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Objective To investigate the effects of different salt ion concentration, polyethylene glycol (PEG) and force on structure of double DNAs braids. Methods Taking the 10 kb DNA as the research object, the effects of different concentrations of salt ions(Na+, K+, Mg2+), PEG and different forces on variation of relative extension of twisted double DNAs with rotation turns were investigated by flow chamber experiment of magnetic tweezers. Results The structure of double DNAs braids was sensitive to salt ion concentration but insensitive to PEG. With the increase of ion concentration, the extension of braids changed more gently with the rotation turns, and the electrostatic shielding saturation concentration of Mg 2+ was much lower than that of the monovalent cation. The effect of crowded environment on DNA was mainly the compression of contour length. The twisted structure of DNA was more stable under high force (above 4 pN), and fluctuated greatly under low force (lower than 2 pN). Conclusions The braiding structure and mechanical properties of DNA are affected by ion concentration in the solution and forces. The results may help to elucidate the mechanism of chromatin torsional torque affected by solution environment, and provide references for the function of topoisomerase under different solution conditions.
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Objective:To investigate the correlation between global burden of small vessel disease(CSVD) on MRI and impaired spatial navigation in patients with CSVD.Methods:Patients with CSVD admitted to the Department of Neurology, Nanjing Jiangning Hospital from November 2020 to June 2022 were selected as the research subjects. The global burden of CSVD was scored according to the head MRI findings, and was divided into mild group (0-1 points), moderate group (2 points), and severe group (3-4 points). All patients were tested for spatial navigation function. Multivariate linear regression model was used to analyze the correlation between the global burden of CSVD and the spatial navigation function.Results:A total of 101 patients with CSVD were enrolled, including 37 patients in the mild group (36.6%), 28 in the moderate group (27.7%), and 36 in the severe group (35.6%). Age, glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol and creatinine, as well as the proportions of hypertension, diabetes, previous stroke or transient ischemic attack in the moderate group and the severe group were significantly higher than those in the mild group, while the high-density lipoprotein cholesterol was significantly lower than that in the mild group (all P<0.05). The spatial navigation function test showed that the environment + self-navigation, self-navigation and environment navigation functions of the moderate group and the severe group decreased significantly compared with the mild group (all P<0.05). Multivariate linear regression analysis showed that after adjusting for age, sex, hypertension, previous stroke or transient ischemic attack history and years of education, the global burden of CSVD and environment + self-navigation ( β=0.518, P<0.001), self-navigation ( β=0.481, P<0.001) and environmental navigation ( β=0.699, P<0.001) function had significant correlation. Conclusion:The global burden of CSVD is correlated with spatial navigation functions.
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Background Exposure to environmental lead can cause kidney damage and telomere wear. However, the relationship among lead, peripheral blood telomere length, and glomerular filtration rate (eGFR) are unclear. Objective This study is conducted to investigate the relationships of urinary lead level with peripheral blood telomere length and renal function index eGFR, and further explore whether peripheral blood telomere length plays an intermediary role in the relationship between urinary lead level and eGFR. Methods A case-control study was conducted to select 497 residents from two communities in a city, including 230 in the control group (eGFR≥80 mL·min−1) and 267 in the abnormal eGFR group (eGFR<80 mL·min−1). Basic information and health information of the subjects were collected through a face-to-face questionnaire survey. Fasting morning urine was collected, and urinary lead and urinary creatinine (UCr) were detected. Fasting peripheral venous blood was collected to detect telomere length and serum creatinine (SCr) in peripheral blood leukocytes. eGFR was estimated by the Levey formula. After further adjusting for age, gender, education level, family per capita monthly income, smoking, and drinking the relationship among urinary lead level, peripheral blood telomere length, and renal function index eGFR was evaluated by mediating effect analysis. Results The overall level of creatinine-adjusted urinary lead [M (P25, P75)] in the abnormal eGFR group was 3.85 (1.56, 7.34) μg·g−1 which was higher than that in the control group, 1.57 (0.60, 3.62) μg·g−1(P<0.001). In addition, the overall level of peripheral blood telomere length in the abnormal eGFR group was 2.42 (1.89, 3.10) Kb, lower than that in the control group, 2.69 (2.09, 3.64) Kb (P<0.001). The results of mediating effect analysis showed that the magnitude of mediating effect by peripheral blood telomere length was −0.276 (95%CI: −0.708-−0.001) and it contributed 3.35% to the relationship between urinary lead level and eGFR. In women, the magnitude of mediating effect by peripheral blood telomere length was −0.484 (95%CI: −1.160-−0.023) between urinary lead level and eGFR, and the proportion of the mediating effect was 5.34%. In men, no mediating role of peripheral blood telomere length was found between urinary lead and eGFR. Conclusion Urinary lead level is closely related to renal function index eGFR and telomere length in peripheral blood. Peripheral blood telomere length plays a mediating role in the relationship between female urinary lead and eGFR in women.
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Objective:To explore the clinical application and diagnosis of the long non-coding RNA plasmacytoma variant translocation gene 1 (PVT1) in plasma for rheumatoid arthritis (RA).Methods:One hundred and nineteen healthy individuals were designed as healthy control (HC), 158 patients with RA, 50 patients with systemic lupus erythematosus (SLE) and 50 patients with primary Sj?gren′s syndrome (pSS) were collected from Xuzhou Central Hospital. The plasma PVT1 of HC, RA, SLE and pSS patients and were determined by real time polymerase chain reaction (qRT-PCR). The t test of two independent-samples and One-Way analysis of variance (ANOVA) were used to compare the levels of plasma PVT1 in HC, RA, SLE and pSS patients. The correlation between PVT1 and RF, IL-6 and anti-CCP of RA patients were analyzed by Spearman's rank correlation test. Receiver operating characteristic (ROC) curves were used to identify the diagnostic performance of plasma PVT1 for RA. Results:Compared to HC [(1.32±1.22)], SLE [(1.15±0.83)] and pSS patients [(1.46±0.88)], the plasma PVT1 relative expression [(3.71±2.68)] were significantly increased in RA patients ( t=8.36, P<0.01; t=6.83, P<0.01; t=5.98, P<0.01). The PVT1 had a strong positive correlation with RF, IL-6 and anti-CCP( r=0.41, P<0.01; r=0.38, P<0.01; r=0.40, P<0.01). The area under curve (AUC) of plasma of PVT1 of RA was 0.79[95% CI(0.72, 0.85); P<0.01]. At the optimal cut-off of 1.97, the diagnostic sensitivity and specificity were 68.27% and 86.45%, and in this point provided better diagnostic accuracy. When combination PVT1 with RF, the AUC was 0.88[95% CI(0.83, 0.93); P<0.01], the sensitivity and specificity were 80.22% and 82.73%. Conclusion:Plasma PVT1 has potential diagnostic value for RA, which may become a new biomarker for the diagnosis for RA patients.
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Objective:To analyze features of sarcopenia and its influencing factors in hospitalized patients at our department.Methods:This was a cross-sectional study.A total of 180 patients aged 80.3±6.7 years admitted to the geriatrics department of our hospital were consecutively recruited.Patients were divided into the non-sarcopenia group(n=80, 44.4%)and the sarcopenia group(n=100, 55.6%)based on the diagnostic criteria for sarcopenia of the Asian Sarcopenia Working Group.All subjects were evaluated by using the comprehensive geriatric assessment.Differences in comorbidity, physical function, nutrition, cognitive function, psychological characteristics, geriatric syndromes, medication and other aspects were analyzed between the two groups.The correlation of the above factors with sarcopenia was analyzed.Results:Scores on the Charlson comorbidity index and the cumulative illness rating scale were higher in the sarcopenia group than in the non-sarcopenia group(2.6±1.7 vs.2.1±1.1, 11.3±4.1 vs.7.9±1.8, P<0.05). Scores on mini-nutrition assessment and mini-cog, grip, chair-rising test(five times), timed get-up and go test(3 m), walking speed, and short physical performance battery were lower in the sarcopenia group than in the non-sarcopenia group[(12.8±2.1) vs.(11.2±1.7), (2.3±1.0) vs.(4.4±0.9), (21.2±5.8)kg vs.(27.6±6.2)kg, (31.4±15.3)s vs.(13.2±4.0)s, (24.2±9.5)s vs.(12.0±2.9)s, (0.6±0.2)m/s vs.(0.9±0.3)m/s, (6.1±1.9) vs.(9.8±1.3), respectively, P<0.05]. The incidences of geriatric syndromes such as incontinence, visual impairment, hearing impairment, sleeping disorders, oral problems, chronic pain, anxiety, depression and falls were higher in sarcopenia patients than in non-sarcopenia patients.Logistic regression analysis showed that body mass index, walking speed and the number of geriatric syndromes were risk factors for sarcopenia( OR=1.401, 1.286 and 3.654, P<0.05). Conclusions:The incidence of sarcopenia is high in hospitalized elderly patients.Comprehensive geriatric assessment can be used to achieve a more complete understanding of the characteristics and influencing factors for patients with sarcopenia and will help provide a basis for appropriate treatment plans.
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Objective To explore the relationship between environmental factors as urinary cadmium and type 2 diabetes mellitus (DM) in adults.Methods Case-control study was adopted,including 166 cases and 427 controls.General characteristics of the subjects were collected by a structured questionnaire.FPG,biochemical indexes and urinary cadmium (UCd) were detected respectively,while UCd was corrected with creatinine.Unconditioned logistic regression model was applied to analyze the relationship between UCd and DM.Results Levels of UCd appeared higher in cases with the following characteristics as:having primary school education (P=0.016),being female (P=0.013),being non-smokers (P=0.014) or non-alcoholic (P=0.025),and with BMI＞25.00 kg/m2 (P=0.040,P=0.025) than those appeared in the control group.Same results were shown in the 60-69 years (P=0.024) old group.Data from the unconditional logistic regression analysis showed that family history of DM (OR=3.19,95％ CI:1.45-7.03),education status (OR=1.50,95％CI:1.08-2.08) and UCd (OR=1.61,95％CI:1.08-2.41) were influencing factors on DM.Conclusion A close association between UCd and DM was noticed.UCd appeared a risk factor on DM that called for setting up related prevention program to reduce the exposure of Cd and to control the risk on DM.
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Objective To explore the association between white matter hyperintensities volume and cognitive function in patients with hypertension.Methods Eighty-two patients with hypertension enrolled from the Department of Neurology of Nanjing Drum Tower Hospital from January 2017 to December 2017 were recruited in this study sequentially,who aged between 50 and 80 years.All subjects used automatic white matter quantitative technique to get their personal whole white matter hyperintensities volume,periventricular white matter hyperintensities volume and deep white matter hyperintensities volume.Neuropsychological scales were used to evaluate their global cognitive function,memory function,fluency,executive function and processing speed.The association between white matter hyperintensities volume and cognitive function via linear regression analysis was assessed.To explore whether the association between white matter hyperintensities volume and cognitive function be affected by the duration of hypertension,stratification analyses were conducted using the median of the duration of hypertension as separation.Results After adjusting for age,sex,education,lacunar infarctions and global cortical atrophy grade,the Trail Marking Test (2-1) score which reflects executive function was found to be related to whole white matter hyperintensities volume (standardized beta-value=0.268,P=0.019),periventricular white matter hyperintensities volume (standardized beta-value=0.243,P=0.037) and deep white matter hyperintensities volume (standardized beta-value=0.243,P=0.021).Victorial Snoop Test-2 score which reflects processing speed was found to be related to periventricular white matter hyperintensities volume (standardized beta-value=0.270,P=0.023).After additional adjusting for the duration of hypertension,the Trail Marking Test (2-1) score was still found to be related to whole white matter hyperintensities volume (standardized beta-value=0.277,P=0.016),periventricular white matter hyperintensities volume (standardized beta-value=0.251,P=0.032) and deep white matter hyperintensities volume (standardized beta-value=0.248,P=0.019).The Victorial Stroop Test-2 score was found to be related to whole white matter hyperintensities volume (standardized beta-value=0.237,P=0.041) and periventricular white matter hyperintensities volume (standardized beta-value=0.290,P=0.013).Conclusion Whole white matter hyperintensities volume,periventricular white matter hyperintensities volume and deep white matter hyperintensities volume are related to executive function,periventricular white matter hyperintensities volume is also related to processing speed in patients with hypertension,and the association between white matter hyperintensities volume and cognitive domain is not influenced by the duration of hypertension.
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Objective To observe the differences in T-lymphocyte subsets between patients with sepsis,non-sepsis and healthy controls with different ages,and to investigate the effect of cellular immune function on readmission rate.Methods The 337 patients with sepsis,350 patients with non-sepsis and 141 healthy controls were enrolled in this prospective study from general department and intensive care unit(ICU)of emergency department in Beijing Chaoyang Hospital during May 2017 to April 2018.The effects of ages on T lymphocyte subsets and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)and the effects of T lymphocyte subsets and APACHE Ⅱ on 30-day rehospitalization rate were comparatively studied.Results In patients with non-sepsis,the values of CD3+T,CD4+T,CD8+ T,natural killer(NK)cell count were lower in elderly group than in the non-elderlygroup(956.0±85.8)×10-6/L vs.(1363.3±46.7)×10 6/L,(647.3±59.9)×10-6/L vs.(875.8±33.4) × 10-6/L,(288.9± 31.1)× 10-6/L vs.(451.2±21.2)× 10-6/L and (14.5±0.64)％vs.(15.4±0.6)％,respectively,P＜0.01.In patients with sepsis group,the values of CD3+ T,CD4+T,NK cells count were decreased and APACHE Ⅱ were increased in the elderly group as compared with the non-elderly group.The 30-day readmission rate was higher in elderly patients than in the non-elderly patients(74 cases vs.39 cases,P ＜0.01).Compared with the non-elderly patients,the elderly patients had decreased values of CD3+ T,CD4+ T,CD8+ T,NK cells,CD4+/CD8+ cell count and an increased APACHE Ⅱ (P ＜0.05).Conclusions The cellular immune function is decreased in elderly patients,which is more obvious in elderly patients with sepsis.Age,CD3+ T,CD4+ T,CD8+T and APACHE Ⅱ could be used as an independent predictor for 30 day readmission rate.
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Objective@#To test the effect of metastasis associated in lung adenocarcinoma transcript 1 (MALAT1) and/or osimertinib on the proliferation and apoptosis of HCC827 cells, and explore the potential mechanism of MALAT1 induced resistance to osimertinib.@*Methods@#We transfected HCC827 cells with LV-vector or LV-over/MALAT1. Stable transfected cells (HCC827/Vector, HCC827/MALAT1) were selected by adding puromycin. HCC827/MALAT1 cells were further transfected with the shRNA-negative control (NC) or shRNA-human epidermal growth factor receptor 3 (ERBB3) plasmid. The effects of overexpression of MALAT1, knockdown of ERBB3 and/or osimertinib on the proliferation of HCC827 cells were evaluated by 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide (MTT) assay. Cell apoptosis induced by MALAT1 overexpression, knockdown of ERBB3 and/or osimertinib treatment were analyzed by flow cytometry analysis. The expressions of EGFR and ERBB3 signal pathway related proteins in HCC827 cells treated with overexpression of MALAT1, knockdown of ERBB3 and/or osimertinib treatment were detected by western blot.@*Results@#The MTT assay showed that sensitivity to osimertinib of HCC827/MALAT1 cells were significantly repressed. The 50% inhibitive concentration (IC50) of osimertinib >4 000 nmol/L in HCC827/MALAT1 cells. However, knockdown of ERBB3 facilitated the anti-proliferation effect of osimertinib, and the IC50 of osimertinib in shRNA-ERBB3 cells was (17.27±3.21) nmol/L. The results of flow cytometry analysis showed that the apoptotic rate of HCC827/MALAT1 cells induced by 10 nmol/L osimertinib was (8.38±0.92)%, significantly lower than (27.17±5.83)% of knockdown of ERBB3 (P<0.01). Western blotting showed that the expression of p-ERBB3, p-AKT and p-extracellular regulated protein kinases (ERK) in HCC827/MALAT1 cells was markedly up-regulated, while the expression of p-epithelial growth factor receptor (EGFR) was inhibited. The expressions of p-ERBB3, p-AKT and p-ERK were marginally affected by osimertinb. However, osimertinib downregulated the expressions of p-EGFR, p-ERBB3, p-AKT and p-ERK in ERBB3 deleted cells.@*Conclusions@#MALAT1 confers resistance to osimertinb in HCC827 cells by activating of the ERBB3/PI3K/AKT and ERBB3/MAPK/ERK signaling pathways.
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Objective To explore the long non-coding RNA that ineract within dentridic cell (lnc-DC) in plasma as a novel bio-marker for primary Sj(o)grens syndrome (pSS).Methods Case-control study.One hundred and thirty-nine patients of pSS,50 patients of systemic lupus erythematosus(SLE) and 50 patients of rheumatoid arthritis(RA) were collected from Xuzhou Central Hospital from January 2017 to January 2018,and 78 healthy individuals were designed as healthy control.The plasma lnc-DC of pSS,SLE and RA patients and healthy control(HC)was determined by real time polymerase chain reaction (RT-PCR).The plasma levels of anti-SSA(anti-Sj(o)gren's syndrome type A) and anti-SSB(anti-Sj(o)gren's syndrome type B) were tested by ELISA.The correlation between lnc-DC and dry mouth,dry eyes,ESR,β2-microglobulin,anti-SSA and anti-SSB of pSS patients were analyzed by Spearman's rank correlation test.Receiver operating characteristic (ROC) curves were used to identify the diagnostic performance of plasma lnc-DC for pSS.Results Compared to healthy control (3.38 ± 0.44),the lnc-DC relative expression (6.82 ± 0.51) was significantly increased in pSS patients (t=4.78,P＜0.01).The lnc-DC had a strong positive correlation with dry mouth (r=0.81,P＜0.01),dry eyes(r=0.75,P＜0.01),ESR(r=0.73,P＜0.01),β2-microglobulin(r=0.63,P＜0.01),anti-SSA(r=0.45,P＜0.01)and anti-SSB(r=0.53,P＜0.01).The area under curve (AUC) of plasma of lnc-DC was 0.81,(95％ CI:0.71-0.90).When combination lnc-DC with anti-SSA and anti-SSB,the AUC is 0.86 (95％CI:0.78-0.94).At the optimal cut-off of 5.1,the diagnostic sensitivity and specificity were 0.73(95％CI:0.60-0.84) and 0.82 (0.66-0.92).And in this point may provided better diagnostic accuracy.Meanwhile,compared with SLE and RA patients,the plasma level of lnc-DC were higher,ROC curves of lnc-DC in pSS patients can distinguish pSS from other autoimmune disease such as SLE and RA.Conclusions Plasma lnc-DC can provide additional diagnostic information beyond other clinican characteristics such as dry mouth,dry eyes,ESR,β2-microglobulin,anti-SSA and anti-SSB.It can be used as a novel bio-marker for pSS patients,and also have significant values in diagnosis of pSS.
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Objective To explore the relationship between environmental factors as urinary cadmium and type 2 diabetes mellitus (DM) in adults.Methods Case-control study was adopted,including 166 cases and 427 controls.General characteristics of the subjects were collected by a structured questionnaire.FPG,biochemical indexes and urinary cadmium (UCd) were detected respectively,while UCd was corrected with creatinine.Unconditioned logistic regression model was applied to analyze the relationship between UCd and DM.Results Levels of UCd appeared higher in cases with the following characteristics as:having primary school education (P=0.016),being female (P=0.013),being non-smokers (P=0.014) or non-alcoholic (P=0.025),and with BMI＞25.00 kg/m2 (P=0.040,P=0.025) than those appeared in the control group.Same results were shown in the 60-69 years (P=0.024) old group.Data from the unconditional logistic regression analysis showed that family history of DM (OR=3.19,95％ CI:1.45-7.03),education status (OR=1.50,95％CI:1.08-2.08) and UCd (OR=1.61,95％CI:1.08-2.41) were influencing factors on DM.Conclusion A close association between UCd and DM was noticed.UCd appeared a risk factor on DM that called for setting up related prevention program to reduce the exposure of Cd and to control the risk on DM.
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Objective To research the correlation between the level of serum brain natriuretic peptide (BNP) ,soluble vascular endothelial growth factor receptor 1 (sFlt-1) and nitric oxide (NO) and the changes of condition in preeclampsia(PE) patients.Methods Totally 89 patients with PE who had prenatal examina-tion and normal delivery in the hospital from May 2014 to January 2017 were enrolled in this study as the PE group ,and 94 healthy pregnant women who underwent normal delivery during the same period were selected as the NP group.The levels of serum BNP ,sFlt-1 and NO in PE patients with different severity and different onset stages were compared and analyzed.Results The levels of serum BNP and sFlt-1 in the PE group were significantly higher than those in the NP group ,and the level of NO was significantly lower than that in the NP group ,and the differences were statistically significant (P＜0.05).The levels of serum BNP and sFlt-1 in the severe PE group were significantly higher than those in the mild PE group ,and the level of NO was signifi-cantly lower than that in the mild PE group ,and the differences were statistically significant (P＜0.05).The levels of serum BNP and sFlt-1 in the early and late onset PE groups were significantly higher than those in the early NP group and the late NP group ,while the NO levels were significantly lower than those in the early NP group and the late NP group ,and the differences were statistically significant (P＜0.05).Conclusion On the occurrence of PE ,the levels of serum BNP and sFlt-1 in pregnant women elevated abnormally ,and the lev-el of NO decreased.The changes of serum BNP ,sFlt-1 and NO levels are closely related to the development of PE ,and can be used as a reference index to detect the changes of PE.
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Objective In patients with non -small cell lung cancer(NSCLC)undergoing radical surgery,there were still many inevitable recurrences and distant metastases,even after systemic postoperative adjuvant chemotherapy.At the same time,many patients were in the stage Ⅳ at the time of initial treatment.The aims of this study were to investigate and compare the first-line chemotherapy(First-line Chemotherapy at Recurrence Post-adjuvant Chemotherapy,FCRPC)in NSCLC patients with distant metas-tasis after adjuvant chemotherapy with initial treatment at the phase Ⅳ of NSCLC patients with first-line chemotherapy(Initial First-line Chemotherapy,IFC).Methods A total of 603 patients with distant metastatic NSCLC were collected in this study.Among them,73 of them were FCRPC and 530 of them for IFC.Statistical methods for propensity score matching were used to balance the clinical features between FCRPC and IFC groups.Chi-square test was used to compare the short-term efficacy between FCRPC and IFC groups.Survival analysis was performed using regression analysis and Kaplan-Meier analysis.Results There was no significant difference in objective response rate(ORR)and disease control rate(DCR)between FCRPC and IFC groups in NSCLC patients with dis-tant metastases(ORR rate:27.46% in the FCRPC group,24.7% in the PFC group,P=0.851 and DCR rate:78.1% in the FCRPC group,65.6% in the PFC group,P=0.140).There was also no significant difference in the median progression-free survival(9.8 months in the FCRPC group and 8.5 months in the PFC group,P=0.337)and median overall survival(20.0 months in the FCRPC group and 14.4 months in the PFC group,P=0.087).Conclusion There is no significant difference in the prognosis of first-line chemotherapy between NSCLC patients with distant metastases and with initial treatment at the stageⅣafter adjuvant chemotherapy.
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Cerebral small vessel disease (CSVD) refers to the syndromes of clinical,cognitive,radiographic and pathological manifestations caused by intracranial small vessel disease.Due to the insidious onset of CSVD,unknown etiology,diverse clinical manifestations,and better short-term prognosis,it is easily ignored,resulting in misdiagnosis,missed diagnosis,and non-standard diagnosis and treatment.This article reviews the advances in research on clinical manifestations,imaging features,diagnosis and treatment of CSVD.
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Objective To investigate serum levels of interleukin(IL)-22 in typeⅠhypersensitivity disease patients with monosensitization and polysensitization,inhaled allergens and food allergens,and explore the correlation between IL-22 levels and allergens.Methods A total of 100 patients with typeⅠhypersensitivity disease and 30 normal controls were recruited in this study.Western blot and enzyme-linked immuno sorbent assay were used to detect 19 types of allergens′ specific IgE antibody and IL-22 concentrations,respectively.Results Serum level of IL-22 was positive correlated with the number of sensitized allergens(r=0.318,P=0.001).The levels of IL-22 in polysensitization patients,monosensitization patients and normal controls were 24.52(20.41,29.27),22.02(15.25,25.59),18.06(16.02,23.04)pg/mL respectively.IL-22 in polysensitization patients(n=42) were higher than those in monosensitization patients(n=58) and normal controls(U=867.500 and 229.000,P0.05).Conclusion Serum level of IL-22 increases in type Ⅰhypersensitivity disease patients,was is positive correlated with the number of sensitized allergens.
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Objective To investigate the effect of propofol and midazolam anesthesia in the treatment of persistent state of intractable epilepsy in children.Methods A total of fifty children with intractable epilepsy were selected in Guangzhou Women and Children''s Medical Center from May 2011 to May 2016,and were divided into propofol group and midazolam group according to the method of anesthesia,each group 25 cases.In the treatment,continuous EEG and ECG monitoring were applied in both groups,and the changes in hemodynamics were recorded in order to compare the medication and treatment effects.Results After epilepsy was under control and drug was withdrawn,the heart rate (HR),systolic pressure (SBP),diastolic pressure (DBP) of the two groups were all reduced,lower than the data collected before the treatment,the differences were statistically significant (P<0.05);in the propofol group,HR and SBP after control were (93.21±17.61) time/min and (92.44±12.84) mmHg (1 mmHg=0.133 kPa),lower than those of the midazolam group((109.84±18.41) time/min,(101.93±14.79) mmHg,t=3.264,2.423,P<0.05);the medication time,control time,intubation time of the propofol group were all shorter than those of the midazolam group ((13.21±2.14) h vs.(15.39±3.39) h,(3.47±0.89) min vs.(8.79±1.21) min,(2.03±0.79) d vs.(6.31±1.34) d,t=2.719,17.709,13.757,P<0.05);the total effective rate in the propofol group was significantly higher than that of the midazolam group (97.5%(39/40) vs.82.5%(33/40),χ2=5.357,P=0.021).Conclusion Propofol is effective in the treatment of persistent state of intractable epilepsy in children with good sedative effect,and can also reduce children''s resistance,therefore it''s worth promoting and applying into treatment.
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Objective To investigate the effect of Tangshan earthquake stress on the executive and memory func?tion in adults. Methods The objects were recruited from Tangshan Kailuan Mining Group. The exposed group included 251 subjects whose mothers exposed to the Tangshan earthquake during pregnancy in 1976. The control group included 341 subjects whose mothers was pregnant the year after the Tangshan earthquake. According to mother's pregnancy time relative to the earthquake exposed group was divided into 3 subgroups:the late pregnancy of earthquake exposed group, the second trimester of earthquake exposed group and the early pregnancy of earthquake exposed group. Wisconsin Card Sorting Test (WCST) was used to evaluate executive function, Brief Visuospatial Memory Test-Revised (BVMT-R) was used to evaluate memory function. Results The index of WCST were not different between two groups (P>0.05). Com?pared with control group, BVMT-R total scores were lower in earthquake exposed group [(25.54 ± 7.45) vs. (27.28 ± 7.10), P<0.01]. In the earthquake exposed group, pregnancy and sex had interaction effect on the nonpreservative errors (nRpe) of WCST (P<0.05). In the late pregnancy earthquake exposed group, male had higher nRpe than female (P<0.01). Preg?nancy time had main effect on offsprings' BVMT-R scores (P<0.05). The BVMT-R total scores were lower in late trimes?ter pregnancy and in second trimester pregnancy than in the early pregnancy (P<0.05). Conclusion The Tangshan earth?quake has potential effect on the memory function of the offsprings. The second trimester (4-to 6-month) and the third trimester (7-to 9-month) may be the sensitive pregnancy window of the stress during the pregnancy. The male offspring from late pregnancy of exposed earthquake have poorer executive function than female.
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Objective To investigate the clinical features and the imaging examination changes of bacterial meningitis in children of different age groups,and to offer theoretical basis for the clinic diagnosis of bacterial meningi-tis. Methods The sick children with bacterial meningitis treated in Guangzhou Women and Children′s Medical Center from January 2011 to June 2013,were recruited and divided into three groups according to the age,including newborns group,infants group and more than 1 year group. Eighty-nine cases with purulent meningitis were recruited,included 58 males and 31 females. Among them,there were 34 cases in the newborns group,41 cases in the infants group and 14 ca-ses in the more than 1-year group. The information on the clinical features,laboratory examination and the imaging ex-amination were summarized and analyzed,and were compared among the 3 groups. Results (1)Among them,54 cases with high fever,44 cases with respiratory symptoms,12 cases with alimentary tract symptoms. (2)The major neurologi-cal features included convulsions(44 cases,49. 4%),fatigue(36 cases,40. 4%),vomiting(21 cases,23. 6%),cervical rigidity(9 cases,10. 1%),fontanel full(7 cases,7. 9%),headache(6 cases,6. 7%),limb paralysis(5 cases,5. 6%). The percentage of high fever,vomiting,headache,cervical rigidity in the more than 1 year group were significantly more than those of the newborns group and the infants group(χ2=10. 093,12. 063,34. 466,7. 177,all P<0. 05). (3)Among them,whitebloodcell(WBC)accountswerefrom2.20to60.60×109/L,themeanwas(16.49±10.37)×109/L.Hy-persensitive C-reaction protein concentration in blood was 4. 00 to 376. 53 g/L,the mean was (131. 07±86. 91) g/L. In cerebrospinal fluid(CSF),WBC accounts were from 1 to 21 800×106/L,the mean was (910. 05±274. 07)×106/L, the glucose concentration from 0. 00 to 4. 50 mmol/L,the mean (1. 72±1. 03)mmol/L,the protein concentration from 0. 42 to 4. 89 g/L,the mean was(1. 64±1. 03)g/L. In 40 cases with atypical CSF change, 23 cases with CSF glucose ratio(CSF glucose/blood glucose) less than or equal to 0. 4, and 15 cases with blood cultures positive. (4)The image examination showed magnetic resonance imaging( MRI) abnormalities in 51/75 cases,computerized tomography( CT) scan abnormalities in 15/30 cases. The percentage of convulsions,the brain MRI abnormalities and the MRI display rate of bacterial meningitis in the infants group were significantly more than those of the newborns group and the more than 1 year group(χ2=11. 768,9. 047,7. 674,all P<0. 05). The display rate of meningitis and subdural hydroma by the brain MRI were significantly more than those of the head CT scan(χ2=7. 430,5. 291,all P<0. 05). Conclusions Be-cause of the atypical clinical features of bacterial meningitis in newborn and infant, lumber puncture should be per-formed in all doubtful cases who had a fever and/or seizure. CSF glucose less than or equal to 0. 4 of simultaneously ob-tained blood glucose value,the enhanced MRI sequence or blood cultures were useful for the likelihood of meningitis,if CSF chemistries and cytology vary atypically. The MRI sequence can significantly mostly improve the display rate of bacterial meningitis than the enhance CT.
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Objective To evaluate the factors influencing prognosis and to explore the pathological mechanism in which herpes simplex virus encephalitis(HSE) was one of the severe types of acute viral encephalitis in children and had poor prognosis.Methods Twenty-one children with HSE were diagnosed by the clinical syndrome of focal encephalitis and HSV DNA-PCR positive in cerebrospinal fluid(CSF) from Jan.2012 to Oct.2013,among whom,19 patients were treated with intravenous Acyclovir,30 mg/(kg · d) 48 hours after onset and were followed up for 6 to 24 months.Clinical data were collected including Glasgow Coma Score,the brain magnetic resonance imaging(MRI),and electroencephalography(EEG).All MRI examinations including plain scan and contrast enhancement were carried out at the beginning of admission and 1 month after the onset of symptoms.The clinical outcomes were divided into two levels accoming to the severity of the neurological deficit,then the data were analyzed by using Logistic regression and Fisher's exact probability method.The OR value was calculated.Results Eighteen children survived,of whom 5 cases had no neurological deficit(27.8％),3 cases were left with mild impairment(16.7％),and the above 8 cases were thought to have better outcome.Six cases had moderate impairment (33.3％) and 4 cases had severe impairment(22.2％) and 1 child died,and these 11 cases were thought to have worse outcome.Patients aged between 1 month and 10 years,average (2.03 ± 2.23) years old.The mean GCS score was (9.68 ± 2.65) scores,the GCS of the patients were more than 7except for one death child with 3 scores.The multiple factor analysis showed that EEG,age,GCS and the range and character in MRI were significantly correlative to the prognosis(P ＜ 0.05).The single factor analysis illustrated that age 1-4 years old(OR =30,95％ CI 2.066-366.510,P =0.002),GCS ≤ 10 scores(OR =27.518,95％ C1 2.066-366.510,P =0.004)and the wide necrosis existence involving diffuse white matter or deep nuclei of MRI findings (OR =12,95 ％ CI 1.294-111.323,P =0.017) indicated the worse outcome.Conclusions Age,GCS score,nature and damage degree of MRI lesions are the main important factors affecting the prognosis of children's HSE.HSE in children is apt to involve the cortex such as frontal lobe,parietal lobe even diffuse white matter or deep nuclei,which indicates the poor prognosis.
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Objective To explore the value of carcinoembryonic antigen ( CEA) and cancer antigen 153 ( CA153 ) in detecting tumor recurrences and to establish the optimal operating point of diagnosis of recurrences in HER-2 overexpressing breast cancer using ROC curves .Methods A total of 127 HER -2 overexpressing breast cancer patients was enrolled into this study and subdivided into two groups ,the recurrence group and the non-recurrence group .We created a ROC curve and found out the optimal operating point .Then we compared the advantage of detecting recurrences between optimal operating point in the ROC curve and the diagnostic point that we usually used .Results The recurrence groups showed significantly higher CEA and CA 153 levels than the non-recurrence groups(P<0.0001).The area under the curve(AUC)of the CEA and CA153 were 0.752 and 0.820 respectively and the optimal operating point were 3.5 ng/mL and 17.89 U/mL,respectively.The sensitivi-ties of the optimal operating point of CEA and CA 153 were 46.15%and 65.38%respectively,and the specifici-ties were 97.33%and 89.33%, respectively.Conclusion CEA and CA153 process medium value for detecting recurrences in HER-2 overexpressing breast cancer .