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Risk prediction models play an important role in the primary prevention of cardiovascular diseases (CVD) in the elderly population. There are fifteen papers about CVD risk prediction models developed for the elderly domestically and internationally, of which the definitions of disease outcome vary widely. Ten models were reported with insufficient information about study methods or results. Ten models were at high risk of bias. Thirteen models presented moderate discrimination in internal validation, and only four models have undertaken external validation. The CVD risk prediction models for the elderly differed from those for the general population in terms of model algorithm and the effect size of association between predictor and outcome, and the prediction performance of the models for the elderly attenuated. In the future, high-quality external validation researches are necessary to provide more solid evidence. Different ways, including adding new predictors, using competing risk model algorithms, machine learning methods, or joint models, and altering the prediction time horizon, should be explored to optimize the current models.
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Humans , Aged , Cardiovascular Diseases/epidemiology , Algorithms , Machine LearningABSTRACT
@#Abstract: To analyze the clinical, therapeutic and laboratory characteristics of disseminated cryptococcosis caused by Cryptococcus neoformans invading the blood stream in patient with liver cirrhosis and splenectomy. A 30-year-old male underwent splenectomy plus pericardial devascularization due to "splenomegaly and hypersplenism" in March in 2016. The patient had intermittent fever after operation for many times, and successively accompanied with back pain, left lower limb abscess and right hip pain. The highest body temperature was 39 ℃. CT and MRI revealed the lung lesion and multiple bone destruction. During that period, the effect of antibiotics was not good. On April 19th, 2017, Gram's stain, India ink stain, API 32C, Vitek 2 Compact, ribosomal ITS and IGS sequence analysis were performed to identify the strain isolated from the pus and blood stream. The serum of the patient was detected for cryptococcal antigen. Antifungal susceptibility test was used to determine drug sensitivity and minimum inhibitory concentration (MIC). The Cryptococcus neoformans isolated from fresh pus specimen showed a prominent, thick capsule after India ink stain. The colonies isolated from pus and blood stream were identified Cryptococcus neoformans using API 32C, Vitek 2 Compact, and sequence analysis of rDNA ITS and IGS. Cryptococcal capsule antigen was positive. The minimal inhibitory concentrations of 5-Flucytosine, amphotericin B, fluconazole, itriconazole, voriconazole against the isolate were <4 μg/mL, <0.5 μg/mL, 4 μg/mL, ≤0.25 μg/mL, 0.125 μg/mL respectively. The patient was initially treated with intravenous amphotericin B and flucytosine. After anti-Cryptococcus treatment for two months, the patient clinically improved, and the lesions were reduced on a follow-up CT scan. The patient made a full functional recovery after treatment for six months. Cryptococcosis has hidden onset, atypical clinical symptoms and lack of specificity. Blood stream is the main channel for Cryptococcus to spread and involve many organs of the whole body, including skin, bone and so on. Therefore, early use of blood culture to monitor blood flow dissemination, actively removing the primary focus and cutting off the infection route in time and carrying out effective anti-Cryptococcus treatment are conducive to the patient's early recovery.
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Objective:To explor the effects of mentalization-based family therapy (MBFT) on the emotions of anxiety and depression, reflective functions, and related brain regions of adolescents with depression.Methods:Thirty-two adolescent patients with depression were selected in Beijing Huilongguan Hospital.Among them, fifteen patients treated with conventional drugs were defined as the control group, the other seventeen patients served as the observation group.On the basis of routine drug treatment, patients in the observation group were treated with 1.5 h MBFT once a week, for a total of 3 months.Among them, 10 patients underwent resting functional magnetic resonance imaging(rs-fMRI) scans before and after the intervention.SPSS 23.0 was used for statistical analysis of scale evaluation data by using chi-square test and repeated-measure analysis of variance, and pairwise Pearson correlation was used to construct a brain network matrix for the MRI results.The patient's brain network matrix was put into Gretna to calculate, and then use repeated measures analysis of variance and t test for judgment. Results:(1)Repeated measurement analysis of variance showed, over time and group, before and after intervention, the group×time interactions of patients' reflective function, anxiety, depression were statistically significant ( F=5.113, 9.350, 5.264, all P<0.05). Further simple effect analysis showed, in the observation group, there were statistically significant differences in patients' anxiety ((55.09±14.35) vs (30.58±3.62)), depression ((61.58±16.81) vs (31.00±3.48)) before and after intervention (all P<0.01). There was no significant difference in reflective function ((8.71±0.51) vs (8.87±0.50) ) in the observation group before and after intervention( P> 0.05). The reflective function((8.92±0.33) vs (8.73±0.35)) and anxiety((50.67±13.88) vs (45.78±12.89)) scores of the control group were not statistically significant different before and after intervention(all P>0.05), and the depression scores of the control group before and after inter-vention((69.33±9.11) vs (50.94±7.99)) were statistically significant different( P<0.01). (2)rs-fMRI showed that, using the posterior parietal lobe and the medial prefrontal lobe as seed points, the group×time interactions with right inferior frontal gyrus, right fusiform gyrus, right superior temporal gyrus, left middle temporal gyrus and right superior frontal gyrus were statistically significant ( F=29.56, 20.63, 8.69, 9.49, 8.62, all P<0.05). The further simple effect analysis showed in the observation group, the pre-test was less than the post-test, and the difference was statistically significant( P<0.05). In the control group, there were not statistically significant differences in the functional connection strength before and after the test(all P>0.05). (3)The brain network analysis of 264 regions of interest (ROIs) in the whole brain showed that the number of modules in the observation group was less than that in the control group, and the difference was statistically significant ( t=-2.64, P=0.046). Conclusion:MBFT can improve the anxiety and depression of adolescent patients with depression.It enhances the functional link between mentalization related brain regions and the whole brain, and enhances the activity of the whole brain link to become more integrated.
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Objective:To determine the current situation of food safety risk monitoring ability of centers for disease control and prevention （CDCs） in a province， and provide reference for strengthening the construction of food safety monitoring ability in the future. Methods:A self-administered questionnaire survey was conducted among 14 CDCs who are responsible for food safety risk monitoring in the province in 2018. Results:The ratio of food inspection staff with senior， middle， and primary professional titles was 1∶1∶1. The educational background of food inspection staff at the provincial and municipal levels was mainly bachelor degree or above， while that of county level directly under the administration of the province was mainly college degree. The age composition of the staff at the provincial level tended to be elder； however， there were more staff with less working experience at the county level. The qualification proportion of laboratory area was 50%. The distribution proportion of food inspection equipment in the CDC at all levels was 83.3%， 79.5% and 36.3%， respectively. In total， 14 CDCs completed the monitoring task as required. They were all accredited with laboratory qualifications； however， one CDC did not conduct re-evaluation after the certification of food inspection qualification expired. Each CDC ensured the accuracy and reliability of monitoring data through the supervision in food testing. Conclusion:The food safety risk monitoring ability of the CDCs in the province is continuously improved， which can meet the needs of routine monitoring. However， the composition of professional titles of food inspection staff is not very reasonable. There is still a gap between the equipment configuration and the national requirements. The ability of food inspection needs to be improved， in which quality management and laboratory qualification should be further strengthened.
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Objective:The phase separation of Baihutang was carried out. The content of mangiferin，new mangiferin，calciumion，glycyrrhizin and ammonium glycyrrhizinate in the solution phase，the nano phase and the precipitated phase of Baihutang were measured，so as to define the effect of nanometer particles of Baihutang on the growth of active components，and explain the mechanisms of Baihutang in potent detoxification and heat removal. Method:The phase separation of Baihutang was performed by high-speed centrifugation and dialysis. The contents of mangiferin，new mangiferin，glycyrrhizin and ammonium glycyrrhizinate in Baihutang were determined by HPLC. Chromatographic column Diamonsil C18 (4.6 mm×250 mm，5 μm) was adopted, with acetonitrile-25 mmol·L-1 potassium dihydrogen phosphate solution as the mobile phase, and eluted in a gradient mode. The detection wavelength was 257 nm，the column temperature was 30 ℃，and the flow rate was 1.0 mL·min-1. EDTA-2Na solution was used to calibrate the calcium concentration in different phase states of Baihutang. Result:1 mL Baihutang nanoparticles contained 483.00 μg new mangiferin，1 068.88 μg mangiferin，219.93 μg glycyrrhizin and 187.10 μg ammonium glycyrrhizin，and the content of new mangiferin and mangiferin accounted for 89.4% and 89.9% respectively in 1 mL Baihutang. The new mangiferin and mangiferin in the nano phase were 230.0 and 23.3 times the true solution，and 8.5 and 14.4 times of the precipitation，respectively. The content of calcium ions in Baihutang in the nano phase was higher，accounting for 86.9% of Baihutang，and the content of calcium ions in Baihutang and Baihutang in the nano phase was higher than that in gypsum group. Conclusion:The content of main components in Baihutang in nanometer phase is significantly higher than that in other phases. The nanoparticles of Baihutang have a solubilizing effect on the main antipyretic components, such as mangiferin，mangiferin and calcium ions as well as the antitoxic components glycyrrhizic acid and glycyrrhizic acid. The mechanism of action of Baihutang is related to the formation of nanoparticles.
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Zixue was first recorded in detail in Qianjin Yifang, and practitioners of later generations renamed it as Zixuesan and Zixuedan, which is the representative prescription of antipyretic preparations and has high clinical application and research value. At present, there have been many studies on the pharmacological effect and clinical application of Zixue, but the medical books of the past dynasties have slightly different records on Zixue, which has brought some difficulties to the reasonable clinical application and research of this prescription. In addition to the introduction of Zixuesan, which is different from the ancient recipe, the researchers have questions about which development method can reasonably inherit and develop the classical preparation. The authors intend to summarize the historical evolution of "formula" and "preparation" of Zixue, in order to clarify its historical context, which can provide a reference for the modern research and development of this formula, and provide a new ideas for the in-depth exploration of other classic preparations.
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Objective:To investigate the role of NRF2 pathway in the drug resistance to sorafenib in hepatocellular carcinoma (HCC).Methods:Two sorafenib-resistant cells HepG2-SR and Huh7-SR were established by incubating human HCC HepG2 and Huh7 cells at a increasing concentration of sorafenib,and verify resistant cell properties by detecting the cell apoptosis.The levels of NRF2 were detected by Western blot and Real-time PCR.SiRNA was used to silence NRF2,then the cell apoptosis were detected by flow cytometry to explore the effect of reversing the drug resistance and synergy in combination with sorafenib.Results:Sorafenib induced pro-apoptosis effect was significantly in Huh7 and HepG2 cells than the corresponding Huh7-SR and HepG2-SR cells.The NRF2 expression levels were significantly higher in sorafenib-resistant cells and the parental cells treated with sorafenib than the corresponding untreated parental cells,while the NFR2 mRNA expression levels were no significant.When in combination with sorafenib,NRF2 siRNA showed the synergistic effect in inducing cell apoptosis in sorafenib-resistant cells and parental cells.Conclusion:NRF2,activated by post-transcriptional level after sorafenib exposure,is responsible for the drug resistance to sorafenib in HCC.Inhibiting NRF2 could reverse the drug resistance to sorafenib in HCC.
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We screened echinococcosis-specific diagnostic antigen and verified its immunogenicity.The sequencing data of Echinococcus granulosus released by the National Human Genome Research Center was analyzed.The bioinformaties method was used to screen out Eg-07279 antigen gene Eg-07279,which was not expressed in Echinococcus granulosus and highly expressed in the original metacercariae.After expression,the recombinant protein rEg-07279 was purified by affinity chromatography.The specific IgG level was detected in the recombinant protein immunized mice and the immunogenicity was verified by Western blot.The selected antigen molecule Eg-07279 was cloned,expressed and purified to obtain the recombinant protein.The results of ELISA showed that the specific IgG level of Eg-07279 (2.559±0.125) was significantly higher than that of the blank group (0.319 0±0.01),the difference was statistically significant (P＜0.01);the Western blot results showed that the recombinant plasmids could be recognized by the secondary infection of the protoscolex and the serum of the recombinant protein immunized group,while the serum of the blank control group was not recognized by the serum.In summary,the Eg07279 antigen of E.granulosus was obtained and it was proved that the recombinant protein has good immunogenicity and is a good diagnostic antigen candidate molecule.
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<p><b>BACKGROUND</b>The surgical management of occult breast cancer is controversial. We compared the outcomes of different treatments of occult breast cancer and evaluated the potential prognostic factors for overall survival and recurrence.</p><p><b>METHODS</b>We retrospectively reviewed 77 patients who presented to our hospital from 1968 to 2011 with a diagnosis of occult breast cancer. Patients were divided into three groups: 42 patients (63%) were treated with modified radical mastectomy+axillary lymph node dissection (ALND), 16 patients (24%) were treated with ALND + postoperative radiotherapy, and 9 patients (13%) with only ALND. Survival analyses were undertaken to compare the efficacy of these three treatments.</p><p><b>RESULTS</b>Of the 77 patients with occult breast cancer, 2 patients were lost to follow-up and 8 patients refused surgical treatment: 67 patients (90.4%) were included in this analysis. The median follow-up was 62.2 (0.6-328.0) months. Kaplan-Meier analyses showed no significant difference in overall survival and recurrence-free survival between the three groups (P = 0.494 and 0.397, respectively). The prevalence of local recurrence was 11.9% for the mastectomy + ALND, 18.8% for ALND + radiotherapy, and 11.1% for ALND-only groups, and those for distant recurrence were 2.4%, 12.5%, and 11.1%, respectively. Compared with progesterone receptor-negative subjects, progesterone receptor-positive patients had better overall survival and lower recurrence rates (P = 0.057 and 0.062, respectively).</p><p><b>CONCLUSIONS</b>There was no significant difference in outcomes between mastectomy and breast-preserving surgery. Expression of the progesterone receptor should be taken into account when evaluating the prognosis of occult breast cancer.</p>
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Adult , Aged , Female , Humans , Middle Aged , Breast Neoplasms , Diagnosis , Mortality , Therapeutics , Lymph Node Excision , Mastectomy , Neoplasm Recurrence, Local , Prognosis , Receptors, Progesterone , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To study the effects of Qingre Xiaoji Recipe (QXR) on the migration, chemotaxis, and tube formation capability of human umbilical vein endothelial cells (HUVECs) induced by human lung adenocarcinoma cells (SPC-A-1).</p><p><b>METHODS</b>The QXR groups at different final concentrations (2.5, 5.0, 10.0, and 20.0 mg/mL) and a control group were set up. Then the chemotaxis and tube formation capabilities were observed using Erasion trace test, Transwell chamber assay, and Matrigel matrix tube formation assay.</p><p><b>RESULTS</b>QXR at three concentrations (2.5, 5.0, and 10.0 mg/mL) had inhibition on the migration of HUVECs cultured by SPC-A-1 cell supernatant (P<0.05). Besides, the migration rate decreased along with increased concentrations. The number of chemotactic HUVECs was significantly less than that of the positive control group (P <0.01), and the inhibition rate of chemokine increased along with increased concentrations. Furthermore, the number of chemotactic HUVECs was negatively correlated to the drug concentration (r = -0.830, P <0.01). The area of HUVEC cell tubule formation was significantly lower than that of the positive control group (P <0.01). The inhibition rate of HUVEC cell tubule formation increased along with increased drug concentration. Besides, the area of HUVEC cell tubular formation was negatively correlated with the drug concentration (r = -0.937, P <0.01).</p><p><b>CONCLUSION</b>The mechanism of QXR for fighting against tumor angiogenesis might be correlated with its inhibition on the migration, chemotaxis, and tube formation of tumor vascular endothelial cells.</p>
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Humans , Adenocarcinoma , Pathology , Cell Line, Tumor , Chemotaxis , Drugs, Chinese Herbal , Pharmacology , Human Umbilical Vein Endothelial Cells , Cell Biology , Lung Neoplasms , Pathology , Neovascularization, PathologicABSTRACT
ObjectiveBy analyzing the epidemiological characteristics and trends of brucellosis in Hebei province,provide a scientific basis for the formulation of strategies for effective prevention and control of the disease.MethodsUsing the descriptive epidemiological method,data of the “China information system for disease control and prevention” from 2006 to 2010 were statistically analyzed.ResultsThere were 13 632 reported cases from 2006 to 2010 in Hebei province,no death,the annual incidence rates reported were 3.4068/10 million,3.4851/10 million,4.5701/10 million,4.6045/10 million,and 3.5582/10 million,respectively.Eleven counties throughout the province had reported cases.The cases were found intensively in Zhangjiakou,Chengde,Baoding,Handan and Shijiazhuang,which accounting for 90.02％ (12 271/13 632) of the total cases.The disease was found each month throughout the year,and showed a seasonal cycle with peak period in spring and summer.The disease was most commonly found in 25 - 65 age people,which accounting for 84.57％(11 529/13 632).The incidence in male was higher than that of female,and male to female ratio was about 3.56:1.00.Vocational high risk population was farmers,accounting for 91.15％ of the total cases(12 425/13 632).ConclusionsBrucellosis epidemic in Hebei province is relatively serious,and the epidemic range has expand each year,even highly active in some particular areas.To control the outbreak of brucellosis,departments cooperation between health and animal husbandry should be strengthened; management of source of infection should be strengthened; health education and behavior intervention should be carried out thoroughly and deeply for high-risk groups.
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Objective To study the relationship between atherosclerotic plaques in carotid artery and ischemic cerebrovascular diseases. Methods The extracranial carotid arteries (ECA) and middle cerebral artery (MCA) of 54 patients with transient ischemic attack (TIA) or cerebral infarction (CI) were examined with doppler ultrasound. The distribution of atherosclerotic plaque, degree of stenosis and ultrasounic classification of ECA and the mean velocity of blood flow in MCA were examined. Results ①Stenosis over middle-grade on asymptomatic side in extracranial internal carotid artery (EICA) in group of patients with TIA was significantly higher than symptomatic side(P<0.01). Stenosis over high-grade on asymptomatic side in ELCA in group of patients with CI was significantly higher than symptomatic side (P<0.01). ②Flat and soft plaque are most common in group of patients with TIA or CI, then are hard and ulcerative plaques. Incidence of soft plaques on asymptomatic side in group of patients with TIA or CI are significantly higher than symptomatic side (P<0.01); ③Among the group of patients with CI, mean velocity of MCA decreased on asymptomatic side in 31 cases (68.9%), and significantly higher than symptomatic side (P<0.01). Conclusion Atheroclerotic plaques in carotid artery and intracranial hemodynamic characteristics are the important risk factors for ischemic cerebrovascular diseases. These findings have important values in predicting subsequent TIA or CI in asymptomatic subjects.
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Objective To study the relationship between atherosclerotic plaques in carotid artery and ischemic cerebrovascular diseases. Methods The extracranial carotid arteries (ECA) and middle cerebral artery (MCA) of 54 patients with transient ischemic attack (TIA) or cerebral infarction (CI) were examined with doppler ultrasound. The distribution of atherosclerotic plaque, degree of stenosis and ultrasounic classification of ECA and the mean velocity of blood flow in MCA were examined. Results ①Stenosis over middle-grade on asymptomatic side in extracranial internal carotid artery (EICA) in group of patients with TIA was significantly higher than symptomatic side(P<0.01). Stenosis over high-grade on asymptomatic side in ELCA in group of patients with CI was significantly higher than symptomatic side (P<0.01). ②Flat and soft plaque are most common in group of patients with TIA or CI, then are hard and ulcerative plaques. Incidence of soft plaques on asymptomatic side in group of patients with TIA or CI are significantly higher than symptomatic side (P<0.01); ③Among the group of patients with CI, mean velocity of MCA decreased on asymptomatic side in 31 cases (68.9%), and significantly higher than symptomatic side (P<0.01). Conclusion Atheroclerotic plaques in carotid artery and intracranial hemodynamic characteristics are the important risk factors for ischemic cerebrovascular diseases. These findings have important values in predicting subsequent TIA or CI in asymptomatic subjects.