ABSTRACT
OBJECTIVE@#To investigate the prevalence, risk factors, duration and outcome of delirium in intensive care unit (ICU) patients.@*METHODS@#A prospective observational study was conducted for critically ill patients admitted to the department of critical care medicine, the Affiliated Hospital of Guizhou Medical University from September to November 2021. Delirium assessments were performed twice daily using the Richmond agitation-sedation scale (RASS) and confusion assessment method of ICU (CAM-ICU) for patients who met the inclusions and exclusion criteria. Patient's age, gender, body mass index (BMI), underlying disease, acute physiologic assessment and chronic health evaluation (APACHE) at ICU admission, sequential organ failure assessment (SOFA) at ICU admission, oxygenation index (PaO2/FiO2), diagnosis, type of delirium, duration of delirium, outcome, etc. were recorded. Patients were divided into delirium and non-delirium groups according to whether delirium occurred during the study period. The clinical characteristics of the patients in the two groups were compared, and risk factors for the development of delirium were screened using univariate analysis and multivariate Logistic regression analysis.@*RESULTS@#A total of 347 ICU patients were included, and delirium occurred in 57.6% (200/347) patients. The most common type was hypoactive delirium (73.0% of the total). Univariate analysis showed statistically significant differences in age, APACHE score and SOFA score at ICU admission, history of smoking, hypertension, history of cerebral infarction, immunosuppression, neurological disease, sepsis, shock, glucose (Glu), PaO2/FiO2 at ICU admission, length of ICU stay, and duration of mechanical ventilation between the two groups. Multivariate Logistic regression analysis showed that age [odds ratio (OR) = 1.045, 95% confidence interval (95%CI) was 1.027-1.063, P < 0.001], APACHE score at ICU admission (OR = 1.049, 95%CI was 1.008-1.091, P = 0.018), neurological disease (OR = 5.275, 95%CI was 1.825-15.248, P = 0.002), sepsis (OR = 1.941, 95%CI was 1.117-3.374, P = 0.019), and duration of mechanical ventilation (OR = 1.005, 95%CI was 1.001-1.009, P = 0.012) were all independent risk factors for the development of delirium in ICU patients. The median duration of delirium in ICU patients was 2 (1, 3) days. Delirium was still present in 52% patients when they discharged from the ICU.@*CONCLUSIONS@#The prevalence of delirium in ICU patients is over 50%, with hypoactive delirium being the most common. Age, APACHE score at ICU admission, neurological disease, sepsis and duration of mechanical ventilation were all independent risk factors for the development of delirium in ICU patients. More than half of patients with delirium were still delirious when they discharged from the ICU.
Subject(s)
Humans , Prevalence , Critical Care , Risk Factors , Sepsis , Intensive Care UnitsABSTRACT
Objective:To explore the role of N 6-methyladenosine (m6A) and its regulator METTL3 in the non-coding RNA of endometrial cancer.Methods:The expression levels of m6A and METTL3 were quantified in 20 paired carcinoma and adjacent clinical tissue samples from patients at from Jul. 2016 to Dec. 2020. HEC-1-A cell lines were constructed with METTL3 overexpression and knockdown. Western blot was used to detect the phosphorylation levels of key molecules in METTL3 and Akt/mTOR. The quantitative detection of mRNA levels were used qRT-PCR. The binding level of m6A to its receptor DGCR8 was determined by RNA immunoprecipitation.Results:The results of the m6A RNA methylation quantification kit showed that m6A (1.0±0.15) vs (1.7±0.34) ( P<0.01) and METTL3 levels were elevated in endometrial cancer cells, and METTL3 (1.0±0.13) vs (2.5±0.45) ( P<0.05) levels were elevated in endometrial cancer cells. Western blot and qRT-PCR detection of miR-17-92 cell clusters overexpressing METTL3, METTL3 overexpression significantly increased m6A modification on pri-miR-17-92 ( P<0.05) . Phosphorylation levels of AKT/mTOR pathway-related proteins were upregulated. In addition, RIP test results indicated that the binding of DGCR8 to pri-miR-17-92 was significantly facilitated. Conclusion:METTL3 modification of m6A facilitates the processing of pri-miR-1792 into the miR-17-92 clusters via m6A/DGCR8-dependent mechanism, which in turn activated the AKT/mTOR pathway.
ABSTRACT
Objective To investigate the effect of color magnetic resonance imaging (MRI) combined with serum levels of carbohydrate antigen 153 (CA153),carcinoembryonic antigen (CEA) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) on the diagnostic efficacy of breast cancer patients.Methods From December 2015 to December 2017,80 cases of breast cancer in our hospital were selected as the observation group.Another 98 patients with benign breast diseases as control group A,and 94 healthy women as control group B.The serum levels of CA153,CEA and CYFRA21-1in the three groups were measured by electrochemiluminescence and the level of the above serum indexes in patients with different disease stages (stage Ⅰ to Ⅱ,Ⅲ to Ⅳ) in the observation group were compared.The 3 groups were examined by color Doppler high frequency ultrasound.The specificity,sensitivity and accuracy of color Doppler ultrasound combined with serum CA153,CEA and CYFRA21-1 or detecting alone in the diagnosis of breast cancer analyzed.Results There were significant differences in the levels of serum CA153,CEA and CYFRA21-1 in the 3 groups (P ＜0.05),and the level of serum CA153,CEA and CYFRA21-1 in the observation group was higher than that in the control group A and the control group B (P ＜ 0.05).The levels of serum CA153,CEA and CYFRA21-1 in patients in stage Ⅲ to Ⅳ of the observation group were higher than those in patients in stage Ⅰ to Ⅱ (P ＜ 0.05).The sensitivity and accuracy of color Doppler ultrasound combined with serum CA153,CEA and CYFRA21-1 in the diagnosis of breast cancer were 96.25％ (77/80) and 84.93％ (231/272),respectively,which were all higher than those of serum CA153,CEA and CYFRA21-1 alone (P ＜ 0.05).And the sensitivity of combined diagnosis was higher than that of color Doppler high frequency ultrasound alone (P ＜ 0.05).Conclusions Color Doppler ultrasound combined with serum levels of CA153,CEA and CYFRA21-1 can significantly improve the sensitivity and accuracy of breast cancer diagnosis,reduce the risk of missed diagnosis,and provide a strong basis for diagnosis and treatment of breast cancer.
ABSTRACT
Objective To explore the clinical value of magnetic resonance time-resolved imaging of contrast kinetics (MR-TRICKS)in the assessment of lower extremity venous lesions in Klippel-Trenaunay syndrome (KTS).Methods Image data of 20 patients (total 21 affected limbs)diagnosed with KTS in our hospital were analyzed retrospectively.All patients underwent MR-TRICKS angiography and ascending phlebography of the lower extremities.The images acquired by these two methods were graded and compared.Kappa test was used to examine the consistency between the results of two inspection methods.Results The image quality of MR-TRICKS angiography and ascending phlebography graded on excellent proportion were 85.71％(18/21)and 80.95％(17/21)for the deep veins,95.24％(20/21)and 90.48％(19/21)for the superficial veins,and 90.48％(19/21)and 85.71％(18/21) for venous malformation,respectively.MR-TRICKS demonstrated that the deep veins were normal in 61.90％ (13/21),hypogenetic in 25.57％(7/21),atretic in 4.86％(1/21).Superficial vein diseases including varicosis of the great saphenous vein accounted for 25.57％(6/21), varicosis of the small saphenous vein accounted for 14.29％ (3/21 ),while marginal veins in venous malformation accounted for 100％ (21/21).Ascending phlebography of the lower limbs showed that the deep veins were normal in 57.14％(12/21)and dysplasia in 39.10％(8/21),while the other results were consistent with those of TRICKS.Consistency between results from the two methods were excellent (Kappa >0.75).Conclusion MR-TRICKS can accurately describe the angioarchitecture of the lower extremity vena in patients with KTS,and has an important clinical value in providing support for the assessment and treatment of KTS.
ABSTRACT
Objective To explore the clinical value of magnetic resonance time-resolved imaging of contrast kinetics (MR-TRICKS)in the assessment of lower extremity venous lesions in Klippel-Trenaunay syndrome (KTS).Methods Image data of 20 patients (total 21 affected limbs)diagnosed with KTS in our hospital were analyzed retrospectively.All patients underwent MR-TRICKS angiography and ascending phlebography of the lower extremities.The images acquired by these two methods were graded and compared.Kappa test was used to examine the consistency between the results of two inspection methods.Results The image quality of MR-TRICKS angiography and ascending phlebography graded on excellent proportion were 85.71％(18/21)and 80.95％(17/21)for the deep veins,95.24％(20/21)and 90.48％(19/21)for the superficial veins,and 90.48％(19/21)and 85.71％(18/21) for venous malformation,respectively.MR-TRICKS demonstrated that the deep veins were normal in 61.90％ (13/21),hypogenetic in 25.57％(7/21),atretic in 4.86％(1/21).Superficial vein diseases including varicosis of the great saphenous vein accounted for 25.57％(6/21), varicosis of the small saphenous vein accounted for 14.29％ (3/21 ),while marginal veins in venous malformation accounted for 100％ (21/21).Ascending phlebography of the lower limbs showed that the deep veins were normal in 57.14％(12/21)and dysplasia in 39.10％(8/21),while the other results were consistent with those of TRICKS.Consistency between results from the two methods were excellent (Kappa >0.75).Conclusion MR-TRICKS can accurately describe the angioarchitecture of the lower extremity vena in patients with KTS,and has an important clinical value in providing support for the assessment and treatment of KTS.
ABSTRACT
Objective To evaluate the postoperative related aesthetic parameters and satisfactory degree between CT 3D reconstruction augmentation rhinoplasty with silicone and augmentation rhinoplasty with silicone in adult Han women.Methods Totally 60 adult healthy Han women voluntarily subjected to augmentation rhinoplasty with silicone were randomly divided into groups A and B,30 people each group;Row CT 3D reconstruction augmentation rhinoplasty with silicone was performed in group A,and the augmentation rhinoplasty with silicone in group B;6 months after surgery related data measurement and questionnaire collected,we compared the objective and subjective indicators for the nasal root,dorsum and ministry,respectively.Results There was a difference between group A and group B in the nasorostral angle,the nasal facial angle,the asofrontal angle and the height of the nasal root (89.50±1.40)°,(28.85±2.20)°,(136.26±1.92)°,(6.45±0.27) mm in group A,and (85.40±3.70)°,(26.43±4.39)°,(138.88±4.78)°,(5.28±0.34) mm in group B (all P＜0.05).There was a difference between group A and group B in operation time (51.77 ± 5.35) min vs (29.83±5.76) min (P＜0.05).Conclusions Owing to its preoperative prosthesis design purpose and avoiding local swelling,CT 3D reconstruction augmentation rhinoplasty with silicone has better effects than that of augmentation rhinoplasty with silicone,especially on the nasal dorsum and the nasal root),which can obviously shorten the operation time,and therefore it is more suitable for the defects of the nasal root and dorsum.
ABSTRACT
Objective To estimate the prevalence of thyroid dysfunction and thyroid autoantibodies in adults with alopecia areata (AA), and to analyze the relationship between alopecia areata (AA) and thyroid autoimmunity in adults.Methods A predesigned questionnaire was used to collect data on demographic information, medical history,and family history of AA in first-degree relatives from patients with AA.Thyroid function was evaluated, and anti-thyroid peroxidase antibody (TPO-Ab) was screened in all the patieuts.Statistical analysis was carried out by the chi-square test and Fisher's exact test.Results Totally, 209 patients with AA were enrolled.Of these patients, 6.7％ were complicated by thyroid diseases, 20.6％ were positive for TPO-Ab.Compared with the patients without TPO-Ab, those with TPO-Ab showed a significant increase in the proportion of patients with early-onset (＜ 18 years) AA (x2 =5.589, P =0.025),prevalence rate of alopecia totalis/alopecia universalis (x2 =9.990, P=0.006) and thyroid diseases (x2 =12.279, P =0.002), and incidence rate of AA in first-degree relatives (x2 =14.426, P =0.001).Conclusions The positive rate of TPO-Ab is increased in patients with AA.It is recommended to evaluate thyroid function and to screen for thyroid autoantibodies in patients with AA despite of the absence of clinical manifestations of thyroid diseases.
ABSTRACT
This paper described a rapid and se nsitive HPLC method to analyze (E)-3, 5,4'-trimethoxystilbene (BTM-0512) in rat plasma and tissues. The analysis used a BDS Hypersil C18 analytical column (250 mm×4.6 mm ID, 5 μm) and acetonitrile / water as the mobile phase. The UV detection wavelength was 319 nm. Proteins were precipitated with acetonitrile and diethylstilbestrol as internal standard. The method was validated according to State Food and Drug Administration of China and ICH of Technical Requirements for Registration of Pharmaceuticals for Human Use Guidelines. The limit of interday precision values (%RSD) were in the range of 2.6% -5.1% and 2.4% -4.8%, respectively.Mean accuracy and absolute recoveries of BTM-0512 ranged from 95.3% - 100. 1% and 95.9% -100.9% for plasma and tissues, respectively. This method can be quite useful for BTM-0512 pharmacokinetic and tissue distribution studies, for purpose which multiple plasma and tissue samples can be analyzed quickly with high reproducibility.