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Pythiosis is a rare and refractory infectious disease in human caused by Pythium insidiosum, which mainly occurs in the tropics, subtropics and some temperate regions. There are few reports of pythiosis in China. The mortality of the disease is very high, however, there is uncertainty in its diagnosis and treatment. This article reviews the epidemiological characteristics, clinical manifestations, diagnostic methods, treatment strategies, and prognosis of pythiosis in human, to provide reference for clinical management of pythiosis.
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Objectives:To investigate the risk factors associated with carotid atherosclerosis based on a retrospective longitudinal monitoring cohort study of healthy subjects during physical examinations.Methods:From 2005 to 2019, a total of 3 344 healthy adults who received at least five routine physical examinations at the Beijing Physical Examination Center and had no carotid atherosclerosis for the first time were selected as the research objects, including 1 714 males (51.25%).The average age of the male and female participants was 47.14 and 47.56 years old, respectively. A retrospective longitudinal monitoring cohort was established and the incidence of carotid atherosclerosis was documented during the follow-up. A Cox regression model was used to analyze the risk factors related to carotid atherosclerosis.Results:At the follow-up of 5.17 years, 2 038 patients had developed carotid atherosclerosis (60.94%, 66.69% in males and 54.91% in females). Multivariate Cox regression analysis showed that advanced age (>60 years old, HR=18.973, 95% CI: 12.353-29.139), female ( HR=0.639, 95% CI: 0.582-0.701), hypertension ( HR=1.166, 95% CI: 1.047-1.298), and low estimated glomerular filtration rate ( HR=1.011, 95% CI: 1.009-1.013) were associated with the onset of carotid atherosclerosis. Conclusions:The main factors influencing the development of carotid atherosclerosis included age, sex, blood pressure, and estimated glomerular filtration rate.
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Objective:To analyze the effect of home quarantine on blood glucose and lipids in healthy adults during the COVID-19 epidemic times.Method:From April 7, 2020 to May 1, 2020, 512 adults wereexamined in Beijing physical examination center, of which 87 adults aged olderthan 18, received community closed management or home quarantine from January 23, 2020 to March 30, 2020, and theadultshad physical examination in Beijing physical examination center in the same month of 2018 and 2019 were selected as controls. The change trend of blood glucose and blood lipid acrossthe three years was analyzed by one-way repeated measurement of variance, and the difference of blood lipid and blood glucose between two years of physical examination was further analyzed by Bonferroni method. Datawereanalyzed by gender.Result:Among the 87 subjects, 36 (41.4%) were male and 51(58.6%) were female. The average age was (46.3±13.2) years and ranged from 24 to 74. The difference of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC) and fasting blood glucose (FBG) among 2018, 2019 and 2020 was statistically significant (all P<0.05), while differences in LDL-C, TC and FBG were statistically significant for males (all P<0.05) and HDL-C, LDL-C, TC and FBG were statistically significant for females (all P<0.05). HDL-C in 2018and 2020were significantly lower than that in 2019 [(1.27±0.29), (1.30±0.31) vs. (1.36±0.34) mmol/L], LDL-C in 2020was significantly higher than that in 2018and 2019 [(3.11±0.88) vs. (2.81±0.77), (2.84±0.71) mmol/L], TG in 2020 was significantly higher than that in 2019[(1.54±1.17) vs. (1.32±0.80) mmol/L], TC in 2019and 2020were significantly higher than that in 2018 [(4.88±0.94), (5.10±0.99) vs. (4.63±0.90) mmol/L], and the FBG in 2019and 2020were significantly lower than that in 2018 [(5.34±1.17), (5.44±1.58) vs. (5.84±1.70) mmol/L] (all P<0.05). The comparative analysis of men and women showed that the means of LDL-C, TG, TC and FBG of men were higher than those of women while the mean of HDL-C was lower than that of women in each year; compared with 2019, the increase of LDL-C and TC of men was obvious while the decrease of HDL-C of women was obvious (all P<0.05) in 2020. Conclusion:During the epidemic period of COVID-19, the home quarantine has adverse effects on blood glucose and lipid.
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Objective:Based on the occupational cohort of Beijing Medical Examination Center, to explored the relevant factors of nonalcoholic fatty liver disease (NAFLD), and to provide scientific basis for screening and early diagnosis of NAFLD in high-risk population.Methods:Based on the cohort of occupational population who underwent physical examination in Beijing physical examination center from January to December 2009, the physical examination indexes were collected, and a retrospective survival cohort with a follow-up period of 3 years was established.According to the idea of nested case-control study, each case was randomly matched with the same gender, age and physical examination time in the same month by using the method of random sampling without putting back.Conditional logistic regression model was established by using the matched data.The diagnostic value of related indicators for NAFLD was analyzed by receiver operating characteristic curve (ROC).Results:A total of 1 194 subjects were included, including 684 males (57.3%, 684/1 194) and 510 females (42.7%, 510/1 194). The age was (50.8±11.6) years.The age ranged from 24.0 to 88.0 years.There were 597 patients with NAFLD, including 342 males and 255 females.Logistic regression analysis showed that body mass index, high density lipoprotein cholesterol, hemoglobin, platelet count, uric acid and urea nitrogen were statistically significant in male model (all P<0.05). Body mass index( OR=1.242, 95% CI 1.143-1.349, P<0.001), hemoglobin( OR=1.034, 95% CI 1.015-1.053, P<0.001), platelet( OR=1.005, 95% CI 1.002-1.009, P=0.005), uric acid( OR=1.004, 95% CI 1.001-1.006, P=0.004), high density lipoprotein cholesterol( OR=0.377, 95% CI 0.184-0.775, P=0.008) and urea nitrogen( OR=0.807, 95% CI 0.693-0.938, P=0.005) were protective factors for NAFLD in male patients..Body mass index( OR=1.552, 95% CI 1.366-1.762, P<0.001), triglyceride ( OR=2.606, 95% CI 1.616-4.204, P<0.001), blood glucose( OR=2.199, 95% CI 1.332-3.631, P=0.002), uric acid( OR=1.005, 95% CI 1.001-1.010, P=0.024) in female model were statistically significant ( P<0.05), and were risk factors for NAFLD in female patients. Conclusion:The incidence rate of NAFLD was different among different gender and age, body mass index, high density lipoprotein cholesterol, hemoglobin, platelet count, uric acid, urea nitrogen, triglyceride and blood glucose were closely related to the incidence of NAFLD.
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Objective To evaluate HCC family history on recurrence and survival of HCC patients after curative hepatectomy. Methods The family history,postoperative recurrence rate,1,2 and 5 year survival rate of 79 HCC patients who received surgical resection were collected.Patients were divided into two groups:34 cases in familial aggregation HCC group (FH group ) and 45 cases in non- familial aggregation HCC group (NH group).All these HCC patients were followed up for 3 months to10 years after surgery,and the median follow-up period was 48.5 months.We analyzed the survival rate of HCC patients by Kaplan -Meier survival curve to compare the postoperative recurrence rate and survival rate between two groups. Results 34 cases of HCC probands came from 33 families,and there were 104 cases of HCC patients in these families,an average of 3.2 cases per family.There were 6 families in which 3 or more cases developed HCC,and there were 13 families in which father or (and) mother had HCC accounting for 39.4％.The six months,1 year,2 year posthepatectomy recurrence rate in FH group was 15.1％,22.3％,40.1％,significantly higher than NH group of 10.3％,17.4％,25.6％ (x2 =5.762,6.434,5.987,P ＜0.05),and 1,2,5 year's survival rate in FH group was 57％,46％,40.3％,much lower than NH group of 85.3％,75.2％ and61.5％ (x2 =8.986,9.765,7.634,P＜0.05). Conclusions Family history of HCC affects the prognosis of HCC patients after surgery. Patients with HCC family history have higher postoperative recurrence rate and worse prognosis than that of patients who do not have HCC family history.
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ObjectiveTo evaluate the effect of labor analgesia and the outcome of maternals and neonatals by applying the vitamin B6- folic acid mixture to combined with spinal-epidural analgesia(CSEA) in nulliparous women at latency.MethodsAll the 112 full-term nulliparous parturients were selected and divided into the treated group and controlled group.Nulliparous women in two groups received CSEA,with which the additional vitamin - folic acid mixture was used only in treatment group.The contrast between the analgesic effect in groups,and alalgesic effect-acting period,fentanyl Apgar score and newborn usage were compared between groups also.ResultsThe analgesic effect-acting period and fentanyl dosage in the treated group were significantly decreased.There was significant difference between the 2 ( P ＜ 0.05 ).ConclusionsIt could be effective applying vitamin B6- folic acid mixture at latency in nulliparous women based on CSEA,which could shorten the lumbar hemp effect-acting period and reduce fentanyl narcotic drugs dosage.
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Objective To investigate the effect of extracorporeal shock wave (ESW) on physically or hormonally induced femoral head necrosis of rabbits, and to study the underlying mechanism. Methods Twenty two Japanese rabbits were randomly divided into two groups: group A and group B. Different methods were used for each group to establish the model of bilateral femoral head necrosis: freezing for group A and hormone injection for group B. The right hind limbs of all rabbits were used as the treatment side treated with ESW while the left hind limbs as control without any treatment. The rabbits were sacrificed at 2, 4, 8 weeks, respectively, after the treatment. X ray, pathological and electron microscope examinations were adopted to observe the changes of the femoral head. Results At the 8th week after ESW treatment, X ray imaging showed less severe cave in on the femoral head of the control side than that of the treatment side in both groups. The empty lacunae ratio, the number of the osteoblast and the blood vessels were significantly different between the treatment and the control sides, but not between the two groups. Conclusion ESW is an effective treatment for the physically and the hormonally induced femoral head necrosis. The mechanism may include recanalization of the blocked vessel and promotion of the osteoblast growth.