ABSTRACT
Objective:To noninvasively evaluate the clinical value of early renal function changes in patients with type 2 diabetes mellitus (T2DM) using blood oxygenation level dependent (BOLD) and arterial spin labeling (ASL) MRI.Methods:A total of 63 T2DM patients from Tianjin First Central Hospital from September 2019 to May 2022 were prospectively collected, 30 healthy volunteers (control group) were collected during the same period. According to albumin creatinine ratio (ACR), patients with T2DM were divided into normal albuminuria (NAU, ACR<30 mg/g) group and microalbuminuria (MAU, 30 mg/g≤ACR≤300 mg/g) group, there were 35 and 28 cases respectively. All subjects underwent abdominal BOLD and ASL scans. The values of renal cortical and medullary apparent relaxation rate (R 2*) and renal cortical renal blood flow (RBF) were measured. One-way ANOVA was used to compare the differences in R 2* and RBF among the three groups. Receiver operating characteristic curve was used to analyze relevant parameters to identify the diagnostic effectiveness of each group, and area under the curve (AUC) was compared by Z-test. Results:There were significant differences in renal medullary R 2* and renal cortical RBF among the control group, NAU group and MAU group ( F=45.83, 34.15, P<0.001). There was no significant difference in renal cortical R 2* ( F=2.98, P=0.056). In differentiating the control group from the NAU group, the AUC of renal medullary R 2*, renal cortical RBF and their combined parameters were 0.921 (95%CI 0.827-0.973), 0.704 (95%CI 0.578-0.811), 0.964 (95%CI 0.885-0.994), respectively. The AUC of combined parameters was significantly different from renal cortical RBF ( Z=4.07, P<0.001), but not from renal medullary R 2* ( Z=1.57, P=0.117). In differentiating the NAU from the MAU group, the AUC were 0.898 (95%CI 0.796-0.960), 0.919 (95%CI 0.823-0.973), 0.985 (95%CI 0.881-0.994), respectively. The AUC of combined parameters was significantly different from renal medullary R 2* and renal cortical RBF ( Z=2.39, P=0.017; Z=2.20, P=0.028). Conclusions:The changes of renal oxygenation level and blood flow in early stage of T2DM patients can be evaluated noninvasively and quantitatively using BOLD and ASL. Renal medullary R 2* combined with renal cortex RBF shows better diagnostic efficacy for early renal function changes in diabetes than each single index.
ABSTRACT
OBJECTIVE To evaluate the efficacy and safety of PD-1/PD-L1 inhibitors for neoadjuvant treatment of bladder cancer， and to provide evidence-based reference for clinical treatment. METHODS Retrieved from PubMed， Cochrane Library， Embase， American Society of Clinical Oncology Meeting Library， CNKI， VIP and Wanfang database， etc.， the randomized controlled trials （RCTs）， non-RCT， case-control studies， cohort studies， etc. about PD-1/PD-L1 inhibitors for neoadjuvant treatment of bladder cancer were collected from the inception to Jan 31st， 2023. After literature screening， data extraction and quality evaluation， RevMan 5.3 software was used to perform meta-analysis of single-group rates； sensitivity analysis and publication bias analysis were conducted using Stata12 software. RESULTS A total of 25 studies were included in this discussion， involving 940 patients. The results of meta-analysis showed that the pathologic complete response （pCR） rate was 32% [OR＝0.32， 95%CI （0.22， 0.45）， P＝0.006]， downstaging rate was 52% [OR＝0.52， 95%CI （0.45， 0.60）， P＝0.55]， and the incidence of ≥grade 3 immune-related adverse events （irAEs） was 16% [OR＝0.16， 95%CI （0.11， 0.22）， P＜0.000 01]. Subgroup analysis showed that the patients receiving PD-1/PD-L1 inhibitors alone had a pCR rate of 25% and a incidence of Grade≥3 irAEs of 9%； the patients receiving combined immunotherapy had a pCR rate of 29% and a incidence of Grade≥3 irAEs of 28%； the patients receiving PD-1/PD-L1 inhibitors combined with chemotherapy had a pCR rate of 43% and a incidence of Grade≥3 irAEs of 12%； PD-L1 positive patients had a pCR rate of 44%， and PD-L1 negative patients had a pCR rate of 25%. The results of the sensitivity analysis showed that the study was robust. The results of the publication bias analysis showed that there was no significant publication bias. CONCLUSIONS PD-1/PD-L1 inhibitors are effective and safe for adjuvant treatment of bladder cancer.
ABSTRACT
Objective:To analyze the related factors affecting the inter-arm systolic blood pressure difference (IASBPD) in a physical examination population.Methods:A total of 3 600 adults who underwent physical examination and completed the arteriosclerosis test in the first affiliated hospital of Anhui medical university from January 2019 to June 2021 were selected as the participants by systematic sampling method. Data on age, sex, and history of smoking, heavy drinking, hypertension, type 2 diabetes, and coronary heart disease were recorded. The height, weight, waist circumference, hip circumference, total muscle, total fat and body fat ratio were measured, and body mass index was calculated. The blood pressure of the limbs, ankle brachial index (ABI) were measured synchronously with the arteriosclerosis tester of the Chinese Academy of Sciences, and the IASBPD were calculated. According to the IASBPD value, the participants were divided into two groups: IASBPD<10 mmHg (1 mmHg=0.133 kPa) group and IASBPD≥10 mmHg group, The differences between the two groups were compared, and the related influencing factors of IASBPD were analyzed by multivariate logistic regression.Results:Weight, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, total muscle, total fat, body fat rate, history of hypertension, proportion of type 2 diabetes mellitus, and proportion of history of coronary heart disease in the IASBPD≥10 mmHg group was higher than that of IASBPD<10 mmHg group [(69.1±11.2) vs (65.3±10.8) kg, (25.6±3.4) vs (24.4±3.3) kg/m 2, (91.3±11.3) vs (87.8±10.6) cm, (98.5±10.4) vs (96.5±9.8) cm, (139.7±20.0) vs (129.7±17.6) mmHg, (80.3±11.6) vs (76.7±10.1) mmHg, (47.5±9.1) vs (45.3±8.8) kg, (19.4±7.0) vs (17.6±6.4) kg, (27.9%±8.5%) vs (26.8%±8.1%), 41.1% vs 29.3%, 16.6% vs 11.7%, 13.1% vs 7.3%] (all P<0.05); ABI was lower than that in IASBPD<10 mmHg group [(1.15±0.11) vs (1.20±0.09)] ( P<0.001). There were no significant differences in height, smoking history and heavy drinking history between the two groups (all P>0.05). Multivariate logistic regression analysis showed that age, systolic blood pressure, body weight and ABI were independent influencing factors of IASBPD≥10 mmHg. Age, systolic blood pressure and body weight were positively correlated with IASBPD≥10 mmHg, while ABI was negatively correlated with IASBPD≥10 mmHg. Conclusion:Increases in age, systolic blood pressure, and body weight and a decrease in ABI are important influencing factors leading to the elevation of IASBPD.
ABSTRACT
@#Objective To design a novel ankle rehabilitation trainer to meet the rehabilitation needs of multiple motion after ankle injury.Methods Based on the model of ankle motion, combined with the mechanical design and the rehabilitation techniques, a trainer was designed using SolidWorks software, including rotational plane and dynamic mechanism design, allowing a multi-dimensional motion.Results The trainer completed the motion of plantar-flexion/dorsiflexion, inversion/eversion, and adduction/abduction of ankle, to carry out uniaxial or multidimensional motor rehabilitation.Conclusion The mechanical structure of the rehabilitation trainer is simple, meeting the needs of ankle rehabilitation training program, which can be used to relieve ankle joint motor dysfunction.
ABSTRACT
Objective:To investigate the pathogenic distribution of benign infantile convulsions with mild gastroenteritis(BICE)and explore the relevance of serum cytokines and BICE.Methods:Eighty BICE infants admitted in Inner Mongolia Maternal and Child Health Hospital from January 2017 to December 2019 were selected as BICE group, and 80 mild gastroenteritis infants without convulsion attack were selected as control group during the same period.Fluorometric real-time PCR was used to detect the pathogen of enterovirus.Serum cytokines including interleukin(IL)-6, tumor necrosis factor(TNF)-α, IL-8 and soluble interleukin-2 receptor(SIL-2R)were detected by using chemiluminescence method.The relevance of frequency and duration of convulsion in infants with BICE and the indicators above were analyzed.Results:Rotavirus infection was the main cause of BICE during the study period in this region.Among 80 cases in the BICE group, rotavirus positive infants accounted for 38.8%(31/80) and norovirus positive infants accounted for 10.0%(8/80). The levels of IL-6, IL-8 and SIL-2R in the BICE group were prominently higher than those in the control group( P<0.05); the difference of TNF-α level between two groups had no statistical significance( P>0.05). The levels of IL-6, TNF -α, IL-8, SIL-2R in the group with convulsion attack times ≥ 2 and convulsion duration ≥5 min were higher than those in the group with convulsion attack times<2 and convulsion duration<5 min( P<0.05). The frequency and duration of convulsions were positively correlated with the levels of IL-6, TNF -α, IL-8 and SIL-2R( P<0.05). Conclusion:Rotavirus is the main pathogen of BICE in this region.There is immunologic imbalance in children with BICE, especially the changes of IL-6 and SIL-2R levels, which may provide effective cytological and experimental data evidence for judging progression and prognosis of the disease.
ABSTRACT
Objective:To explore the value of diffusion tension imaging (DTI) in the evaluations of hepatic ischemia-reperfusion injury (WIRI) regulation of liver regeneration after partial hepatectomy.Methods:Thirty healthy adult male New Zealand white rabbits were randomly divided into five groups of control and 10/20/30/40 min warm ischemia time (A0-A4)( n=6 each). Routine magnetic resonance (MR) and diffusion tensor imaging (DTI) were performed at 6 h, 3 d, 7 d, 14 d, 30 d post-keratectomy. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were measured at Day 30 post-keratectomy. The levels of malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and proliferating cell nuclear antigen (PCNA) in frozen liver tissues were examined and histopathological examination was performed. The values of apparent diffusion coefficient (ADC), fractional anisotropy (FA) and liver volume were measured and liver regeneration rate (LRR) was calculated. Repeated measurement analysis of variance was employed for comparing the difference of DTI and LRR in different groups at different follow-up times. One-way analysis of variance was utilized for comparing the differences of DTI and LRR between groups at the same follow-up time. Pearson or Spearman correlation analysis was employed for evaluating the correlation between DTI, LRR and biochemical parameters. Results:The interaction between time and warm ischemic factor ( P<0.05) and the effect of both alone ( P<0.001) had statistically significant effects on ADC values. FA value and LRR interaction were not significant between time and warm ischemic factor. However, the dominant effect of time factor was significant ( P<0.05). A significant positive correlation existed between ADC value and LRR in the same warm ischemia group ( P<0.01). FA and LRR were negatively correlated ( P<0.05), except for A3 group. FA had a weak correlation with IL-6 at Day 30 post-operation. Conclusions:DTI can non-invasively and quantitatively evaluate the effect of hepatic WIRI on liver regeneration after partial hepatectomy in rabbits. A certain degree of WIRI (≤30 min) can promote liver regeneration after partial hepatectomy. The longer warm ischemia time, the more obvious promotion effect. However, the promotion effect declines significantly after 30 min.
ABSTRACT
Febrile seizures (FS) is the most common convulsive disorder in childhood and is a frequent problem for pediatricians.Most of the children have a good prognosis, but some children have recurrent attacks. Severe cases can even develop into epilepsy, which can cause great damage to the physical and mental health of children.Further understanding and studying issues related to febrile seizures has become a major concern for pediatricians and many families.This article reviews the definition, incidence, classification, etiology, pathogenesis, and epilepsy correlation and management measures of febrile seizures, and is expected to be applied in clinical practice to provide guidance for the prevention, diagnosis and treatment of febrile seizures.
ABSTRACT
Objective@#To determine the diagnostic value of serum cystatin C (Cys C) for acute kidney injury (AKI) in patients with liver cirrhosis.@*Methods@#Serum Cys C levels in 150 liver cirrhosis patients (88 AKI and 62 non-AKI patients) were measured by the Particle-Enhanced Nephelometric Immuno-Assay. The accuracy of serum Cys C for the diagnosis of AKI in liver cirrhosis was evaluated by the ROC curve.@*Results@#Liver cirrhosis patients with AKI had significantly higher serum Cys C levels [2.37 (1.75-2.83) mg/L] than those without AKI [0.97 (0.85-1.09) g/L] (P <0.001). Serum Cys C level was highest in the acute tubular necrosis group [5.41 (2.77-6.19) mg/L], followed by the hepatorenal syndrome group [2.55 (2.28-3.59) mg/L] and prerenal azotemia group [2.07 (1.70-2.41) mg/L], and the serum Cys C level was significantly different between the three groups (P <0.001). In addition, patients with AKI were further divided into infection group and non-infection group. Serum Cys C level was significantly higher in the infection group than in the non-infection group (P <0.05). The area under the ROC curve of serum Cys C for the diagnosis of AKI in liver cirrhosis was 0.99 (0.98-1.00) at a cut-off value of 1.36 mg/L, and the sensitivity and specificity were 97% and 95%, respectively.@*Conclusion@#Serum Cys C is a good marker for detecting AKI in liver cirrhosis, and the different levels of increase in Cys C may be useful in differentiating the different types of AKI.
ABSTRACT
Objective:To explore the adjustment factors to the migration and functional activity on macrophages in the uterine of inflammatory mice induced by LPS.Methods:150 Kunming female mouse were divided into control group (group A),LPS model group (group B),MCP-1 blocking-up group (group C),the mice uterines were extracted separately at hour 1,3,6,12,24.The number of CD14+ macrophages and the expression of CD14 macrophages were detected by Immunohistochemistry,ELISA detects the expression of TNF-α and MCP-1.Results:①Compared with group A,the number of CD14+ macrophages and the expression of CD14 in endometrium,myometrium,perimrtrium of group B were highly significantly increased (P<0.01) at every time points,the endometrium,myometrium of group C were closely to normal level at 1,3,6 h;compared with group B,the number of CD14+ macrophages and the expression of CD14 were highly significantly decreased(P<0.01)at 1,3,6 h of perimrtrium of group C and every time points of endometrium,myometrium of group C.②Compared with group A,the content of TNF-α and MCP-1 were highly significantly increased (P<0.01) at every time points of group B and 12,24 h of group C;compared with group B,the content of TNF-α and MCP-1 of group C were highly significantly decreased(P<0.01) at every time points.Conclusion:The migration of macrophages and the expression of CD14 and TNF-α in the uterine of inflammatory mice induced by LPS were regulated by MCP-1.
ABSTRACT
Objective]The aim of this study was to investigate the level of serum C3,C4 and HDL-C in patients with coronary heart disease and the correlation between C3,C4 and HDL-C in patients with coronary heart disease.[Methods]We collected 251 cases of patient diagnosed with coronary artery disease by coronary angiography in Sun Yat-sen Memorial Hospital ,Sun Yat-Sen University from 2015-12 to 2016-07 and collected over our Boji Medical Center healthy people in 214 cases. These patients were divided into acute coronary syndrome group with 180 cases and stable coronary heart disease group with 71 cases. Each test results was adopted from clinical laboratory of Sun Yat-Sen Memorial Hospital ,Sun Yat-Sen University.[Results]Compared with the healthy control ,the difference of serum C3,C4 and HDL-C from acute coronary syndrome group and stable coronary heart disease group,was statistically significant(P 0.05)between C3,C4 and HDL-C. In healthy group,complement C3 negatively correlated with HDL-C,the difference was statistically significant(P<0.05).[Conclusions]In patients with coronary heart disease, the level of C3 and C4 increased,while the level of HDL-C decreased ,and inflammation may affect the relevance judgments between complement and HDL-C.
ABSTRACT
OBJECTIVE:To observe the clinical efficacy and safety of Kangfuxin solution combined with rhEGF solution for external use in the treatment of vitamin B12 deficiency atrophic glossitis. METHODS:Totally 94 patients with vitamin B12 deficien-cy atrophic glossitis in Xinjiang Production and Construction Corps Hospital during Jul. 2012-Jun. 2015 were divided into observa-tion group and control group according to random number table,with 47 cases in each group. Both groups received etiological treat-ment of vitamin B12 supplement. Control group was additionally given rhEGF solution for external use on tongue surface,qid. Based on control group,observation group was additionally given Kangfuxin solution and applied medical gauze saturated with liq-uid medicine to the affected area,more than 30 min each time,tid. Treatment course of 2 groups lasted for 4 week,a referral of the week. Clinical efficacies were compared between 2 groups as well as average pain indexes and lesion areas of tongue before and after treatment,and the occurrence of ADR. RESULTS:Cure rate(76.6% vs. 57.4%)and total response rate(97.9% vs. 83.0%) of observation group were significantly higher than those of control group,with statistical significance (P0.05). 1-4 weeks after treatment,average pain indexes and lesion areas of tongue in 2 groups were significantly decreased,with statistical sig-nificance compared to before treatment (P<0.05). The average pain indexes of observation group were significantly lower than those of control group (3,4 weeks after treatment),and lesion areas of tongue was significantly smaller than control group (2-4 weeks after treatment),with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:For vita-min B12 deficiency atrophic glossitis,Kangfuxin solution combined with rhEGF solution for external use can significantly improve tongue lesion and have good analgesic effect and safety.
ABSTRACT
Objective To analyze the CT features of osteosarcoma and chondrosarcoma and to explore the value of CT differential diagnosis.Methods The CT findings of 35 cases with osteosarcoma and 22 cases with chondrosarcoma confirmed by operation and pathology were analyzed retrospectively.P<0.05 for the difference was statistically significant.Results Periosteal reaction, Codman triangle, radial spicule, type Ⅰ and Ⅳ calcium-like density, long tubular soft tissue mass around greater than 1/2, the ratio of tumor CT to muscle CT (△T/△M) was statistically significant.Of all the above image performance, the sensitivity and specificity of the type I calcium-like density were the highest, while those of the type Ⅳ calcium-like density were the lowest.Conclusion The osteosarcoma is more likely to have the signs of periosteal reaction, Codman triangle, radial spicule and type Ⅰ calcium-like density, while the chondrosarcoma is more likely to have the signs of type Ⅳ calcium-like density.
ABSTRACT
Objective To explore the value of combined detection of carbohydrate antigen 125(CA125),human epididymis secre-tory protein 4 (HE4)and plasma D-dimer in early diagnosis of ovarian cancer.Methods Fifty-six patients with ovarian cancer and 50 patients with benign ovarian tumors in the gynecology department of our hospital from January 2014 to June 2016 were selected. Contemporaneous 50 women undergoing healthy physical examination were selected.The chemiluminescence method was adopted to determine serum CA125 and HE4 levels,and the immune turbidimetry method was adopted to detect plasma D-dimmer level.Their early diagnostic values for ovarian cancer were comparatively analyzed.Results The serum CA125 and HE4 levels and plasma D-di-mer level in the cancer group were significantly higher than those in the control group with statistical difference(P<0.05),moreo-ver HE4 had higher sensitivity(89.28%)and higher specificity (88.00%)for detecting ovarian cancer.In the 3-index combined de-tection,sensitivity and specificity were greatly improved.Conclusion The combined detection of CA125,HE4 and plasma D- dimer can improve the accuracy of early diagnosis of ovarian cancer.
ABSTRACT
Objective To investigate the association between the neck circumference and central obesity in the elderly.Methods The neck circumference(NC),height,weight,waist circumference (WC) and hip circumference(HC) of 2820 subjects aged over 60 years were detected from some communities in Nanchang.All subjects were divided into different groups,according to the two different obesity indicators of WC and BMI.The relationship between NC and obesity was analyzed.A multiple linear regression analysis was conducted using the Enter method.An R()C curve analysis was employed to judge the tangent point of NC in central obesity.Results The height,weight and BMI were reduced along with age (all P＜0.05),and the waist hip ratio(WHR) was increased along with age(P＜0.01) in the elderly.The NC was decreased along with age in males(P＜0.01),and the WC was increased along with age in females(Pt＜0.01).The NC was longer in males than in females [(36.5±3.0) cm vs.(32.6±2.4) cm,P＜0.01].The NC was increased along with body weight,WC and BMI in the elderly:with each 1 kg increase in body weight,the NC was increased by 0.079 cm in males and 0.139 cm in females;with each 1cm increase in WC,the NC increased by 0.073 cm in males and 0.040 cm in females;with each 1 kg/m2 increase in BMI,the NC increased by 0.121 cm in males and 0.065 cm in females;with 1 year increase in age,the NC was decreased by 0.033 cm in males(all P＜0.05).when obesity was diagnosed according to both BMI and NC,the NC was longer in the obesity group than in the control group,(P ＜ 0.01).The area under receiver operating characteristic(ROC) curve of NC for diagnosing central obesity showed that the area was 0.802 and 0.743 in males and females,and the optimal cut-off value of NC was 36.85 cm and 31.75 cm in males and females,respectively.Conclusions NC is increased along with the increases of body weight,WC and BMI in the elderly.NC is significantly associated with central obesity.NC is more predictive of the central obesity when the value ＞36.85 cm in males and ＞31.75 cm in females.
ABSTRACT
Objective To investigate the relationships between the neck circumference and cardiovascular risk factors of middle-aged and elder people in a community. Methods Altogether 9 665 community residents ( age≥40 years) were enrolled in the present study. The height, weight, neck circumference, waist circumference, blood pressure, total cholesterol, triglycerides, low density lipoprotein-cholesterol ( LDL-C ) , high density lipoprotein-cholesterol ( HDL-C) , blood glucose, glycosylated hemoglobin, and fasting insulin were measured, and documented in the questionnaire along with other basic information. After adjusted for age, Pearson correlation coefficient was used to analyze the relationship between the neck circumference and the binary variables of cardiovascular risk factors. SPSS16.0softwarewasusedforstatisticalanalysis. Results (1)Theneckcircumferenceswere(37.11±2.79)cm in male and (32. 79 ± 2. 31) cm in female;which were higher in males than females. In both males and females, after adjusted for age, the neck circumference was positively correlated to waist circumference, body mass index, blood pressure, plasma glucose, LDL-C, triglycerides, and insulin resistance, the neck circumference was negatively correlated to HDL-C(all P0. 05). (2) After adjusted for body mass index and the waist circumference, the neck circumference of males increased with the risk of diabetes ( OR=1. 14, 95% CI 1. 02-1. 28);while the higher neck circumference of females increased the risk of hypertension (OR=1.17,95% CI1.08-1.27),diabetes(OR=1.24,95% CI1.13-1.37),dyslipidemia(OR=1.17,95%CI 1.09-1.27),andinsulinresistance(OR=1.15,95% CI1.06-1.26). Theneckcircumferenceexertedhigher impact on women than it did on men. Conclusion The neck circumference is associated with the cardiovascular risk factors. This association in females is stronger than that in males. The neck circumference seems to be an independent indicator for the cardiovascular risk.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the acute kidney injury classification systems of RIFLE,AKIN,KDIGO and conventional criteria for determining prognosis of acute-on-chronic liver failure (ACLF) patients.</p><p><b>METHODS</b>Patients with ACLF admitted to our hospital between July 2008 and March 2014 were enrolled in the study. The incidence, stages, and outcomes of acute kidney injury were determined according to the RIFLE, AKIN,KDIGO and conventional criteria.ROC curves were generated to compare the predictive ability for 30-day mortality of the four systems.Chi-square test and Fisher's exact test were used for statistical analyses, as well.</p><p><b>RESULTS</b>All four classification systems detected acute kidney injury among the patients in the study population (n =358), but the detection rates were not consistent (expressed as % of total): KDIGO criteria: 45.0%, AKIN: 38.8%, rIFLE: 35.5%, conventional criterion: 20.4%. The KDIGO and AKIN criteria showed higher sensitivity (72%), especially to early kidney injury, but the conventional criterion showed higher specificity (92%). The AUC for 30-day mortality was highest for the conventional criteria (0.75), followed by AKIN (0.72), rIFLE (0.70) and KDIGO (0.69) (all, P less than 0.05). In-hospital mortality increased with severity of AKI in a stepwise manner.</p><p><b>CONCLUSION</b>Among the four common evaluation systems for acute kidney injury, the conventional criteria has the highest specificity for predicting short-term prognosis of patients with ACLF, while the AKIN and KDIGO criteria have the highest sensitivity for the presence of acute kidney injury, especially at the early stage.</p>
Subject(s)
Humans , Acute Kidney Injury , Classification , Diagnosis , Acute-On-Chronic Liver Failure , Diagnosis , Hospital Mortality , Incidence , Prognosis , ROC Curve , Retrospective Studies , Sensitivity and SpecificityABSTRACT
Hepatitis B virus (HBV)-induced liver failure is a severe clinical syndrome with complicated manifestations resulting in high mortality.The prognosis largely depends on early diagnosis and timely intervention.This article reviews the predictive and prognostic evalua-tion system for the development and progression of HBV-induced liver failure,so to improve the early diagnosis of this disease and the prog-nosis of patients.
ABSTRACT
Objective To investigate the predictive value of red cell volume distribution width RDW),RDW to platelet ratio (RPR),aspartate aminotransferase (AST) to platelet ratio index APRI),fibrosis index based on the 4 factor (FIB-4) and aspartate-alanine aminotransferase ratio (AAR) in assessing esophageal varices (EV) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between December 2013 and July 2015,a total of 190 patients with HBV-related cirrhosis and no previous history of endoscopic therapy for EV hospitalized at the Department of Hepatology,Tianjin Third Central Hospital were enrolled.Upper gastrointestinal endoscopy were conducted in all patients to diagnose EV.According to the morphology and degree of EV as well as bleeding risk,patients were categorized into mild,moderate and severe stages.RDW,platelet counts,alanine aminotransferase,aspartate aminotransferase were tested,and RPR,APRI,FIB-4,AAR were calculated.Spearman correlation was used to evaluate the association between EV and these indexes.Receive operating characteristic (ROC) curves were generated and the areas under the curves (AUC) were calculated to assess the performance of these indexes in predicting esophageal varices bleeding (EVB).Results RDW ([16.78±2.27]％),RPR (0.41±0.18),FIB4 (8.99±5.91),APRI (2.09[1.35,2.90]) in patients with EVB were all significantly higher than those ([14.37±1.86]％,t=-7.449;0.19±0.09 [t=-8.132];5.72±3.92 [t=-3.658];1.29 [0.70,2.39;z=-2.996]) without EVB (all P＜0.05).However,AAR had no statistical significance between two groups (t =1.216,P=0.226).Both of EV and EVB had positive correlation with RDW,RPR,FIB-4 and APRI (all P＜0.05) and no correlation withAAR(P＞0.05).RDW (F=9.604),RPR (F=47.530),FIB-4 (F=18.071) and APRI (H=12.320) showed statistically significant differences among patients with different stages of EV (all P＜0.05),whereas AAR showed no difference (F=1.177,P=0.320).The AUC of RPR (0.896) for EVB was highest,followed by RDW (0.824,P＜0.05).AUC of FIB-4 and APRI was 0.690 and 0.642,respectively,with no statistical difference (P＞0.05).The optimal cut-off levels of RDW,RPR,FIB-4 and APRI were 14.450 (sensitivity:88.24％,specificity:64.03％),0.209 (sensitivity:96.10％,specificity:69.10％),6.912 (sensitivity:66.67％,specificity:73.38％) and 1.338 (sensitivity:76.47％,specificity:51.08％),respectively.Conclusions RPR and RDW are closely correlated with EV in HBV-related cirrhotic patients,which are of clinical importance in predicting EVB.Both of them can be used as clinical screening methods and RPR may be superior to RDW.Although FIB-4 and APRI are correlated with EV,their predictive value of EBV are low.
ABSTRACT
Objective To observe protective effects of four active liposoluble alkaloids of a Chinese herb, lotusine (Lot), liensinine (Lien), isoliensinine (Iso) and neferine (Nef) of embryo loti (the green embryo), against H2 O2-induced oxidative damage on human umbilical vascular endothelial cell ECV-304.Methods The protective effects of Lot, Lien, Iso and Nef on the survival of normal and oxidatively damaged ECV 304 cells were studied by cell morphology observation and 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium (MTT) assay.The levels of nitric oxide (NO) and nitric oxide synthase ( NOS) were measured using colorimetric assay.Results Lot, Lien, Iso and Nef did not affect cell morphology and cell viability of normal ECV 304 cells.The survival of oxidative damaged vascular endothelial cells was rescued by incubating with Lot at 100μmol/L, and Lien, Iso and Nef at 0.1 μmol/L.The proliferative activity of medicated groups increased to 112.8%, 129.3%, 125.6 and 118.2%, respectively (P<0.01 or 0.05), relative to that of the group with H2O2 induced oxidative damage.The four alkaloids restrained oxidative injury of endothelial cells induced by H2 O2 and the protective influences were similar with captopril, which served as a positive control.Each alkaloid except Lot reduced intercellular space and increased the connections of oxidative damaged cells, concomitant with more recognizable cell borders.Lien, Iso and Nef also increased the concentration of NO ( P<0.05 ) .Besides, all of the four alkaloids activated NOS in damaged vascular endothelial cells ( P<0.05 ) . Conclusion The four alkaloids of embryo loti, especially Lien, Iso and Nef, have certain protective effects against H2 O2-induced oxidative damage on vascular endothelial cells.The protective mechanism may be promotion of NO release through the increase of NOS production.
ABSTRACT
Objective The aim of this study was to evaluate the outcomes of auditory perception skills after cochlear implantation in children with malformed inner ear and compare them with a group of congenitally deaf chil ‐dren implantees with a normal inner ear .Methods 21 children with inner ear malformation were retrospective stud‐ied .There were 9 cases with large vestibular aqueduct syndrome (LVAS) ,7 with Mondini abnormality ,5 with com‐mon cavity .The postoperative outcomes of these 21 cases were compared with 21 cases with normal inner ear struc‐ture .The outcomes of all the children after the surgery in 1 year were studied using the soundfield test in frequency ranging 0 .5 to 4 kHz and the auditory perception skills ,and the auditory perception skills consisted of natural envi‐ronmental sound recognition ,consonants recognition ,vowels recognition ,numeral recognition ,tone recognition , monosyllabe recognition ,disyllabe recognition ,trisyllabe recognition ,short sentences recognition ,selective hearing recognition .Results The results of soundfield test and auditory perception skills after cochlear implantation in 9 children with LVAS and 6 with Mondini abnormality had no significant difference (P > 0 .05) comparing with the control cases .Postoperative thresholds in soundfield test were 50 ~ 75 dB HL for 1 case with severe Mondini abnor‐mality ,the mean value of hearing ability score was 70 .5% ,and less than the results of control cases .Postoperative mean thresholds in soundfield test were 65 .26 ± 5 .13 dB HL for 5 cases with common cavity ,the hearing ability score was less than the results of control cases (P< 0 .05) .Conclusion The effect of rehabilitation had no difference between the children with LVAS and the cases with normal inner structure after cochlear implantation ,but was poo‐rer in children with severe Mondini abnormality and common cavity .It was necessary to evaluate the degree of mal‐formation of inner ear structure before cochlear implantation .