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OBJECTIVE@#To dynamically observe the levels and activities of von Willebrand factor (vWF) and ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) in plasma of children with congenital ventricular septal defect (VSD) during perioperative period, and explore the value of plasma vWF antigen (vWF:Ag) and ADAMTS-13 activity (ADAMTS-13: AC) in evaluating vascular endothelial injury and prognosis in children with VSD.@*METHODS@#In this cross-sectional study, a total of 74 children with VSD who underwent surgical treatment in TEDA International Cardiovascular Hospital from September 2018 to March 2019 were enrolled in the observation group. Among them, there were 28 cases of pure VSD, 32 cases of VSD combined with pulmonary hypertension, and 14 cases of VSD combined with valvular heart disease. 31 healthy children who underwent physical examination in Tianjin Children's Hospital during the same period were collected as the control group. The biochemical indexes of the children at admission were recorded. Peripheral plasma was collected at admission, postsurgery day 0 and day 1, respectively, and the levels of vWF activity (vWF:AC), vWF:Ag, ADAMTS-13 antigen (ADAMTS-13:Ag) and ADAMTS-13:AC were detected.@*RESULTS@#The level of plasma vWF:Ag and vWF:AC in the observation group before surgery were significantly lower than those in the control group (P<0.001), and increased continuously, on postsurgery day 0 and day 1 (P<0.001). The level of ADAMTS-13:Ag in the observation group before surgery was significantly higher than that in the control group (P<0.001), which decreased significantly on postsurgery day 0 (P<0.001), and increased significantly on postsurgery day 1 compared with postsurgery day 0 (P=0.033). The level of ADAMTS-13:AC in the observation group before surgery was significantly lower than that in the control group (P=0.015), which decreased significantly on postsurgery day 0 (P=0.037), and increased on postsurgery day 1, but the difference was not statistically significant (P=0.051). The changes of vWF and ADAMTS-13 in the three subgroups were basically similar to the observation group. vWF: Ag/ADAMTS-13: AC ratio on postsurgery day 0 and day 1 had high diagnostic value in vascular endothelial injury (AUC=0.80, P<0.001; AUC=0.93, P<0.001). Preoperative vWF and ADAMTS-13 levels, and related baseline indicators were not correlated with postoperative infection, bleeding, thrombosis,etc.@*CONCLUSION@#Preoperative vWF: Ag, vWF: AC and ADAMTS-13: AC levels in children with VSD are low, while the level of ADAMTS-13: Ag is high. After surgery, the levels of vWF: Ag and vWF: AC are increased and the level of ADAMTS-13: Ag is decreased. The postoperative vWF: Ag/ADAMTS-13: AC ratio shows high diagnostic value in evaluating vascular endothelial injury. There is no correlation between preoperative vWF and ADAMTS-13 levels with perioperative clinical events.
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Child , Humans , ADAMTS13 Protein , Cross-Sectional Studies , Heart Septal Defects, Ventricular , Prognosis , von Willebrand FactorABSTRACT
Non-alcoholic fatty liver disease (NAFLD) is considered to be a manifestation of metabolic syndrome and has become one of the chronic diseases that endanger health around the world. There is still a lack of effective therapeutic drugs in clinical practice. Farnesoid X receptor (FXR) has been a popular target for NAFLD research in recent years. Fexaramine (Fex) is a potent and selective agonist of FXR, and its mechanism of action to improve NAFLD is unclear. Therefore, in this study, a mouse model of NAFLD was constructed using a high-fat, high-cholesterol diet and treated with Fex orally for 6 weeks. We evaluated the ameliorative effect of Fex on disorders of glucolipid metabolism in NAFLD mice, and preliminarily explored its potential mechanism of action. The animal experiments were approved by the Animal Ethics Committee of Shanghai University of Traditional Chinese Medicine (approval number: PZSHUTCM210913011). In this study, it was found that 100 mg·kg-1 Fex significantly inhibited body weight gain, alleviated insulin resistance, improved liver injury and lipid accumulation in NAFLD mice. The effect of Fex on the expression of hepatic intestinal FXR and its target genes in NAFLD mice was further examined. Analysis of serum and hepatic bile acid profiles and expression related to hepatic lipid metabolism. It was found that Fex could stimulate intestinal FXR, promote fibroblast growth factor 15 (FGF15) secretion, inhibit the expression of cytochrome P450 family 7 subfamily A member 1 (CYP7A1), the rate-limiting enzyme of bile acid synthesis in liver, regulate bile acid synthesis by negative feedback, and improve the disorder of bile acid metabolism. At the same time, Fex reduces liver lipid synthesis and absorption, increases fatty acid oxidation, thus improving liver lipid metabolism. This study shows that Fex can improve NAFLD by activating intestinal FXR-FGF15 signal pathway and regulating liver lipid metabolism.
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Objective:To explore the clinical and histopathologic features of lupus nephritis (LN) patients with positive antineutrophil cytoplasmic antibody (ANCA), so as to provide more theoretical basis to recognize and treat this disease.Methods:Clinical data of biopsy-proven LN patients with ANCA test in the First Affiliated Hospital of Sun Yat-sen University from November 1, 2002 to September 11, 2020 were collected and analyzed retrospectively. The difference of clinical data, laboratory examination, and pathological examination of renal biopsy between ANCA-positive group and ANCA-negative group. The clinicopathological characteristics between different ANCA serotypes were compared.Results:A total of 1 304 patients with LN confirmed by renal biopsy and ANCA test results were enrolled. Eighty ANCA-positive patients from 1 304 LN patients were screened. There are 55(68.8%) ANCA-positive LN patients with positive anti-myeloperoxidase antibodies (MPO). There were 14(17.5%) ANCA-positive LN patients with positive anti-proteinase 3 antibodies (PR3), and 11(13.8%) ANCA-positive patients with double positive antibodies of MPO and PR3. ANCA-positive LN patients had significantly higher serum creatinine [135.5(68.0, 361.8) μmol/L vs 88.0(64.0, 165.0) μmol/L, P=0.004] and blood urea nitrogen [12.35(6.35, 21.18) mmol/L vs 8.60 (5.50, 15.70) mmol/L, P=0.026] as well as lower estimated glomerular filtration rate [45.70(13.83, 84.10) ml·min -1·(1.73 m 2) -1 vs 66.75(38.43, 96.22) ml·min -1·(1.73 m 2) -1, P=0.001] than ANCA-negative patients (stratified sampling of 160 patients). ANCA-positive LN patients had higher chronicity index than ANCA-negative LN patients [3(2, 7) vs 2(0, 5), P=0.006]. There were statistically significant difference in hemoglobin, serum creatinine and estimated glomerular filtration rate among ANCA-positive group, ANCA-negative group, and MPO-ANCA and PR3-ANCA double positive group. MPO-ANCA and PR3-ANCA double positive LN patients had the lowest hemoglobin and estimated glomerular filtration rate, and highest serum creatinine among the three groups (all P<0.05). Conclusions:ANCA-positive LN patients have worse renal function and higher renal histological chronicity index than ANCA-negative LN patients, especially for patients with double positive MPO-ANCA and PR3-ANCA. More stringent monitoring and therapy may be needed in this subgroup of LN patients.
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OBJECTIVE@#We provided baseline data for oral public health through epidemiological surveys to investigate the prevalence of malocclusion and orthodontic treatment proportion in 12- to 14-year-old adolescents in Jiangxi province, China.@*METHODS@#Multi-stage random cluster sampling was used. A total of 5 387 12- to 14-year-old adolescents were examined by three professional dentists according to Angle's classification of malocclusion. The subjects were recruited from 30 secondary schools in five counties in Jiangxi Province. Results were statistically analyzed by SPSS19.0.@*RESULTS@#The prevalence of malocclusion was 79.67% among adolescents aged 12-14 years in Jiangxi province. The composition ratios of ClassⅠ, Class Ⅱ Division 1, Class Ⅱ Division 2, and Class Ⅲ malocclusion were 30.96%, 16.36%, 12.78%, and 19.13% respectively. ClassⅠmalocclusion had the highest composition ratio, and the most common clinical manifestation of malocclusion was dentition crowding with a prevalence of 91.30%. The prevalence rate of malocclusion was higher in boys than in girls at 81.16% and 78.21%, respectively (P<0.05). This condition had different prevalence rates in Nanchang, Yichun, Jiujiang, Shangrao, and Ganzhou (P<0.05) with the highest in Nanchang and lowest in Ganzhou. Malocclusion was related to caries, and its prevalence rate was higher in patients with caries than in those without caries (P<0.05). The orthodontic rate of malocclusion was 2.63%, and the value was higher for girls than that for boys (P<0.05). The rate of orthodontic in urban areas was higher than that in rural areas (P<0.05).@*CONCLUSIONS@#Compared with local and international findings on malocclusion of adolescents, high prevalence and low orthodontic rate were found in Jiangxi province. Strengthening the combination of prevention and treatment is important for the physical and mental health of adolescents. We should actively conduct oral health education, popularize the knowledge of malocclusion, and actively treat caries.
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Adolescent , Child , Female , Humans , Male , China , Dental Caries , Epidemiologic Studies , Malocclusion , PrevalenceABSTRACT
OBJECTIVE: To find out the mortality trend and related factors in aged hospitalized patients with diabetes mellitus(DM). METHODS: The case information diabetic in patients who died during the period from 2005 to 2014 were collected and the mortality and causes of death were analyzed. RESULTS: From 2005 to 2014, 1297 diabetic patients died, and the mortality of elderly DM inpatients was 4.44%(1162 cases), significantly higher than that of the non-elderly of 0.94%(P<0.001). The death rate of elderly diabetic patients was significantly higher in males than in females(5.22% vs. 3.47%, P<0.001). The mortality of the aged diabetic patients decreased within 10 years(P<0.001), decreasing from 4.75% in 2005 to 3.01% in 2009(P<0.001) in the year of 2005-2009, while there were no differences in the year of 2010-2014. The main death causes of the aged diabetic in-patients were as follows: infections(27.71%), cardiovascular diseases(25.22%), tumor(21.34%), cerebral vascular diseases(10.41%) and diabetic complications(5.51%). The first death cause in the 60-79 yrs group was cardiovascular diseases, while in the ≥80 yrs group, it was infections. The constituent ratio of infection as death cause in the aged during 2010-2014 significantly increased(22.60% vs. 32.50%, P<0.001), increasing by 43.81%, and it became the first cause of death in 2010. CONCLUSION: The death rate of the elderly DM in-patients has decreased significantly within 10 years, from 2005 to 2014, while the rate has kept steady from 2010. Infections and cardiovascular diseases are the main cause of death. So it's important to prevent the elderly hospitalized DM patients from infection, in addition to cardiovascular diseases, and to control in time.
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OBJECTIVE@#This study aimed to investigate the oral health service needs and dental treatment among 3-year-old to 5-year-old preschool children in Jiangxi province and provide data to support the development of relevant oral health policies, enhance the oral health service utilization and visit rate, and optimize oral manpower and service resources.@*METHODS@#A total of 2 880 preschool children were selected via stratified cluster sampling. Dental examination methods and criteria according to the fourth national oral health epidemiological survey were adopted. Excel 2007 and SPSS 19.0 softwares were used for statistics analysis. Chi-square test and logistic regression analysis were performed.@*RESULTS@#The caries prevalence was 49.13% (1 415/2 880) among the 2 880 cases of 3- year-old to 5-year-old preschool children in Jiangxi province, approximately 53.37% (1 537/2 880) of which possessed oral health service needs. The parents of younger children assessed the oral situation better in older age than in their younger years (P<0.05), which was better in urban children than in rural children (P<0.05). The visiting rate of all the respondents was 12.33% (355/2 880), while the visiting rate of children with oral diseases was 17.31% (266/1 537). The top three reasons why patients did not visit the dentist were as follows: children's teeth have no problem, the teeth damage in teeth was considerably minimal, and primary teeth would be replaced without the need for treatment. The influencing factors included lower visiting rate in females than in males (OR=0.499, 95%CI: 0.411-0.606) and lower visiting rates in rural areas than in urban areas (OR=0.428, 95%CI: 0.353-0.519). Subjects with poor oral health and high oral knowledge scores possessed high dental service visit rates.@*CONCLUSIONS@#The prevalence of caries in 3-year-old to 5-year-old preschool children in Jiangxi province is at a lower level than that in the national level. The proportion of the population actively seeking medical services is low, and their main purpose of treatment is to treat rather than prevention. Oral health education should be strengthened, and it should be incorporated to the contents of the kindergarten teacher training program to improve residents' awareness regarding children's oral health.
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Child, Preschool , Female , Humans , Male , DMF Index , Dental Caries , Health Education, Dental , Oral Health , Prevalence , Tooth, DeciduousABSTRACT
<p><b>OBJECTIVE</b>To investigate the hypoglycemic characteristics of hospitalized elderly patients with type 2 diabetes mellitus (T2DM).</p><p><b>METHODS</b>From January, 2014 to December, 2015, the data of 58 565 blood measurements using a standard blood glucose monitoring system (BGMS) were collected from 1187 cases of patients with type 2 diabetes during hospitalization in the Department of Endocrinology, Guangdong General Hospital (Guangzhou, China). Stratified analyses were conducted by dividing the patients into 3 age groups, namely <45 years group (128 cases), 45-64 years group (594 cases), and ≥65 years group (465 cases). The incidence and time distribution of hypoglycemia in these patients were compared among the 3 age groups.</p><p><b>RESULTS</b>The risk of hypoglycemia increased with age. Compared with those below 45 years of age, the patients beyond or equal to 65 years had a significantly increased hypoglycemic density (0.95% vs 0.40%, P<0.001), a higher proportion of patients with hypoglycemia (28.17% vs 10.94%, P<0.001), and greater patient-days with hypoglycemia (4.48% vs 1.76%, P<0.001). In the elderly patients, hypoglycemia occurred most frequently before dawn, at which time the hypoglycemic density was 2.66% in patients ≥65 years of age, significantly higher than that in patients below 45 years (1.09%, P<0.05) and between 45 and 64 years (1.90%, P<0.05); the proportion of patients with hypoglycemia was also significantly higher in the elderly patients (14.57%) than in those below 45 years (3.77%, P<0.02) and between 45 and 64 years (9.42%, P<0.02). The proportion of patients with recurrent hypoglycemia (≥2 times) was significantly higher in patients ≥65 years (13.33%) than in younger patients (2.34% in <45 years group and 9.43% in 45-64 years group, P<0.05).</p><p><b>CONCLUSION</b>The hypoglycemic risk in hospitalized elderly patients with T2DM is significantly higher than that in younger patients, especially before dawn and in terms of recurrent hypoglycemia. Clinicians should develop differential blood glucose monitoring and management strategies for these elderly patients to improve the clinical safety.</p>
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Objective To explore the effect of food hand measurement exchange on patients with type 2 diabetes in communities. Methods A stratified random sampling method was used to divide the community into five groups according to the geographical location. Forty patients were randomly selected from each group and randomly divided into intervention group and control group. The control group was administered according to the requirements of the management of diabetes mellitus in the national basic public health service project. The intervention group conducted the dietary instruction for 12 months on the basis of the management of the national basic public health service project. Two groups were investigated before and after the intervention,and physical examination were conducted and biochemical indicators were detected. Results Before and after the intervention,there was no significant difference between the two groups in behavior and physical examination (P>0.05) . In the intervention group, the proportion of drug treatment decreased from 96.00% to 92.00% after 12 months of intervention. The proportion of people controlling diet increased from 90% to 99%, and the proportion of control weight increased from 75.00% to 91.00% . The proportion of patients who were monitored blood sugar was from 71% to 98%.Compared with the control group, the behavioral habits of the intervention group in drug use, diet control, weight control and blood glucose monitoring were higher than those in the control group(Wald x2=10.644, 4.324, 5.957, 12.229, P<0.05) . In the intervention group, the compliance rate of blood pressure and HDLC compliance rate increased from 16.00% and 56.00% to 64.00% and 76.00% respectively after 12 months intervention. Compared with the control group, the increase of blood pressure, FPG and HDL-C in the intervention group was higher than that in the control group(Wald x2=16.642, 10.128, 6.457, P<0.05) . Conclusion Food hand measurement exchange method on patients with type 2 diabetes in communities was a simple calorie intake measurement tool,and could greatly improve the patient's control diet compliance, and could promote drug treatment and monitor of blood sugar and other behavior improvement, thus ultimately improve the blood pressure, blood sugar and blood lipids.
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Objective To prepare 99Tcm-succinimidyl-6-hydrazinonicotinate hydrochloride (SHNH)-AC133 and evaluate its targeting ability on CD133 positive colon cancer by Gamma imaging,and to explore its feasibility as a molecular probe for cancer stem cells (CSCs).Methods CD133 expression was detected by immunofluorescence assay and flow cytometry on Lovo cell lines and tumor xenografts.CD133 specific monoclonal antibody (AC133) was conjugated with SHNH,and then labeled with 99Tcm to prepare 99Tcm-SHNH-AC133.The radiolabeled yield and radiochemical purity were investigated.Colon cancer xenografts were developed and Gamma imaging were performed.Region of interest (ROI) was drawn and the tumor/non-tumor (T/NT) ratio was calculated.For the blocking experiment,animals were pre-injected with excess unlabeled AC133.Two-sample t test was used to analyze the data.Results CD133 was expressed on the surface of Lovo cells.And the percentage of CD133 positive cells in Lovo tumor tissues was (29.5±3.4)％.The radiolabeled yield of 99Tcm-SHNH-AC133 was more than 85％ and radiochemistry purity was (97.7±2.4)％.Gamma imaging demonstrated that 99Tcm-SHNH-AC133 could specifically target to Lovo tumors which could be gradually visible after 12 h.The tumor uptake was obvious at 24 h and T/NT ratio was 8.16±0.45.In blocking study,the tumor uptake was significantly reduced by pre-injection of excess unlabeled AC133 (3.52±0.13;t=19.8,P＜0.05).Conclusions 99Tcm-SHNH-AC133 has high labeling yield and radiochemistry purity.The excellent targeting properties of 99Tcm-SHNH-AC133 on CD133 positive colon cancer demonstrate that it is a promising imaging agent for CSCs tracking in vivo.
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Objective To learn the situation of glucose,blood pressure and lipid control among community residents with type 2 diabetes mellitus and to guide health education and behavior intervention.Methods According to the geographical location,Cicheng Town in Jiangbei District were divided into 5 areas.Using the random number table method,40 cases of patients with type 2 diabetes mellitus were selected from each area.Questionnaire and laboratory tests were conducted on all subjects.Results A total of 199 patients with type 2 diabetes mellitus were investigated.Blood glucose,blood pressure and blood lipid compliance ratio were 23.12%,15.58% and 31.66%,respectively.Blood glucose levels was associated with age of the patients (OR =0.621,95%CI =0.393 -0.981).Blood pressure was associated with patient and the family doctor (OR =0.393,95%CI =0.177 -0.872).Blood lipids were associated with gender and central obesity (OR=0.461,0.384,95%CI =0.247 -0.863,0.205 -0.719).Conclusion The situation of glucose,blood pressure and lipid control among community residents with type 2 diabetes mellitus is not ideal.The combination of effective self -management and individual management of family doctor is recommended.
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Six compounds were isolated from the secondary metabolites of the jellyfish-derived fungus Aspergillus fumigates, whose structures were identified by chemical methods and spectroscopic analysis as pseurotin F1 (1), azaspirofurans B (2), (22E, 24R)-24-methyl-5α-cholesta-7,22-diene-3β,5,6β-triol (3), 5α,8α-epidioxyergosta-6,22-dien-3β-o1 (4), cyclo-(L-Pro-L-Tyr) (5), fumitremorgin C (6). The compounds 1 - 5 were isolated from the fungus Aspergillus fumigates for the first time. The isolated compounds (1 - 6) were evaluated for antibiotic activity and cytotoxicity against six bacterial strains and ten human tumor cell lines, respectively.
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Humans , Aspergillus , Cell Line, Tumor , FungiABSTRACT
<p><b>BACKGROUND</b>Left atrial (LA) maximum volume is becoming a prognostic biomarker for left ventricular (LV) diastolic dysfunction. However, we assessed LV diastolic function by measuring LA phasic volumes using real-time threedimensional echocardiography (RT3DE) in patients with stable coronary artery disease (CAD).</p><p><b>METHODS</b>Sixty-five stable CAD patients with normal LV ejection fraction (LVEF) were divided into three groups according to degree of coronary stenosis: control (n = 15) with <50% stenosis as control group, mildS (n = 25) with mild stenosis (50%-70%) and severeS (n = 25) with >70% stenosis. LA phasic volumes and function were evaluated and compared using RT3DE and two dimensional echocardiography (2DE). N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were examined. The correlations of RT3DE-derived parameters with other conventional indices were analyzed.</p><p><b>RESULTS</b>Significant correlations between RT3DE and 2DE for LA volume measurements were: control, r = 0.93; mildS, r = 0.94; severeS, r = 0.90 (all P < 0.05). Patients with severe coronary stenosis presented higher NT-proBNP level, indices of LA minimum volume and volume before atrial contraction, but lower LA total emptying fraction (LAEF) and LAEFpassive. Significant correlations of RT3DE derived LA volume indices with E/E' (r = 0.695) and NF-proBNP (r = 0.630) level were found.</p><p><b>CONCLUSIONS</b>RT3DE derived, LA indices correlate well with NT-proBNP level and may be superior to 2DE measurements for the evaluation of LV diastolic dysfunction. Enlargement of LA minimum volume in stable CAD patients without systolic dysfunction appears earlier and may be better correlated with LV diastolic function than that of LA maximum volume.</p>
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Female , Humans , Male , Middle Aged , Echocardiography , Echocardiography, Three-Dimensional , Methods , Ventricular Dysfunction, Left , DiagnosisABSTRACT
<p><b>BACKGROUND</b>Renal biopsy is necessary for diagnosing the pathological changes of primary nephrotic syndrome (NS). However, it is invasive, time-consuming and can not be performed frequent on the same patient. Thus, development of a non-invasive and rapid diagnostic method may improve clinical patient management.</p><p><b>METHODS</b>Proteomic tool magnetic bead-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MB-based MALDI TOF MS) was applied to serum to determine peptidome patterns that are characteristic of different pathological changes.</p><p><b>RESULTS</b>Serum specimen from 114 patients with NS (62 were minimal change disease (MCD), 30 were membranous nephropathy (MN), and 22 were focal segmental glomerulosclerosis (FSGS)) and 60 normal individuals were analyzed using MB-based MALDI TOF MS. The peptidome pattern was generated by genetic algorithms using a training set of 31 MCD, 15 MN, 11 FSGS and 30 normal individuals and was validated by an independent testing set of the remaining samples. The serum peptidome pattern, based on a panel of 14 peaks, accurately recognized samples from MCD, MN, FSGS and healthy control with sensitivities of 93.5%, 86.7%, 63.6% and 90.0%, and specificities of 98.2%, 94.4%, 100% and 89.5%, respectively. Moreover, one peptide from peptidome pattern was identified by liquid chromatography tandem mass spectrometry (LC MS/MS) as fibrinogen A.</p><p><b>CONCLUSION</b>Detection of the serum peptidome pattern is a rapid, non-invasive, high-throughout, and reproducible method for identifying the pathological patterns of patients with nephrotic syndrome.</p>