Influencing factors of telangiectasia secondary to diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the influencing factors of abnormal telangiectasia secondary to diabetic retinopathy(DR).METHODS: Prospective studies. A total of 153 cases(240 eyes)with DR treated in our hospital from January 2021 to January 2023 were selected to analyze the risk factors of abnormal telangiectasia secondary to DR and its predictive efficacy.RESULTS: The patients were divided into dilated group(77 eyes of 40 cases)and non-dilated group(163 eyes of 113 cases)according to whether they had secondary abnormal telangiectasia. There were significant differences in diabetic macular edema, hard exudates grade and fasting blood glucose level between the two groups(P<0.05). Logistic regression analysis showed that diabetic macular edema, high hard exudates grade and high blood glucose level were the risk factors for abnormal telangiectasia secondary to DR(P<0.05).CONCLUSION: The occurrence of telangiectasia secondary to DR may be related to diabetic macular edema, grade 3 hard exudates and high blood glucose level.

Association of serum biomarkers with frailty in elderly hospitalized patients / 中华老年医学杂志

Objective:To evaluate the association of different biomarkers with frailty in elderly hospitalized patients.Methods:In this cross-sectional study, a total of 319 elderly patients aged 65 years or older hospitalized in Beijing Hospital between September 2018 and February 2019 were enrolled.Patients had a mean age of(75.0±6.6)years and 151(47.3%)were women.Based on the Fried phenotype, patients were divided into a non-frail group(244 cases, 76.5%)and a frail group(75 cases, 23.5%). The clinical characteristics and biomarker levels of the two groups were compared.The association of different biomarkers with frailty was evaluated by using the receiver operating characteristic(ROC)curve.The Youden index was used for the optimal cutoff values and the area under the curve(AUC)were calculated.AUCs of different biomarkers were compared to assess their correlations with frailty.Results:Hemoglobin, lipid levels(triglycerides, total cholesterol and low-density lipoprotein cholesterol), and prealbumin were significantly lower in the frail group than in the non-frail group( P<0.05), while N-terminal pro-B type natriuretic peptide(NT-proBNP)and high-sensitivity C reactive protein(hsCRP)levels were significantly higher than in the non-frail group( P<0.05). Thyrotropin(TSH)and free triiodothyronine(FT3)levels were significantly lower( P<0.05)and trans-triiodothyronine(rT3)was significantly higher( P<0.05)in the frail group.The combination of six biomarkers[hemoglobin, prealbumin, hsCRP, 25-dihydroxy vitamin D3[25(OH)D3], rT3 and NT-pro BNP]had the most powerful correlation with frailty(AUC=0.705, 95% CI: 0.652-0.755), but the correlation was not significantly different from that of the combination of 3 markers(hemoglobin, rT3 and hsCRP)(ROC=0.010, 95% CI: -0.0106-0.0306, P>0.05). Either of the two combinations was significantly better than the combination of 2 markers(hemoglobin and rT3)(ROC=0.143, 95% CI: 0.0406-0.245; ROC=0.153, 95% CI: 0.0498-0.256; all P<0.01). Conclusions:Hemoglobin, lipids, prealbumin, TSH and FT3 levels decrease while NT-proBNP and hsCRP levels increase in elderly hospitalized frail patients.The 6-biomarker combination[hemoglobin, prealbumin, hsCRP, 25(OH)D3, rT3 and NT-pro BNP]and 3-biomarker combination(hemoglobin, rT3 and hsCRP)have better correlation with frailty than the 2-biomarker combination(hemoglobin and rT3).

Clinical significance of high-risk HPV-DNA detection combined with TCT in screening and follow-up of cervical lesions / 上海预防医学

ObjectiveTo explore the application value of high-risk HPV-DNA detection combined with TCT in cervical lesion screening and follow-up. MethodsThis study was conducted from February 2019 to February 2021. During this period， 241 subjects who were the patients referred from the primary community hospitals to the center for re-examination of cervical lesions. Of which 80 were patients with cervical intraepithelial neoplasia. Liquid-based cytology （TCT） technology was used to examine the cervical cytological morphology. The second-generation high-throughput sequencing technology and time-of-flight mass spectrometry technology， independently developed by BGI， were used to screen for HPV-DNA typing. At the same time， biopsy sampling was carried out， and the final pathological diagnosis was made. TCT detection and combined HPV-DNA detection were performed on 80 patients to compare the relationship between TCT alone and TCT/HPV-DNA combined test for the diagnosis and prognosis of CIN Ⅱ and CIN Ⅲ. Follow-up was conducted， and the HPV infection and TCT were re-tested. ResultsAmong the 80 cases of cervical intraepithelial neoplasia， 41 cases （51.25%） were between 35 and 44 years old， higher than the other age groups （P<0.001）. Compared with either TCT or HPV-DNA， TCT combined with HPV-DNA had obvious advantages in sensitivity， specificity， positive predictive value， and negative predictive value （P<0.05）. The recurrence rate in CIN Ⅱ and CIN Ⅲ groups was 9.52% and 16.67% respectively after 18 months of the follow-up. ConclusionTCT detection plays a positive role in cervical pre-cancer screening. By combining high-risk HPV-DNA typing and TCT detection， the detection values of sensitivity and specificity are significantly higher， which can improve the accuracy of cervical lesion screening and is of great significance for the follow-up work.

IL-33 gene recombination and expression does not affect the phenotypic characteristics of rabies virus in vitro / 细胞与分子免疫学杂志

Objective To create a recombinant rabies virus overexpressing IL-33 and to clarify the effect of IL-33 overexpression on the phenotypic characteristics of recombinant virus in vitro. Methods The IL-33 gene was obtained and amplified from the brain of a highly virulent strain of rabies infected mouse. It was then inserted between the G and L genes of the parental virus LBNSE genome by reversing genetic manipulation and rescuing a recombinant virus overexpressing IL-33. BSR cells or mouse NA cells were infected with recombinant rabies virus (rLBNSE-IL33) and the parental strain LBNSE. Sequencing and fluorescent antibody virus neutralization assay was employed to detect the stability of recombinant virus at multiplicity of infection=0.01. Viral titres focal forming units (FFU) were detected to plot multi-step growth curves (multiplicity of infection=0.01). Cytotoxicity assay kit was used to detect cellular activity. ELISA was adopted to identify the IL-33 in the supernatant of infected cells of different multiplicity of infection. Results Rescued rLBNSE-IL33 overexpressing IL-33 remained stable for at least 10 consecutive generations and had virus titers of approximately 108 FFU/mL. rLBNSE-IL33 was able to express IL-33 at high levels in a dose-dependent manner, but no high expression of IL-33 was detected in the supernatant of cells infected by LBNSE. Examination of the titers of rLBNSE-IL33 and the parental strain LBNSE in BSR and NA cells over 5 days showed no significant differences and similar kinetic properties in growth. Overexpression of IL-33 had no significant effect on the proliferation and activity of infected cells. Conclusion Overexpression of IL-33 does not significantly affect the phenotypic characteristics of recombinant rabies virus in vitro.

Establishment of infrared fingerprints and multivariate statistical analysis of Achyranthes bidentata / 中国药房

OBJECTIVE To establish the infrared fingerprints of Achyranthes bidentata from different producing areas ，and to conduct multivariate statistical analysis. METHODS The infrared fingerprints of 61 batches of A. bidentata samples were established by Spectrum for Window 3.02 and OMNIC 9.2 software. Taking the relative peak height of common peaks of infrared fingerprint as the variable ，the normal distribution analysis was carried out by Excel 2016 software；SPSS 22.0 software was used for cluster analysis and principal component analysis ，and the comprehensive score was calculated ；the orthogonal partial least squares-discriminant analysis was carried out by SIMCA 14.1 software，and the marker wave numbers affecting the quality of A. bidentata were screened by taking the variable importance in projection （VIP）＞1 as the standard. RESULTS The correlation coefficients of infrared spectra of 61 batches of A. bidentata samples were 0.967 2-0.997 7；there were 13 common peaks. The results of normal distribution analysis showed that the normal distribution curve of relative peak height of common peaks for A. bidentata from Henan and Hebei did not cross ，and the normal distribution curve of A. bidentata from Henan and Inner Mongolia crossed. The results of cluster analysis showed that when the distance between groups was 15，61 batches of A. bidentata samples could be clustered into 3 categories，including N 1-N12 were clustered into one category ，N13-N45 were clustered into one category，and N 46-N61 were clustered into one category. The results of principal component analysis showed that the cumulative variance contribution rate of the first three principal components was 91.121％；comprehensive score of qq.com A. bidentata （number N 40） in Jiabu village ，Jiaozuo City ， Henan Province was the highest （2.39）， and that of A.bidentata（number N 4）in Xin ’an village ，Anguo City ，Hebei Province was the lowest （－2.89）. The results of orthogonal 163.com partial least squares-discriminant analysis showed that 61 batches of A. bidentata samples were divided into three categories ，including N 1-N12 were clustered into one category ，N13-N28 were clustered into one category and N 29-N61 were clustered into one category. Seven marker wave numbers affecting the quality were selected. The corresponding wave numbers of VIP from large to small were 1 059，927，2 933，813，1 732，1 128 and 3 367 cm－1，1 732 cm－1 was the characteristic obsorption peak of saponins ，1 059，1 128，927 cm－1 were the characteristic obsorption peaks of glycosides. CONCLUSIONS Infrared fingerprint combined with normal distribution analysis ，cluster analysis ，principal component analysis and orthogonal partial least squares-discriminant analysis can be used to identify A. bidentata from different producing areas.

Effects of different habitat processing methods on the quality of Cyperus rotundus / 中国药房

OBJECTIVE To investigate the eff ects of different habitat processing methods on the quality of Cyperus rotundus ， such as sun-drying after steaming ，sun-drying after boiling and direct sun-drying ，and to investigate the optimal habitat processing method of C. rotundus from the perspective of chemical component. METHODS The fingerprint of C. rotundus was established by high performance liquid chromatography （HPLC）combined with the Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 edition）. The similarity evaluation was conducted to determine the common peak. Cluster analysis （CA）combined with principal component analysis （PCA）and partial least squares-discriminant analysis （PLS-DA）was used to differentiate and compare C. rotundus treated by different habitat processing methods. And the contents of cyperrenone ，α-cyperone，luteolin and ferulic acid in C. rotundus were determined by HPLC. RESULTS There were 22 common peaks in the HPLC fingerprints of C. rotundus reated by different habitat processing methods ；their similarities were higher than 0.9；common peak 16 and common peak 20 were cyperrenone and α-cyperone. CA results showed that C. rotundus boiled for 4，8 and 12 min were clustered into one category，the rest of the samples clustered into one category. PCA results showed that comprehensive score of C. rotundus steamed for 10 and 15 min and boiled for 2 min were the highest. The steaming treatment had small effect on comprehensive score of samples，while the boiling treatment had a great effect on the quality of the samples ；the overall score of samples decreased sharply after boiling for 2 min. Results of PLS-DA showed that variable importance projection （VIP）of peak 20（α-cyperone），peak 16 （cyperrenone），peak 22，peak 17 and peak 22 in HPLC fingerprints were all higher than 1. The results of content determination showed that there was significant difference in the contents of α-cyperone，cyperrenone and luteolin in samples treated by different habitat processing methods.With the increase of steaming and boiling time ，the contents of α-cyperone，cyperrenone and luteolin showed a significant downward trend ，and boiling had a great impact on them. CONCLUSIONS Too long boiling treatment greatly；2019 destroys the chemical composition of C. rotundus ， andsteaming for 10，15 min or boiling for 2 min is the optimal processing method.

Research Progress of Radiotherapy Combined with Immune Checkpoint Inhibitors in Treatment of Glioblastoma / 肿瘤防治研究

Glioma is the most common primary intracranial tumor, and most patients present as glioblastoma, with high morbidity and mortality. The prognosis of patients with glioblastoma remains poor after surgical resection combined with standardized treatment of radiotherapy and chemotherapy. In recent years, although the breakthrough of immunotherapy have been achieved in the treatment of a variety of solid tumors, the existing data show that immunotherapy is not effective in improving the survival of patients with glioblastoma. However, studies have shown that immunotherapy can have a synergistic effect with radiotherapy which can increase antigen presentation and promote the formation of pro-inflammatory tumor microenvironment, providing more relevant targets for immunotherapy. The purpose of this paper is to discuss the effect of radiotherapy on tumor immune microenvironment and the role of radiotherapy combined with immune checkpoint inhibitors in the treatment of glioblastoma.

Dynamics of parenting styles of adolescent students from the perspective of intergenerational conflict / 中国学校卫生

Objective@#To explore dynamics of parenting styles of adolescents from 1999 to 2019 from the perspective of intergenerational conflict, to provide support for family education and adolescent healthy development.@*Methods@#Using a multistage stratified cluster random sampling method, the unified questionnaire was administered to 2 590 students in the same sampling junior and senior high schools in 1999, 2009, and 2019 using the Egna Minnen av Barndoms Uppfostran own memories of parental rearing practices in childhood(EMBU).@*Results@#Overall there were differences in the nine factors of parenting styles across generations ( F = 12.07-72.52, P <0.01), with decreasing ratings of warmth and understanding of father and mother (F1, M1), over interference of father (F3) over generations(F1:46.72±9.41, 45.87±11.33, 43.61±11.27; M1:51.56±9.38, 51.03±11.59, 46.23± 12.27 ; F3:19.03±4.00, 18.29±4.32, 17.95±4.51), and all other parenting styles rated higher in 2019 than in 2009 and 1999(except for the over protection and over interference of mother, and punishment, firm control of mother). Parenting styles across generations (except for the rejection and denial of father among girls) showed gender difference.The overall gender trend coincided with the total population trend. Parenting styles across generations varied significantly among middle and high school students( F =3.92-47.27, P <0.05 ), changes in F1 and F3 factors coincided with the overall decreasing trend. Factor analysis showed that parenting styles could be classified into two dimensions, with varied factor loading across generation.@*Conclusion@#Intergenerational decreases in parental emotional warmth and paternal interfering are observed in a sex and grade specific manner. Based on the diversity of needs and population differentiation, optimal intervention for comprehensive health development of adolescents are in great need to keep pace with the times and promoting the high quality development of adolescents.

Analysis of interactions of immune checkpoint inhibitors with antibiotics in cancer therapy / 医学前沿

The discovery of immune checkpoint inhibitors, such as PD-1/PD-L1 and CTLA-4, has played an important role in the development of cancer immunotherapy. However, immune-related adverse events often occur because of the enhanced immune response enabled by these agents. Antibiotics are widely applied in clinical treatment, and they are inevitably used in combination with immune checkpoint inhibitors. Clinical practice has revealed that antibiotics can weaken the therapeutic response to immune checkpoint inhibitors. Studies have shown that the gut microbiota is essential for the interaction between immune checkpoint inhibitors and antibiotics, although the exact mechanisms remain unclear. This review focuses on the interactions between immune checkpoint inhibitors and antibiotics, with an in-depth discussion about the mechanisms and therapeutic potential of modulating gut microbiota, as well as other new combination strategies.

Hematological malignancies immunotherapy-related coagulopathy and laboratory tests / 中华检验医学杂志

Immunotherapy has been one of the most promising approaches in tumor-treating fields, including immune checkpoint inhibitors, bispecific antibodies, and CAR-T therapy, etc. It has achieved major breakthroughs in the treatment of hematological and other malignancies. However, related safety management issues are becoming increasingly prominent, especially the diagnosis and treatment of coagulopathy deserves the attention of clinical and laboratory physicians. Therefore, this review summarizes immunotherapy-related coagulopathy from the perspectives of epidemiology, pathogenesis and laboratory indicators and provides guidance for early clinical identification, diagnosis and intervention.

OX40L enhances antibody response induced by H7N9 whole-virion inactivated vaccine through promoting T follicular helper cell proliferation / 中华微生物学和免疫学杂志

Objective:To analyze and evaluate the effect of OX40L as a potential adjuvant for H7N9 whole-virion inactivated vaccine (WIV).Methods:Fifty BALB/c mice were randomly divided into five groups and immunized intramuscularly with PBS (control group) and 1.5 μg WIV alone or in combination with 0.6, 1.8 or 3.0 μg Fc-fused OX40L (OX40L/Fc) adjuvant. Three weeks after immunization, IgG, IgG1 and IgG2 titers were measured by ELISA and hemagglutination inhibition (HI) assay. Moreover, the mice were challenged with 50×median lethal dose (LD 50) of homologous virus and the changes in mouse body weight and survival rate were recorded to evaluate the effects of OX40L. Flow cytometry was used to analyze the mechanism of OX40L as an adjuvant 7 d after immunization. Results:Compared with immunization with WIV alone, co-immunization of WIV with OX40L/Fc induced higher antigen-specific IgG in mice. The geometric mean titers (lgGMT) of antibodies induced by 0.6, 1.8 and 3.0 μg OX40L/Fc reached 3.79, 4.40 and 4.20, respectively. WIV combined with OX40L/Fc induced high levels of IgG1 and IgG2a without influencing Th1/Th2 balance. HI antibodies were also higher in WIV+ 1.8 μg OX40L/Fc and WIV+ 3.0 μg OX40L/Fc groups than in WIV group (6.25±0.50 and 5.70±0.97 vs 3.00±0.97, both P<0.05). WIV combined with 1.8 or 3.0 μg OX40L/Fc could protect 80% or 75% of mice against lethal challenge with H7N9 and result in less weight loss as compared with WIV alone. The most effective dose of OX40L/Fc was 1.8 μg. Flow cytometry showed that WIV (0.6, 1.8, 3.0 μg) in combination with OX40L/Fc enhanced the proliferation of T follicular helper cells (Tfh) through promoting the expression of CXCR5 and PD-1 as compared with WIV alone (all P<0.05). Conclusions:This study suggested that OX40L was beneficial to potent antibody responses induced by H7N9 WIV through promoting Tfh cell proliferation.

Differential diagnosis of cerebellum cystic-solid hemangioblastoma and pilocytic astrocytoma according to MRI enhancement degree / 中国介入影像与治疗学

Objective: To investigate the value of MRI enhancement degree in differential diagnosis of cerebellum cystic-solid hemangioblastoma and pilocytic astrocytoma. Methods: MRI data of 30 patients with cerebellum cystic-solid hemangioblastoma and 30 patients with cerebellum cystic-solid pilocytic astrocytoma confirmed by operation and pathology were retrospectively analyzed. The enhancement value of the solid component of the lesion was calculated, then ROC curve was drawn, and the diagnostic effect of the solid component enhancement level was evaluated. Results: Among 30 cases of cerebellum cystic-solid hemangioblastoma, cystic nodules were in 15 cases, while solid masses with cystic changes were observed in other 15 cases, and the parenchyma part was uniformly strengthened. Among 30 cases of cerebellum cystic-solid pilocytic astrocytoma, cystic nodules were detected in 11 cases, where as solid masses with cystic changes were noticed in 19 cases, 21 cases had uniform enhancement of parenchyma and 9 cases showeduneven enhancement. The parenchyma enhancement degree of cerebellum cystic-solid hemangioblastoma was 4.20 (3.28,4.84), of cerebellum cystic-solid pilocytic astrocytoma was 1.95 (1.49,2.43) (F=72.69,P<0.01). The specificity and sensitivity of diagnosis of cerebellum cystic-solid hemangioblastoma was 88.9% and 92.9%, respectively. Taken the enhancement amplitude 2.58 as the threshold, the AUC was 0.95. Conclusion: The degree of MRI enhancement of solid tumor components is helpful to distinguishing cerebellum cystic-solid hemangioblastoma and pilocytic astrocytoma.

Curcumin inhibits the proliferation and induces the apoptosis of nephroblastoma through activating miR-192-5p/PI3K/Akt signaling pathway / 中华微生物学和免疫学杂志

Objective:To study whether curcumin inhibits the proliferation and promotes the apoptosis of nephroblastoma through activating the miR-192-5p/PI3K/Akt signaling pathway.Methods:CCK-8 assay was used to investigate the effects of curcumin on the proliferation of nephroblastoma SK-NEP-1 cells and the appropriate concentration. The apoptosis rate of SK-NEP-1 cells was detected by V-FITC/PI. Luciferase reporter assay was used to verify the binding activity between miR-192-5p and PI3K. RT-PCR was performed to detect the expression of miR-192-5p at mRNA level. Western blot was used to detect the expression of PI3K and Akt at protein level.Results:Curcumin could significantly inhibit the proliferation of SK-NEP-1 cells and induce cell apoptosis in a dose-dependent manner. RT-PCR results showed that curcumin could significantly increase the expression of miR-192-5p. In addition, miR-192-5p significantly inhibited cell proliferation, induced cell apoptosis, and enhanced the effects of curcumin on the proliferation and apoptosis of SK-NEP-1 cells. Luciferase reporter assay suggested that miR-192-5p could bind to PI3K. Western blot results showed that curcumin down-regulated the expression of PI3K and Akt at protein level by mediating the expression of miR-192-5p.Conclusions:Curcumin could inhibit the proliferation and induce the apoptosis of nephroblastoma cells through mediating the expression of miR-192-5p and further inhibiting the downstream PI3K/Akt signaling pathway.

Comparative study on the diagnostic value of multiparametric transrectal ultrasound and multiparametric MRI in prostate cancer / 中华泌尿外科杂志

Objective The aim of the study is to compare the diagnostic value of multiparametric transrectal ultrasound(TRUS) and multiparametric magnetic resonance imaging (MRI) in prostate cancer.Methods The clinical data of 102 patients who received multiparametric TRUS (including conventional transrectal ultrasound,shear wave sonoelastography and contrast enhanced ultrasound),multiparametric MRI (including T2 weighted diffusion weighted,and dynamic contrast enhanced MRI) and laboratory tests from April 2016 to May 2018 were retrospectively analyzed.The average age was 66.1 years old,ranging 38.0-85.0 years old.The average PSA was 30.1 ng/ml,ranging 0.4-227.0 ng/ml.The average PSAD was 0.67 ng/ml2,ranging 0.02-4.27 ng/ml2.The pathology results from TRUS guided biopsy or surgical operation were chosen as gold standard.Diagnostic performance including sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV),accuracy and area under the receiver operating characteristic curve (AUROC) of multiparametric TRUS and multiparametric MRI in prostate cancer were analyzed.Results There were 62 prostate cancer and 40 BPH patients in our study.Parallel multiparametric TRUS diagnosed 63 prostate cancer and 39 BPH,and multiparametric MRI diagnosed 75 prostate cancer and 27 BPH.The sensitivity,specificity and accuracy of parallel multiparametric TRUS were 98.4％,70.0％ and 87.3％,respectively.And those of multiparametric MRI were 95.2％,60.0％ and 81.4％,respectively.The AUROC of parallel multiparametric TRUS and multiparametric MRI were 0.842 and 0.776,with no significant differences (P =0.208).Conclusion The diagnostic value of multiparametrie TRUS was not inferior to multiparametrie MRI in prostate cancer.

The correlation between frailty and N-terminal pro-B-type natriuretic peptide in elderly hospitalized patients / 中华老年医学杂志

Objective:To investigate the relationship between N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels and frailty in elderly hospitalized patients.Methods:A total of 604 patients aged 65 years or older(with a mean age of 74.9±6.5)admitted to Beijing Hospital from September 2018 to February 2019 were consecutively enrolled in this cross-sectional study.Patients with clinical diagnosis of heart failure or left ventricular ejection fraction(LVEF)>50% were excluded.Participants were divided into the non-frail(n=130, 21.5%), pre-frail(n=327, 54.1%)and frail(n=147, 24.3%)groups based on the Fried phenotype.Clinical data, laboratory test results and echocardiographic data were collected.Blood levels NT-proBNP were measured.The ability of daily living activities was evaluated.The relationship of NT-proBNP levels with frailty and the diagnostic value of NT-proBNP levels for frailty screening were analyzed.Results:As the severity of frailty increased, elevated NT-proBNP levels were observed( P<0.01). NT-proBNP levels were higher in the frail group than in the pre-frail group [235.7(104.1, 650.3)ng/L vs. 123.2(67.7, 281.7)ng/L, P<0.01] and higher in the pre-frail group than in the non-frail group [123.2(67.7, 281.7)ng/L vs.88.2(49.9, 203.1)ng/L, P<0.01]. With increased severity of frailty, the anterior and posterior diameter of the left atrium increased( P<0.05), while LVEF decreased( P<0.05). Logistic regression analysis showed that NT-proBNP levels were independently associated with frailty( P<0.01). The level of NT-proBNP had a certain diagnostic value for frailty, and the area under the receiver-operating characteristics(ROC)curve was 0.688( P<0.01). Conclusions:The level of NT-proBNP is elevated in elderly frail inpatients, it is an independent factor for frailty.Measuring NT-proBNP levels in frail groups can help clinicians pay attention to patients' cardiac function and give appropriate interventions as early as possible.

Antibiotic resistance spectrum and genetic characteristics of MDRSA nasal isolate among primary school students / 中国学校卫生

Objective@#To investigate the antibiotic resistance spectrum and genetic characteristics of multidrug-resistant Staphylococcus aureus(MDRSA) nasal isolate among primary school students, and to provide a scientific basis for the prevention and control of masal MDRSA resistance and the selection of clincal drugs in children.@*Methods@#Antibiotic susceptibility experiments were performed on all SA isolates of 1 705 primary school students from 8 primary schools in Guangzhou selected by using multistage cluster stratified sampling method. MDRSA antibiotic susceptibility spectrum was analyzed, and the resistant, virulence and immune evasion cluster(IEC) genes detected by polymerase chain reaction(PCR).@*Results@#The prevalence of MDRSA nasal carriage was 20.76%(354/1 705), and the proportion of multidrug resistance among SA isolates was 96.20%(354/368). The predominant resistant antibiotics of MDRSA isolates were penicillin(99.72%), erythromycin(96.33%), clindamycin(90.96%) and teicoplanin(90.11%). Notably, 240(67.80%, 240/354) MDRSA isolates were resistant to more than six antimicrobial categories. And the predominant detection rates of resistant genes were BlaZ(92.66%), Tet(M)(49.72%), virulence genes Tst(25.42%) and IEC genes Sak(92.09%), Hlb(61.58%).@*Conclusion@#We found high prevalence of nasal colonization MDRSA from healthy children. Moreover, MDRSA isolates has a high resistant rate to multiple antibiotics, and the proportion of resistant to ≥6 antimicrobial categories is high.

Analysis of the characteristics of capillary blood flow density and macular avascular area of retina in patients with acute central serous chorioretinopathy / 中国基层医药

Objective:To investigate the change characteristics of SCP/DCP blood flow density and FAZ in retina of patients with acute central serous chorioretinopathy (CSC).Methods:The clinical data of 45 patients(45 eyes) with acute CSC in our hospital from January 2017 to October 2019 were retrospectively analyzed.All patients included 45 lesion eyes and 45 healthy eyes were set as lesion eye group and healthy eye group respectively, and 30 healthy people with 30 eyes were set as control group.The FAZ, blood flow density, CMT and SFCT of different groups were compared, and the enhanced morphology of capillary blood flow was analyzed.Results:There was no statistically significant difference in FAZ level in SCP among the three groups( P>0.05). The FAZ in DCP of the lesion eye group[(0.81±0.19)mm 2] was significantly higher than that in the healthy eye group [(0.43±0.12)mm 2] and the control group [(0.38±0.08)mm 2]( t=3.17, 3.22, all P<0.05). The blood flow density in the SCP/DCP of the lesion eye group and healthy eye group were significantly lower than those in the control group( t=2.69, 3.01, all P<0.05). The levels of CMT and SFCT in the lesion eye group [(427.43±35.66)μm and (359.43±32.95)μm] were significantly higher than those in the healthy eye group [(276.35±17.02)μm and (260.38±25.66)μm] and the control group [(285.69±11.47)μm and (235.76±20.50)μm] ( t=8.17, 9.89; 10.26, 15.92; all P<0.05). There was no statistically significant difference in CMT level between the healthy eye group and the control group( P>0.05). The level of SFCT of the healthy eye group was significantly higher than that in the healthy eye group and control group( t=4.39, P<0.05). The results of optical coherence tomography showed that the local enhancement of capillary blood flow was seen in 23 eyes, and the diffuse enhancement of blood flow was seen in 22 eyes in the affected eye group, and there was subretinal effusion at the same time.In the healthy eye group, the signal changes of capillary strength and intensity were seen.In the control group, there was no significant change. Conclusion:The results of OCTA showed that in lesion eye group, local enhancement of capillary blood flow was seen in 23 eyes and diffuse enhancement of blood flow was seen in 22 eyes, and subretinal effusion was all found.In healthy eye group, even strong and weak signal changes of capillary were seen, while there were no above changes in control group.

Comparative study on the diagnostic value of multiparametric transrectal ultrasound and multiparametric MRI in prostate cancer / 中华泌尿外科杂志

Objective@#The aim of the study is to compare the diagnostic value of multiparametric transrectal ultrasound(TRUS) and multiparametric magnetic resonance imaging (MRI) in prostate cancer.@*Methods@#The clinical data of 102 patients who received multiparametric TRUS (including conventional transrectal ultrasound, shear wave sonoelastography and contrast enhanced ultrasound), multiparametric MRI(including T2 weighted diffusion weighted, and dynamic contrast enhanced MRI) and laboratory tests from April 2016 to May 2018 were retrospectively analyzed. The average age was 66.1 years old, ranging 38.0-85.0 years old. The average PSA was 30.1 ng/ml, ranging 0.4-227.0 ng/ml. The average PSAD was 0.67 ng/ml2, ranging 0.02-4.27 ng/ml2. The pathology results from TRUS guided biopsy or surgical operation were chosen as gold standard. Diagnostic performance including sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), accuracy and area under the receiver operating characteristic curve(AUROC)of multiparametric TRUS and multiparametric MRI in prostate cancer were analyzed.@*Results@#There were 62 prostate cancer and 40 BPH patients in our study. Parallel multiparametric TRUS diagnosed 63 prostate cancer and 39 BPH, and multiparametric MRI diagnosed 75 prostate cancer and 27 BPH. The sensitivity, specificity and accuracy of parallel multiparametric TRUS were 98.4%, 70.0% and 87.3%, respectively. And those of multiparametric MRI were 95.2%, 60.0% and 81.4%, respectively. The AUROC of parallel multiparametric TRUS and multiparametric MRI were 0.842 and 0.776, with no significant differences(P=0.208).@*Conclusion@#The diagnostic value of multiparametric TRUS was not inferior to multiparametric MRI in prostate cancer.

Clinical and pathological characteristics of heart failure with preserved ejection fraction in advanced elderly patients / 中华老年医学杂志

Objective@#To analyze the clinical and pathological characteristics of heart failure with preserved ejection fraction(HFpEF)in advanced elderly patients.@*Methods@#Systematic anatomical data from pathology database of Beijing Hospital from April 1969 to October 2013 were retrospectively analyzed.The 154 HFpEF patients aged(85.7±7.4)years with left ventricular ejection fractions(LVEF)≥50%, and 49 patients aged(82.8±7.8)years who had heart failure with reduced LVEF ≤40%(HFrEF)were included.Clinical feature and pathological changes of heart and other organs were compared between patients with HFpEF and HFrEF, and between groups aged less 80 years versus over 80 years in HFpEF patients.@*Results@#The parameters were higher in HFpEF group versus in HFrEF group as follows: the average age of patients(85.7±7.4 vs.82.8±7.8 years, P=0.017), hypertension(80.5% or 124 cases vs.26.5% or 13 cases, P<0.001), diabetes mellitus(58.4% or 90 vs.20.4% or 10 cases, P<0.001), atrial fibrillation(65.6% or 101 cases vs.12.2% or 6 cases, P<0.001)and chronic obstructive pulmonary disease(COPD)(26.6% or 41 cases vs.4.1% or 2 cases, P=0.001). As compared with HFpEF patients aged 61-85 years group, the same HFpEF patients aged 86-99 years group had significantly increased proportion of atrial fibrillation(P=0.046), of COPD(P=0.002), of senile degenerative heart valvular disease(P=0.009), of chronic myocardial ischemia(P=0.027), of mini-focal old myocardial infarction(P=0.041)and of emphysema(P=0.005).@*Conclusions@#The proportion of patients with HFpEF increases along with ageing.Atrial fibrillation and COPD are common geriatric co-morbidities in the elderly especially advanced elderly HFpEF patients.The patients are prone to complicated with atrial fibrillation and COPD, and often have chronic myocardial ischemia.Therefore, we should pay attention to the influences of the above diseases on elderly patients with HFpEF.

Clinical and pathological characteristics of heart failure with preserved ejection fraction in advanced elderly patients / 中华老年医学杂志

Objective To analyze the clinical and pathological characteristics of heart failure with preserved ejection fraction (HFpEF)in advanced elderly patients.Methods Systematic anatomical data from pathology database of Beijing Hospital from April 1969 to October 2013 were retrospectively analyzed.The 154 HFpEF patients aged(85.7± 7.4)years with left ventricular ejection fractions(LVEF) ≥50％,and 49 patients aged(82.8± 7.8)years who had heart failure with reduced LVEF ≤ 40％ (HFrEF)were included.Clinical feature and pathological changes of heart and other organs were compared between patients with HFpEF and HFrEF,and between groups aged less 80 years versus over 80 years in HFpEF patients.Results The parameters were higher in HFpEF group versus in HFrEF group as follows:the average age of patients(85.7±7.4 vs.82.8±7.8 years,P=0.017),hypertension(80.5％ or 124 cases vs.26.5％ or 13 cases,P ＜0.001),diabetes mellitus (58.4％ or 90 vs.20.4％ or 10 cases,P＜0.001),atrial fibrillation(65.6％ or 101 cases vs.12.2％ or 6 cases,P＜0.001)and chronic obstructive pulmonary disease(COPD)(26.6％ or 41 cases vs.4.1％ or 2 cases,P=0.001).As compared with HFpEF patients aged 61-85 years group,the same HFpEF patients aged 86-99 years group had significantly increased proportion of atrial fibrillation(P =0.046),of COPD(P =0.002),of senile degenerative heart valvular disease(P =0.009),of chronic myocardial ischemia(P =0.027),of mini-focal old myocardial infarction (P =0.041) and of emphysema (P =0.005).Conclusions The proportion of patients with HFpEF increases along with ageing.Atrial fibrillation and COPD are common geriatric co-morbidities in the elderly especially advanced elderly HFpEF patients.The patients are prone to complicated with atrial fibrillation and COPD,and often have chronic myocardial ischemia.Therefore,we should pay attention to the influences of the above diseases on elderly patients with HFpEF.