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@#Abstract: Objective To investigate the influence of the variation of SARS-CoV-2 on the clinical feature, and to provide early warning signs for the variation of SARS-CoV-2 in clinical work. Methods From Jan 2, 2021 to Jun 30, 2021, a total of 105 COVID-19 patients were included in the study using a case-control method. Nasal swab samples were collected from the study subjects, the viral genes were sequenced, and patients were divided into Delta variant group and non-Delta variant group according to their gene sequences. Clinically relevant data were collected from the two groups, and indicators such as days of hospitalization, age distribution, lymphocytes, neutrophils, B lymphocytes, NK cells, IL-4, and IL-10 were compared; subgroup analysis was performed based on the number of days of viral negativity in the study subjects as the basis for grouping, and differences in immunological characteristics were compared, including lymphocytes, neutrophils, B lymphocytes, NK cells, IL-4, IL-10, etc. Results The theoretical hospitalization days of Delta variant group were (22.2±8.33) d, which were significantly longer than (17.6±10.50) d of non-Delta variant group (t=2.396, P<0.05). The total lymphocyte count and IL-4 of Delta variant group were (1.22±0.86) ×109/L and (0.80±0.23) ng/mL, which were significantly lower than corresponding (1.91±0.70) ×109/L and (1.59±0.59) ng/mL of non-Delta variant group (t=4.329, 9.072, P<0.05), while IL-10 was (7.16±7.77) ng/mL, which was significantly higher than (4.26±3.91) ng/mL of non-Delta mutation group (t=1.980, P<0.05). Subgroup analysis showed that the total lymphocyte count and IL-4 concentration in Delta variant group were (1.04±0.60) ×109/L and (0.74±0.25) ng/ml, which were significantly lower than corresponding (1.62±0.56) ×109/L and (1.56±0.52) ng/mL in non-Delta variant group, in patients with delayed discharge (P<0.05). Conclutions SARS-CoV-2 variant has an impact on clinical manifestations. The patient's B cell count and IL-10 concentration increased or IL-2 and IL-4 concentration decreased within 12 hours of admission indicated variant virus infection. The decrease of total lymphocyte count, especially T lymphocyte reduction, strongly suggests discharge delay due to viral clearance disorder.
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@#Abstract: Objective To investigate whether the complement system of COVID-19 is affected by vaccination, and also to explore the relationship between complement and length of stay in hospital, with a view to providing input for clinical diagnosis and the management of COVID-19 patients. Methods The patients admitted from November 1st to November 30th, 2021 in the Eighth Affiliated Hospital of Guangzhou Medical University were selected as subjects. According to the time of vaccination, the patients were divided into two groups as vaccinated within half a year and over half a year. Then C3, C4, IgG, IgM, IgA, COVID-19 IgG and IgM, neutral granulocyte and lymphocyte count were detected and all patients' hospitalized days were recorded. With their hospitalization days of 14 d as a threshold, the patients were divided into two groups, and the above indicators were compared. Results C3 concentration was (0.86±0.157) g/L in patients with vaccination within six months, which is significantly lower than (0.96±0.172) g/L in those over six months (P<0.05), but as for C4, IgG, IgM, IgA, COVID-19 IgG and IgM, neutral granulocyte and lymphocyte counts, there were no significant difference between two groups; as for the patients within 14 days of hospitalization, C3 and C4 concentrations were lower than those for more than 14 days, but the COVID-19 antibody IgG and IgM, lymphocyte counts were higher (all P<0.05). Conclusion Vaccination within half a year can make the body's immune function and complement system to identify viruses earlier, more beneficial to remove viruses, but this effect is weakened after half a year; when admission, C3, C4, COVID-19 IgG level and lymphocyte counts can be used to predict hospitalization time in COVID-19 patients.
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Resumo Fundamento: A fração de ejeção (FE) tem sido utilizada em análises fenotípicas e na tomada de decisões sobre o tratamento de insuficiência cardíaca (IC). Assim, a FE tornou-se parte fundamental da prática clínica diária. Objetivo: Este estudo tem como objetivo investigar características, preditores e desfechos associados a alterações da FE em pacientes com diferentes tipos de IC grave. Métodos: Foram incluídos neste estudo 626 pacientes com IC grave e classe III-IV da New York Heart Association (NYHA). Os pacientes foram classificados em três grupos de acordo com as alterações da FE, ou seja, FE aumentada (FE-A), definida como aumento da FE ≥10%, FE diminuída (FE-D), definida como diminuição da FE ≥10%, e FE estável (FE-E), definida como alteração da FE <10%. Valores p inferiores a 0,05 foram considerados significativos. Resultados: Dos 377 pacientes com IC grave, 23,3% apresentaram FE-A, 59,5% apresentaram FE-E e 17,2% apresentaram FE-D. Os resultados mostraram ainda 68,2% de insuficiência cardíaca com fração de ejeção reduzida (ICFEr) no grupo FE-A e 64,6% de insuficiência cardíaca com fração de ejeção preservada (ICFEp) no grupo FE-D. Os preditores de FE-A identificados foram faixa etária mais jovem, ausência de diabetes e fração de ejeção do ventrículo esquerdo (FEVE) menor. Já os preditores de FE-D encontrados foram ausência de fibrilação atrial, baixos níveis de ácido úrico e maior FEVE. Em um seguimento mediano de 40 meses, 44,8% dos pacientes foram vítimas de morte por todas as causas. Conclusão: Na IC grave, a ICFEr apresentou maior percentual no grupo FE-A e a ICFEp foi mais comum no grupo FE-D.
Abstract Background: Ejection fraction (EF) has been used in phenotype analyses and to make treatment decisions regarding heart failure (HF). Thus, EF has become a fundamental part of daily clinical practice. Objective: This study aims to investigate the characteristics, predictors, and outcomes associated with EF changes in patients with different types of severe HF. Methods: A total of 626 severe HF patients with New York Heart Association (NYHA) class III-IV were enrolled in this study. The patients were classified into three groups according to EF changes, namely, increased EF (EF-I), defined as an EF increase ≥10%, decreased EF (EF-D), defined as an EF decrease ≥10%, and stable EF (EF-S), defined as an EF change <10%. A p-value lower than 0.05 was considered significant. Results: Out of 377 severe HF patients, 23.3% presented EF-I, 59.5% presented EF-S, and 17.2% presented EF-D. The results further showed 68.2% of heart failure with reduced ejection fraction (HFrEF) in the EF-I group and 64.6% of heart failure with preserved ejection fraction (HFpEF) in the EF-D group. The predictors of EF-I included younger age, absence of diabetes, and lower left ventricular ejection fraction (LVEF). The predictors of EF-D were absence of atrial fibrillation, lower uric acid level, and higher LVEF. Within a median follow-up of 40 months, 44.8% of patients suffered from all-cause death. Conclusion: In severe HF, HFrEF presented the highest percentage in the EF-I group, and HFpEF was most common in the EF-D group.
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Humans , Heart Failure/drug therapy , Prognosis , Stroke Volume , Ventricular Function, Left , Heart VentriclesABSTRACT
Abstract Background: Homophobic harassment can compromise mental health of sexual minority youths. Objectives: This study examined the rates of persistent and multisite homophobic harassment and their associations with school difficulties during childhood and adolescence among gay and bisexual men in Taiwan. Methods: Participants were recruited through advertisements on the Facebook, Bulletin Board Systems, and the home pages of health promotion and counseling centers for the gay, lesbian, and bisexual community. The experiences of traditional and cyber harassment based on gender role nonconformity and sexual orientation of 500 gay or bisexual men were examined. The associations of multisite and persistent harassment victimization with school difficulties were evaluated. Results: A total of 239 (47.8%) and 131 (26.2%) participants experienced persistent and multisite harassment victimization, respectively. Harassment victimization was significantly associated with low satisfaction with academic performance in any stage of study. Moreover, the participants who were harassed in senior high schools were more likely to miss classes or be truant than those who were not harassed. The victims of multisite harassment at senior high schools were more likely to miss classes or be truant than those of school-only harassment. Discussion: Prevention and intervention programs are warranted to reduce homophobic harassment in sexual minority youths.
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OBJECTIVE To investigate the regulation of{O2 (2,4-dinitrophenyl)1-[(4-ethoxycarbonyl) piperazin-1-yl] diazen-1-ium-1, 2-diolate} (JS-K), a nitric oxide donor, on tumor energy metabolism in H22 tumor-bearing mice. METHODS The hepatoma animal model in BALB/c mice was established with H22 cell line. The inoculated mice were randomly divided into four groups. The JS-K group and model group received JS-K (0.75 and 1.50 mg?kg-1) and saline via tail the vein intravenously once every 3 d for 14 d, and 5 injections, respectively. The fluorouracil (5-FU) group received 5-FU 20 mg·kg-1 by intra-peritoneal injection once a day for 14 d. On the 15th day after the first administration, mice were sacri-ficed and the tumor, thymus and spleen were isolated and weighed immediately. The tumor growth inhibitory rate and organ index were calculated. The activities of hexokinase (HK), phosphofructokinase (PFK), pyruvate kinase (PK), succinate dehydrogenase (SDH), adenosinetriphosphatase (ATPase), and the levels of lactic acid (LD) and adenosine triphosphate (ATP) in tumor tissues were determined by colorimetric method. The expression of hypoxia-inducible factor 1 alpha (HIF-1α) and hexokinaseⅡ(HKⅡ) in the tumor tissue was analyzed by Western blotting. RESULTS Compared with model group, the tumor mass of JS-K 0.75 and 1.50 mg · kg-1 groups was significantly reduced (P<0.01), and the tumor growth inhibitory rate was 23.9%and 50.3%, respectively. There was no diffrence in thymic and splenic indexes between JS-K group and model group. The activity of HK, PFK, SDH, PK and ATPase of tumor tissue in model group was 22.6±3.7, 14.4±2.6, (10.5±2.6) U·g-1protein, (12.9±3.2) kU·g-1 protein and (0.70 ± 0.10) mmolPi · g-1protein · h-1, respectively, which dropped by 42.0%, 26.6%, 22.7%, 23.3%and 21.7%respectively (P<0.01, P<0.05) in JS-K 1.50 mg?kg-1 group. Compared with the model group, the level of ATP of tumor tissue in JS-K 1.50 mg?kg-1 groups dropped by 16.6%(P<0.01) and the level of LD in JS-K 0.75 and 1.50 mg?kg-1 groups dropped by 38.7%and 59.4%(P<0.01), respectively. In addi-tion, the expression of HIF-1αof tumor tissue in JS-K 1.50 mg?kg-1 group was decreased (P<0.01), and the expression of HKⅡ of tumor tissue in JS-K 0.75 and 1.50 mg?kg-1 groups was decreased signifi-cantly (P<0.05, P<0.01). CONCLUSION JS-K can inhibit the growth of tumor in H22 tumor-bearing mice and its mechanism may be related to regulating the tumor energy metabolism by inhibiting glycolysis and aerobic oxidation.
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Specific information on geographic distribution of a species is important for its conservation. This study was conducted to determine the potential geographic distribution of Alhagi sparsifolia, which is a plant used in traditional Uighur medicine, and predict how climate change would affect its geographic range. The potential geographic distribution of A. sparsifolia under the current conditions in China was simulated with MaxEnt software based on species presence data at 42 locations and 19 climatic variables. The future distributions of A. sparsifolia were also projected in 2050 and 2070 under the climate change scenarios of RCP2.6 and RCP8.5 described in 5th Assessment Report of the Intergovernmental Panel on Climate Change (IPCC).The result showed that mean temperature of the coldest quarter, annual mean temperature, precipitation of the coldest quarter, annual precipitation, precipitation of the wettest month, mean temperature of the wettest quarter and the temperature annual range were the seven climatic factors influencing the geographic distribution of A. sparsifolia under current climate, the suitable habitats are mainly located in the Xinjiang, in the middle and north of Gansu, in the west of Neimeng, in the north of Nei Monggol. From 2050 to 2070, the model simulations indicated that the suitable habitats of A. sparsifolia would decrease under the climate change scenarios of RCP2.6 and scenarios of RCP8.5 on the whole.
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Objective: To analyze the current situation and effect of vertical integrated of rural health services in Dafeng County. Method: Policy documents and data are collected and interviews are implemented for studying the integrated situation. Results: The vertical integration in Dafeng County is virtual joint form with forming 6 city-level medical volunteer service teams and 52 health management teams. With the imple-mentation of fully integrated management, signing service with rural doctor mode is carried out, which pro-mote the establishment of rural unified service standards and regulations. Using health card of residents which promote the regional shared of treatment information. Conclusions: Vertically integrated mode had connection in health management teams, supported by fully integration, developed by signing service with rural doctor and carried by residents’ health card, which could provide reference for implementing vertical integration of rural health service. But strategies needed to be strengthened in improving health services’ ability of township hospitals, clarifying interest relationship as well as integrating health service regulations and strengthen the health information system for sharing and docking.
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OBJECTIVE: Recent studies have shown that circulating microRNAs might be useful, novel biomarkers for the diagnosis of acute myocardial infarction. The aims of this study were to evaluate the expression of cardiac-specific miRNAs (miR-1, -133a, -208b, and -499) in patients with acute myocardial infarction and to compare the diagnostic values of these miRNAs with that of cardiac troponin T. METHODS: Sixty-seven plasma samples obtained from patients with acute myocardial infarction and 32 plasma specimens collected from healthy volunteers were analyzed in this study. The levels of cardiac-specific miRNAs (miR-1, -133a, -208b, and -499) were measured by quantitative reverse transcription-polymerase chain reaction, and the concentrations of plasma cardiac troponin T were measured using electrochemiluminescence-based methods and an Elecsys 2010 Immunoassay Analyzer. RESULTS: The levels of plasma miR-1, -133a, -208b, and -499 were significantly higher in acute myocardial infarction patients (all p<0.001) than in healthy volunteers. The expression of the cardiac-specific miRNAs in acute myocardial infarction patients decreased to close to the baseline levels at the time of hospital discharge (all p>0.05). There were no correlations between the levels of the four circulating miRNAs and the clinical characteristics of the study population (all p>0.05). Furthermore, receiver operating characteristic curve analyses showed that the four plasma miRNAs were not superior to cardiac troponin T for the diagnosis of acute myocardial infarction (all p>0.05). CONCLUSION: Our results demonstrate that circulating miR-1, -133a, -208b, and -499 may be useful biomarkers in acute myocardial infarction patients but that these miRNAs are not superior to cardiac troponin T for the diagnosis of acute myocardial infarction.
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Aged , Female , Humans , Male , Middle Aged , MicroRNAs/blood , Myocardial Infarction/diagnosis , Troponin T/blood , Biomarkers/blood , Epidemiologic Methods , Immunoassay , Luminescent Measurements , Myocardial Infarction/genetics , Predictive Value of Tests , Reference Values , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
Objective To simulate the supination-external rotation ankle injury and establish a 3D finite element model of the ankle. Methods Based on CT images of the normal human ankle joint, the 3D model of the ankle with ligaments was established. The supination-external rotation ankle injuries with four different degrees of Lauge-Hanson were analyzed by finite element method. Distributions of the ankle joint stress and tibial articular surface pressure were obtained. Results The maximum stress was at the anterior tibiofibular ligament attachment point of the tibial under supination-external rotation loading. When the anterior tibiofibular ligament was ruptured, the maximum stress was at the interosseous membrane. After the interosseous membrane was ruptured, the high stress was at the posterior ligament of the ankle. When the posterior tibiofibular ligament was ruptured, the high stress was at the deltoid ligament. The high pressure was at the distal fibula or the rear of tibial articular surface. Conclusions The established ankle-foot 3D numerical model can be used for the mechanical analysis of supination-externalrotation ankle injury. The calculated distributions of the ankle stress and the tibial articular surface pressure were in agreement with the description of Lauge-Hanson classification.
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Objective To investigate the interface pressure on above knee residual limb at mid stance during walking，so as to provide basis for the establishment of measurement and evaluation system for the above-knee socket. Methods Based on CT images of the femur, soft tissue and above knee socket of the patient with residual limb, the three-dimensional model was first built, and then to assemble them according to changes of the hip joint in a gait cycle. The finite element model was then established to simulate the loading conditions at mid stance during a gait cycle, and the effect of pre-stress was investigated by nonlinear large deformation analysis. Results If considering the effects such as joint changes and pre-stress, the maximum value by calculation for normal interface pressure distributed on the terminal of stump was 257.66 kPa, which could better match the maximum stress actually measured by the Mflex Sensor Distributing System as 258.9 kPa. Conclusions The three-dimensional finite element model with considering the factors such as hip joint change, pre-stress and friction could effectively simulate the stress condition of patient with residual limb during walking.
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Background Corneal contact lens have been widely used in vitrectomy.The corneal ring accompanying with the contact lens therefore is also much concerned.We designed a sutureless silicone corneal ring to renew a suturing?ring,but its detection of physicochemical properties and hiocompatihility is necessary for clinical application. Objective This study was to investigate the physicochemical properties and biocompatibility of the newly designed sutureless silicone corneal ring. Methods The Shore hardness,tensile stress-strain tests,tear strength,transmittance and the haze of the novel silicone ring were tested.The bioeompatibility of sutureless silicone corneal ring to corneal epithelial cells was evaluated by determining cytotoxieity.The ring was implanted into the counjunctival soc of 6 Japanese white rabbits for 4 hours to determine its stimulation response by measuring the area of corneal fluorescence staining,and then the ring was placed on the skin surface of 6 SD rats for 4 hours to assess the presence of allergic reaction by calculating the swelling area of skin. Results The new sutureless silicone corneal ring showed good physiological features with a Shore hardness of 63.4 degree,tensile strength more than 5.86 MPa,elongation＞100%and tear strength 34 kN/m.The transmittance of 3 legs in the ring was more than 93%;however,the haze was less than 0.1%.Cytotoxicity of the ring was 3.1 1×10-6%.No obvious corneal fluorescence staining was seen at any time point in all the rabbit eyes in the stimulating test.Furthermore,there was not any skin swelling in various time points in all the SD rats in the allergy test. Conclusion The physicochemical properties of the silastic used in our newly designed sutureless silicone cornea ring can meet the demands of the ring.The biological evaluation complies with the ISO i0993-1 international standards and meets the demands of the organism.Thus,it is all ideal material to use in constructing the corneal ring.