Prognosis assessment of strong ion gap in adult patients with cardiac arrest / 中华急诊医学杂志

Objective:To investigate the correlation between strong ion gap (SIG) and prognosis of adult hospitalized patients who experienced cardiac arrest (CA).Methods:A retrospective cohort study was conducted on adult CA patients (≥18 years old) who were admitted to the intensive care unit (ICU) for the first time from the Medical Information Mart for Intensive Care Ⅲ (MIMIC-Ⅲ) database from 2001 to 2012. The patients were divided into 3 groups based on the tertiles of serum SIG value. The clinical baseline characteristics and related data of CA patients were compared. Kaplan-Meier method was used to draw the 28- and 90-day cumulative survival curves of CA patients. Meanwhile, the log-rank test was used to compare the differences in the survival curves among different groups, and Cox proportional hazard regression model was established to analyze whether SIG was an independent predictor of all-cause mortality in CA patients.Results:Six hundred and six adult CA patients were eligible for final analysis. The patients were divided into 3 groups based on the tertiles of serum SIG value [<3.91 mmol/L ( n=202), 3.91~7.32 mmol/L ( n=202) and >7.32 mmol/L ( n=202)]. The mean age was (66.91±15.95) years and 382 patients (63.04%) were male. The all-cause mortality rates of ICU, 28 days and 90 days were 36.47%, 49.17% and 56.93%, respectively. There were significant differences in SOFA score, SIG, anion gap, pH, lactic acid, white blood cells, prothrombin time, creatinine, blood potassium, blood phosphorus, hypertension, coronary heart disease, cardiogenic shock, and ICU, 28-day and 90-day all-cause mortality among the 3 groups (all P<0.05). The Kaplan-Meier survival curves showed that the 28- and 90-day cumulative survival rates of CA patients decreased gradually with the increase of SIG level, and the differences were statistically significant among the 3 groups (all P<0.001). Multivariate Cox proportional hazard models showed that the increase of SIG level (>7.32 mmol/L) was an independent risk factor for 28-day ( HR=1.610, 95% CI: 1.177-2.203, P=0.003) and 90-day all-cause mortality ( HR=1.506, 95% CI: 1.123-2.019, P=0.006) among CA patients, after adjusting for the related confounders. Conclusions:The elevated SIG level (>7.32 mmol/L) is an independent predictor of 28- and 90-day all-cause mortality in CA patients. The calculation of SIG level in these patients is helpful for early identification of patients with poor prognosis.

Advances in methods and applications of electroencephalogram microstate analysis / 生物医学工程学杂志

Electroencephalogram (EEG) is characterized by high temporal resolution, and various EEG analysis methods have developed rapidly in recent years. The EEG microstate analysis method can be used to study the changes of the brain in the millisecond scale, and can also present the distribution of EEG signals in the topological level, thus reflecting the discontinuous and nonlinear characteristics of the whole brain. After more than 30 years of enrichment and improvement, EEG microstate analysis has penetrated into many research fields related to brain science. In this paper, the basic principles of EEG microstate analysis methods are summarized, and the changes of characteristic parameters of microstates, the relationship between microstates and brain functional networks as well as the main advances in the application of microstate feature extraction and classification in brain diseases and brain cognition are systematically described, hoping to provide some references for researchers in this field.

Design and application of a multi-assisted function incision and orifice closure buckle / 中华危重病急救医学

Incision infection is one of the common complications in surgery. Infected incisions usually need to perform procedures including suture removal, debridement, drainage, sterilization and anti-inflammatory. Until, the wound edge was sutured again after the wound infection was controlled. This contributes to considerable physical and psychological suffering for patients. To this end, with Dalian Medical University as the main inventor and other several experts, a multi-assistance function incision and orifice closure buckle have been designed and obtained the national utility model patent (patent number: ZL 2019 2 1803918.4). The closure buckle with was composed of two blocks with an adhesive layer and one tensioning mechanism. The device is easy to operate, and could effectively play an analgesic, antibacterial and promote healing on the basis of perfecting its wound margins and orifice. It has certain clinical application value.

Red cell distribution width and prognosis in patients with cardiac arrest: A retrospective cohort study / 中华急诊医学杂志

Objective:To investigate the association between the initial red cell distribution width (RDW) and all-cause mortality in patients with cardiac arrest (CA) in intensive care unit (ICU).Methods:We conducted a retrospective cohort study and extracted the related clinical data in ICU among adult CA patients (age ≥18 years), using the Multiparameter Intelligent Monitoring Intensive Care III (MIMIC-Ⅲ, v1.4) database from 2001 to 2012. Based on whether they survived or not on 90 days, the patients were divided into the survival group and death group, and the clinical data of the two groups were compared. Meanwhile, the RDW values were divided into four parts according to quartile. The cumulative survival rate of 28-day and 90-day were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox proportional hazard models were also used to reveal the association between RDW and all-cause mortality.Results:Based on the inclusion and exclusion criteria, 853 adult CA patients were finally enrolled. The mean age was (67.26±15.84) years, and 534 (62.60%) patients were male. And the mean SOFA score was (6.13±3.70). Compared with the survival group ( n=410), the patients in the death group ( n=443) were older and had a higher SOFA score, RDW, anion gap, creatinine and blood phosphorus. Moreover, the proportion of chronic obstructive pulmonary disease, acute kidney injury and sepsis in the death group were higher than those in the survival group, and the length of stay in ICU in the death group was longer than that in the survival group (all P<0.05). However, the indicators of arterial blood oxygen partial pressure, hemoglobin and total blood calcium, as well as the proportion of coronary heart disease and acute myocardial infarction were lower than those in the survival group, and a shorter duration of hospitalization in the death group was noted (all P<0.05). Kaplan-Meier survival curves demonstrated that there was a significant difference in the cumulative survival rate of 28-day and 90-day (all P<0.001). In the multivariate Cox proportional hazard models, a higher RDW at ICU admission was an independent risk factor for 28-day ( HR=1.399, 95% CI: 1.014-1.930, P=0.041) and 90-day ( HR=1.433, 95% CI: 1.064-1.929, P=0.018) all-cause mortality among CA patients. Conclusions:An elevated RDW is an independent predictor for 28-day and 90-day all-cause mortality of CA patients. As a clinical indicators, it indicates a poor prognosis for adult CA patients.

Role of PPARγ/CD36 signaling pathway in macrophage lipid metabolism after Mycobacterium tuberculosis infection / 中华微生物学和免疫学杂志

Objective:To investigate the role of peroxisome proliferator-activated receptor γ (PPARγ)/CD36 signaling pathway in macrophage lipid metabolism after Mycobacterium tuberculosis ( Mtb) infection. Methods:THP-1-derived macrophages were infected with Mtb. Four groups were included in this study, which were control group, Mtb infection group, Mtb+ rosiglitazone (ROZ, PPARγ agonist) group and Mtb+ GW9662 (PPARγ antagonist) group. Western blot and RT-PCR were used to detect the expression of PPARγ in macrophages at protein and mRNA levels, respectively. The lipids in cells were detected by oil red O staining. The concentrations of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C) in the supernatant of cell culture were detected by automatic biochemical analyzer. The expression of CD36 was detected by immunohistochemistry. CCK-8 was used to detect the proliferation rate of macrophages. Results:Mtb infection significantly increased the expression of PPARγ in macrophages ( P<0.001), promoted intracellular lipid aggregation and CD36 expression and decreased the levels of TC, TG, LDL-C and HDL-C in the supernatant of cell culture ( P<0.001) and cell proliferation rate ( P<0.001). PPARγ agonist significantly enhanced the intracellular lipid accumulation and CD36 expression that were induced by Mtb infection and down-regulated the lipid level in the supernatant of cell culture and cell proliferation rate, while PPARγ antagonist reversed the above effects. Conclusions:PPARγ played a role in lipid metabolism in Mtb-infected macrophages through affecting CD36 expression.

Study on Puerariae Lobamle Radix with UPLC fingerprint / 国际中医中药杂志

Objective:To establish the UPLC fingerprint analysis method for Puerariae Lobamle Radix. Methods:The column was Agilent ZORBAX Eclipse Plus C18 column (2.1 mm×100 mm, 1.8 μm). The mobile phase consisted of acetonitrile (A)-0.1% formic acid (b), gradient elution, flow rate was 0.3 ml/min. The detection wavelength was 250 nm. The column temperature was set at 30 ℃. The sample volume was 2 μl, and the similarity evaluation system of traditional Chinese medicine fingerprint was adopted. The cluster analysis, principal component analysis and partial least square method in SPSS software were used to judge the differences of Pueraria lobata from different habitats.Results:With puerarin as reference peak, 22 common peaks were calibrated, and 6 peaks were identified. The similarity of 25 batches of samples was above 0.990 except S22 was 0.935, which indicated that the samples were with good consistency. Through cluster analysis, principal component analysis and partial least square analysis, 25 batches of Puerariae Lobamle Radix can be clustered into 4-5 categories, and different components such as 3'-hydroxy puerarin were found. The extraction process of Puerariae Lobamle Radix was optimized based on analytic hierarchy process and multi-index orthogonal test. The results showed that adding 50% ethanol 40 ml and refluxing for 40 min was the best extraction process. Conclusion:UPLC fingerprint is suitable for Puerariae Lobamle Radix, and the results are reliable. It can be used as a quality evaluation method for Puerariae Lobamle Radix.

The relationship between heart rate variability and cardiac function and prognosis in patients with Parkinson′s disease and chronic heart failure / 中国医师杂志

Objective:To analyze the relationship between heart rate variability (HRV) and cardiac function and prognosis in patients with Parkinson′s disease (PD) and chronic heart failure (CHF).Methods:60 patients with PD and CHF admitted to our hospital from January 2018 to December 2019 were selected as group A. 50 patients with simple PD admitted in the same period were selected as group B , and 40 patients in the healthy control group were selected as group C. The high frequency (HF), low frequency (LF), high frequency and low frequency ratio (HF/LF), left ventricular ejection fraction (LVEF) were monitored in the three groups, and the incidence and mortality of cardiovascular events such as acute coronary syndrome, malignant arrhythmia and acute heart failure were recorded during six months follow-up.Results:The HF, HF/LF ratio and LVEF of group C were significantly higher than those of group A and B, and LF value was significantly lower than that of group A and B ( P<0.05). The HF, HF/LF ratio and LVEF of group B were significantly higher than those of group A, and LF value was significantly lower than that of group A ( P<0.05). The HF and HF/LF ratio of patients with LVEF≥50% in group A was significantly higher than those with LVEF<50%, and LF was significantly lower than those with LVEF<50% ( P<0.05). The HF and HF/LF values of the patients in group A who died and had cardiovascular events were significantly lower than those of the surviving patients and those without cardiovascular events, and the LF values were significantly higher than those of the surviving patients and those without cardiovascular events ( P<0.05). The HF and HF/LF value of group A was positively correlated with LVEF value ( r HF=0.883, rHF/ LF=0.854, P<0.05), and negatively correlated with mortality ( r HF=-0.819, rHF/ LF=-0.802, P<0.05) and cardiovascular events ( r HF=-0.736, rHF/ LF=-0.794, P<0.05) ; LF value was negatively correlated with LVEF value ( r=-0.743, P<0.05). LF value was positively correlated with mortality ( r=0.743, P<0.05) and the incidence of cardiovascular event ( r=0.750, P<0.05). Conclusions:The decrease of HRV in PD patients with CHF will weaken their cardiac function and increase their adverse prognosis. Therefore, the monitoring of HRV is helpful for the treatment and prognosis intervention in PD patients with CHF.

Analysis of PDHA1 gene variant in a patient with pyruvate dehydrogenase E1alpha deficiency and pyramidal tract involvement / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a patient with episodic ataxia and pyramidal tract signs.@*METHODS@#The patient was subjected to high-throughput sequencing, Sanger sequencing and analysis of dynamic variant site associated with spinocerebellar ataxias (SCA).@*RESULTS@#The patient was an adolescent male presenting with episodic ataxia, bilateral knee hyper-reflexia and ankle clonus. By genetic testing, he was found to harbor a c.1159-1162dupAAGT variant of PDHA1 gene. The same variant was not found in his parents and elder sister. No abnormalities were found by SCA dynamic variant screening. The patient was diagnosed as pyruvate dehydrogenase E1alpha deficiency due to variant of the PDHA1 gene.@*CONCLUSION@#The de novo c.1159-1162dupAAGT variant of the PDHA1 gene probably underlies the disease in the proband. Patients with pyruvate dehydrogenase E1alpha deficiency have complex phenotypes and very few have pyramidal tract involvement, which may be attributed to abnormal early neuronal development.

Research on the influence of bilateral oophorectomy on the BMD, body components and sex hormone of women during the perimenopause

To investigate the effect of bilateral oophorectomy on bone mineral density, body composition and sex hormone of peri-menopause women. 33 cases of peri-menopause women patients performed bilateral oophorectomy were chosen from xxx gynaecology and obstetrics department of xxx hospital from January 1[st],2014 to Dec31[st], 2014. And the 33 cases were taken as ovariectomy group. 35 women who were the naturally postmenopausal after menopause collected in clinic and in the same period with the patients of ovariectomy group were taken in control group. American GE-Lunar-Prodigy dual energy X-ray absorptiometry and chemiluminescence method were employed to detect the bone mineral density, fat content, muscle content and sex hormone of the patients in both groups at the 6[th] and 12[th] month after menostasis. There was no statistical significance on the comparative difference of bone mineral density, fat content and muscle content at the 6[th] and 12[th] month after menostasis between both groups, P>0.05. At the 6[th] month after menostasis, the estradiol [E[2]] level in ovariectomy group was significantly lower than that of control group [[14.79+/- 22.17]U/L vs [32.74+/- 31.02U/L]], P<0.05; at the 12[th] month after menostasis, it had the statistical significance for the comparative difference between the level of E[2] and and follicle-stimulating hormone [FSH] in ovariectomy group and that in control group, E[2]: [8.09+/- 4.38]U/L vs [25.92+/- 3.53]U/L; FSH: [64.88+/- 18.39]U/L vs [40.69+/- 31.63]U/L], P<0.05. The change of E[2] and FSH were the main symptom of peri-menopausal women within 12 months after bilateral oophorectomy, the decrease of E[2] level had no effect on bone mineral density, fat content and muscle content

Epidemiological analysis of adult carpal fractures at The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012 / 中华创伤骨科杂志

Objective To investigate the epidemiological features and trends of adult carpal fractures at The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the adult patients with carpal fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender and fracture type were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 1,181 carpal fractures were collected,accounting for 5.99％ (1,181/19,712) of the hand fractures and 1.10％ (1,181/107,648) of the total fractures in the same period.They involved 967 males and 214 females,with a male/female ratio of 4.52∶ 1.The high-risk age group was from 21 to 30 years (33.28％);the high-risk type was scaphoid fracture (72.99％).In group A of 453 cases,the male/female ratio was 6.68∶1,the median age 29 years and the high-risk type scaphoid fracture (83.89％).In group B of 728 cases,the male/female ratio was 3.70∶ 1,the median age 34 years and the high-risk type also scaphoid fracture (66.21％).Group B had a significantly lower male/female ratio,a significantly lower proportion of scaphoid fractures and a significantly older median age than group A (P ＜ 0.05).Conclusions In the 10 years at our institute,adult carpal fractures accounted for 5.99％ of the hand fractures and 1.10％ of the total fractures in the same period.They mostly occurred in males and during the age from 21 to 30 years.Of all the carpal bones,the scaphoid was the most often fractured.The latter 5 years witnessed significantly increased median age,proportion of females and proportion of scaphoid fractures compared with the former 5 years.

Epidemiological survey of supracondylar humeral fractures from 2003 to 2012 at The Third Affiliated Hospital to Hebei Medical University / 中华创伤骨科杂志

Objective To investigate the epidemiological features and trends of supracondylar humeral fractures from 2003 to 2012 at The Third Affiliated Hospital to Hebei Medical University.Methods The data of the patients with supracondylar humeral fracture who had been treated between 2003 and 2012 at our hospital were collected through the PACS system and case reports checking system.The data between 2003 and 2007 were classified as group A and those between 2008 and 2012 as group B.The data concerning gender,age and fracture type were statistically analyzed and compared between the 2 groups.Results Atotalof3,111 supracondylar humeral fractures were treated,accounting for54.4％ (3,111/5,723) of the distal humeral fractures,34.8％ (3,111/8,932) of the elbow fractures and 2.5％ (3,111/126,479) of the total fractures.They were 2,018 males (64.9％) and 1,093 females (35.1％).The age range from 1 to 10 years obtained the highest constitute ratio for both genders,77.0％ (1,554/2,018) for males and 78.2％ (854/1,093) for females.The extension type and flexion type had 2,693 (86.6％) and 418 (13.4％) cases,respectively,and their male to female ratios were 2.0:1 and 1.2:1 respectively,all showing significant differences (P ＜ 0.001).There were 1,902 cases in group A and 1,209 cases in group B,accounting for 60.0％ (1,902/3,168) and 47.3％ (1,209/2,555) of the distal humeral fractures,41.4％ (1,902/4,199) and 27.9％ (1,209/4,333) of the elbow fractures,and 2.9％ (1,902/65,267) and 2.0％ (1,209/61,212) of the total fractures,respectively,all showing significant differences between groups (P ＜ 0.001).The male to female ratio was 1.9:1 for group A and 1.8:1 for group B,showing an insignificant difference (P ＞ 0.05).The age range from 1 to 10 years had a constitute ratio of 75.0％ (1,426/1,902) for group A and that of 81.2％ (982/1,209) for group B,showing a significant difference (P ＜ 0.001).The proportion of extension type was 85.4％ (1,624/1,902) for group A and 88.4％ (1,069/1,209) for group B,showing a significant difference (P ＜ 0.05).Conclusions The current investigation has revealed the epidemiological features and trends of supracondylar humeral fractures which had been treated between 2003 and 2012.They were mostly seen in children from 1 to 10 years old.The extension type predominated.Compared with the first 5 years,the proportion of age range from 1 to 10 years and the extension type increased in the latter 5 years.

Epidemiological comparison of fractures at the base of the first metacarpal bone between East and West China from 2010 to 2011 / 中华创伤骨科杂志

Objective To compare and analyze the epidemiological features of fractures at the base of the first metacarpal bone between East and West China.Methods We retrospectively analyzed the clinical data of the patients with fracture at the base of the first metacarpal bone who had been treated from January 2010 to December 2011 in 63 hospitals in the east and west areas of China.The data from 35 hospitals in East China were classified as group A while the data from 28 hospitals in West China as group B.The analytic items included gender,age,age distribution and fracture classification.Results A total of 890 cases were collected.The total male/female ratio was 4.56∶ 1.The youth accounted for the highest proportion and the high-risk type of fracture was type Ⅲ (44.49％,396/890).The male/female ratio was 4.59∶1 in group A of 621 patients and 4.49∶1 in group B of 269 patients,showing no statistic between-group difference (P ＞ 0.05).The median age in group A was 39 years,significantly older than that in group B (35 years) (Z =-3.687,P ＜ 0.001).In both groups,the youth accounted for the highest proportion and there were more right-side fractures than left-side ones.Group A had a significantly lower proportion of the youth and a significantly higher proportion of the middle-aged than group B (P ＜ 0.05),but there was no statistic difference in proportions of the children and the aged (P ＞ 0.05).Type Ⅲ was the high-risk type in both groups;group A had significantly more fractures of type Ⅰ and significantly fewer fractures of type Ⅱ than group B (P ＜ 0.05),but there was no statistic difference in proportions of type Ⅲ and type Ⅳ between the 2 groups (P ＞ 0.05).Conclusions Fractures at the base of the first metacarpal bone mostly occurred in the young males.There were more fractures at the right side than at the left side.The most frequent type was type Ⅲ.The proportion of type Ⅰ fractures in East China was higher than in West China while the proportion of type Ⅱ fractures in East China lower than in West China.

Epidemiological analysis of adult fractures at the base of the first metacarpal bone in The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012 / 中华创伤骨科杂志

Objective To investigate the epidemiological features and trends of adult fractures at the base of the first metacarpal bone in The Third Mfiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The data of human fractures treated between January 2003 to December 2012 at our hospital were collected through the PACS system and case reports checking system.Adult fractures at the base of the first metacarpal bone were included in the present study and assigned into 2 groups,group A containing the data between 2003 and 2007 and group B the data between 2008 and 2012.Comparison and analysis was done with analytic items of gender,age and fracture type.Results A total of 378 adult fractures at the base of the first metacarpal bone were included,accounting for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures involved 311 males (82.28％) and 67 females (17.72％).The youth group had 254 fractures with the highest constituent ratio (67.20％).The right side was involved in 286 cases (75.66％) and the left side in 92 (24.34％).There were 198 cases of extra-articular fracture with the highest constituent ratio (52.38％).Group A had 200 fractures,a male to female ratio of 6.14∶ 1,a median age of 34 years,the highest constituent ratio in youth (73.50％) and in type A1 fractures (53.50％);group B had 178 fractures,a male to female ratio of 3.56∶ 1,a median age of 40 years,the highest constituent ratio in youth (60.11％) and in type A1 fractures (51.12％).Compared with group A,group B had a higher constituent ratio of females,older ages,a higher constituent ratio of elderly patients,a lower constituent ratio of youth,and a lower constituent ratio of type C1 fractures.All these differences between the 2 groups were statistically significant (P ＜ 0.05).Conclusions During the 10 year,the adult fractures at the base of the first metacarpal bone accounted for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures occurred mostly in men and in the age range of 16 to 44 years.About 3/4 of them occurred on the right side.Compared with the first 5 years,the latter 5 years witnessed increasing trends of female and elderly patients and decreasing trends of young patients and type C1 fractures.

Epidemiological investigation of humeral intercondylar fractures at The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012 / 中华创伤骨科杂志

Objective To investigate the epidemiological features and trends of humeral intercondylar fractures at our hospital from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the patients with humeral intercondylar fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender,fracture site and AO classification were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 303 humeral intercondylar fractures were recorded,accounting for 5.29％ of the distal humeral fractures,3.39％ of the elbow fractures and 0.24％ of the total fractures at the same period.They involved 197 males and 106 females,with a male/female ratio of 1.86∶ 1.The high-risk age group was adolescent and middle-aged adults,accounting for 63.70％.The high-risk type was type 13-C2,accounting for 44.00％.There were 171 and 132 cases in group A and group B,accounting for 5.40％ and 5.17％ of the contemporary distal humeral fractures,3.72％ and 3.05％ of the contemporary elbow fractures,and 0.26％ and 0.22％ of all the contemporary fractures,respectively,showing no significant differences between the 2 groups(P ＞ 0.05).In groups A and B respectively,the male/female ratios were 1.44∶1 and 2.67∶ 1,the proportions of adolescents and the middle-aged 58.48％ and 70.45％,the proportions of type 13-C1 35.83％ and 18.10％,and the proportions of type 13-C3 14.17％ and 44.76％,showing significant differences between the 2 groups in all the above comparisons (P ＜ 0.05).Conclusion The humeral intercondylar fractures were common in the adolescent and middle-aged patients,with a male predominance (about twice more in males).Compared with the first five years,the latter 5 years witnessed increased proportions of males,adolescent and middle-aged patients,and type 13-C3 but a decreased proportion of type 13-C1.

Influence of intrahepatic cholestasis during pregnancy on the incidence of preterm birth / 中华流行病学杂志

Objective Intrahepatic cholestasis during pregnancy (ICP) and its relation to incidence of preterm birth (PTB) were under study.Methods A prospective cohort study was carried out that including all the hospitalized pregnant women with live singleton births,from January 2014 to March 2015 in Anqing Municipal Hospitals.Informed consent was followed in every pregnant woman with related demographic information collected through questionnaire and hospital electronic medical record system.Both univariate and multi-variate statistical methods were used to analyze the relations between ICP and incidence of PTB.Results A total of 2 758 pregnant women were included in this study.The incidence proportions of ICP and PTB appeared as 7.25％ and 16.28％ respectively.Results from the logistic regression analysis showed that ICP increased the risk of both overall PTB (RR=2.33,95％CI:1.67-3.25) and medically indicated PTB (RR=8.46,95％CI:5.45-13.12),but not the spontaneous PTB (RR=0.94,95％CI:0.57-1.54).Conclusion ICP seemed to have increased the risk on medically indicated PTB but not the spontaneous PTB.

A prospective comparison cohort study between baseline serum uric acid level and coronary artery disease in first-degree relatives and non-first-degree relatives of type 2 diabetes males / 中华内分泌代谢杂志

Objective To investigate the relationship between baseline serum uric acid and the severity of coronary artery disease ( CAD ) in the first-degree relatives or non-first-degree relatives of men with type 2 diabetes. Methods Three hundred and eighty-one men with negative coronary angiography for the first time were divided into diabetes and non-diabetes groups and followed-up for 5 years. The primary outcome was acute coronary syndrome suspected during subsequent 5 years, and the coronary angiography was conducted simultaneously. The severity of CAD was assessed by the coronary stenosis index ( CSI) and the number of coronary lesion vessels. Results In normal blood glucose group, serum uric acid was higher in the first-degree relatives of diabetics compared with non-first-degree relatives(P<0. 01), along with higher morbidity of CAD, CSI, and coronary lesion vessels (all P<0.01). Correlation analysis showed that CSI(r=0. 250, P=0. 041) and coronary lesion vessels(r=0. 252, P=0. 040) in non-diabetics group were associated with baseline levels of serum uric acid. Conclusion The elevation of serum uric acid was closely related to subsequent CAD, especially in first-degree relatives of male with type 2 diabetes, which could be used as an early indicator for CAD prediction.

Correlation of contract nurse′s organizational commitment and intention to drop out / 现代临床护理

Objective To study the correlation between organizational commitment of nurses and their intention to drop out. Methods Toally 304 contract nurses were recruited in this investigation. The questionnaires including demographic data, scale of organizational commitment and intention to drop out scale were used. Results The score of intention to drop out was 16.94 ± 2.16. The score on organizational commitment was 71.19 ± 6.65. There was a positive correlation between intention to drop out and organizational commitment among the contract nurses. Conclusions Improving contract nurses′organizational commitment can be an effective mean to reduce contract nurses′intention to drop out. It is an important means to promote the development of the nurse team and provide a reference for the scientific development of nursing.

Clinical features and proportion analysis of adult hip fractures at 11 hospitals in Southwest China from 2010 to 2011 / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical feature and constituent ratio of adult hip fractures in Southwest China.</p><p><b>METHODS</b>The data of adult inpatients and outpatients with hip fractures treated between January 2010 and December 2011 in 11 hospitals of the Southwest China were collected and analyzed. The data includes gender, age, age distribution and fracture pattern according to AO classification.</p><p><b>RESULTS</b>There were a total of 2,833 adult hip fractures, including 1,340 (47.30%) males and 1,493 (52.70%) females, with a male-to-female incidence ratio of 1: 1.11 and a mean age of (66±18) years. The highest frequency of hip fractures was seen in the 71 to 85 years age group (42.18%, 1,195/2,833). There were 844 fractures (29.79%) in the young and middle-aged group (16-<60 years) and 1 898 fractures (70.21%) in the geriatric group (≥60 years). Men had a higher rate than women (men: 577 fractures, 68.4%) in the young and middle-aged group, while women had a higher rate than men (women: 1,226 fractures, 61.64%) in the geriatric group, with a significant difference in the sex distribution between the two groups (χ2=214.001, P<0.01). The proportion of intertrochanteric fracture (type 31-A), femoral neck (type 31-B) and femoral head fracture (type 31-C) was 46.59%, 49.74% and 3.67% respectively. The highest frequency of the sub-type in each fracture type was type 31-A2, type 31-B2 and type 31-C2.</p><p><b>CONCLUSIONS</b>Women have a higher rate than men in Southwest China. Geriatric patients are more than the young and middle-aged patients. The femoral neck fractures, intertrochanteric fractures and femoral head fractures are in descending orders according to the proportion of the three different hip fractures.</p>

Expressions of ASPP family in colorectal carcinoma tissue and their clinical significances / 吉林大学学报(医学版)

Objective To investigate the expressions of apoptosis stimulating protein of P53 (ASPP)family in colorectal carcinoma tissue and to explore their relationship with the clinicopathological characteristics of colorectal carcinoma,and to clarify the effect of ASPP family in the development of colorectal carcinoma.Methods 45 cases of colorectal carcinoma tissue and 20 cases of healthy controls were selected. Among 45 cases of colorectal carcinoma tissue, there were 1 1 cases of well differentiated colorectal carcinoma, 2 1 cases of moderately differentiated colorectal carcinoma,and 13 cases of poorly differentiated colorectal carcinoma;7 cases of T1 stage colorectal carcinoma,8 cases of T2 stage colorectal carcinoma,25 cases of T3 stage colorectal carcinoma,and 5 cases of T4 stage colorectal carcinoma;19 cases of N1 stage with lymph node metastasis,26 cases of N0 stage without lymph node metatasis.The expressions of ASPP1,ASPP2,and iASPP in 45 cases of colorectal carcinoma tissue and 20 cases of normal colon tissue were detected by immunohitochemistry SP method,and the correlations between the expressions of ASPP family and the pathologic typing,infiltrative depth,and lymph node metastasis of colorectal carcinoma were analyzed. Results ①The immunohitochemical staining results showed that the ASPP family members expressed in colorectal carcinoma tissue and normal colon tissue, and there were no significant differences in ASPP1 and ASPP2 positive rates between colorectal carcinoma tissue and normal colon tissue (P>0.05);the positive expression rate of iASPP in colon cancer tissue was higher than that in normal colon tissue (P0.05);the expression of ASPP2 positive rate was decreased when the differentiation degree of tumor cells reduced,they had positive correlation (rs=0.454,P=0.002);the expression of iASPP in colon cancer tissue had no correlation with the differentiation degree of tumor cells (rs=-0.171,P>0.05).③ The expression of ASPP1 in colon caner tissue had no correlation with the infiltrative depth of tumor (rs=-0.268,P>0.05);the expression of ASPP2 positive rate was decreased when the tumor infiltrative depth increased,they had negative correlation (rs=-0.348,P0.05).④The expressions of ASPP1,ASPP2, and iASPP in colon caner tissue had no correlation with lymph node metastasis (rs=0.089,rs=0.044,rs=0.210, P>0.05).Conclusion The expression levels of iASPP in colon cancer and normal colon tissues are different,it may be useful for the diagnosis, differential diagnosis and evaluation in benign and malignant colorectal diseases. The expression of iASPP is negatively correlated with the pathologic typing and neoplasm staging of colorectal carcinoma,it indicates that iASPP can be used as a indicator in judging the prognosis of colorectal carcinoma.

Value of EUS-FNA cytology and fluid carcinoembryonic antigen in differential diagnosis between benign or malignant pancreatic cystic lesion / 中华消化内镜杂志

Objective To study the value of EUS-FNA cytology and fluid carcinoembryonic antigen (CEA) for differential diagnosis of malignant and benign pancreatic cystic lesions.Methods Data of 27 patients who underwent EUS-FNA were reviewed.According to Youden exponent,the optimal cut-off points for cyst fluid CEA were determined by receiver operating characteristic (ROC) curve.Compared with surgical pathology,the accuracy,sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of the EUS imaging,cytology as well as cyst fluid CEA were determined.Results Of the 27 cases,14 were diagnosed as benign lesions,13 were diagnosed as malignant or premalignant lesions.The accuracy,sensitivity,specificity,PPV and NPV of EUS imaging were 77.8％ (21/27),69.2％(9/13),85.7％ (12/14),81.8％ (9/11) and 75.0％ (12/16).The accuracy,sensitivity,specificity,PPV and NPV of EUS-FNA cytology were 85.2％ (23/27),76.9％ (10/13),92.9％ (13/14),90.9％ (10/11),and 81.3％ (13/16).The corresponding values of fluid carcinoembryonic antigen under the ROCderived ideal cut-off were 74.1％ (20/27),84.6％ (11/13),64.3％ (9/14),68.8％ (11/16) and 81.8％ (9/11) (CEA ＞ 22.24 ng/ml).Conclusion EUS-FNA cytology is highly accurate and specific for differential diagnosis of malignant and benign pancreatic cystic lesions.Cyst fluid CEA shows better sensitivity.EUS-FNA cytology and cyst fluid CEA analysis can basically meet the requirement of differentiating the benign and (pre)malignant pancreatic cystic lesions.