinical prediction model was constructed. The receiver operating characteristic curve (ROC curve) was plotted, and the area under ROC curve (AUC) was calculated to evaluate the accuracy of the prediction model.Results:A total of 2 649 eligible patients with AMI were enrolled, of whom 134 (5.06%) developed VT/VF during hospitalization. The in-hospital mortality rate in VT/VF group was significantly higher than that in non-VT/VF group (38.1% vs. 1.7%, P < 0.01). Compared with the non-VT/VF group, the patients in the VT/VF group with lower systolic blood pressure [SBP (mmHg, 1 mmHg = 0.133 kPa): 125.9±28.2 vs. 132.0±24.2], higher random blood glucose (mmol/L: 8.6±4.8 vs. 7.4±3.7), worse cardiac function [Killip heart function grade ≥ 3: 36.6% vs. 10.7%, left ventricular ejection fraction (LVEF) < 0.50: 56.7% vs. 33.6%, frequent premature ventricular contractions: 12.7% vs. 1.2%] and more hypokalemia (46.3% vs. 17.3%), with significant differences (all P < 0.05). Multivariate Logistic regression analysis showed that Killip classification of cardiac function ≥ 3 [odds ratio ( OR) = 3.540, 95% confidence interval (95% CI) was 2.336-5.363], random blood glucose > 11.1 mmol/L ( OR = 1.841, 95% CI was 1.171-2.893), LVEF < 0.50 ( OR = 0.546, 95% CI was 0.374-0.797), frequent premature ventricular contractions ( OR = 12.361, 95% CI was 6.077-25.144), potassium < 3.5 mmol/L ( OR = 4.268, 95% CI was 2.910-6.259), SBP < 90 mmHg ( OR = 0.299, 95% CI was 0.150-0.597) and creatinine (Cr) > 100 μmol/L ( OR = 2.498, 95% CI was 1.170-5.334) were independent risk factors for VT/VF in patients with AMI (all P < 0.05). The clinical prediction model of VT/VF risk was constructed based on the variables selected by multivariate regression analysis. The ROC curve analysis showed that the AUC of the model in predicting VT/VF was 0.779 (95% CI was 0.735-0.823, P < 0.001); the optimal cut-off value of the model was 17, the sensitivity was 76.1%, the specificity was 67.3%. Conclusions:The incidence of VT/VF during hospitalization of AMI patients significantly increases the risk of in-hospital death. The independent risk factors of VT/VF are Killip grade ≥ 3, random blood glucose > 11.1 mmol/L, LVEF < 0.50, frequent ventricular premature beats, potassium < 3.5 mmol/L, SBP < 90 mmHg and Cr > 100 μmol/L. The newly constructed clinical prediction model has certain predictive value for the occurrence risk of VT/VF.
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Objective To investigate the relationship between MRI signal,pathological changes and neurological function after sciatic nerve injury in rabbits.Methods Twenty New Zealand white rabbits were randomly and evenly divided into 5 groups,and the right sciatic nerve crush models were established.T2 fat suppression fast recovery spin echo (T2 fs FRFSE) sequence scanning was performed 3 days,7 days,2 weeks,3 weeks and 4 weeks after injury,and TE was set as 30,60 and 90 ms,respectively.Signal intensity ratio (SIR) and relative signal intensity (△S) of proximal and distal part of injured nerve and control side nerve were measured.The relationship between SIR,△S,pathology and rabbit lower limb nerve function were analyzed.Results In the distal part of injured nerve,SIR and △S increased 3-7 days after injury,pathological results showed vacuolar degeneration,and basic toe function lost was found.SIR and △S reached the peak 2 weeks after injury,with most serious disintegration of myelin and toe function disable.SIR,△S and toe function disable gradually recovered,and the nerve regenerated at 3-4 weeks after injury.The injure display rate of T2 fs FRFSE images with TE=90 and 60 ms,SIR of both distal and proximal part of injured nerve were higher than those on images with TE=30 ms (all P＜0.05).Conclusion SIR and △S changes on T2 fs FRFSE imaging can be used to predict rabbit nerve injury.
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Objective To observe the expression of apoptosis and invasion genes in different tissues of laryngeal lesions,and to detect the content of proliferation related protein and proliferation inhibition gene.Methods In our hospital,the clinical diagnosis of laryngeal carcinoma,precancerous lesions and vocal polyps in 88 cases of laryngeal carcinoma,surgical excision of lesion specimens cut from the amount of Pro apoptotic genes and promote invasion and proliferation related protein,gene the content of tissue proliferation inhibition gene detection.Results The laryngeal carcinoma group of Pro apoptotic genes nicotinamide adenine dinucleotide phosphate oxidase 1 (NOX1) and large tumor suppressor gene 1 (LATS1) were all significantly lower than lesion group and polyp group (P ＜ 0.05).Laryngeal carcinoma invasion promoting gene tumour necrosis factor receptor associated factor 6 (TRAF6),and cellular FADD-like interleukin1βconverting enzyme inhibitory protein (c-FLIP) content were significantly higher than that of laryngeal pre cancerous lesions and vocal polyps (P ＜ 0.05).The proliferation related protein Cyclin-dependent kinase 6 (CDK6) and E2F1 in laryngeal carcinoma were significantly lower than that in the lesion and polyp group,and cyclin D1 (CCND1),Bmi-1,and Livin contents were significantly higher than that in the lesion group and the polyp group (P ＜ 0.05).The levels of differentiated embryo-chondrocyte expressed gene 1 (DEC-1),IκB kinase 16(IKK16),large tumor suppressor gene 1 (LAST-1),receptor-interacting proteins-1-(RIP-1),and c-myc promoter binding protein-1 (MBP-1) in the tissue of laryngeal carcinoma were significantly lower than those in the lesion group and polyp group (P ＜ 0.05).Conclusions The laryngeal carcinoma invasion promoting gene was higher than that in other tissues,inhibition of gene content was lower than that of other tissues proliferation related protein gene,apoptosis and proliferation,apoptosis and invasion of lesions in gene expression level,proliferation related protein and proliferation inhibition of gene content and laryngeal squamous cell carcinoma were related to laryngeal disease prevention significance of detection.
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Objective To study the expression of human papillomavirus ( HPV) and ATM protein in laryngeal squamous cell carcinoma (LSCC), and discuss the correlation among the expression and its prognosis Method The expression of HPV16/18 mRNA was detected by PCR , and the expression of ATM proteins by immunohistochemical method in 63 LSCC specimens and 30 specimens of normal tissue adjacent to cancer. Results The positive expression rates of HPV16 /18 and ATM protein in LSCC group were 39.7% (25 /63) and 41. 3% (26 /63) respectively and those of HPV16 /18 and ATM protein in normal group were 9.5% ( 6/63 ) and 83.3% (25 /30) respectively. There was no correlation between the expression of ATM and HPV16/18 in LSCC. The accumulative 5-year survival rates of HPV16/18 positive group and HPV16/18 negative group in 63 patients were 69.8% and 52.6% respectively ,and there was no significant difference (P> 0.05. The accumulative 5-year survival rates of ATM positive group and ATM negative group in 63 patients were 65.4%and 45.9% respectively and there was no significant difference (P>0.05. Conclusion Both HPV16/18 and ATM are abnormally expressed in LSCC , but there is no correlation between the expression of HPV16/18 and ATM and the expression and its prognosis.
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<p><b>OBJECTIVE</b>To detect the expression of SMG-1, ATM and P53 in laryngeal squamous cell carcinoma (LSCC) and their correlation with the clinicopathological features and outcomes of the patients.</p><p><b>METHODS</b>Sixty-three specimens of surgically resected LSCC tissues and 30 specimens of adjacent normal tissue were examined for the expressions of ATM, SMG-1 and P53 using immunohistochemistry. The correlation of ATM, SMG-1 and P53 expressions with the clinicopathological factors and their interactions were analyzed.</p><p><b>RESULTS</b>The positive expression rates of SMG-1, ATM and P53 in LSCC were 36.5% (23/63) , 41.3% (26/63) and 57.1% (36/63) respectively, significantly different from those in the adjacent tissue (73.3%, 83.3% and 20.0%, respectively; P<0.05). The expression of SMG-1 in LSCC was positively correlated with the pathological grade and T stage of the tumors (P<0.05), and ATM and P53 were not related to the clinicopathological factors (P>0.05). The 5-year survival rate of patients negative for SMG-1 expression was significantly higher than that of SMG-1-positive patients (P<0.05). The expression of SMG-1 was negatively correlated with that of P53 (r=-0.476, P<0.01).</p><p><b>CONCLUSION</b>SMG-1, ATM and P53 are closely related to the occurrence of LSCC. SMG-1 expression is an important factor associated with the clinicopathological features and prognosis of LSCC patients, and may play an important role in the development of LSCC by regulating P53 expression.</p>
Subject(s)
Humans , Ataxia Telangiectasia Mutated Proteins , Genetics , Metabolism , Carcinoma, Squamous Cell , Genetics , Metabolism , Immunohistochemistry , Laryngeal Neoplasms , Genetics , Metabolism , Lymphatic Metastasis , Phosphatidylinositol 3-Kinases , Genetics , Metabolism , Prognosis , Survival Rate , Tumor Suppressor Protein p53 , Genetics , MetabolismABSTRACT
Objective To explore the role of human papillomavirus (HPV) in squamous cell carcinoma of the larynx.Methods A cohort of 152 laryngeal squamous cell carcinoma (LSCC) patients,40 premalignant lesions of the larynx,and 40 vocal fold polyp patients was evaluated for the expression of HPV16 E7 protein by immunohistochemistry (IHC).E7 protein expression was correlated with clinicopathological features and outcomes.Results The expression of E7 protein in vocal fold polyp was negative,and it's positive expression in precancerous lesions and laryngeaI carcinomas was 2.5％,and 32.9％,respectively.There were no other significant clinical or demographic differences between pl6-positive and-negative cases.There was no difference in overall survival (OS) between E7-positive and-negative patients with 5-year survival of 79％ and 66％ for p16 positive and negative patients,respectively (P =0.581).There was no statistically significant difference in failure-free survival (FFS) with 5-year FFS of 57.8％ and 42.3％ for p16 positive and negative patients,respectively (P =0.579).Conclusions E7 expression is infrequent in laryngeal carcinomas.There are no statistically significant correlations between E7 IHC status and OS or FFS.
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Objective:To investigate the effect of Yupingfeng on hyaluronic acid (HA) and Foxp3+Treg in patients with nasopharyngeal carcinoma.Methods:A total of 58 cases of nasopharyngeal carcinoma were divided into two groups, 30 cases in the treatment group, 28 cases in the control group. Patients in two groups were treated with synchronous radiotherapy and chemotherapy treatment, the treatment group was treated with the Yupingfeng granules through oral administration, 10 g/time, tid for 2 courses. The serum Foxp3+ Treg markers of each group were detected by flow cytometry assay before treatment and after treatment, and the level of HA in serum was detected by radio immunoassay.Results:After radiotherapy and chemotherapy, the contents of Foxp3+ Treg and HA were significantly decreased in two groups (P<0.05), and the decrease of treatment group was more significantly (P<0.01). Correlation analysis showed positive correlation between Foxp3+ Treg and HA (P<0.05). After treatment, the incidence of side effects in two groups was significantly decreased. And there was significant difference between two groups (P<0.05).Conclusions:Combined chemotherapy and radiotherapy with Yupingfeng treatment can decrease the levles of Foxp3+ Treg and HA in nasopharyngeal carcinoma patients. Yupingfeng can also effectively reduce the side effect due to radiation and chemotherapy.
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Objective To investigate the survival rate and its prognostic factors of laryngeal carcinoma. Methods We retrospectively analyzed 63 cases of laryngeal carcinoma. A total of 7 clinicopathologic factors were studied by univariate analysis and Cox multivariate model. Results The overall cumulative survival rate was 69.8% at 3 years,54.0%at 5 years.In univariate analysis, the survival was related to location of the tumor(P 0.05). In Cox multivariate model, T status (P < 0.01) and N status (P < 0.01) were independent prognostic factors. Conclusions T and N status were independent prognostic factors for patients with laryngeal carcinoma. Early detection and treatment should be given to improve the survival of patients.
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Objective To understand the distribution of inhaled allergens throughout Hainan province and explore effective preventive measures against allergen by examining the serum allergen of patients with chronic rhinosinusitis (CRS), which will provide evidence for specific immunotherapy for treating CRS. Methods Three hundred and eighteen CRS patients underwent Phadiatop blood test by using the UniCAP 100 , a completely automatic autoanalyser. Allergen-specific IgE of 7 common allergens were tested and the concentration of total immunoglobulin E (TIgE) was collected and evaluated. Results The positive rates of the serum TIgE and inhaled allergens were 64.15% and 37.74% respectively. The incidences of the positive serum SIgE is 33.96%. Among the positive cases, 28.30% of the inhaled allergens were dermatophagoides pteronyssinus, 27.36% for tropical mites, 21.07% for dermatophagoides farinae, 13.52% for cockroach, 11. 64% for house dust, 7. 86% for cat dander and 0.63% for dog dander. The incidences of positive TIgE and SIgE were not significantly different between patients with nasal polyps and sinusitis only. Conclusions Dermatophagoides pteronyssinus, tropical mites and dermatophagoides farinae are the main inhaled allergens for CRS patients in Hainan.
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OBJECTIVE@#To study the early gene diagnosis of hereditary hemorrhagic telangiectasia (HHT) induced severe nosebleed.@*METHOD@#Clinical features of 23 family members in two HHT pedigrees were examined. Genomic DNA was extracted from peripheral blood samples. PCR amplification was conducted to screen ENG and ACVRL-1 genes with their specific primers. Direct sequencing was performed to detect the mutation. Mutation analysis was carried out to evaluate its significance.@*RESULT@#A heterozygous c. 263A > G mutation was identified in exon 3 of ACVRL-1 in 6 out of 11 members in NMG-1 pedigree. In GD-2 pedigree, 5 of 11 members carried c. 199C > G mutation. Mutation detection rate was 100% in subjects with nosebleed history and 25% in family members without epistaxis.@*CONCLUSION@#Gene diagnosis characterized by high sensitivity and specificity is of great practi-cal significance and early genetic screening should be a clinical routine test for HHT induced severe nosebleed.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Activin Receptors, Type II , Genetics , Antigens, CD , Genetics , DNA Mutational Analysis , Endoglin , Epistaxis , Diagnosis , Genetics , Exons , Genetic Testing , Pedigree , Receptors, Cell Surface , Genetics , Telangiectasia, Hereditary Hemorrhagic , Diagnosis , GeneticsABSTRACT
This paper presents a wireless temperature and humidity control system for hospital's video room. The system realizes one to multiple communication using wireless communication module CC1020 and SHT11 as sensors, and then sets up the communication between system and the central station with serial communication controller MSCOMM. The system uses VISUAL C++ programming to realize the video room temperature and humidity alarm control. It is wireless, efficacious and manpower-efficient.
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Computer Communication Networks , Diagnostic Equipment , Environment, Controlled , Equipment Design , Equipment and Supplies, Hospital , Humidity , Software , Temperature , Wireless TechnologyABSTRACT
BACKGROUND: Intrapulmonary vascular abnormalities result in the right-to-left shunting and severe hypoxemia in liver transplantation candidates. Currently, a convenient, sensitive and effective method is absent to screen the intrapulmonary vascular dilatations.OBJECTIVE: To evaluate the role of contrast-enhanced echocardiography on clinical diagnosis of intrapulmonary shunting in liver transplantation candidates.DESIGN, TIME AND SETTING: The experiment, prospective controlled observation based on cases, was performed at the Hepatology Unit of the 458 Hospital of PLA (Guangzhou, Guangdong, China) from February 2004 to February 2006.PARTICIPANTS: Twenty-four consecutive liver transplantation candidates were recruited from the Hepatology Unit of the 458Hospital of PLA.METHODS: Routine examination was conducted under the condition without any regimen of vascular dilatation drugs.Contrast-enhanced echocardiography was applied to detect the prevalence of right-to-left shunting in the patients with end-stage liver disease. The microvesicle of the left ventricle in patients was qualitatively assessed by a score from 1+ to 3+. Accordingly, all patients were divided into two groups: intrapulmonary shunting and non-intrapulmonary shunting.MAIN OUTCOME MEASURES: The prevalence of right-to-left shunting and clinical characteristics of liver transplantation candidates were determined.RESULTS: Ten (41.7%) of 24 patients with positive contrast-enhanced echocardiography were proved to develop the intrapulmonary right-to-left shunting, including 6 for l+ and 4 for 2+ by left ventricle abnormality, which emerged after 6-10 cardiac cycles of right ventricle abnormality. There were no significant differences in age, gender, arterial blood gas analysis and liver function tests between the two groups (P > 0.05). Echocardiography results demonstrated that, the upper digestive tract hemorrhage,spleen thickness that indicated portal hypertension, pulmonary artery systolic pressure and Tei index were significandy higher in the patients of intrapulmonary shunting than in those of non-intrapulmonary shunting (P<0.05-0.01 ).CONCLUSION: Intrapulmonary vascular dilatation occurs frequently in liver transplantation candidates associated with intrapulmonary shunting but without hypoxemia. Contrast-enhanced echocardiography is a sensitive and non-invasive method for the early diagnosis of intrapulmonary vascular dilatation. The pathogenic cause is portal hypertension. Tel index can be used as an important parameter for evaluating right ventricular function in patients of intrapulmonary vascular dilatation.
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Objective To evalvate the influence of elbow joint stability following ulna coronoid process fractures. Methods Three cadaveric upper extremities were used. The height, width, thickness, diameter and opening angle of ulna coronoid process were measured in six arms, while the coronoid process fragments at the level of 2 mm, quarter, half, three quarter and whole height were resected consecutively, the changes of the range of the elbow joint movement were recorded. Another sixteen specimens were divided into two groups: the anterior bundle of the ulnar collateral ligaments (UCL) in one group was unrepaired; While the other repaired, then the angle of cubitus valgus between two groups was compared. Results If the osteotomy bone was within quarter of ulna coronoid process, the elbow joint function was good. However, in cases of osteotomy on half of coronoid process, the elbow extension function was limited and the elbow became unstable. After reduction with internal fixation, the angle of cubitus valgus was greater in the second group, and the difference of elbow joint in flexion 0?, 30?, 60?, 90? and 120? had statistical significance(P