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Objective:To analyze and compare the association between different obesity-related indices and vitamin D deficiency in middle-aged and elderly population dwelled in Lanzhou city.Methods:From May, 2011 to September, 2012, middle-aged and elderly individuals with complete baseline data were included via randomly cluster sampling from 3 communities in Lanzhou. The subjects were divided into 4 subgroups by vitamin D levels and various obesity-related indices were compared across subgroups with the same gender. The relationship between the obesity-related indices and the severity of vitamin D deficiency was analyzed using Spearman correlation analysis, and the effects of different obesity-related indices on the severity of vitamin D deficiency was analyzed using multivariate logistic regression analysis.Results:A total of 9 437 residents were included. The overall prevalence of vitamin D deficiency was 97.7%. Compared with the group with lower vitamin D level, participants in the group with higher vitamin D level showed evidently lower body mass index (BMI), waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglyceride/ high density lipoprotein cholesterol (TG/HDL-C) ratio in the total population and females, while only WC, LAP, VAI and TG/HDL-C in the males (all P<0.05). Spearman correlation analysis showed that BMI, WC, LAP, VAI and TG/HDL-C were positively correlated with the severity of vitamin D deficiency in the total population and the females, while only LAP, VAI and TG/HDL-C in the males (all P<0.05) . Multivariate logistic regression analysis showed that higher levels of these obesity related indices were correlated with more severe vitamin D deficiency in the total population and the females, while only higher LAP, VAI and TG/HDL-C in the males (all P<0.05). The effects of higher LAP was the most prominant in the total population ,the females and the males. Conclusion:Various obesity phenotypes are closely related to vitamin D deficiency in middle-aged and elderly women, while only visceral obesity and abnormal lipid metabolism are related to vitamin D deficiency in middle-aged and elderly men, with LAP being the most important influencing factor.
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Radiological isolated syndrome has been a hot topic in the field of neuroimmunology in recent years, but there were rare reports and reviews on this field in domestic literature. With the development of imaging technology and the proposed modified McDonald diagnostic criteria for multiple sclerosis in 2017, new perspectives have been proposed in diagnostic criteria, clinical research, functional imaging research and treatment strategies of radiological isolated syndrome. The purpose of this review is to improve the understanding of radiological isolated syndrome by sorting and summarizing the above contents.
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Objective:To investigate clinical features of patients with chronic spontaneous urticaria (CSU) in China.Methods:A questionnaire survey was carried out in CSU patients at the first visit and 4 follow-up visits in Departments of Dermatology of 12 third-grade hospitals in northern and southern China from January to December 2019. The survey content included demographic characteristics, pruritus intensity, the number of wheals, concomitant symptoms (such as pain in skin lesions, arthralgia, fever) during the last week prior to the admission, classification and subtypes of urticaria, and previous and current treatment regimens, etc., and the 7-day urticaria activity score (UAS7) was used to evaluate the therapeutic effect. Patients from 9 hospitals in Sichuan, Hubei and Fujian provinces were enrolled into the southern China group, and patients from 3 hospitals in Beijing municipality and Liaoning province were enrolled into the northern China group. Differences between groups were analyzed by two-independent-sample t-test, Mann-Whitney U test or chi-square test. Results:Overall, 1 396 CSU outpatients were enrolled, including 592 males and 804 females; their age was 38.32 ± 16.13 years, 1 109 (79.5%) were aged between 20 and 60 years, and 660 (47.3%) were aged between 20 and 40 years. Their age at onset was 35.85 ± 16.03 years, and the disease duration was 0.50 (0.25, 2.00) years. Allergic diseases were the most common concomitant diseases, 269 (19.3%) patients were diagnosed with accompanied allergic rhinitis or conjunctivitis, 169 (14%) with accompanied eczema/dermatitis, 39 (2.8%) with accompanied asthma; only 19 (1.4%) CSU patients had a history of thyroid diseases, but 133 (9.5%) were positive for anti-thyroid peroxidase (TPO) or anti-thyroglobulin (Tg) antibodies at the visit; elevated serum total IgE levels were observed in 437 (31.3%) patients, and 104 (7.4%) were positive for autoantibodies. There were 1 078 (77.2%) patients in the southern China group and 318 (22.8%) in the northern China group, and the southern China group showed significantly longer disease duration (2.16 ± 4.76 years vs. 1.53 ± 2.80 years, P < 0.001) , and significantly higher proportions of patients with family history (10.7% vs. 3.5%) , with painful lesions (5.8% vs. 0.9%) , and those with arthralgia (10.7% vs. 0) compared with the northern China group (all P < 0.05) . The three most prevalent urticaria subtypes were CSU (835 cases, 49.9%) , symptomatic dermographism (437 cases, 31.3%) , and angioedema (138 cases, 9.9%) , and the proportion of patients with the single diagnosis of CSU was significantly higher in the southern China group (53%) than in the northern China group (38.9%, P < 0.001) . In terms of treatment, 1 365 (97.8%) patients received conventional-dose second-generation H1 antihistamines alone or in combination, and only 31 (2.2%) were treated with antihistamines at high doses; other medicines were mostly administered in combination, and compound glycyrrhizin was most frequently prescribed (36.6%) , while omalizumab was only administered in 7 patients (0.5%) . Conclusions:Significant differences in the clinical features of CSU were observed between northern and southern China. Nowadays traditional modalities are inadequate for the treatment of CSU, and new therapeutic drugs are somewhat promising.
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Objective:To investigate the expression of soluble T cell immunoglobulin and mucin domain-3 (Tim-3) in peripheral blood of patients with pancreatic cancer and its diagnostic value in combination with serum Carbohydrate antigen 19-9 (CA19-9) .Methods:106 newly diagnosed pancreatic cancer patients and 65 age and sex matched healthy individuals were enrolled. Tim-3 concentration was quantitatively determined by enzyme-linked immunosorbent assay (ELISA). According to the expression levels of soluble Tim-3 and serum CA19-9, a binary logistic regression model of receiver operating characteristic (ROC) curve was established to compare the diagnostic effects of serum CA19-9 and soluble Tim-3 alone or combined with the two tests.Results:The levels of soluble Tim-3 in the pancreatic cancer group were significantly higher than those in the healthy control group ( P<0.001). The expression level of soluble Tim-3 was significantly higher in patients with stage III-IV pancreatic cancer than in patients with stage I-II ( P=0.003). The AUC of soluble Tim-3 diagnosis for stage I-II pancreatic cancer was 0.856 (95%CI: 0.765 to 0.992 P<0.001), Serum CA19-9 The AUC used for the stage I-II pancreatic cancer diagnosis was 0.862 (95%CI: 0.772 to 0.926 P<0.001), The AUC for the combined diagnosis was 0.949 (95%CI: 0.880 - 0.985 P<0.001) ; In a healthy population and in patients with stage III-IV pancreatic cancer, the AUC of soluble T I I-IV pancreatic cancer in stage III was 0.927 (95%CI: 0.873 to 0.963 P<0.001), the AUC of serum CA19-9 used for the diagnosis of stage III-IV pancreatic cancer was 0.933 (95%CI: 0.881 to 0.968 P<0.001), the AUC for the combined diagnosis was 0.989 (95%CI: 0.956 to 0.999 P<0.001) . Conclusions:The combination of soluble Tim-3 and serum CA19-9 can improve the diagnostic rate of pancreatic cancer patients.
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Objective To investigate the expression of multi-glycan in serum of patients with dual-phenotype hepatocellular (DPHCC) and its clinical significance. Methods Serum samples were collected from 65 patients with DPHCC, 80 patients with primary hepatocellular carcinoma (HCC), and 120 patients with liver cirrhosis (LC) who were treated in Mengchao Hepatobiliary Hospital of Fujian Medical University from June 2019 to December 2020. DNA sequencer-aided fluorophore-assisted carbohydrate electrophoresis was used to measure the expression of N-glycan in serum, The measurement data of normal distribution were compared by t -test between the two groups and analysis of variance between multiple groups; The measurement data with non normal distribution were compared by Mann-Whitney U test between the two groups and Kruskal-Wallis H test between multiple groups, the chi-square test was used for comparison of categorical data between groups.The logistic regression method was used to establish the common index model. The efficacy of AFP, PIVKA - Ⅱ, CEA, CA19-9 and multi glycan in the diagnosis of DPHCC was evaluated by receiver operating characteristic (ROC) curve, and the area under ROC curve (AUC) was compared by Z test. Results There was a significant difference in multi-glycan between the DPHCC group and the HCC group ( P < 0.001), while there were no significant differences in AFP, PIVKA-Ⅱ, CEA, CA19-9, and SUM between the two groups ( P =0.924, 0.084, 0.442, 0.924, and 0.206). Multi-glycan had an area under the ROC curve (AUC) of 0.775, which was significantly higher than that of AFP (0.507), PIVKA-Ⅱ (0.584), CEA (0.537), CA19-9 (0.505), and SUM (0.561), and multi-glycan had a sensitivity of 69.23%, which was increased compared with the other 5 items. There were significant differences in multi-glycan, AFP, PIVKA-Ⅱ, CA19-9, and SUM between the DPHCC group and the LC group (all P < 0.001), but there was no significant difference in CEA between the two groups ( P =0.14). Multi-glycan had an AUC of 0.780, which was also higher than that of AFP (0.767), PIVKA-Ⅱ (0.743), CEA (0.566), CA19-9 (0.689), and SUM (0.713), and multi-glycan had a sensitivity of 89.23%, which was increased compared with the other five items. Conclusion Multi-glycan can be used as one of the indicators for the auxiliary diagnosis of DPHCC.
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ObjectiveTo analyze the anxiety status among elderly hypertensive patients in Hongkou district of Shanghai city， and to screen the influencing factors. MethodsConvenience sampling method was adopted to enroll 265 hypertensive patients aged 60 years or above from 8 communities in Hongkou district of Shanghai city， and Generalized Anxiety Disorder-7 item （GAD-7） was used to assess their anxiety status， then Logistic regression analysis was applied to explore the influencing factors. ResultsAmong 265 patients with hypertension， 45 patients （17.0%） had anxiety symptoms. Multivariate Logistic regression analysis showed that non-hypertensive chronic disease comorbidity in recent six months （OR=3.093， 95% CI： 1.075~8.898， P<0.05）， excessive alcohol consumption （OR=5.203， 95% CI： 1.407~19.234， P<0.05）， living with spouse （OR=0.061， 95% CI： 0.005~0.699， P<0.05） and regular exercise （OR=0.360， 95% CI： 0.167~0.775， P<0.01） were the factors affecting anxiety in hypertensive patients. ConclusionAnxiety symptoms are quite common among elderly hypertensive patients in community，among which comorbidities and excessive alcohol consumption are risk factors， while living with spouse and regular exercise are protective factors.
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A case of hemolytic disease of the newborn (HDFN) caused by immunoglobulin (Ig) G anti-E was analyzed in this study. The ABO and Rh blood group of the newborn was O and CcDEe, respectively. The ABO and Rh blood group of her mother was A and CCDee, respectively. Thus, the reason of ABO and RhD hemolysis were impossible. The incompatible antibodies were found in the newborn serum by three serological tests. The antibody screening and identification test using the plasma and the red blood cell eluate from the newborn and the plasma from her mother showed that the HDFN was caused by the IgG anti-E antibodies. The case was caused by failing to prenatal screening for irregular antibodies. Therefore, the prenatal screening for irregular antibodies seems necessary for pregnant women to prevent, diagnose or manage the HDFN at an early time, reducing the occurrence of perinatal complications.
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Objective To investigate the clinical significance of autophagy-related protein 7 (ATG7) in the diagnosis of HBV-related hepatocellular carcinoma (HBV-HCC) by measuring the expression level of serum ATG7 in patients with HBV-HCC. Methods A total of 50 patients with chronic hepatitis B (CHB) and 89 patients with HCC who were hospitalized in Mengchao Hepatobiliary Hospital of Fujian Medical University from June 2018 to December 2020 were enrolled, among whom 67 patients had HBV-HCC (HBV-HCC group) and 22 patients had no HBV-HCC (non-HBV-HCC group), and 20 healthy volunteers who underwent physical examination were enrolled as healthy control (HC) group. Demographic data and laboratory data including alpha-fetoprotein (AFP) were collected from each group, and ELISA was used to measure the serum level of ATG7. The receiver operating curve (ROC) was plotted for ATG7 and AFP used alone or in combination, and the area under the ROC curve (AUC) was compared. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test was used for comparison between two groups; the chi-square test was used for comparison of categorical data between groups; a Spearman correlation analysis was used to investigate correlation. Results The serum level of ATG7 was 22.88(19.79-23.04) ng/mL in the HBV-HCC group, 17.06(14.45-19.40) ng/mL in the non-HBV-HCC group, 19.21(16.65-20.82) ng/mL in the CHB group, and 13.82(8.70-17.82) ng/mL in the HC group, with a significant difference between groups ( χ 2 =65.144, P < 0.001). ATG7 had an AUC of 0.818 (95% confidence interval [ CI ]: 0.743-0.879) and AFP had an AUC of 0.777 (95% CI : 0.698-0.843) in the diagnosis of HBV-HCC, suggesting that ATG7 had a slightly higher AUC than AFP ( Z =0.852, P =0.394). ATG7 combined with AFP had an AUC of 0.859 (95% CI : 0.790-0.913) in the diagnosis of HBV-HCC, which was significantly higher than the AUC of ATG7 alone ( Z =2.192, P =0.028) and AFP alone ( Z =2.076, P =0.038). Conclusion ATG7 is a good marker for the diagnosis of HBV-HCC, and combined measurement of ATG7 and AFP can significantly improve the diagnostic rate for HBV-HCC.
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Objective To investigate the clinical significance of autophagy-related protein 7 (ATG7) in the diagnosis of HBV-related hepatocellular carcinoma (HBV-HCC) by measuring the expression level of serum ATG7 in patients with HBV-HCC. Methods A total of 50 patients with chronic hepatitis B (CHB) and 89 patients with HCC who were hospitalized in Mengchao Hepatobiliary Hospital of Fujian Medical University from June 2018 to December 2020 were enrolled, among whom 67 patients had HBV-HCC (HBV-HCC group) and 22 patients had no HBV-HCC (non-HBV-HCC group), and 20 healthy volunteers who underwent physical examination were enrolled as healthy control (HC) group. Demographic data and laboratory data including alpha-fetoprotein (AFP) were collected from each group, and ELISA was used to measure the serum level of ATG7. The receiver operating curve (ROC) was plotted for ATG7 and AFP used alone or in combination, and the area under the ROC curve (AUC) was compared. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test was used for comparison between two groups; the chi-square test was used for comparison of categorical data between groups; a Spearman correlation analysis was used to investigate correlation. Results The serum level of ATG7 was 22.88(19.79-23.04) ng/mL in the HBV-HCC group, 17.06(14.45-19.40) ng/mL in the non-HBV-HCC group, 19.21(16.65-20.82) ng/mL in the CHB group, and 13.82(8.70-17.82) ng/mL in the HC group, with a significant difference between groups ( χ 2 =65.144, P < 0.001). ATG7 had an AUC of 0.818 (95% confidence interval [ CI ]: 0.743-0.879) and AFP had an AUC of 0.777 (95% CI : 0.698-0.843) in the diagnosis of HBV-HCC, suggesting that ATG7 had a slightly higher AUC than AFP ( Z =0.852, P =0.394). ATG7 combined with AFP had an AUC of 0.859 (95% CI : 0.790-0.913) in the diagnosis of HBV-HCC, which was significantly higher than the AUC of ATG7 alone ( Z =2.192, P =0.028) and AFP alone ( Z =2.076, P =0.038). Conclusion ATG7 is a good marker for the diagnosis of HBV-HCC, and combined measurement of ATG7 and AFP can significantly improve the diagnostic rate for HBV-HCC.
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Anti-N-methyl-aspartate receptor encephalitis (anti-NMDARE) is a rare autoimmune panencephalitis. We report the case of a patient with anti-NMDARE with severe ictal laryngospasm. A 17-year old boy was referred to our neurological intensive care unit for refractory behavioural symptoms and cognitive decline. Brain magnetic resonance imaging was normal. Screening for antineuronal antibodies showed positive results for anti-NMDA in serum and cerebrospinal fluid,which confirmed the diagnosis of anti-NMDARE. During his admission,he developed severe ictal laryngospasm resulting in intubation, tracheostomy, and repeated courses of intravenous immunoglobulin and methylprednisolone. The patient then made an uneventful recovery and was discharged to outpatient follow-up. Our report intends to raise awareness that patients with anti-NMDARE may manifest fatal ictal laryngospasm,requiring urgent and aggressive management.
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Late onset methylmalonic acidemia (MMA) is a rare genetic metabolic disease.This case is a 46 year old adult patient with MMA complicated with hyperhomocysteinemia.It starts with progressive limb weakness and mental abnormality, and has dysuria and respiratory failure.Neurological examination showed decreased muscle strength of limbs and pyramidal tract sign.The levels of blood homocysteine and urinary methylmalonic acid increased significantly.Head, neck, thoracolumbar magnetic resonance imaging showed abnormal signals in the spinal cord from the level of foramen magnum to the level of lumbar 1 vertebral body.Two heterozygous variants of mmachc were found by gene detection: c: 609G>A, c: 349G>A, consistent with cobalamin C deficiency.Treat with L-carnitine, vitamin B12 and betaine.The patients′ mental symptoms, limb muscle strength and respiratory failure were improved, and the level of blood homocysteine also decreased significantly.
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Objective:To explore the current situation of college students′ risk behavior and its relationship with alexithymia.Methods:A total of 992 college students from two colleges in Jiangxi Province were investigated with evaluation scale for risk behaviors of teenagers and Toronto alexithymia scale. SPSS 17.0 software was used for descriptive statistics, correlation analysis and regression analysis.Results:Evaluation scale for risk behaviors showed that 15.2% of college students had at least one risk behavior factor scored more than 3, and 1.0% had at least one factor scored more than 4. The scores of bad habits and extroversion behavior question of boys((1.72±0.50), (1.61±0.56)) were significantly higher than those of girls ((1.66±0.38), (1.45±0.40), t=2.205, P=0.028, t=5.020, P<0.01), and the scores of introversion behavior question and academic maladjustment of girls ((2.13±0.56), (2.51±0.53)) were significantly higher than those of boys ((1.97±0.62), (2.39±0.63), t=-4.157, P<0.01, t=-3.282, P=0.001). The four factors of risk behaviors were positively correlated with each other (0.497-0.673), and the risk behaviors of college students were clustered. There were significant differences in the total score of risk behaviors ((2.28±0.43), (1.99±0.37), (1.71±0.36)), introversion behavior question ((2.60±0.54), (2.17±0.49), (1.80±0.50)), bad habits ((1.95±0.49), (1.73±0.38), (1.54±0.36)), academic maladjustment ((2.82±0.52), (2.57±0.50), (2.25±0.54)) and extroversion behavior question ((1.72±0.56), (1.57±0.46), (1.37±0.38)) in alexithymia group, possible alexithymia group and non alexithymia group( F=157.252, 172.027, 75.654, 85.424, 45.604, all P<0.01). Multiple stepwise regression analysis showed that alexithymia could predict college students′ risk behaviors. Conclusion:Taking effective measures to reduce the level of alexithymia can reduce the occurrence of risk behaviors of college students.
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OBJECTIVE：To establish th e fingerp rint and c onduct cluster analysis of Hefu zhiyang decoction （HFZYD），and establish the method for content determination of 8 components，so as to provide reference for the quality control of HFZYD. METHODS：UPLC method was adopted. The determination was performed on ACQUITY UPLC BEH C 18 column with mobile phase consisted of acetonitrile- 0.1％ glacial acetic acid solution （gradient elution ）at the flow rate of 0.25 mL/min. The column temperature maintained at 30 ℃，and detection wavelength was 236 nm. The sample size was 5 μL. The fingerprint of 10 batches of HFZYD was established with Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 edition）. Compared with substance control ，the common peaks were identified. The similarity evaluation was conducted. SPSS 21.0 software was used to conduct cluster analysis of 10 batches of samples. The contents of 8 components such as gallic acid in 10 batches of samples were determined by above UPLC. RESULTS ：There were 34 common peaks in the UPLC fingerprint of 10 batches of HFZYD ， identified as peak 1 was gallic acid ，peak 10 was ferulic acid ，peak 13 was astilbin ，peak 23 was paeonol ，peak 28 was dictamnine，peak 31 was obacunone ，peak 32 was fraxinellone ，and peak 34 was osthole. Its similarity with the control fingerprint was 0.923-0.979. Among 10 batches of samples ，S1，S2，S5，S6，S7，S8 and S 10 were clustered into one category ，and S 3，S4 and S 9 were clustered into one category. The average contents of above 8 components were 0.596-0.714，0.262-0.321，7.647-9.859， 0.113-0.644，0.170-0.202，0.854-1.281，0.631-0.857，3.243-3.548 mg/g，respectively. CONCLUSIONS ：UPLC fingerprint and the method for content determination of 8 components in HFZYD are established successfully.
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OBJECTIVE@#To explore the correlation of different glucose metabolism statues with chronic kidney disease (CKD) in middle-aged and elderly individuals in Lanzhou.@*METHODS@#Based on the baseline data of REACTION Study in Lanzhou area, we randomly sampled 10 038 residents aged 40-75 years in 3 communities in Lanzhou, who were classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes groups. The estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR) were used to assess the renal function and albuminuria, respectively. Binary logistic regression was performed to analyze the contribution of the risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR.@*RESULTS@#Among all the participants, the prevalences of albuminuria, CKD and renal insufficiency (RI) were 26.2%, 27.4% and 2.5%, respectively. The prevalence of albuminuria, CKD and RI were significantly higher in the diabetes group than in IGR and NGT groups (@*CONCLUSIONS@#Diabetes mellitus is a significant risk factor for albuminuria and RI, while IGR is not. Screening for albuminuria and eGFR is highly recommended for individuals with diabetes, hypertension, and obesity, especially in women and the elderly population.
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Adult , Aged , Female , Humans , Middle Aged , Albuminuria/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Glomerular Filtration Rate , Glucose , Prevalence , Renal Insufficiency, Chronic/epidemiology , Risk FactorsABSTRACT
OBJECTIVES@#Peroxisome proliferator-activated receptor gamma coactivator 1α (PGC1α) controls mitochondrial biogenesis, but its role in cardiovascular diseases is unclear. The purpose of this study is to explore the effect of PGC1α on myocardial ischemia-reperfusion injury and the underlying mechanisms.@*METHODS@#The transverse coronary artery of SD rat was ligated for 30 minutes followed by 2 hours of reperfusion. Triphenyltetrazolium chloride (TTC) staining was performed to measure the area of myocardial infarction. Immunohistochemistry and Western blotting were used to detect the PGC1α expression in myocardium. The rat cardiomyocyte H9C2 was subjected to hypoxia/reoxygenation (H/R) with the knockdown of PGC1α or hypoxia- inducible factor 1α (HIF-1α), or with treatment of metformin. Western blotting was used to detect the expression of PGC1α, HIF-1α, p21, BAX, and caspase-3. CCK-8 was performed to detect cell viability, and flow cytometry was used to detect apoptosis and mitochondrial superoxide (mitoSOX) release. RT-qPCR was used to detect the mRNA expression of PGC1α and HIF-1α. Besides, chromatin immunoprecipitation (ChIP)-qPCR and luciferase reporter gene assay were applied to detect the transcriptional regulation effect of HIF-1α on PGC1α.@*RESULTS@#After I/R, the PGC1α expression was increased in infarcted myocardium. H/R induced H9C2 cell apoptosis (@*CONCLUSIONS@#After I/R, HIF-1α up-regulates the expression of PGC1α, leading to an increase in ROS production and aggravation of injury. Metformin can inhibit the accumulation of HIF-1α during hypoxia and effectively protect myocardium from ischemia/reperfusion injury.
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Animals , Rats , Apoptosis , Hypoxia-Inducible Factor 1, alpha Subunit/genetics , Myocardial Reperfusion Injury/genetics , Myocytes, Cardiac/metabolism , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha/metabolism , Rats, Sprague-Dawley , Reperfusion InjuryABSTRACT
Objective:To construct a computed tomography (CT)-based three-dimensional digital model of small bowel, and investigate its application value for predication of small bowel length before bariatric surgery.Methods:The retrospective and descriptive study was conducted. The clinical data of 3 patients with obesity who were admitted to the Daping Hospital of Army Medical University from December 2018 to January 2019 were collected. There were 2 males and 1 female, aged from from 24 to 44 years, with a median age of 25 years. Patients underwent abdominal enhanced CT examination before operation, and the three-dimensional digital models of small bowel for each patient were constructed respectively. Of the 3 patients, 2 underwent sleeve gastrectomy and 1 underwent Roux-en-Y gastric bypass. The 3 patients were numbered as No.1, No.2, and No.3 according to the operation time. Observation indicators: (1) construction of three-dimensional digital model of small bowel and preoperative prediction of small bowel length; (2) intraoperative measurement of small bowel length and the relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length. Count data were represented as absolute numbers or percentages.Results:(1) Construction of three-dimensional digital model of small bowel and preoperative prediction of small bowel length: the three-dimensional digital models of small bowel for each patient were constructed respectively before operation. The volume of small bowel, area of each cross-section for the 10 cross-sections of small bowel, average area of cross-section of small bowel, preoperative prediction of small bowel length in the three-dimensional digital model of small bowel of No.1 patient were 1 312 985 mm 3, 174 mm 2, 154 mm 2, 143 mm 2, 172 mm 2, 345 mm 2, 213 mm 2, 357 mm 2, 173 mm 2, 382 mm 2, 154 mm 2, 227 mm 2, 578 cm. The above indicators of No.2 patient were 1 817 224 mm 3, 274 mm 2, 196 mm 2, 487 mm 2, 413 mm 2, 520 mm 2, 254 mm 2, 231 mm 2, 170 mm 2, 212 mm 2, 168 mm 2, 293 mm 2, 620 cm. The above indicators of No.3 patient were 2 183 019 mm 3, 320 mm 2, 408 mm 2, 281 mm 2, 222 mm 2, 194 mm 2, 219 mm 2, 188 mm 2, 419 mm 2, 326 mm 2, 235 mm 2, 281 mm 2, 777 cm. (2) Intraoperative measurement of small bowel length and the relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length: the length of small bowel measured intraoperatively for No.1, No.2, and No.3 patients were 570 cm, 600 cm, and 780 cm, respectively. The relative error between preoperative prediction of small bowel length and intraoperative measurement of small bowel length of No.1, No.2, and No.3 patients were 1.40%、3.33%、0.38%, respectively. Conclusion:Three-dimensional digital model of the small bowel can predict the small bowel length before bariatric surgery.
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OBJECTIVE：To establish c harge-by-dose model for pediatric drugs in our hospital ，so as to provide reference for reducing patients ’expenditure，saving medical insurance funds and reducing drug proportion. METHODS ：Since June 2019，a total of 12 kinds of drugs with heavy usage ，high price and large savings in our hospital were selected to establish pediatric charge-by-dose list. The drugs included in the list were split into 1/2 or 1/5 small-sized drug for charge-by-dose model. The process，quality control standards and surplus （loss）drug record of charge-by-dose model were formulated to coordinate the use of pediatric drugs between pharmacies and pediatric departments. The quantity and amount of drugs which were split ，and the drug proportion in pediatric departments were compared between charge-by-dose model and charge-by-unit model （theoretical value of dosage conversion in the same period ）during Jun.-Dec. 2019. RESULTS ：From Jun. to Dec. 2019，the quantities of split drugs each month with charge-by-dose model and charge-by-unit model were （3 346.43±734.73）and（6 821.71±1 468.81）；the amounts of split drugs each month with two models were （53 576.03±10 958.78）yuan and （112 642.75±21 308.77）yuan， respectively，with statistical significance （P＜0.05）. The drug proportion in four pediatric internal medicines departments and one neonatal medicine department had decreased to varying degrees. CONCLUSIONS ：Pediatric drug charge by dose can reduce the use and amount of drugs ，save medical insurance expenditures ，decrease the drug proportion of department.
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Objective To investigate the value of molecular probe USPIO-PEG-sLeX in metastasis model of nasopharyngeal carcinoma. Methods According to the pathological results of transplanted tumors of nude mice with nasopharyngeal carcinoma,the tumor-bearing mice were divided into metastatic group and non-metastatic group.T2 ? values of the transplanted tumors at four different time points were measured before and after the injection of USPIO-PEG-sLeX(t0＝plain scan,t1＝scan immediately after enhancement,t2＝1 hour post-enhancement scan,t3＝2 hours post-enhancement scan).ΔT2 ? and enhancing rates at t1 ,t2,t3 were calculated.Results The plain T2 ? values of the metastatic group and the non-metastatic group were 22.25±8.08 and 27.01±9.45,respectively.There was no significant difference between the two groups at t0 (P＞0.05).The T2 ? values at t1,t2 and t3 were 11.57±4.02 and 24.82±7.84,10.09±4.88 and 24.15±8.74,12.46±5.63,23.42±7.12 respectively in the metastatic and non-metastatic groups,differences were statistically significant (P values were 0.005,0.008 and 0.01 9,respectively).ΔT2 ? values at time t1 ,t2 and t3 in nude mice in the metastatic and non-metastatic groups were 10.69±6.23,3.86±2.20,12.1 7±8.67 and 2.87±1.37,9.80±3.03,4.32±2.28 respectively.The differences were statistically significant (P values were 0.027,0.048 and 0.043,respectively).The enhancement rates at t1,t2 and t3 in nude mice in metastatic and non-metastatic groups were 45.98±14.03,7.10±5.18,5 1.1 5±22.70 and 1 1.04±6.01 ,44.05 ±13.92,12.09 ±7.54,respectively,with statistically significant differences (P values were 0.001,0.005 and 0.007,respectively).After two-way repeated-measures analysis of variance,there was a statistically significant difference in T2 ? values between the metastatic and non-metastatic groups (P＝0.02＜0.05).There was a statistically significant difference in T2 ? values at different times (P＝0.001＜0.05).There was an interaction between the metastatic and non-metastatic groups and the scan time (P＝0.043＜0.05).Conclusion USPIO-PEG-sLeX molecular probe can non- invasively monitor E-selectin expression,and has a good application prospect in monitoring the metastasis of nasopharyngeal carcino-ma xenograft models.
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Objective To investigate the incidence of venous thrombosis related to totally implantable access port (TIAP) in upper arm in cancer patients, and to discuss its risk factors. Methods The clinical data of a total of 1 724 patients, who received upper arm TIAP for deliverance of chemotherapy at authors' hospital during the period from February 2014 to April 2018, were collected. The general data of patients, catheterization, disease progression and incidence of venous thrombosis in upper limbs were analyzed. The univariate analysis and multivariate logistic regression analysis were used to determine the risk factors related to symptomatic thrombus. Results A total of 17 patients developed symptomatic venous thrombosis of the upper extremities, the incidence rate was 0.99％ (17/1 724) . The mean time interval from the implantation of upper arm TIAP to the diagnosis of thrombosis was 55.6 d (2-334 d) . Univariate analysis indicated that infection (P<0.01) and spontaneous catheter dislodgment (P<0.01) were significantly related to the risk of upper extremity venous thrombus (UEVT) . Multivariate binary logistic regression analysis revealed that infection (RR =16.85, P <0.01) and catheter spontaneous dislodgment (RR =101.09, P <0.01) were two important independent predictors for UVTE related to upper arm TIAP. Conclusion Infection and spontaneous catheter dislodgment are independent risk factors for upper arm TIAP-related thrombosis.
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Objective To study the airflow characteristics in lower respiratory tract of acute respiratory distress syndrome (ARDS) patients with different degrees of respiratory distress by using computational fluid dynamics (CFD) technology. Methods Three-dimensional model of lower respiratory tract from a healthy subject was established based on CT image data. Standard k-ε turbulence model was used to simulate the airflow in lower respiratory tract, and the distribution characteristics of air velocity, airflow rate, air pressure and wall shear stress (WSS) in lower respiratory tract were analyzed. Results The function relationship between the pressure drop of airflow in lower respiratory tract and the respiratory intensity was fitted. The distribution characteristics of air velocity, air pressure and WSS in lower respiratory tract were obtained, and the airflow distributions in the lungs and the bronchi of each lobe were also obtained. Conclusions More detailed data of lower respiratory airflow field can be obtained by CFD simulation analysis, which provides the theoretical basis for clinical treatment of ARDS patients.