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Objective To explore the acute effects of NO2 on children's respiratory hospitalization risk in Foshan City. Methods The daily average concentrations of six air pollutants such as NO2 and fine particulate matter, and meteorological data including average temperature and relative humidity in Foshan were collected from 2016 to 2019. Data on the daily number of children newly hospitalized for respiratory diseases (ECRH) in Foshan Women and Children Hospital were retrieved. Time series analysis was used to quantitatively evaluate the effect of daily NO2 concentration on the hospitalization risk of children with respiratory diseases. Results From 2016 to 2019, the average ECRH in the hospital was 10. The daily average concentrations of air pollutants NO2, PM2.5, PM10, and SO2 were 42.0 μg/m3, 35.3 μg/m3, 58.1 μg/m3, and 11.4 μg/m3, respectively. The air pressure, daily average temperature and relative humidity of atmosphere were 1008.4 Pa, 23.7℃ and 73.3%, respectively. ECRH was significantly correlated with the daily average concentration of NO2 (r=0.079, P3 increase of NO2 concentration in the single pollutant model, the excess risk of ECHR in the hospital increased by 1.22% (95% CI: 0.06%, 2.40%) and 1.37% (95% CI: 0.23%, 2.53%) in lag0 and Lag1 day, respectively. The strongest effect appeared in lag0:7 with the excess risk increasing by 1.70% (95% CI:0.12%, 3.31%). In the NO2 + SO2 + CO + O3_8h + PM2.5 and NO2 + SO2 + CO + O3_8h + PM10 multi-pollutant models, significance correlation still existed between the daily average NO2 concentration and ECHR in lag0, lag1 and lag0:1 to lag0:7. The strongest effect appeared in lag0:1, and the excess risks were 4.06% (95% CI: 1.83%, 6.34%) and 3.95% (95% CI: 1.85%, 6.09%), respectively. Dose-response relationship analysis showed a linear relationship between the daily average NO2 concentration and ECHR, and the excess risk of new hospitalization gradually increased with the increase of daily average NO2 concentration. Conclusion There was a significant correlation between NO2 concentration and hospitalization risk of children with respiratory diseases in Foshan City, which suggests that the government should further strengthen the prevention and control of air pollution.
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Objective@#This study aimed to analyze the temporal trends and characteristics associated with waist circumference (WC) among elderly Chinese people.@*Methods@#We used data from 3,096 adults ≥ 65 years who participated in the China Health and Nutrition Survey (CHNS), an ongoing cohort study, between 1993 and 2015. We used longitudinal quantile regression models to explore the temporal trends and characteristics associated with WC.@*Results@#WC increased gradually among the elderly Chinese population during the survey. The WC curves shifted to the right with wider distributions and lower peaks in men and women. All WC percentile curves shifted upward with similar growth rates in the 25th, 50th, and 75th percentiles. The WC means increased from 78 cm to 86 cm during the 22 years of our study. WC significantly increased with age and body mass index and decreased with physical activity (PA). These associations were stronger in the higher percentiles than in the lower percentiles.@*Conclusions@#WC is rising among Chinese adults ≥ 65 years. Factors affecting WC in elderly people may have different effects on different percentiles of the WC distribution, and PA was the most important protective factor in the higher percentiles of the WC distribution. Thus, different interventional strategies are needed.
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Aged , Female , Humans , Male , Body Mass Index , China/epidemiology , Cohort Studies , Nutrition Surveys , Waist CircumferenceABSTRACT
UHPLC-Q-TOF/MS metabonomics technology was used to clarify the metabolic regulation pathways by which Platycodon total saponins (PTS) exert antitussive and expectorant effects in a mouse cough model, in which coughing is induced by concentrated ammonia, and in a phenol red excretion model. After approval by the Experimental Animal Ethics Committee of Jiangxi University of Chinese Medicine (Approval No. JZLLSC-20190235), the mice were randomly divided into a normal group, a model group, a positive drug group and a PTS group. Endogenous metabolites in mouse serum were identified by UHPLC-Q-TOF/MS. Principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were used for multivariate analysis. Metabolic pathways were analyzed by the Metaboanalyst platform. The results show that PTS can significantly prolong the cough latent period and cough frequency of mice, and significantly increase phenol red excretion. UHPLC-Q-TOF/MS identified 19 metabolites related to cough, and PTS significantly decreased 16 of them; 17 metabolites related to expectoration were identified, and PTS decreased the levels of all. Metabolic pathway analysis showed that linoleic acid metabolism, arachidonic acid metabolism and glycerophospholipid metabolism were the main pathways involved in serum metabolite changes in this mouse cough model. Linoleic acid metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, arachidonic acid metabolism, phenylalanine metabolism and α-linolenic acid metabolism were the main pathways involved in serum metabolite changes in the phenol red excretion model. This study is the first to elucidate the regulation of antitussive and expectorant metabolic pathways and the effect of PTS on these pathways.
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Objective@#To investigate the intake of liquid dairy products and identify its influencing factors among the fourth grade students in Nanjing City. @*Methods@#The fourth grade students were selected as the study subjects in Nanjing City using a multi-stage random cluster sampling method in September 2020. Their general information, frequency of liquid dairy product intake one week prior to survey and mean intake amount per time were collected. According to the 2016 Dietary Guidelines for Chinese Residents, weekly intake of liquid dairy products of 2 100 g and greater was defined eligible. Factors affecting the frequency and amount of liquid dairy product intake were identified using multivariable logistic regression analysis.@*Results@#A total of 2 268 questionnaires were allocated and 2 216 valid questionnaires were recovered, with an effective recovery rate of 97.71%. The respondents included 1 199 boys ( 54.11% ) and 1 017 girls ( 45.89% ). The frequency of liquid dairy product intake was (6.41±4.86) times per week, and the median intake amount was 1 250.00 g per week (interquartile range, 1 750.00 g per week). There were 607 students ( 27.39% ) consuming liquid dairy products of 2 100 g and greater a week, and 1 016 students ( 45.85% ) consumed liquid dairy products for 7 times and more a week. Multivariable logistic regression analysis showed that living in urban areas ( OR=1.204, 95%CI: 1.005-1.443 ), knowing nutrition labels ( OR=1.221, 95%CI: 1.021-1.460 ), periodical measurement of body weight (OR=1.486, 95%CI: 1.098-2.011) and restricted intake of sugar-containing drinks ( OR=1.264, 95%CI: 1.005-1.590 ) facilitated the intake of liquid dairy products for 7 times and more a week, and students with periodical measurement of body weight were more likely to consume liquid dairy products for 2 100 g and greater a week ( OR=1.821, 95%CI: 1.240-2.676 ).@*Conclusions@#Inadequate intake of liquid dairy products is found among the fourth grade students in Nanjing City. Residence, awareness of nutrition labels, periodical measurement of body weight, and parental restriction of sugar-containing drink intake affect the intake of liquid dairy products.
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Objective:To explore the association between different paths of diabetic progression and dyslipidemia in a Nanjing adult population.Methods:From January 2017 to June 2018, 61, 098 local residents aged ≥18 years were selected from the Chronic Disease and Risk Factor Surveillance database in Nanjing using a five-stage stratified cluster random sampling method. Data were collected through interview surveys, physical measurements, and laboratory examinations. The relationship between different rates of diabetic progression and dyslipidemia was analyzed using complex weighting and multilevel models.Results:In all, 60, 283 participants were finally enrolled in the study. The weighted proportions of normal glucose regulation, pre-diabetes, and diabetes were 71.2%, 17.9%, and 10.9%, respectively. The overall weighted prevalence, awareness, treatment, and control of dyslipidemia were 29.8%, 41.6%, 28.9%, and 22.9%, respectively. The weighted proportion of patients with dyslipidemia combined with diabetes was 52.9%. The weighted prevalence of dyslipidemia in adults with normal glucose regulation, pre-diabetes, and diabetes was 24.0%, 38.8%, and 52.9%, respectively (all P<0.001). Compared to the normal glucose regulation group, subjects with pre-diabetes ( OR = 2.04, 95% CI: 1.95-2.13) or diabetes ( OR= 3.87, 95% CI: 3.66-4.10) had possibly gradually increased risks of dyslipidemia (all P<0.001). In addition, there was an increasing trend toward awareness, treatment, and control of dyslipidemia with increasing levels of glucose (all P<0.001). The weighted awareness of dyslipidemia in adults with normal glucose regulation, pre-diabetes, and diabetes was 36.3%, 42.8%, and 56.2%, respectively; the corresponding rates of treatment and control were 23.7%, 29.2%, and 43.7%, and 20.4%, 22.6%, and 30.1%, respectively. Conclusion:Diabetes and dyslipidemia have become the main chronic diseases in the Nanjing population.
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Bi-specific T-cell engagers (BiTEs) show great clinical outcomes for anti-cancer purposes. However, potential cytokine release syndrome (CRS) is notorious to all BiTEs. The mechanism underlying CRS is still not fully known, even though such toxicities are considered to be cytokine release related. Assessment of CRS is a key to non-clinical de-risk programs for BiTEs therapeutic development. In the present review, possible mechanisms are discussed, especially factors contributing to CRS develop?ment. T cell activation may be just an initiation of the CRS cascade, and other cell types can greatly contribute to CRS, such as a chain reaction triggered by downstream B-cells, monocytes, and endothe?lium cells. A non-clinical de-risk program can be designed based on these components in the CRS cascade. Combination of in vitro cytokine release assay, and in vivo mouse and non-human primates studies should be reliable enough to predict and mitigate CRS risk in the clinics. Further more, a good de-risk program should be able to provide ranking for candidates for further development and provide enough confidence to select a first-in-human dose.
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Anxiety disorders are one of the most common mental disorders in adults, the cause of which derives from a combination of genetics and environmental factors. A series of animal models have been established according to their pathogenesis to measure the level of anxiety or induce anxiety only, and these models have been widely applied in the non-clinical evaluation of anxiolytics. In this review, we present the current trends in the study of anxiety disorders and summarize typical non-clinical anxiety animal models, including models that both measure anxiety levels and induce anxiety, and models that induce anxiety only. This review summarizes the important issues in standardized non-clinical research of anxiety disorders and proposes criteria for the selection of an appropriate R&D model.
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Objective:To investigate the joint associations of smoking and insufficient physical activity with hypertension, diabetes and dyslipidemia in male adults.Methods:Based on the data from the 2017 Nanjing Chronic Diseases Risk Factors Surveillance Program, 61 098 Nanjing residents aged 18 and older was randomly recruited from 12 districts, using the multi-stage stratified cluster sampling method. Information about smoking behaviors, physical activity and chronic disease-related indicators within the first 12 months before the survey was obtained through questionnaires.Results:Among the 29 848 valid male samples, the proportions of non-smokers, current smokers and ex-smokers were 59.6%, 37.2% and 3.2%, and the proportions of those who had physically active<600 MET-min/w (insufficient physically active) and ≥600 MET-min/w (adequate physically active) were 18.8% and 82.2%, respectively. In non-smokers, current smokers and ex-smokers, the prevalence of hypertension was 24.7%, 34.0% and 43.8%, and the prevalence of diabetes was 8.8%, 12.3% and 16.5%, and the prevalence of dyslipidemia was 26.8%, 36.1% and 41.9%, respectively. Multivariate logistic regression analysis showed that current smokers had a higher risk of hypertension ( OR=1.164, 95% CI: 1.086-1.248), diabetes ( OR=1.324, 95% CI: 1.207-1.452), and dyslipidemia ( OR=1.291, 95% CI: 1.216-1.371) than non-smokers in male adults. Compared with people who had adequate physical activity, someone with insufficient physical activity had higher hypertension ( OR=1.452, 95% CI: 1.331-1.583), diabetes ( OR=1.170, 95% CI: 1.041-1.315) and dyslipidemia ( OR=1.245, 95% CI: 1.158-1.338). And current smokers with insufficient physical activity had the highest risk of hypertension ( OR=1.749, 95% CI: 1.550-1.974), diabetes ( OR=1.363, 95% CI: 1.165-1.595), and dyslipidemia ( OR=1.614, 95% CI: 1.461-1.782) in male adults. Conclusions:Smoking and insufficient physical activity are risk factors for hypertension, diabetes, and dyslipidemia. People who is characterized by smoking together with insufficient physical activity presents with increased risk on developing hypertension, diabetes, and dyslipidemia.
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Objective:To study the biological basis of Banxia Xiexintang against chronic gastritis by using quantitative proteomics. Method:The experimental rats were divided into normal group，chronic gastritis model group，and Banxia Xiexintang group. The chronic gastritis model was established four weeks later by gavage with 56% ethanol. After treatment，the stomach tissues were stained with hematoxylin and eosin （HE） to observe the histopathological damage and improvement of gastric tissue in each group. The protein in gastric tissue was extracted. The differential proteins among different groups were studied by quantitative proteomics using tandem mass spectrometry tag（TMT），and the key differentially expressed proteins（DEPs） were verified by Western blot. Result:A total of 4 452 proteins were identified from rat stomach tissues，of which 318 proteins were different between the model and the normal group. After the intervention of Banxia Xiexintang，compared with the model group，there were a total of 258 differential proteins， which were mainly enriched in cell killing，nucleoid and hijacked molecular function. Kyoto encyclopedia of genes and genomes（KEGG） pathway enrichment included tricarboxylic acid（TCA） cycle，steroid hormone biosyntheis，and Retrograde endocannabinoid signaling，as well as phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt），nuclear transcription factor-<italic>κ</italic>B（NF-<italic>κ</italic>B） signal pathways. Western blot verification found that 14-3-3 theta，Tenascin-C，ntercellular adhesion molecule-1（ICAM-1），stem cell factor（SCF），Caspase-3，GTPase of the Immunity-associated protein 4（GIMAP4） and mitochondrial pyruvate carrier 1（Mpc1） might be the crucial proteins for the treatment of chronic gastritis. Conclusion:The mechanism of Banxia Xiexintang in the treatment of chronic gastritis involves energy metabolism，hormone regulation，inflammation and immune processes. The target proteins found by differential proteomics and the signaling pathways may be the biological basis of Banxia Xiexintang in the treatment of chronic gastritis.
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OBJECTIVE@#To explore the clinical application value of using needle electrode in transurethral plasmakinetic resection of bladder tumor around ureteral orifice.@*METHODS@#Retrospective analysis was performed on the clinical data of 16 cases who had bladder tumors around ureteral orifice and underwent transurethral resection using plasmakinetic needle electrode in Department of Urology, Peking University International Hospital from June 2015 to December 2019. There were nine cases with the tumor of one to two centimeters from the ureteral orifice. The rest of the seven cases had tumor that was within one centimeter from the ureteral orifice, including two cases whose ureteral orifice was invaded by the tumor. All the patients studied were diagnosed before surgery and contraindications were excluded. The plasmakinetic needle electrode was used to treat the tumor with en bloc resection, and all the excised tissue was sent for pathological examination. Intravesical chemotherapy and postoperative follow-ups were performed. Statistical analysis was performed on the operation time, the incidence of obturator nerve reflex, the peri-operative bleeding, the parameters of indwelling ureteral catheter or double-J stent, the incidence of postoperative hydronephrosis, the clinical stage of tumor, and the recurrence rate.@*RESULTS@#The operation was successfully completed for all the sixteen cases. The operation time was 16 to 57 minutes, with an average of (32.6±11.8) minutes. No obvious obturator nerve reflex and perioperative bleeding occurred in all the patients. Ureteral catheters were indwelled prior to the operation of tumor resection in seven cases. Four of the seven cases had the ureteral catheters remained while the rest three were replaced by double-J stent after surgery. Postoperative pathological analysis showed that all the tumors were urothelial carcinoma, including 9 cases of low grade and 7 cases of high grade. Pathological staging: 10 cases were in Ta stage, 5 cases in T1 stage, and 1 case in T2a stage. All tumor bases and lateral margins were negative. All the patients received 3-56 months, with an average of (26.0±18.1) months of follow-up. There was no case of upper urinary tract hydronephrosis or tumor recurrence.@*CONCLUSION@#The transurethral plasmakinetic resection of bladder tumor using needle electrode can realize en bloc tumor resection without obturator nerve reflex and reduce the risk of ureteral orifice injury. It is a safe and effective surgical method for treating bladder tumors around the ureteral orifice.
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Humans , Carcinoma, Transitional Cell , Electrodes , Neoplasm Recurrence, Local , Retrospective Studies , Urinary Bladder Neoplasms/surgeryABSTRACT
OBJECTIVE@#To explore the clinical effect of bridging system in the treatment of severe comminuted femoral fracture.@*METHODS@#From March 2016 to October 2018, 50 patients with severe comminuted femoral fracture including 35 males and 15 females, aged 48 to 72(54.6±8.7) years, were admitted. All cases were comminuted fractures of the femoral shaft, 16 with proximal femur fractures and 7 with distal femur fractures. All cases were all unilateral fractures, 23 on the left and 27 on the right. The time from injury to operation was 5 to 60 (26.7±13.3) hours. The cause of injury was traffic accident, 12 cases with high fall, 35 cases fell and 3 cases fell accidentally. The patients were treated with bridge combined internal fixation system, and the operative effect and fracture healing were analyzed.@*RESULTS@#The operation was successful in all patients. There was no change to other fixed operation. The operation time was (75.8±12.3) min, the amount of bleeding was(356.4±64.8) ml, and there was no serious postoperative complications such as infection, internal fixation displacement, re fracture and nonunion. After 6 to 36 months follow-up, the fracture healing was evaluated by Warden's score. With the extension of observation time, Warden's score gradually increased, and the time of bone healing was(5.5±0.9) months. Harris score and HSS score were used to evaluate the function of hip and knee joint respectively. With the extension of time, Harris score and HSS score increased gradually. Six months after operation, Harris score was 83.5±11.2, HSS score was 79.7±10.5. During the follow-up period, there were no serious complications such as internal fixation displacement, re-fracture, nonunion of fracture and deep vein thrombosis of lower extremity.@*CONCLUSION@#The bridge combined internalfixation system has better safety and effectiveness in the treatment of severe comminuted femoral fracture. As long as the requirements of local anatomy and biomechanics are strictly mastered and the operation risks are fully evaluated in combination with imaging, the better fixation effect can be achieved. The operation has less trauma, fewer complications and simple operation, which is believed to have a wider application potential. Due to the limited sample size and follow-up time, no clinical control was set up, the results of the study still need to be further verified by prospective trials.
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Aged , Female , Humans , Male , Middle Aged , Femoral Fractures , General Surgery , Fracture Fixation, Internal , Fracture Healing , Fractures, Comminuted , General Surgery , Prospective Studies , Treatment OutcomeABSTRACT
The present study was designed to investigate the targets and synergistic mechanism of Shenfu Decoction (SFD) in the treatment of heart failure. A heart failure animal models was established to evaluate the pharmacological effects of SFD for anti-heart failure, then constructed ingredient-target interaction network by developing ingredient and target databases, the Discovery sdudio software was used for molecular docking. In addition, we validated the predicted protein targets of active ingredients in SFD by using surface plasmon resonance (SPR) technology. Our results demonstrated that SFD could enhance ejection fraction, alleviate myocardial histopathological characteristics, and reduce the level of angiotensin converting enzyme (ACE), aldosterone (ALD), atrial natriuretic polypeptide (ANP) and Renin (REN) in heart failure rat model. In addition, the ingredient database including 349 constituents and target database including 236 proteins were established, and 75 proteins were screened and identified by molecular docking strategy. 22 core target proteins were identified through network pharmacology, and the component-core target network was constructed. Finally, the affinity between the compounds and targets were verified by the SPR analysis method. The present study suggested that SFD may act on ACE 2, REN, ACE, ICAM-1, EGF, HTR2B, PARP1, NPPB and other proteins through AC, BAC, ACN, Re, Rg1, Rb1 to exert synergistic effects against heart failure.
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@#【Objective】 To find out the possible marker for early warning or therapeutic target of severe dengue disease ，we studied B cell responses during natural dengue virus（DENV）infection and their association with disease severity.【Methods】Sixty-two cases and their blood samples were collected from the patients hospitalized during September to December in 2014 and three groups were designated as mild dengue（DF，n=33），severe dengue（SD，n=29）and control group（Control ，n=6）. Multicolor flow cytometrywas used to analyze the dynamic changes of B cells and plasmablasts in the peripheral blood of patients during the acute phase and the critical phase. The plasmablasts in a succession of samplesfrom the same infected patients （including 3 mild and 3 severe cases） were further analyzed. We also observed the changes of B cells and their subsets ，including naive B cells ，memory B cells and plasmablasts，during primary and secondary infections. 【Results】 The expansion of B cells in the severe group was significantly higher than that in the mild group（P=0.013），especially on day 5 and day 6 after the symptom onset（P = 0.017 and 0.002，respectively）. Compared with those in the control group，the plasmablasts in the mild and severe groups showed significant proliferation（P=0.011 and 0.032，respectively），but no statistical difference was observed between these two groups. The analysis of the serial blood samples showed that the plasmablasts，in mild cases，peaked on day 7 and 8 and returned to baseline on day 10，whereas in the severe group，peaked on day 7 to 9，and still existed at a certain rate after day 10. In mild dengue group，more proliferative B cells，less naive B cells and memory B cells were found in secondary infection than in primary infection（P = 0.028，0.010 and 0.037，respectively），but plasmablasts revealed no difference. In severe dengue group， only naïve B cells significantly decreased in secondary infection （P = 0.018）. 【Conclusion】 B cell responses between mild and severe dengue after DENV- 1 infection present different trends. The significant proliferation of B cells in the early stage of the disease and the persistent existence of plasmablasts may be related to the severity of the dengue disease.
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Alzheimer's disease (AD) is the most common neurodegenerative disease that causes dementia among elderly people. The pathogenesis of AD is still unclear, and currently approved drugs only provide symptomatic benefits and do not prevent or delay progressive neurodegeneration. Meanwhile, potential drugs in development are facing great challenges in clinical translation. Therefore, finding effective treatment for the unmet clinical needs of AD is of great economic value and social significance. In this review, we will summarize the current models and pharmacodynamics evaluation methods of anti-AD drug based on the recent studies at home and abroad, and provide reference for drug development in AD at nonclinical stage.
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Objective:To explore the efficacy and safety of one-stage transurethral ureteroscopic lithotripsy for the management of ureteral calculi with secondary silent obstructive pyonephrosis.Methods:Retrospective analysis was performed on the clinical data of 32 cases who had ureteral calculi with secondary silent obstructive pyonephrosis and underwent one-stage transurethral ureteroscopic lithotripsy in Peking University International Hospital from January 2018 to May 2020. Of all the 32 patients, 27 were males and 5 were females, with median age of 39.5 years, ranged from 18 years to 76 years.The distribution of stone location included left side in 23 cases and right side in 9 cases.The median stone volume was 138.84 mm 3, ranged from 33.28 mm 3 to 866.32 mm 3.All patients had no fever before surgery, and no obvious infection was indicated by preoperative blood routine, urine routine and urine bacterial culture.All patients underwent one-stage transurethral ureteroscopic lithotripsy and the dignosis of pyonephrosis was made intraoperatively.Purulent urine was collected during the operation for urine routine and bacterial culture test.We first suck out the pus at low pressure through an aspirator, and then turned down the perfusion pressure and flow to the lowest value of the pump.Intermittent low pressure and low flow perfusion combined with negative pressure suction were maintained during the subsequent lithotriptic operation.The double J stent must be indwelt routinely at the end of the operation, and anti-infective drug therapy was started postoperatively.We evaluated the stone free rate by rechecking KUB on the second day after the operation, and urinary CT scan or color ultrasound examination 4-6 weeks after the double J stent was removed.Postoperative infection was evaluated according to the incidence of systemic inflammatory response syndrome(SIRS) and the score of sequential organ failure assessment (SOFA) scale.Complications were graded by a Clavein-Dindo system to evaluate the safety of surgery. Results:All 32 patients underwent one-stage ureteroscopic lithotripsy, and 28 of them completed successfully, with a single-stage stone free rate of 87.5%. The operation time was 11 to 66 minutes, with a median of 28 minutes.During the operation, there were two patients calculi returned to the kidney, one patient had a too narrow ureter, and one patient had a unclear intraoperative visual field to continue the operation.Double J stents were indwelt in all of them at the end of the first stage surgery, and secondary ureteroscopic lithotripsy or flexible ureteroscopic lithotripsy was performed several weeks later. Calculi were cleared in all of them, with a second-stage stone free rate of 100%.Urine routine tests of pyuria collected during the operations showed that the bacterial count was 46-2 488/μl with a median of 295/μl and white blood cell count 57-7 863/μl with a median of 160.5/μl.The bacterial culture results of the pus showed that 22 cases had no bacterial growth and 10 cases had bacterial growth. One patient had fever on the first day after surgery, but the blood culture was negative. The temperature returned to normal after antibiotic treatment and symptomatic treatment for 1 day.There were 6 cases developed to SIRS but no sepsis occurred.No Clavein-Dindo Ⅲ or Ⅳ grade of operative complications occured.Conclusions:Transurethral ureteroscopic lithotripsy is clinically feasible with high stone free rate and no serious postoperative complications for one-stage treatment of ureteral calculi with secondary silent obstructive pyonephrosis for selected cases.Operation time should be shortened and the perfusion pressure and flow should be turned down as low as possible.
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Objective:To analysis and compare the burden of ischemic heart disease (IHD) attributable to metabolic risks in population aged 25 years and older in 2011 and 2017 in Nanjing.Methods:The data were extracted from the Nanjing Chronic Disease and Risk Factor Surveillance (2011 and 2017), the Nanjing Mortality Surveillance (2011 and 2017) and the 2016 Global Burden of Disease Study (GBD). Using GBD′s Comparative Risk Assessment Theory, the attribution burden was estimated by comparing the observed health outcomes with the health outcomes that may be observed when exposed to counterfactual levels. Based on population attributable fractions, the deaths and life expectancy losses of ischemic heart disease due to high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high total cholesterol (TC), high body mass index (BMI) and combination of four risks were estimated in 2011 and 2017. The average population structure of the world′s population from 2000 to 2025 wasusedas the standard population for standardization.Results:The number of IHD deaths attributable to four metabolic risks combination was 3 204, andwhich resulted in a loss of life expectancy of 0.90 years in 2017. High SBP appeared as the major cause of IHD deaths and Years of Life Lost (YLL). In 2017, the world standardized mortality rate (25.60×10 －5, 19.94×10 －5 and 6.83×10 －5) and the standardized YLL rate (389.31×10 －5, 335.16×10 －5, 134.60×10 －5) of the population due to high systolic blood pressure, high total cholesterol and high body mass index were significantly lower than those in 2011 (31.75×10 －5, 26.74×10 －5, 7.45×10 －5 and 469.07×10 －5, 463.70×10 －5, 142.66×10 －5); the world standardized rate and the standardized YLL rate due to high blood sugar (11.90×10 －5 and 174.61×10 －5) were significantly higher than those in 2011 (9.67×10 －5 and 150.61×10 －5) (all P<0.05). Males appeared to have higher standardized rate of YLL of IHD deaths than females, due to having metabolism risks( P<0.05). Conclusion:Metabolic exposures especially high SBP are the important risk factors whichleadto IHD deaths in Nanjing.
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Objective:To explore the blood glucose control status, influencing factors, and self-management level of patients before participating in diabetes self-management groups in the Nanjing community, and to provide baseline data and the scientific basis for the community to promote self-management activities for diabetic patients.Methods:From April to June 2017, patients in diabetes self-management groups were recruited through the use of multi-stage cluster random sampling. Prior to the self-management group activities, patients were surveyed for general conditions, physical examinations and blood glucose and blood lipid tests were conducted, and the Chronic Disease Self-Management Research Measurement Form was used to investigate the patient's self-management level face to face.Results:A total of 345 diabetic patients were included, and 342 effective scales were returned with an effective rate of 99.1%. The age of the 342 patients with diabetes was (63.8±8.7) years, 129 (37.7%) were male and 213 (62.3%) were female. The average levels of FPG and HbA1c were (7.61±2.23) mmol / L and (7.15±1.57) %, respectively. The FPG and HbA1c control compliance rates were 44.7% (153 cases) and 52.3% (179 cases), respectively. The level of FPG [(7.85±2.32) mmol/L compared with (7.29±2.07) mmol/L] and HbA1c[(7.31±1.78) mmol/L compared with (6.93±1.23) mmol/L] was higher in patients with a diabetes course ≥5 years than that of patients with diabetes course <5 years, and the level of HbA1c [(7.30±1.64) mmol/L compared with (6.92±1.44) mmol/L] was higher in patients with primary school education and below than that in junior high school and above. Compared with the non-control group, the proportion of married patients (42.9%, 132 cases) in the FPG control group was lower, with lower levels of BMI [(23.38±3.27) kg/m 2vs. (26.27±3.40) kg/m 2], waist circumference [(84.47±10.97) cm vs. (88.74±10.48) cm], and hip circumference [(94.46±8.68) cm vs. (97.40±9.92) cm]. In the HbA1c control group, the proportion of males (44.2%, 57 cases), those with primary school education or below (47.3%, 97 cases), and those with a diabetes course ≥5 years (44.1%, 86 cases) were lower. BMI [(25.52±3.50) kg/m 2vs. (26.26±3.19) kg/m 2], waist circumference [(85.34±11.63) cm vs. (88.47±9.80) cm], systolic blood pressure [(132.65±14.73) mmHg vs. (136.15±15.14) mmHg], total cholesterol [(4.41±1.08) mmol/L vs. (4.76±1.11) mmol/L], and triacylglycerol [(1.67±0.72) mmol/L vs. (1.92±1.12) mmol/L] were all lower, and the levels of HDL [(2.73±0.97) mmol/L was higher than that of (2.48±1.02) mmol/L], with statistically significant differences (all P <0.05). In terms of the level of self-management, compared with the non-control group, the weekly stretching and/or strength training time of the FPG control group was (26.27±41.27) min higher than (17.06±33.46) min, and the difference was statistically significant ( P<0.05); HbA1c control group weekly stretch and/or strength exercise time (7.32±20.82) min vs. (16.47±14.33) min, weekly endurance exercise time (105.67±50.75) min vs. (91.66±51.07) min, symptom management self-efficacy (6.87±1.62) points (6.36±1.93) points were higher, fatigue (2.52±2.23) points(3.07±2.54) points, dyspnea (0.27±0.82) points (0.67±1.46) points, social. Both the activity and/or role restriction scores (0.58±0.64) and (0.74±0.79) scores were lower, and the differences were statistically significant (all P<0.05). Conclusions:Patients with diabetes in communities in Nanjing have better blood glucose control and higher levels of self-management. Patients with good control of BMI, blood pressure and blood lipids have higher blood glucose compliance rates. Communities with conditions can gradually promote self-management group activities to further control patients' blood glucose levels and reduce the incidence of complications.
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Objective:To evaluate the prognostic effects of gradient boosting machine (GBM) model on the short-term effects of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of lumbar disc herniation.Methods:Clinical data and outcomes of 475 patients who underwent PELD surgery for single-segment lumbar disc herniation from October 2016 to March 2018 were retrospectively collected. The lumbar JOA score was used as a reference for the evaluation of curative effects. The improvement rate ≥50% was considered as good curative effects, while <50% was considered as poor curative effects. GBM model and multivariate Logistic regression model were utilized to screen out the influencing factors of the short-term clinical effects of PELD. Prognostic models were established, receiver operating characteristic (ROC) curves were drawn and compared. Sensitivity, specificity and Youden index were compared to evaluate the predictive performance of GBM model.Results:A total of 395 patients were followed up effectively for 24 months. There were 347 patients (87.8%) with good curative effects. However, forty-eight patients (12.2%) had poor curative effects. There were statistically differences in the lumbar JOA score improvement rates between the groups in regards to age, location and type of herniated disc, degeneration level of intervertebral disc and facet joint in surgical segment, sagittal diameter of the protrusion and whether or not there was calcification, onset time to the surgery time period and degeneration level of intervertebral disc in adjacent segment ( P<0.05). The results of multivariate analysis showed that patients with age ≥60 [ OR=9.15, 95% CI(4.04, 20.73), P<0.001] and with larger sagittal diameter of the protrusion [ OR=1.37, 95% CI(1.18, 1.58), P<0.001] were more likely to have a poor prognosis. Patients with unilateral disc herniation had a better prognosis than the extreme lateral type [ OR=0.17, 95% CI(0.06, 0.55), P=0.003]. The prognoses of patients with grade Ⅲ intervertebral disc degeneration in surgical segment were worse than those with grade Ⅱ [ OR=0.17, 95% CI(0.04, 0.70), P=0.014]. The prognoses of patients with grade Ⅲ intervertebral disc degeneration in adjacent segment were worse than those with grade Ⅱ [ OR=0.29, 95% CI(0.10, 0.81), P=0.018]. The AUC predicted by GBM model was 0.92 [95% CI(0.77, 0.96)] with 93.46% sensitivity, 83.33% specificity and 0.77 Youden index. The above parameters were higher than those by the Logistic regression model. The predictive effects of the two models were both statistically significant ( P<0.001). The AUC values of the two models were also statistically significant ( Z=0.11, P<0.001). Conclusion:GBM model is better than multivariate logistic regression analysis model in predicting the short-term clinical effects of PELD in treating lumbar disc herniation.
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To mine and discover the active components of " Coptidis Rhizome-Magnoliae Officinalis Cortex( C&M) " based on the network pharmacology,integrate and analyze the potential targets and mechanisms. The TCMSP database was used to screen active ingredients. TTD and Drug Bank databases were used to predict the potential targets by referring to relevant literature,and the pathway annotation technology was used to enrich and analyze the active ingredients and potential targets of " C&M". A total of 29 potential target active ingredients were screened from " C&M",including 12 alkaloids components such as( R)-canadine,berberine,coptisine,and palmatine; 3 lignans consisting of magnolol,honokiol and obovatol; 6 volatile oils consisting of α-eudesmol,β-eudesmol,eucalyptol and so on,and flavonoids including quercetin and neohesperidin. Corresponding 199 predicted targets were screened out,mainly including PTGS2,PTGS1,NCOA2,Hsp90 AB1,and so on. 72 signaling pathways were involved,8 of which were related to cancer,such as prostate cancer,bladder cancer,and pancreatic cancer; 9 of which were related to endocrine,including oxytocin signaling pathway,insulin signaling pathway,thyroid hormone signaling pathway and so on,as well as inflammation-related pathway. This study has preliminarily mined and discovered the main active components and potential targets of " C&M",providing material source for the study on the preparation of structural components of traditional Chinese medicine.
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Humans , Male , Alkaloids , Drugs, Chinese Herbal , Magnolia , RhizomeABSTRACT