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Objective: To explore the present situation and epidemiological characteristics of pesticide poisoning in Chengdu City from 2012 to 2021, and to provide scientific evidence for further prevention and control. Methods: In January 2022, the pesticide poisoning report cards of Chengdu City from 2012 to 2021 were collected from the China Disease Control and Prevention Information System. The data of the report card was reorganized and the distribution characteristics of pesticide poisoning such as time, region, gender, age and pesticide types were analyzed. Results: 14326 cases of pesticide poisoning were reported in Chengdu City from 2012 to 2021, 651 deaths, and the fatality rate was 4.54%. The cases of productive pesticide poisoning and unproductive pesticide poisoning were 504 and 13822, respectively. The fatality rates of productive and unproductive pesticide poisoning were 1.39% and 4.66%, which were significant different (χ(2)=11.99, P=0.001). The highest reported cases of pesticide poisoning was in 2013 (1779) and the lowest in 2021 (1047). The number of reported cases showed a downward trend year by year (t=-12.30, P<0.001), and the fatality rates also showed a downward trend year by year (χ(2)(trend)=25.48, P<0.001). The fluctuation range of unproductive pesticide poisoning cases in each month of the year was small, and the productive pesticide poisoning mainly occurred from May to August. The regions with the largest number of reported poisoning cases were Pengzhou (1620), Jianyang (1393), Jintang (1266) and Qionglai (1158). The high incidence of poisoning was among 25-54 years old (50.21%, 7193/14326). The fatality rate in the age group 75-96 years old was the highest (8.98%, 95/1058), and the fatality rates increased gradually with age (χ(2)(trend)=186.03, P<0.001). The pesticides causing poisoning were mainly insecticide (43.86%, 6284/14326) and herbicides (35.75%, 5121/14326). Herbicides paraquat had the highest fatality rate (9.54%, 286/2998) . Conclusion: Pesticide poisoning in Chengdu City is mainly unproductive poisoning. Health education should be carried out for key areas and people, and the control of highly toxic pesticides such as insecticide and herbicides should be strengthened.
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Humans , Aged , Aged, 80 and over , Adult , Middle Aged , Insecticides , Pesticides , Herbicides , Paraquat , Cities , Poisoning/epidemiologyABSTRACT
Objective:To construct a diabetic foot classification prediction model based on radiomics features of fundus photographs.Methods:A total of 2 035 fundus photographs of patients with type 2 diabetes diagnosed at Nanfang Hospital between December 2011 and December 2018 were retrospectively collected [282 photographs from patients with diabetic foot(DF), and 1 753 from patients with diabetes mellitus(DM)]. All fundus photographs were randomly divided into a training set(1 424 photos) and a test set(611 photos) using a computer generated random number at 7∶3. After pre-processing the fundus photographs, a total of 4 128 texture features based on the gray matrix were extracted by the Radiomic toolkit, and 11 339 other features were extracted using the ToolboxDESC toolkit. The LASSO algorithm was used to select the 30 features most relevant to DF, and then the Bootstrap + 0.632 self-sampling method was used to further select the 7 best combinations. Logistic regression analysis was used to obtain the regression coefficients and establish the final diabetic foot classification prediction model. ROC curve was drawn, and AUC, sensitivity, specificity, and accuracy of the training and test sets were calculated to verify its prediction performance. Results:We screened 7 fundus radiomics markers for diabetic foot patients, and based on this established a DF/DM classification prediction model. The AUC, sensitivity, specificity, and accuracy of the model were 0.958 6, 0.984 0, 0.920 0, and 0.928 0 in the training set, and 0.927 1, 0.988 9, 0.881 0, and 0.896 9 in the test set, respectively.Conclusion:In this study, seven DF fundus markers were screened using radiomics technology. Based on this, a highly accurate and easy-to-use DF/DM classification model was constructed. This technology has the potential to increase the efficiency of DF screening programs.
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ObjectiveTo investigate the therapeutic effect of Xuebijing injection （XBJ） on sodium taurocholate （Na-Tc）-induced severe acute pancreatitis （SAP） in rats. MethodForty rats were randomly assigned into 5 groups： sham operation group， SAP model group， and low-， medium-， and high-dose （4， 8， 12 mL·kg·d-1， respectively） XBJ groups. SAP model was established by retrograde injection of Na-Tc （1 mL·kg-1） into the biliary and pancreatic ducts. XBJ was injected intraperitoneally 3 days before and 0.5 h after modeling. The ascitic fluid volume and the pancreas weight-to-body weight ratio were measured. The pathological changes of pancreatic tissue were observed via hematoxylin-eosin （HE） staining. The protein levels of formyl peptide receptor 1 （FPR1） and nucleotide-binding oligomerization domain-like receptor 3 （NLRP3） in pancreatic tissue were detected by immunohistochemistry. Western blot was employed to determine the expression levels of NADH-ubiquinone oxidoreductase chains 1-6 （MT-ND1， MT-ND2， MT-ND3， MT-ND4， MT-ND5， and MT-ND6） in rat plasma. ResultCompared with sham operation group， the SAP model group showcased increased ascitic fluid volume and pancreas weight-to-body weight ratio （P<0.05）， serious lesions in pancreatic tissue， increased total pathological score （P<0.05）， and up-regulated protein levels of FPR1 and NLRP3 in pancreatic tissue （P<0.05）. The model group had lower MT-ND2 level （P<0.05） and higher MT-ND1， MT-ND3， and MT-ND6 levels in plasma （P<0.05） than the sham operation group， while MT-ND4 and MT-ND5 had no significant differences between the two groups. Compared with SAP model group， the XBJ treatment decreased ascitic fluid volume and pancreas weight-to-body weight ratio （P<0.01）， ameliorated pancreatic lesions， and down-regulated the protein levels of FPR1 and NLRP3 in pancreatic tissue （P<0.01）. The treatments， especially high-dose XBJ （P<0.01）， down-regulated the expression of MT-ND1 （P<0.01）， MT-ND3 （P<0.01）， MT-ND6 （P<0.01）， and MT-ND4 and did not change that of MT-ND5. ConclusionXBJ may antagonize partial mitochondrial N-formyl peptides and excessive inflammatory response mediated by FPR1/NLRP3 to treat SAP in rats.
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OBJECTIVE@#To investigate the clinical characteristics of lower extremity arterial disease (LEAD) and its risk factors in patients with diabetic foot ulcer (DFU).@*METHODS@#We retrospectively collected the clinical and follow-up data of 650 patients with DFU treated in the Department of Endocrinology and Metabolism of Nanfang Hospital between January, 2017 and December, 2019. We compared the data between patients who had LEAD and those without LEAD and used a multivariate logistic regression model to analyze the risk factors of LEAD in DFU patients.@*RESULTS@#Among the 650 DFU patients, 470 (72.4%) had LEAD. The patients were followed up for a mean of 3.5 months, and the mean healing time of DFU was 2.55 months; healing of DFU occurred in 453 patients and 183 patients received amputation. The patients with LEAD and those without LEAD differed significantly in age, hospitalization costs, diastolic blood pressure (DBP), glycated hemoglobin, blood lipid levels, disease course, ankle brachial index, healing time, smoking history, clinical outcomes, Wagner grade and imaging results (P < 0.05). Multivariate logistic regression analysis identified age (OR=1.070, 95% CI: 1.049-1.091), smoking history (OR= 2.013, 95% CI: 1.268-3.195), and a decreased DBP (OR=0.980, 95% CI: 0.963-0.997) as independent risk factors for LEAD in DFU patients. A prolonged healing time was a prominent clinical feature of DFU complicated by LEAD.@*CONCLUSION@#DFU patients have a high incidence of LEAD, which leads to high rates of disability and mortality and is associated with an advanced age, high smoking rate and longer healing time. A decreased DBP is also a risk factor for LEAD in DFU patients.
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Humans , Amputation, Surgical , Diabetes Mellitus , Diabetic Foot/epidemiology , Lower Extremity , Retrospective Studies , Risk FactorsABSTRACT
Objective:To evaluate the effect of esketamine on the efficacy of postoperative patient-controlled intravenous analgesia (PCIA) in the patients with moderate central sensitization undergoing high tibial osteotomy.Methods:Fifty-four patients of both sexes with moderate central sensitization, aged 45-64 yr, with body mass index of 18.0-32.5 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective high tibial osteotomy, were divided into 2 groups ( n=27 each) using a random number table method: control group (group C) and esketamine group (group ES). Ultrasound-guided femoral nerve block was performed with 0.5% ropivacaine 30 ml on the operated side at 30 min before induction of anesthesia.In C and ES groups, midazolam 0.1 mg/kg, sufentanil 0.2 μg/kg, propofol 1.5 mg/kg, and cisatracurium besilate 0.15 mg/kg were intravenously injected in turn during induction of anesthesia, and in addition esketamine hydrochloride 0.5 mg/kg was injected in ES group, and the equal volume of 0.9% sodium chloride was injected in C group, and then a laryngeal mask airway was placed.Anesthesia was maintained with intravenous infusion of remifentanil 0.1-0.3 μg·kg -1·min -1 and propofol 4-6 mg·kg -1·h -1.Esketamine hydrochloride 0.2 mg/kg was intravenously injected once every 20 min until 30 min before the end of operation in ES group, the equal volume of 0.9% sodium chloride was injected according to the amount of esketamine hydrochloride injected for the same body weight at the same time point in C group, and additional cisatracurium besilate was administered intermittently according to the degree of muscle relaxation.Intraoperative BIS values were maintained at 40-60.Postoperative PCIA was performed, and the patient was admitted to the post-anesthesia care unit.When the efficacy of PCIA was not good, ketorolac tromethamine 30 mg was intravenously injected for rescue analgesia.The intraoperative consumption of remifentanil and propofol and emergence time in the anesthesia recovery room were recorded.The pressing times of PCA and the number of rescue analgesia in each group were recorded within 2 days after operation.The Chinese Richards-Campbell Sleep Questionnaire was used to assess the nighttime sleep quality on the night of surgery and 1 and 2 days after surgery.The Chinese Quality of Recovery was used to assess the early recovery quality at 1 and 2 days after surgery.The first postoperative off-bed time and first walked distance were recorded.The adverse reactions were recorded. Results:Compared with group C, the consumption of remifentanil and propofol was significantly reduced, the emergence time in the anesthesia recovery room was prolonged, the pressing times of PCA and the number of rescue analgesia were decreased within 2 days after operation, the quality of nighttime sleep was improved on the night of surgery and 1 and 2 days after operation, the quality of early recovery on 1 and 2 days after operation was increased, the first postoperative off-bed time was shortened, the first walked distance was prolonged, and the incidence of postoperative adverse effects was decreased in group ES ( P<0.05). Conclusions:Esketamine can enhance the efficacy of postoperative PCIA in the patients with moderate central sensitization undergoing high tibial osteotomy.
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Objective:To investigate the clinical effect of gracilis musculocutaneous flap in repair of perineal soft defect with open pelvic fracture.Methods:From June 2009 to June 2019, 11 cases of open pelvic fracture associated with perineal injury were treated in the Department of Trauma and Orthopaedic of 521 Hospital of Norinco Group. There were 4 males and 7 females aged 16-56 (33 in average) years old. Cause of injuries: 6 cases by traffic accident, 4 by falling from height, and 1 by crushing. All the patients had open pelvic fractures. According to Tile classification, 1 case was rated as type A, 7 as type B and 3 as type C. All the patients were accompanied with perineal injury and soft tissue defect. The wound sizes ranged from 5 cm×5 cm to 8 cm×12 cm. The defects were repaired with gracilis musculocutaneous flap. The size of gracilis myocutaneous flaps was 6 cm×5 cm to 9 cm×13 cm. All donor areas of the flap were sutured directly. After surgery, 11 patients treated with strengthened nutritional support, keep supine position to avoid abduction, and appropriately raise the lower limbs. Follow-ups were conducted regularly after surgery.Results:All patients entered 6 to 30 (22 in average) months of follow-up. All of 11 myocutaneous flaps survived, besides 1 had a few necrosis at the distal surface of the myocutaneous flap, and healed after change of dressing. All the incisions at donor site had stage I healing. The colour, texture and flexibility of the gracilis myocutaneous flap were good. There was a scar at the donor sites without causing obvious dysfunction. Over the follow-up period, there was no failure of flap in either the recipient and donor sites. The patients were satisfied with the appearance and function.Conclusion:Gracilis musculocutaneous flap is one of the ideal methods in repair of perineal soft tissue defect with open pelvic fracture.
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Objective To develop an SNP Panel for East Asian population, which has a high individual identification rate and the capability of ancestry analysis. Methods The 55 SNP Panel by Professor KIDD of Yale University and the 128 SNP Panel by Professor SELDIN of Davis School of California University, 170 SNP Panel in total was used as the basis and its test data in the East Asian population was collected. The genetic parameters of SNP loci were calculated and combined with the results of heatmap analysis to screen SNP loci suitable for East Asian population. Some Tibetan and Han samples were tested. The possibility of using the SNP loci in ancestry inference was analyzed by means of STRUCTURE analysis, principal component analysis and heatmap analysis. Results A Panel with 45 SNPs （45 SNP Panel） was screened out, and the average genetic parameters of each SNP were better than 170 SNP Panel, with the same ancestry analysis and inference ability. Conclusion In terms of ancestry inference information, the 45 SNP Panel can completely replace the 170 SNP Panel and achieve the same ancestry analysis and inference ability. In genetic parameters, 45 SNP Panel is better than 170 SNP Panel in the East Asian population, which shows its important potential forensic application value.
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Humans , Asian People/genetics , Gene Frequency , Genetics, Population , Polymorphism, Single Nucleotide , Principal Component AnalysisABSTRACT
Objective To analyze the influence of different materials on thermal stress field of the bipolar high-frequency electric knife. Methods The electric-thermal coupling simulation analysis was performed for thermal stress field in working process of the bipolar high-frequency electric knife. The influence patterns for 4 kinds of insulating layer materials 304 stainless steel, 316 stainless steel, 317 stainless steel, Ti6Al4V and 4 kinds of electrode materials polypropylene (PP), polyamide-6 (PA6), polycarbonate (PC) and acrylonitrile butadiene styrene (ABS) on thermal stress field and thermal deformation field of insulating layer, electrode and coating of bipolar high-frequency electric knife and myocardial tissues were studied. Results The thermal deformation of myocardial tissues was much higher than that of the components of high-frequency electric knife in period of 2 s for continuous power. In terms of myocardial tissue protection, 304 stainless steel was the best electrode material for high-frequency electric knife. For choosing PP as the insulating layer material, thermal deformation of myocardial tissues caused by thermal stress was the smallest, which could better maintain the integrity of myocardial tissues. Conclusions The manufacturing materials of high-frequency electric knife have an important influence on thermal stress field in its working process. The regularity analysis results can provide guidance for the development of high-frequency electric knife.
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Objective:To analyze the epidemiological characteristics and drug resistance of Salmonella in patients with food-borne diarrhea in Jiading District. Methods:From January 2018 to December 2019， feces or anal swabs of patients were collected from five hospitals in monitoring sites， and the drug sensitivity test was conducted using the micro broth dilution method. Results:The total detection rate of Salmonella was 7.85% （142/1 810）， and the detection rates of 0-6， 7-17， 18-40， 41-65 and over 65 years old were 8.97% （13/145）， 6.94% （5/72）， 7.58% （75/989）， 8.69% （41/472） and 6.06% （8/132）， respectively. Salmonella rosenbergii was a new dominant serotype in this area. Many strains were resistant to the third and fourth generation cephalosporins， fluoroquinolones and even azithromycin. The sensitivity rate of Salmonella typhimurium to cefotaxime and cefepime was 84.85%， and the resistance rate to fluoroquinolones was 12% to 16%. The mediating rates of Salmonella and Salmonella enteritidis to fluoroquinolones were 56% to 60% and 95.56%， respectively. Conclusion:The detection rate of Salmonella infection is high in all age groups. It is necessary to pay more attention to new dominant serotypes. Salmonella typhimurium is highly resistant to the third and fourth generation cephalosporins and fluoroquinolones， while the sensitivity of Salmonella， especially Salmonella enteritidis to fluoroquinolones has decreased significantly.
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Objective:To evaluate the effect of web-based problem-based learning software on the Clinical Medicine PBL Comprehensive Course. Methods:Thirty-eight students from the pilot class of undergraduate excellent doctors in clinical medicine were selected as the research objects. Based on the test scores of web-based problem-based learning software before the start of the course, the improvement of scores after passing the training of the Clinical Medicine PBL Comprehensive Course were compared, and the students' clinical thinking were quantitatively evaluated. Results:After all students completed the course, their abilities of expression and communication, teamwork and cooperation, problem analysis and clinical reasoning, and knowledge information management of the students increased steadily with the increase in the number of cases, but it was statistically significant after two PBL case trainings ( P<0.05). Learning intentions and attitudes scored the highest in the second PBL case (acute myocardial infarction), with statistical differences ( P<0.05). After training through the PBL course, diagnostic performance, clinical thinking, treatment scores, and overall performance scores of the students were significantly increased than before, with statistical significance ( P<0.05). The scores of case report writing and knowledge acquisition were not obviously improved. Conclusion:The combination of formative evaluation and web-based problem-based learning software can better evaluate the teaching effect and help students to understand their own shortcomings.
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Objective To investigate the influence of angiotensinreceptor neprilysin inhibitor (ARNI) and angiotensin converting enzyme inhibitor (ACEI) on clinical efficacy and safety of elderly patients with ischemic cardiomyopathy.Methods From January 2017 to December 2018,120 elderly patients with ischemic cardiomyopathy in the Third People's Hospital of Cixi were divided into 2 groups according to treatment methods,59 patients treated with ACEI (control group) and 61 patients treated with ARNI (observation group) on the basis of conventional intervention.The levels of blood lipid index,blood pressure index,B-type brain natriuretic peptide (BNP),6-minute walking test (6MWT) and echocardiographic index,endothelium-dependent diastolic function of brachial artery (FMD) and carotid intima-media thickness (CIMT) before and after treatment were compared.The adverse reactions incidence of 2 groups were compared.Results The levels of blood lipid index and blood pressure index after treatment of 2 groups were significantly lower than those before treatment,and the differences had statistical significant (P ＜ 0.05).There were no significant differences in the levels of blood lipid index and blood pressure index after treatment between 2 groups (P ＞ 0.05).After treatment of 12 weeks,the levels of BNP,6MWT,left ventricular ejection fraction (LVEF),left ventricular end-diastolic dimension (LVEDD) of observation group were significantly better than those of control group [(103.50 ± 23.95) ng/L vs.(175.20 ± 37.24) ng/L,(493.47 ± 92.54) m vs.(411.42 ± 61.09) m,(44.95 ± 5.89)％ vs.(41.54 ± 4.21)％,(149.59 ± 33.26) mm vs.(143.24 ± 34.25) mm](P ＜ 0.05).The level of brachial artery FMD after treatment of observation group was significantly higher than that of control group [(15.14 ± 2.52)％ vs.(9.25 ± 1.12)％](P ＜ 0.05).The level of CIMT after treatment of observation group was significantly lower than that of control group [(1.01 ± 0.28) mm vs.(1.32 ± 0.25) mm] (P＜ 0.05).There was no significant difference in the adverse reactions incidence between 2 groups (P＞ 0.05).Conclusions ARNI in assisted treatment of elderly patients with ischemic cardiomyopathy can efficiently improve cardiac function,increase exercise endurance,enhance vasodilation function and dose not aggravate adverse drug reactions.
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Objective@#To investigate the influence of angiotensinreceptor neprilysin inhibitor(ARNI) and angiotensin converting enzyme inhibitor (ACEI) on clinical efficacy and safety of elderly patients with ischemic cardiomyopathy.@*Methods@#From January 2017 to December 2018, 120 elderly patients with ischemic cardiomyopathy in the Third People′s Hospital of Cixi were divided into 2 groups according to treatment methods, 59 patients treated with ACEI (control group) and 61 patients treated with ARNI (observation group) on the basis of conventional intervention. The levels of blood lipid index, blood pressure index, B-type brain natriuretic peptide (BNP), 6- minute walking test (6MWT) and echocardiographic index, endothelium-dependent diastolic function of brachial artery (FMD) and carotid intima-media thickness (CIMT) before and after treatment were compared. The adverse reactions incidence of 2 groups were compared.@*Results@#The levels of blood lipid index and blood pressure index after treatment of 2 groups were significantly lower than those before treatment, and the differences had statistical significant (P<0.05). There were no significant differences in the levels of blood lipid index and blood pressure index after treatment between 2 groups (P>0.05). After treatment of 12 weeks, the levels of BNP, 6MWT, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension(LVEDD) of observation group were significantly better than those of control group [(103.50 ± 23.95) ng/L vs. (175.20 ± 37.24) ng/L, (493.47 ± 92.54) m vs. (411.42 ± 61.09) m, (44.95 ± 5.89)% vs. (41.54 ± 4.21)%, (149.59 ± 33.26) mm vs. (143.24 ± 34.25) mm](P<0.05). The level of brachial artery FMD after treatment of observation group was significantly higher than that of control group [(15.14 ± 2.52)% vs. (9.25 ± 1.12)%](P<0.05). The level of CIMT after treatment of observation group was significantly lower than that of control group [(1.01 ± 0.28) mm vs. (1.32 ± 0.25) mm](P<0.05). There was no significant difference in the adverse reactions incidence between 2 groups (P>0.05).@*Conclusions@#ARNI in assisted treatment of elderly patients with ischemic cardiomyopathy can efficiently improve cardiac function, increase exercise endurance, enhance vasodilation function and dose not aggravate adverse drug reactions.
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Objective To investigate the protective effect of recombinant adult serine protease inhibitor from Trichinella spiralis (TsadSPI) on sepsis-associated acute kidney injury in mice. Methods A total of 18 male BALB/c mice were randomly divided into the sham-operation group, the model group, and the TsadSPI treatment group, of 6 mice in each group. Sepsis-associated acute kidney injury was modeled in the model group and TsadSPI treatment group by cecal ligation puncture (CLP), while mice in the sham-operation group were only given exploratory laparotomy without ligation or perforation of the cecum. After 30 min of CLP, mice in the sham-operation group and the model group were intraperitoneally injected with PBS (100 μL), and mice in the TsadSPI treatment group were intraperitoneally injected with PBS (100 μL) containing TsadSPI (2 μg). At 12 h following modeling, the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (Cr) and urea nitrogen (BUN) were measured to assess the liver and kidney functions, and the changes of the mouse kidney structure were observed using HE staining. In addition, the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10 and transforming growth factor (TGF)-β were measured using an enzyme-linked immunosorbent assay (ELISA), and the myeloid differentiation factor 88 (MyD88) and nuclear factor kappa-B (NF-κB) p65 expression was determined in kidney tissues using immunohistochemical staining. Results At 12 h following CLP, there were significant differences in the serum levels of ALT (F = 41.031, P < 0.001), AST (F = 54.757, P < 0.001), Cr (F = 24.142, P < 0.001) and BUN (F = 214.849, P < 0.001) among the three groups, and higher levels of ALT, AST, Cr and BUN were measured in model group than in the sham-operation group (P < 0.001), while lower ALT, AST, Cr and BUN levels were found in the TsadSPI treatment group than in the model group (P < 0.001). HE staining showed severe mouse kidney injuries following CLP, and TsadSPI treatment resulted in remarkable alleviation of the injury. ELISA measured significant differences in the TNF-α (F = 47.502, P < 0.001) and IL-6 levels (F = 222.061, P < 0.001) among the three groups, and showed a remarkable reduction in the TNF-α and IL-6 levels in the TsadSPI treatment group as compared to those in the model group (P < 0.001). In addition, there were significant differences in serum IL-10 (F = 16.227, P < 0.001) and TGF-β levels (F = 52.092, P < 0.001) among the three groups, and higher IL-10 and TGF-β levels were seen in the TsadSPI treatment group than in the model group (P < 0.001). Immunohistochemical staining showed greater MyD88 expression and a higher nuclear positive rate of NF-κB p65 in kidney tissues in the model group than in the TsadSPI treatment group. Conclusions TsadSPI may reduce the MyD88 expression and nuclear positive rate of NF-κB p65 in mouse kidney tissues to up-regulate the expression of immunomodulatory factors and down-regulate the expression of pro-inflammatory cytokines, thereby protecting sepsis-associated acute kidney injury.
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Objective: To explore the occurrence of cognitive impairment in Chinese heart failure (HF) patients and it's impact on prognosis. Methods: In this prospective observational study, a total of 990 HF patients were enrolled from 24 hospitals in China during December 2012 to November 2014. All patients were administrated with the interview-format Montreal Cognitive Assessment (MoCA), according to which they were divided into MoCA<26 (with cognitive impairment) group and MoCA≥26 (without cognitive impairment) group. Baseline data were collected and a 1-year follow up was carried out. Univariate and multivariate logistic or Cox regression were performed for 1-year outcomes. Results: Cognitive impairment was evidenced in 628 patients (63.4%) and they were more likely to be older, female, and with higher proportion of New York Heart Association(NYHA) class Ⅲ-Ⅳ, chronic obstructive pulmonary disease (COPD), ischemic heart disease, while body mass index (BMI), education level, and medical insurance rate were lower (all P<0.05) as compared to patients in MoCA≥26 group. The rate of percutaneous intervention, device implantation, cardiac surgery and evidence-based medications were significantly lower in MoCA<26 group than in MoCA≥26 group (all P<0.05). During the 1-year follow up, patients in the MoCA<26 group had higher all-cause mortality (10.2%(64/628) vs. 2.2%(8/362), P<0.01), cardiovascular mortality (5.9%(37/628) vs. 0.8%(3/362), P<0.01) and major adverse cardiac and cerebrovascular events (MACCE) (9.6%(60/628) vs. 2.5%(8/362), P<0.01) than patients in the MoCA≥26 group. In univariate regression, MoCA<26 was associated with increased all-cause mortality (HR(95%CI):4.739(2.272-9.885), P<0.01), cardiovascular mortality (HR(95%CI):7.258(2.237-23.548), P=0.001) and MACCE (OR(95%CI):4.143(2.031-8.453), P<0.01). After adjustment by multivariate regression, MoCA<26 was indicated as an independent risk factor for all-cause mortality (HR(95%CI): 6.387(2.533-16.104), P<0.01), cardiovascular mortality (HR(95%CI): 10.848(2.586-45.506), P=0.001) and MACCE (OR(95%CI): 4.081(1.299-12.816), P=0.016), while not for re-hospitalization for HF (OR(95%CI):1.010(0.700-1.457), P=0.957). Conclusions: Cognitive impairment is common in HF patients,and it is an independent prognostic factor for 1-year outcomes. Routine cognitive function assessment and active intervention are thus recommended for HF patients.
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Female , Humans , China , Heart Failure , Mental Status and Dementia Tests , Prognosis , Prospective StudiesABSTRACT
Objective:To explorer the optimal method of detecting donor kidney carrier carbapenem-resistant Klebsiella pneumoniae (CRKP).Methods:Clinical data were retrospectively analyzed for 1120 donation-after-circulatory-death (DCD) kidneys and bacterial detection of kidney perfusion fluid was performed from January 2015 to January 2019. A total of 1120 kidney perfusion fluid samples were collected with sterile tubes and submitted for culturing. And 451 specimens were delivered in sterile tubes and blood culture bottles simultaneously And 729 specimens assayed for carbapenemase genes with GeneXpert.Results:Among 1120 kidneys, CRKP was confirmed in 21 grafts with an infection rate of 1.87 %. The detection of carbapenemase genes with Genexpert showed that KPC was positive for 9/16 CRKP positive grafts. Sensitivity, specificity, false-positive rate, false-negative rate and ROC-AUC were calculated at 56.3 %, 100 %, 0, 43.7 % and 0.781 respectively. And 11 specimens delivered with sterile tube were culture positive for CRKP. Sensitivity, specificity, false-positive rate, false-negative rate and ROC-AUC were calculated at 52.3 %, 100 %, 0, 47.6 % and 0.762 respectively. Among 451 perfusion fluid samples collected with anaerobic blood culture bottle, 15 samples had a positive culture for CRKP. Sensitivity, specificity, false-positive rate, false-negative rate and ROC-AUC were calculated at 100 %, 100 %, 0, 0 and 1 respectively. In terms to anaerobic blood culture bottle, sensitivity, specificity, false-positive rate, false-negative rate and ROC-AUC were calculated at 60 %, 100 %, 0 , 40 % and 0.80 respectively.Conclusions:Genexpert assay is suitable for rapid and convenient detection of carbapenemase genes using kidney perfusion fluid. Culturing perfusion fluid samples collected with anaerobic blood culture bottle is clinically valuable diagnostic tool of CRKP. A combination of both methods is worthy of clinical promotion and application diagnosis of donor kidney derived CRKP in terms of greater accuracy and timeliness.
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Objective:To investigate the characteristics of urinary microflora in women with type 2 diabetic peripheral neuropathy without lower urinary tract symptoms.Methods:By completing nerve conduction function and the American Urological Association Symptom Index questionnaire (AUA-SI), a total of 30 cases of women hospitalized with type 2 diabetes and no symptoms of lower urinary tract from May 2017 to August 2018 were included. 17 patients with diabetic peripheral neuropathy were assigned to the DPN group, and 13 patients without diabetic peripheral neuropathy were assigned to the nDPN group. Urine specimens were collected from clean catch midstream urine and processed for extracting DNA. Microbial diversity and composition were analyzed using the Illumina sequencing platform targeting to 16S rDNA gene. Sequencing reads were processed by QIIME. LEfSe algorithm was used to analyze the flora with significant differences between the two groups.Results:The duration of diabetes in the DPN group was lower than that in the nDPN group [(4.12 ± 3.28)years vs.(8.03 ± 6.11)years, P = 0.03], and the retinopathy cases were more in the DPN group than those in the nDPN group (6 vs. 0, P=0.03). Except for above two indicators, there was no significant difference in demographic characteristics between DPN group and nDPN group( P>0.05). The urinary microenvironment of DPN was characterized by increased bacterial richness(sobs index, chao index and aec index, 67.24±40.25 vs.108.69±57.18; 81.36±47.99 vs.122.55±55.70; 88.58±55.03 vs.125.78±53.03, all P<0.05) and by the enrichment of Mycoplasmataceae(Metastats value: 0.52±0.01vs.0.01±0.00001, P=0.02). Beta diversity showed that no significant difference of bacterial composition was found between these two group( P>0.05). LEfSe analysis showed that at the genus level, the relative abundance of eight genera(e.g., Bacillus, Duganella, Leptotrichia, Proteus, Propionibacterium, Pseudoxanthomonas, Bdellovibrio and uncultured_soil_bacterium) in DPN group decreased at the level of genus( P<0.05). Conclusions:Female patients with type 2 diabetes without lower urinary tract symptoms of peripheral neuropathy exhibit a different microbial community compared to nDPN controls. Mycoplasmataceae may be a potential biomarker for patients with DPN.
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More and more studies have been focusing on marginal donor livers, such as steatotic liver grafts, to alleviate donor shortage and reduce mortality from waiting lists. Poor tolerance of streatotic liver grafts often leads to primary graft nonfunction, early dysfunction, and postoperative vascular and biliary complications. Some studies have shown that moderate and severe macrosteatosis livers can be used for transplantation with rigorous selection of recipients. In this paper, techniques such as venous systemic oxygenated persufflation, hypothermic oxygenated perfusion, subnormothermic machine perfusion, normothermic machine perfusion, improved liver quality, and steatotic liver grafts transplantation were discussed.
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Objective: To investigate the associations between single nucleotide polymorphisms (SNP) of integrin crsubunit 1 (ITGA1) gene and the risk of non-cardia gastric cancer, and to elucidate the roles of ITGA1 gene polymorphisms in the risk of non-cardia gastric cancer. Methods: The case-control study design was used. A total of 288 patients with non-cardia gastric cancer were selected as case group, and 281 community physical examinees were selected as control group in Han population in Boatou City in Inner Mongolia Autonomous Region. The SNP of rsl862610, rs2432143, and rs2447867 sites of subjects in two groups were genotyped by using TaqMan method, and the haplotype was constructed by Haploview software 4. 0. The odds ratio (OR) and 95% confdence intervals (95% CI) were measured by conditional Logistic regression analysis to evaluate the correlations between the frequencies of allele, genotype, and haplotypes and the susceptibility to non-cardia gastric cancer. Results: The SNP of rsl862610, rs2432143, and rs2447867 sites in ITGA1 gene were not associated with the risk of non-cardia gastric cancer (P>0. 05). The SNP of rsl862610 and rs2432143 sites were in strong linkage disequilibrium (D' =1) and formed a block. Compared with those who carried haplotype CT, those who carried haplotype CC had an increasing risk of non-cardiac gastric cancer (CC vs CT: OR=1.42, 95% CI: 1.02-1.99). Conclusion: The ITGA1 gene polymorphisms may play a role in the risk of non-cardia gastric cancer in Han population in Baotou in Inner Mongolia Autonomous Region. The risk of non-cardia gastric cancer in the person who carries the SNP rsl862610-rs2432143 CC haplotype is increased.
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Objective: To obtain the structural characteristics of chloroplast genome in Psammosilene tunicoides and analyze its phylogenetic position within the family of Caryophyllaceae. Methods: High-through-put sequencing technology and bioinformatic analysis softwares were used to analyze the structures of complete chloroplast genome of P. tunicoides. RAxML 8.2.11 software was utilized to reconstruct the Caryophyllaceae phylogentic tree with Amaranthus hypochondriacus as outgroup. Results: The complete chloroplast genome was 153 977 base pairs (bp) in size, including two inverted repeat (IR, 26 033 bp) regions separated by one large singe copy region (LSC, 84 385 bp) and one small singe copy region (SSC, 17 526 bp). The genome encoded 125 genes, of which 109 were unique, including 75 protein-coding genes (PCGs), 30 tRNA genes and 4 rRNA genes. The overall GC content of P. tunicoides was 36.5%, while those of IR regions (42.4%) were higher than LSC (34.2%) and SSC (30.1%) regions. The phylogenetic tree showed that P. tunicoides and Dianthus longicalyx were sister groups with 100% bootstrap value. All nodes of the phylogenetic tree of Caryophyllaceae were of high supports, and the ML tree had good resolution to reflect the phylogeny relationship among the Caryophyllaceae. Conclusion: The complete chloroplast genome of P. tunicoides and the phylogenetic relationship within Caryophyllaceae were analyzed in this study. The results will provide effective molecular information for further studies on evaluation of germplasm and molecular phylogeny of Caryophyllaceae.
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Objective Exosomes play an extremely important role in the diagnosis and treatment of diseases, but very few studies have been reported on the method, time and results of their preservation. We observed the changes in the size, density, morphology and protein expression of exosomes in the plasma and serum preserved for different lengths of time. Methods Using the Exoquick kit, we isolated exosomes in the plasma and serum from healthy humans which were fresh or preserved at a temperature of －80℃ for 1, 3 or 5 years. We analyzed the numbers and diameters of the isolated exosomes with the nanoparticle-tracking analyzer NanoSight NS 300, observed their morphology under the transmission electron microscope, and detected the expressions of the exosome biomarkers TSG101 and CD63 by Western blot. Results The exosomes preserved for different periods of time ranged in diameter from 30 to 200 nm, more observed in the serum than in the plasma, and with no statistically significant difference in the morphological changes among different groups of preservation time. The expressions of the TSG101 and CD63 proteins in the exosomes were decreased with the prolonging of the preservation time, the latter even more significantly than the former. Conclusion There are no statistically significant differences in the diameter or morphology of the exosomes in the human plasma and serum preserved for different periods of time, but the protein biomarkers of the exosomes are decreased significantly with the prolonged time of preservation. Therefore, freshly isolated exosomes are recommended for experiments in the studies of exosome-related proteins.