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Osteoporosis （OP） is a systemic metabolic bone disease characterized by bone microstructure degeneration and bone mass loss， which has a high prevalence and disability rate. Effective prevention and treatment of OP is a major difficulty in the medical community. The nature of OP is that multiple pathological factors lead to the imbalance of human bone homeostasis maintained by osteoblasts and osteoclasts. Ferroptosis is a non-apoptotic cell death pathway， and its fundamental cause is cell damage caused by iron accumulation and lipid peroxidation. Studies have shown that ferroptosis is involved in and affects the occurrence and development of OP， which leads to OP by mediating the imbalance of bone homeostasis. Ferroptosis is an adjustable form of programmed cell death. The intervention of ferroptosis can regulate the damage degree and death process of osteoblasts and osteoclasts， which is beneficial to maintain bone homeostasis， slow down the development process of OP， improve the clinical symptoms of patients， reduce the risk of disability， and improve their quality of life. However， there are few studies on ferroptosis in OP. Traditional Chinese medicine （TCM） is a medical treasure with unique characteristics and great application value in China. It has been widely used in China and has a long history. It has the multi-target and multi-pathway advantages in the treatment of OP， with high safety， few toxic and side effects， and low treatment cost， and has a significant effect in clinical application. The intervention of TCM in ferroptosis to regulate bone homeostasis may be a new direction for the prevention and treatment of OP in the future. This article summarized the regulatory mechanisms related to ferroptosis， discussed the role of ferroptosis in bone homeostasis， and reviewed the current status and progress of active ingredients in TCM compounds and monomers in the regulation of OP through ferroptosis， so as to provide a theoretical basis for the participation of TCM in the prevention and treatment of OP in the future.
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OBJECTIVE@#To evaluate the therapeutic efficacy of Shexiang Baoxin Pill combined with exercise in heart failure patients with preserved ejection fraction (HFpEF).@*METHODS@#Sixty patients with HFpEF were randomly divided into group A (n=20), receiving Shexiang Baoxin Pill combined with home-based exercise training based on conventional drugs for 12 weeks; group B (n=20), receiving conventional drugs combined with home-based exercise training for 12 weeks; and group C (n=20), receiving conventional drug treatment only. Peak oxygen uptake (peakVO2), anaerobic threshold (AT), 6-min walking test (6MWT), Pittsburgh Sleep Quality Index (PSQI), and SF-36 questionnaire (SF-36) results before and after treatment were compared among groups.@*RESULTS@#After the 12-week intervention, patients in group C showed significant declines in peakVO2, AT, 6MWT, PSQI, and SF-36 compared with pre-treatment (P<0.01), while groups A and B both showed significant improvements in peakVO2, AT, 6MWT, PSQI, and SF-36 results compared with pre-treatment (P<0.01). Compared with group C, patients in groups A and B showed significant improvements in peakVO2, AT, 6MWT, PSQI, and SF-36 (P<0.01). In addition, patients in group A showed more significant improvements in physical function, role-physical, vitality, and mental health scores on the SF-36 questionnaire, and PSQI scores than those in group B (P<0.01).@*CONCLUSIONS@#Exercise training improved exercise tolerance, sleep quality and quality of life (QoL) in patients with HFpEF. Notably, Shexiang Baoxin Pill played an active role in sleep quality and QoL of patients with HFpEF. (The trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2100054322)).
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Humans , Heart Failure/therapy , Quality of Life , Stroke Volume , ExerciseABSTRACT
Objective:To understand the radioactivity levels of water source in five key cities of Chengdu, Yibin, Mianyang, Guangyuan, Leshan in Sichuan province, and evaluate the radiation safety of these water sources.Methods:From 2016 to 2020, the measuring site selection, sampling and analysis were made for measuring the radioactivity levels of total alpha, total beta, 90Sr, 137Cs, 226Ra, U, Th in drinking water sources in these five cities. Reference was made, respectively, to the national standards Determination of total α radioactivity concentration in water thick source method (EJ/T 1075-1998), Determination of total β radioactivity in water evaporation method (EJ/T 900-1994), Radiochemical analysis method of strontium-90 in water and biological samples ash (HJ 815-2016), radiochemical analysis of cesium-137 in the ash of water and biological samples (HJ 816-2016), Analysis and determination of radium-226 in water (GB 11214-1989), Analysis of trace uranium in environmental samples -3 laser fluorescence law (HJ 840-2017), and Food safety in the test of radioactive substances in food determination of natural thorium and uranium (GB 14883.7-2016). Results:The activity concentration ranges from 0.011 to 0.076 Bq/L for total alpha, 0.027 to 0.098 Bq/L for total beta, 0.21 to 0.45 mBq/L for 137Cs, 1.0 to 2.4 mBq/L for 90Sr, 6.1 to 16.0 mBq/L for 226Ra, 0.06 to 0.21 μg/L for Th, and 0.73 to 3.30 μg/L for U. There were no significant differences in the concentrations of total alpha, total beta, 90Sr, 137Cs, 226Ra, U and Th in different water sources and different years ( P>0.05). There were no significant differences in the concentrations of total alpha, total beta, 90Sr, 137Cs and 226Ra during different water periods ( P>0.05). There were statistical differences in U activity concentration in different water periods ( H=16.53, P<0.05), and statistical differences in Th activity concentration in different water periods ( H=15.61, P<0.05). Conclusions:The survey showed that the total alpha, total beta, 90Sr, 137Cs, 226Ra, U and Th radioactivity levels in drinking water sources in Chengdu, Yibin, Mianyang, Guangyuan and Leshan of Sichuan province were at the same level as the relevant data in the Natural environmental radioactivity level in China published by the State Environmental Protection Bureau in 1995. All of there values were within the data range released by the 2013-2021 National Radiation Environment Monitoring Quality Report issued by the Radiation Environment Monitoring Technology Center of the Ministry of Ecology and Environment. The radioactivity level in water sources in the five key cities was at a safe level.
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Objective:To evaluate the effectiveness of prevention and control of coal-burning-borne endemic fluorosis in Sichuan Province, and to provide basis for further development of targeted prevention and control measures.Methods:According to the requirements of the Implementation Plan for the Elimination and Evaluation of Coal-burning-borne Endemic Fluorosis in Sichuan Province, from 2018 to 2021, the assessment of the elimination of coal-burning-borne endemic fluorosis was carried out in all the endemic fluorosis villages of 23 counties (cities, districts) in Sichuan Province. In each village, 30 households were selected to be investigated the use of improved stoves, the drying of corn and pepper for human consumption, and the prevalence of dental fluorosis among all children aged 8 - 12 years old in the village.Results:A total of 222 242 households were surveyed in 1 640 villages, 196 towns, 23 counties (cities, districts) in Sichuan Province. Among them, the rate of qualified improved stoves was 99.99% (222 238/222 242), the correct use rate of qualified improved stoves was 99.90% (212 026/222 238), and the correct drying rate of corn and pepper for human consumption was 99.96% (212 630/212 721). A total of 135 125 children aged 8 to 12 years old were examined, and 5 927 cases of dental fluorosis were detected. The prevalence of dental fluorosis in children was 4.39%. The grading of dental fluorosis was mainly very mild and mild, which were 2.71% (3 656/135 125) and 1.32% (1 783/135 125), respectively. In the county-level self-assessment of 1 640 villages, 1 621 villages had reached the elimination standard, with the elimination rate of 98.84%. Taking counties as a unit, the elimination rate of diseased villages ranged from 96.69% to 100.00%, and 23 diseased counties (cities, districts) had reached the elimination standard. In the provincial-level review results of 174 villages with endemic fluorosis, 174 diseased villages had reached the elimination standard, with the consistency rate of 98.85% (172/174) with the county-level self-assessment results. Among them, except for Gulin County, the consistency rate of self-assessment results was 7/9, the consistency rate of other counties (cities, districts) was 100.00%.Conclusions:The prevention and control of coal-burning-borne endemic fluorosis in Sichuan Province has achieved remarkable results, and all the diseased counties (cities, districts) have reached the elimination standard. In the future, we should continue to take active prevention and control measures to ensure that the elimination status is maintained.
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Objective:This work aims to explore the application value of cervical exfoliated cell DNA (Cysteine dioxygenase type 1, CDO1 and CUGBP Elav-like family member 4, CELF4) methylation in the detection of endometrial cancer in women of childbearing age. Methods:From November 2021 to October 2022, a prospective study was conducted on a total number of 517 reproductive-age women with abnormal uterine bleeding who had surgical indications for hysteroscopy at the Xiangya Third Hospital of Central South University. The cervical exfoliated cells were collected for cytology, HPV (human papillomavirus) and gene methylation detection before operation. Clinical information of patients, level of tumor-related biomarkers, and endometrial thickness of transvaginal ultrasound (TVS) were also collected. Single factor regression method was used to analyze the high-risk factors of endometrial cancer. Receiver operating characteristic curve analysis was used to obtain the area under the curve(AUC), focusing on the screening efficacy of gene methylation test for endometrial cancer in women of childbearing age.Results:The age, body mass index (BMI)≥25 kg/m 2, endometrial thickness≥11 mm, CDO1 m ΔCt≤8.4, CELF4 m ΔCt≤8.8, and double gene methylation were associated with endometrial cancer in women of childbearing age, 1.16(1.08-1.25), 4.33(1.89-10.31), 9.49(3.88-26.69), 69.62(25.70-224.36), 23.64(9.66-63.99), 87.39(24.83-555.05), all P<0.05. The AUC was 0.90 (95% CI 0.83-0.97) of CDO1 m/ CELF4 m in diagnosing endometrial carcinoma was higher than others factors, with sensitivity and specificity of 91.7% (95% CI 80.6%-100%) and 88.8% (95% CI 86.0%-91.6%). TVS combined with DNA methylation detection further improved the sensitivity to 95.8% (95% CI 87.8%-100%), but could not improve the specificity 68.0% (95% CI 63.8%-72.1%). Conclusions:For women of childbearing age with abnormal uterine bleeding or abnormal vaginal discharge, the accuracy of cervical cytology DNA methyl detection of endometrial cancer is better than other non-invasive clinical programs. DNA methylation combined with TVS can improve the sensitivity of detection.
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Objective:To observe the clinical characteristics and optical coherence tomography (OCT) features of pseudopapilledema (PPE) combined with peripapillary hyper-reflective ovoid mass-like structures (PHOMS) in children.Methods:A retrospective observational study. From October 2019 to May 2021, total 22 eyes from 12 children diagnosed as PPE combined with PHOMS in the Neuro-ophthalmology Department of The First Hospital of Xi’an (Affiliated of The First Hospital of Northwest University) were recruited. Among the children, 6 were male and 6 were female. The average age was (10.6±2.7) years. The average course from disease onset to diagnosis of PPE combined with PHOMS was (8.0±7.5) months. All patients underwent best corrected visual acuity (BCVA), relative afferent papillary defect (RAPD), Ishihara's test, fundus photography, OCT, fundus autofluorescence (FAF), ocular B-mode ultrasound, visual field and patternvisual evoked potential (P-VEP). The clinical and OCT characteristics of the patients were observed.Results:The anterior segments of the patients were normal. The intraocular pressures and Ishihara's test were all normal. All RAPD were negative. Total 22 eyes, BCVA was 1.0 in 21 eyes and one eye was 0.12. The fundus photography revealed blurred optic discs margin, showing mild to moderate edema-like elevation with more prominent in the nasal parts, presenting as a "C" shape halo. No obvious abnormal fluorescence was observed in FAF. The OCT scan of involvement eyes showed an elevated appearance in vary degrees, and the sharply marginated ovoid hyper-reflective mass-like structures which laterally herniated into the peripapillary region under retinal nerve fiber layer and above the Bruch membrane were detected with consecutive nasal enlargement scanning, corresponding to the nasal parts in the fundus photography. The higher degree of elevation, the larger the volume. Macular retina pigment epithelium layer and ganglion cell thickness were normal. Ocular B-mode ultrasound showed that the head of the optic nerve in the posterior wall of the eyeball (in front of the optic disc) was elevated in all affected eyes, and there was no strong signal echo in it. Visual field examination showed physical blind spot enlargement in 3 eyes and visual field defect in 2 eyes. P-VEP examination showed that the peak was slightly delayed in 3 eyes and the amplitude was slightly reduced in 3 eyes.Conclusions:Enlarged nasal optic disc OCT scan can improve the detection rate of PHOMS. PHOMS were detected bilaterally in the cases with binocular PPE while only in the effected eye in the cases of monocular PPE; the higher degree of PPE, the lager volume of PHOMS. PHOMS were could contribute to the diagnosis of PPE in children.
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Objective:To observe the anastomotic status of the vortex veins in patients with central serous chorioretinopathy (CSC).Methods:A cross-sectional study of clinical practice. From July 2021 to July 2022, 50 cases (50 eyes) of monocular CSC patients diagnosed through ophthalmic examination at the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, there were 37 males (74.0%, 37/50) and 13 females (26.0%, 13/50), with the mean age of (44.30±9.59) years old. The course of disease from the onset of symptoms to the time of treatment was less than 3 months. The affected eye and contralateral eye of CSC patients were divided into the affected eye group and contralateral eye group, respectively. Fifty healthy volunteers of the same age and gender were selected as the normal control group with 50 eyes. The macular area scanning source optical coherence tomography (OCT) vascular imaging examination was performed with Visual Microimaging (Henan) Technology Co., Ltd. VG200D. Horizontal watershed vortex veins anastomosis rate and asymmetric vortex-venous dilation rate were observed by en face OCT. The device comes with software to calculate the central foveal choroidal thickness (SFCT), mean choroidal thickness (MCT), and choroidal vascular index (CVI). One-way analysis of variance and χ2 test were used to compare the three groups. When variances were unequal between groups, nonparametric tests were performed. Results:The SFCT values of the affected eye group, contralateral eye group, and normal control group were (567.12±129.02), (513.26±133.17), (327.64±97.40) μm, respectively; MCT were (407.38±97.54), (388.24±94.13), (275.46±60.55) μm, respectively; CVI were 0.34±0.05, 0.32±0.04, and 0.27±0.04, respectively; anastomosis rates of vortex veins were 98% (49/50), 78% (39/50), and 40% (20/50), respectively; asymmetric dilation rates of vortex veins were 96% (48/50), 88% (44/50), and 48% (24/50), respectively. The differences of SFCT ( F=53.974), MCT ( Z=51.415), CVI ( F=28.082), vortex vein anastomosis rate ( χ2=43.056), asymmetric dilation rate of vortex veins ( χ2=37.728) among three groups were statistically significant ( P<0.001). Compared with the contralateral eye group, the SFCT, MCT, CVI, vortex vein anastomosis rate, and vortex vein asymmetric dilation rate in the affected eye group were significantly higher than those in the contralateral eye group. Among them, the differences of SFCT ( t=2.054), CVI ( t=2.211), and vortex vein anastomosis rate ( χ2=9.470) were statistically significant ( P<0.05); the differences of MCT ( Z=7.490), asymmetric dilation rate of vortex veins ( χ2=2.714) were not statistically significant ( P=1.000, 0.140). Conclusions:SFCT, MCT, and CVI in the affected and contralateral eyes of monocular CSC patients significantly increase. The anastomotic rate and asymmetric dilation rate of the vortex vein in the opposite eye were lower than those in the affected eye.
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Objective:To quantitatively evaluate the changes of choroidal biomarkers in patients with central serous chorioretinopathy (CSC) and preliminarily explore its pathogenesis.Methods:Clinical cross-sectional study. From July 2021 to December 2022, 74 eyes of 65 patients with CSC (CSC group) confirmed by ophthalmic examination at the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, 46 patients (51 eyes) were male, 19 patients (23 eyes) were female. The duration from the onset of symptoms to the time of treatment was less than or equal to 3 months. A control group consisted of 40 healthy volunteers (74 eyes) matched in age and gender. Among them, 26 patients (50 eyes) were male, and 14 patients (24 eyes) were female. Using VG200D from Microimaging (Henan) Technology Co., Ltd., macular scanning source light coherence tomography angiography was performed, with scanning range 6 mm × 6 mm. According to the division of the diabetes retinopathy treatment research group, the choroid within 6 mm of the macular fovea was divided into three concentric circles centered on the macular fovea, namely, the central area with a diameter of 1 mm, the macular area with a diameter of 1-3 mm, and the surrounding area of the fovea with a diameter of 3-6 mm. The device comes with software to record the three-dimensional choroidal vascular index (CVI), choroidal vascular volume (CVV), perfusion area of the choroidal capillary layer (CFA), choroidal thickness (CT), and three-dimensional CVI, CVV, and CT in the upper, temporal, lower, and subnasal quadrants within 6 mm of the fovea. Quantitative data between the two groups were compared using an independent sample t-test. Qualitative data comparison line χ2 inspection. The value of receiver operating curve (ROC) analysis in predicting the occurrence of CSC, including CVI, CVV, CFA, and CT. Results:Compared with the control group, the CVI ( t=3.133, 4.814), CVV ( t=7.504, 9.248), and CT ( t=10.557, 10.760) in the central and macular regions of the affected eyes in the CSC group significantly increased, while the CFA ( t=-8.206, -5.065) significantly decreased, with statistically significant differences ( P<0.05); CVI ( t=7.129), CVV ( t=10.020), and CT ( t=10.488) significantly increased within 6 mm of the central fovea, while CFA ( t=-2.548) significantly decreased, with statistically significant differences ( P<0.05). The CVI ( t=4.980, 4.201, 4.716, 8.491), CVV ( t=9.014, 7.156, 7.719, 10.730), and CT ( t=10.077, 8.700, 8.960, 11.704) in the upper, temporal, lower, and lower nasal quadrants within 6 mm of the central fovea were significantly increased, with statistically significant differences ( P<0.05). In the CSC group, the maximum CVI and CVV were (0.39±0.10)% and (1.09±0.42) mm 3, respectively, on the nasal side of the affected eye. Upper CT was (476.02±100.89) μm. The nasal side CVI, CVV, and CT have the largest changes. The ROC curve analysis results showed that the area under the curve of CT, CVV, and CVI within 6 mm of the central region, macular region, and fovea was over than 0.5. Subcentral CT was the most specific for the diagnosis of CSC. Conclusion:Choroidal biomarkers CVI, CVV, and CT in CSC patients increase, while CFA decreases. Central CT is the most specific for the diagnosis of CSC.
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Objective:To analyze the trajectory of waist-to-height ratio (WHtR) from childhood to adulthood and its association with the risk of hypertension in adulthood.Methods:In this retrospective cohort study, based on the data of China Health and Nutrition Survey (CHNS) from 1991 to 2015, the group-based trajectory model was applied to identify the trajectory of WHtR in 1 794 subjects aged from 7 to 40 years living in 15 provinces, autonomous regions and municipalities in China. The subjects aged 18 years and above with a systolic blood pressure≥140 mmHg (1 mmHg=0.133 kPa) or diastolic blood pressure ≥90 mmHg or those currently taking antihypertensive drugs were defined as having adult hypertension. And further, the Poisson regression model was used to assess the effect of WHtR trajectory from childhood to adulthood on adult hypertension, and the “E-value” approach was employed to evaluate the potential impact of unobserved confounders on the robustness of the results.Results:Of all the subjects surveyed, 3 trajectory groups were identified, and 750 (41.8%), 958 (53.4%) and 86 (4.8%) subjects were identified as having persistent normal, slow-growing and fast-growing WHtR trajectory, respectively; the incidence of adulthood hypertension in the up-mentioned 3 trajectory groups was 2.1%, 4.7% and 14.0%, respectively ( P<0.001). The risk of adult hypertension in the slow-growing trajectory group ( RR=1.94, 95% CI: 1.12-3.36) and the fast-growing trajectory group ( RR=5.70, 95% CI: 2.65-12.24) were both significantly higher than that in the persistent normal group (both P<0.05). The results of sensitivity analysis showed that the results were relatively robust (E-value was 3.29 and 10.88, respectively). Conclusion:Different trajectories of WHtR from childhood to adulthood exist in the surveyed population, and the increase of WHtR would be positively correlated with the risk of adulthood hypertension.
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AIM:To evaluate the correlation between axial lengths and anterior segment parameters using swept-source optical coherence tomography(SS-OCT).METHODS:For the cross-sectional clinical study, a total of 109 adult volunteers with different degrees of myopia recruited from January 1, 2022, to March 31, 2022, at the ophthalmology clinic of the First Affiliated Hospital of Zhengzhou University were included. Participants were divided into 4 groups based on axial length(AL): group A(AL≤24.0mm), group B(24.0mm<AL≤25.0mm), group C(25.0mm<AL≤26.0mm)and group D(AL>26.0mm). Anterior segment examinations were performed using SS-OCT, including: central corneal thickness(CCT), lens thickness(LT), anterior chamber depth(ACD), anterior chamber width(ACW), angle opening distance(AOD500), angle recess area(ARA500), trabecular iris space area(TISA500), trabecular iris angle(TIA500), crystalline lens rise(CLR). The relationships between these data and AL, spherical equivalent(SE)were analyzed.RESULTS:There was no difference in the comparison of CCT among the four groups(P>0.05). There were differences in SE, LT, ACD, ACW, AOD500, ARA500, TISA500, TIA500 and CLR among the four groups(all P<0.01). SE and LT were negatively correlated with AL(r=-0.75, -0.41, all P<0.01); ACD, ACW and CLR were positively correlated with AL(r=0.58, 0.45, 0.54, all P<0.01); AOD500, ARA500, TISA500 and TIA500(temporal and nasal side)were positively correlated with AL(all P<0.01). ACD and CLR were negatively correlated with SE(r=-0.21,-0.25, all P<0.01), and LT was positively correlated with SE(r=0.21, P<0.05).CONCLUSION:As AL increases, CCT remains unchanged while the ACD and ACW increase. The position of the crystalline lens moves backward and LT decreases.
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More and more evidence shows that there is a close relationship between the inflammatory state and coronary heart disease. Inflammatory state triggers the damage of vascular endothelium in the early stage of coronary heart disease and ultimately mediates the formation of atherosclerotic plaque. The mechanism of occurrence and development of heart disease is of great significance. Phlegm is a pathological product formed by the subtle imbalance of the spleen and stomach in the transportation and transformation of water and grain. It is the general summary of a series of abnormally accumulated inflammatory substances， such as low density lipoprotein， inflammatory cells， and inflammatory factors. The nature of Phlegm determines the invasiveness and turbidity of Phlegm. Phlegm invades the meridians， causing damage to the meridians and gradually accumulating， which eventually causes the local meridian damage to aggravate. This process is similar to the persistent damage of the vascular endothelium caused by inflammation. Phlegm blocks the meridians， affects the operation of Qi and blood， causes Qi stagnation and blood stasis， and finally forms the outcome of heart and blood stasis. This process is similar to the mechanism of atherosclerotic plaques formed by continuous inflammatory damage. Heart blood stasis， depression and heat， heat toxin endogenous， forming the syndrome of heat toxin stasis， which is similar to the process of atherosclerotic plaque rupture and thrombosis causing acute cardiovascular events.The formation of Phlegm is rooted in the deficiency of spleen. Based on the ''phlegm，stasis，toxin'' theory， spleen deficiency is the intrinsic pathogenesis of the inflammatory state of coronary heart disease， and the invasion of phlegm， blood stasis of heart， heat and blood stasis are the evolution of inflammatory damage of coronary heart disease. Traditional Chinese medicine differentiation and treatment is based on strengthening the spleen and nourishing Qi to treat the root and removing phlegm and blood stasis， and clearing heat and detoxifying to treat symptoms. The related Chinese medicine compounds， Chinese patent medicines， and single Chinese medicines can reduce the inflammatory indicators of coronary heart disease， thereby improving the prognosis of coronary heart disease.
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Objective:To analyze the incidence and risk factors of acute kidney injury in children with biliary atresia after liver transplantation.Methods:The retrospective case-control study was conducted.The clinical data of 115 children with biliary atresia who received liver transplantation for the first time in Beijing Friendship Hospital Affiliated to Capital Medical University from December 2018 to November 2020 were collected.The patients were divided into AKI group ( n=39) and non-AKI group ( n=76) according to the diagnostic criteria of the Kidney Disease Improving Global Outcomes(KDIGO). The differences of clinical indicators between the two groups were compared, and multivariate logistic regression analysis was performed for statistically significant variables ( P<0.05) to further determine the independent risk factors for AKI after liver transplantation. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for comparison between groups.Measurement data with non-normal distribution were represented by M( Q1, Q3), and Mann-Whitney U test was used for comparison between groups.Count data were expressed as cases and percentage, and comparisons between groups were made using Chi-square test or Fisher′s exact test. Results:The incidence of AKI in biliary atresia patients after liver transplantation was 33.9%. Univariate analysis showed that there were statistically significant differences in age ( OR=0.721, 95% CI: 0.553-0.938, P=0.014), preoperative infection ( OR=3.307, 95% CI: 1.294-8.468, P=0.013), PELD score ( OR=1.065, 95% CI: 1.031-1.101, P<0.001), serum creatinine numerical value ( OR=0.745, 95% CI: 0.657-0.858, P<0.001), intraoperative red blood cell transfusion ( OR=1.034, 95% CI: 1.028-1.051, P<0.001) and intraoperative plasma transfusion ( OR=1.055, 95% CI: 1.025-1.086, P=0.002) between the AKI group and the non-AKI group ( P< 0.05). Multivariate logistic regression analysis was performed on the selected indicators by univariate analysis, and the results showed that preoperative infection ( OR=3.763, 95% CI: 1.185-11.945, P=0.025) and low serum creatinine ( OR=0.685, 95% CI: 0.570-0.823, P<0.001), intraoperative red blood cell transfusion ( OR=1.033, 95% CI: 1.015-1.056, P=0.028) was independently associated with postoperative AKI ( P<0.05). The inpatient treatment time in ICU and in hospital between the two groups were statistically significant ( P<0.05). Conclusions:Preoperative infection, low creatinine numerical value and intraoperative red blood cell transfusion are independent risk factors for postoperative AKI in children with biliary atresia. AKI may prolong the time in ICU and in hospital.
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Abstract@#Subjective social status and life skill level are important influencing factors of adolescent health risk behaviors, and they interact with each other and jointly act on adolescent health risk behaviors, which make the mechanism of adolescent health risk behaviors become more diverse and complex. The current paper reviews the correlations among subjective social status, life skill level and adolescent health risk behaviors, in order to explore the joint influence of subjective social status and life skill level on adolescent health risk behaviors, then provides future directions for exploring possible mechanisms, and proposes recommendations for effective prevention strategies of adolescent health risk behaviors.
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Objective To investigate the clinical application of multi-criteria optimization (MCO) in radiotherapy for cervical cancer. Methods A retrospective analysis was performed on the clinical data of 15 patients who received radiotherapy for cervical cancer in Shandong Cancer Hospital and Institute. A fixed field intensity-modulated radiotherapy plan was re-optimized using 9 fields on the Halcyon platform, with the goal of achieving a target coverage of > 95% and the lowest dose to organs at risk. The plan was refined until it reached the goal (Plan I) and was calculated using MCO to reach the goal (Plan MI), and the quality assurance verification was performed. The Wilcoxon rank-sum test was used to compare design time, target coverage, radiation dose to organs at risk, and number of monitor units between the plans. Results Both plans met the clinical requirements. There were no significant differences in target dose indices between Plan I and Plan MI (P > 0.05). Plan MI reduced the maximum dose to the small intestine by 0.51 Gy (P < 0.05). There was no significant difference in dose coverage between the bladder and the rectum (P > 0.05). Compared with Plan I, Plan MI saved 34.04 min in design time (P < 0.05). Conclusion MCO can improve the optimization and adjustment, significantly shorten the design time, and improve the efficiency of the plan.
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AIM: To provide guidance for more accurate measurement of axial length(AL)of difficult measuring eyes by comparing the differences in the AL of the patient's difficult measuring eye with three methods of the sitting position, supine position A-scan and Lenstar 900(Lenstar, LS900). METHODS: Clinical case-control study. We selected 102 cases(102 eyes)including cataract patients with combined silicone oil filled, vitreous hemorrhage or retinal detachment and patients with dislocation of the lens or IOL in Zhengzhou Second Hospital from May 2019 to September 2020. AL were measured using LS900 and A-scan on sitting position and supine position respectively, and the results of the three methods were statistically analyzed.RESULTS: The detection rates of LS900 and A-scan axial measurement were 83% and 100% respectively. Three methods of A scan in sitting position, supine position and LS900 to measure the overall AL, silicone oil group, lens dislocation group and vitreous hemorrhage group, the differences were statistically significant(P<0.001), The mean values of AL measured by overall A-scan, supine positions of silicone oil group, supine position of lens dislocation group and vitreous hemorrhage group were statistically significant differences with LS900 measurement(all P<0.05), while there was no statistical difference between the results of the overall sitting position and the difficult measuring eye groups' sitting position compared with the LS900 measurement of AL. The three measurements showed good consistency within the 95% consistency range, but the result of A-scan on sitting position was closer to LS900.CONCLUSION: Changing the conventional decubitus position to the sitting position can improve the accuracy of the measurement results and provide clinicians with more reliable guidance for the treatment of patients with difficult measuring eyes of A-scan axial measurement, especially in diseases with altered ocular structure.
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In this study, chronic emotional stress-induced H1N1 influenza susceptibility model was employed to simulate the states of "emotional stagnation" and "liver fire invading lung", and the protective effect of Qinggan Xiefei Fang on viral pneumonia was investigated. Survival rate and morbidity rate of mice were observed within 21 days after H1N1 infection, the symptoms of viral pneumonia and the level of phospholipid peroxidation were detected in lungs of mice after 6-day infection. The experimental results showed that Qinggan Xiefei Fang could alleviate the decline of survival rate and morbidity rate of mice caused by chronic constraint stress loaded with H1N1, inhibit the replication of H1N1 and the production of inflammatory factors, reduce the level of phospholipid peroxidation, and improve the symptoms of pneumonia in mice. The results also showed that compound-target network of Qinggan Xiefei Fang contained 171 compounds and 260 corresponding targets involved in the signaling pathway of oxidative stress, inflammation and immunity. All the above results indicate that Qinggan Xiefei Fang protecting influenza virus pneumonia was related to the regulation of oxidative stress. The animal experimental protocol has been reviewed and approved by Laboratory Animal Ethics Committee of Jinan University, in compliance with the Institutional Animal Care Guidelines.
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Objective:To investigate the effectiveness and safety of transurethral low power green laser enucleation of prostate (VREP) after transrectal prostate puncture.Methods:The clinical data of 96 patients with VERP in the First Affiliated Hospital of Xinxiang Medical College from October 2020 to October 2021 were retrospectively analyzed. They were randomly divided into the control group ( n=41) and the observation group ( n=55). The control group did not undergo prostate biopsy before operation, and the observation group underwent transrectal prostate biopsy within 1 week before operation. The general data, perioperative indexes, maximum urinary flow rate ( Qmax), international prostate symptom score (IPSS), quality of life score (QOL) and complications of the two groups were compared before and 3, 6 and 12 months after surgery. Results:Preoperatively, the PSA was higher in the observation group compared with the control group ( P<0.05), and the differences in other general information were not statistically significant (all P>0.05). Compared with the control group, the observation group had longer operation times and heavier resected specimens, and the differences were statistically significant (all P<0.05), but there were no statistically significant differences between the two groups in the comparison of enucleation efficiency, crushing efficiency, postoperative hemoglobin (HGB) decline value, postoperative hospitalization time, and postoperative ureter removal time (all P>0.05). At 3, 6 and 12 months postoperatively, Qmax, IPSS and QOL were significantly improved in the observation group compared with the control group (all P<0.05). However, there was no statistically significant difference between the two groups in the comparison of the above-mentioned indexes in the same period after surgery (all P>0.05). There was no statistically significant difference in the complication rate comparison between the two groups ( P>0.05). Conclusions:Transurethral low-power green laser prostate enucleation after transrectal prostate puncture is efficacious and has a certain degree of safety.
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Objective:To describe the clinical features and analyze the prognostic factors of blastemaltype Wilms tumor. To explore the clinical risk factors affecting the prognosis of blastoma.Methods:Clinical data of 75 patients admitted to the surgery department of Beijing Children's Hospital from January 2008 to June 2020 who were confirmed to be blastemal-type Wilms tumor by postoperative pathology without preoperative chemotherapy. The patients' general information, clinical characteristics, inspection data, surgical methods and follow-up results were collected. The related factors which influences its prognosis were analyzed. Among the 75 patients, 45 cases (60.0%) were male and 30 cases (40.0%) were female. The diagnosis age was 6-144 m, mean age was 39.1 m. Left side: 38 cases (50.7%), right side: 37 cases (49.3%). The clinical manifestations were abdominal mass in 35 cases (46.7%), hematuria in 24 cases (32.0%), abdominal pain in 7 cases (9.3%) and physical examination in 9 cases (12.0%). There were Stage Ⅰ 30 cases, Stage Ⅱ 28 cases, Stage Ⅲ 15 cases, Stage Ⅳ 2 cases. There were preoperative tumor rupture in 5 cases, intraoperative tumor rupture in 2 cases. Clinical stage Ⅰ and Ⅱ were classified as early, while stage Ⅲ, Ⅳ were classified as late. According to COG protocol, stage Ⅰ and Ⅱ patients received EE4A, stage Ⅲ and Ⅳ patients received DD4A protocol and radiotherapy. The number of lymph nodes sampled during operation was more than 7 in 10 patients.Results:7 cases were tested for 1p16q. One case(stage Ⅱ) was absent at 1p/16q LOH, and chemotherapy was upgraded from EE4A to DD4A. After the recurrence of 1 case in clinical stage Ⅰ, the 1p/16q heterozygotic deletion test was performed, which was changed to M regimen chemotherapy. Only 1p lost in one case, and 1p/16q was negative in 4 cases, so the original chemotherapy regimen was maintained. A total of 67 patients were recruited to the study. The median follow-up time was 57 months. The 5-year relapse-free survival(RFS) rate was74.7%, and the 5-year overall survival(OS) rate was 88.0%. Cox multivariate regression analysis showed that: advanced clinical stage ( HR=4.9, 95% CI 1.2-19.6, P=0.025), tumor volume ( HR=1.7, 95% CI 0.4-6.9, P=0.048), and tumor rupture ( HR=20.1, 95% CI 4.7-85.5, P<0.001) were independent risk factors for prognosis of blastoma. Gender, age, side profile, clinical manifestations, tumor embolism, and number of lymph nodes sampled had no significant influence on the survival rate of blastoma ( P>0.05). Conclusion:Advanced stage (Ⅲ-Ⅳ), tumor volume≥1 000 ml, tumor weight and tumor rupture were independent risk factors for relapse. Insufficient lymph node sampling and incomplete 1p16q, may be the reasons for the increased risk of local recurrence in low-stage patients due to the underestimated risk classification and insufficient treatment intensity.
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OBJECTIVE@#To investigate the auxiliary diagnostic value of serum adenosine deaminase (ADA) in acute leukemia (AL) at clinical test.@*METHODS@#123 AL patients hospitalized in Zhejiang hospital from November 2018 to March 2020 were enrolled as the observation group, and 98 healthy people in the same period were randomly enrolled as the control group. AL patients were divided into two groups: 77 acute myeloid leukemia (AML) patients for AML group and 46 acute lymphoblastic leukemia (ALL) patients for ALL group. The levels of adenosine deaminase (ADA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH) and homocysteine (Hcy) in serum of the patients were detected, and the correlation of ADA with these items was analyzed. Receiver operating characteristic curve (ROC) was used to analyze the clinical diagnostic value of ADA, Yoden index was used to confirm the best cut-off point.@*RESULTS@#The serum ADA level in AL patients was significant higher than that in control group (P < 0.05). The results of Pearson correlation analysis showed that there was a significant positive correlation of ADA with Hcy, ALT, AST, GGT, LDH in AML group (r = 0.47, r = 0.28, r = 0.37, r = 0.22, r = 0.55); and also there was a significant positive correlation of ADA with GGT in ALL group (r = 0.54). In AML group, the maximum area under ROC curve was 0.761 (P = 0.00), 95% confidence interval was 0.682-0.841, sensitivity was 54.50%, specificity was 98.90%, and the best cut-off point was 17.1 U/L. In ALL group, the maximum area under ROC curve was 0.785, 95% confidence interval was 0.694-0.877, sensitivity was 65.90%, specificity was 84.00%, and the best cut-off point was 13.45 U/L.@*CONCLUSION@#The detection of ADA in serum can be used as an auxiliary examination in patients with AL, which can provide a certain value for the diagnosis of the disease.
Subject(s)
Humans , Adenosine Deaminase , L-Lactate Dehydrogenase , Leukemia, Myeloid, Acute/diagnosis , ROC Curve , Retrospective StudiesABSTRACT
Objective@#This study aimed to investigate the effects of @*Methods@#In this study, 0.1% DMG was supplemented in 20% casein diets that were either folate-sufficient (20C) or folate-deficient (20CFD). Blood and liver of rats were subjected to assays of Hcy and its metabolites. Hcy and its related metabolite concentrations were determined using a liquid chromatographic system.@*Results@#Folate deprivation significantly increased pHcy concentration in rats fed 20C diet (from 14.19 ± 0.39 μmol/L to 28.49 ± 0.50 μmol/L; @*Conclusion@#DMG supplementation exhibited hypohomocysteinemic effects under folate-sufficient conditions. By contrast, the combination of folate deficiency and DMG supplementation has deleterious effect on pHcy concentration.