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Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is highly contagious and can cause death in severe cases. As reported by the World Health Organization (WHO), as of 6:36 pm Central European Summer Time (CEST), 12 August 2022, there had been 585 950 285 confirmed cases of COVID-19, including 6 425 422 deaths (WHO, 2022).
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Humans , COVID-19 , SARS-CoV-2 , Mental Health , Cohort Studies , Quality of Life , China/epidemiology , Health Personnel , Hospitals , LungABSTRACT
Objective:To investigate the relationship between parathyroid hormone（PTH） level and permanent hypoparathyroidism（PHPP） on the first day after radical papillary thyroidectomy, and its predictive value. Methods:A total of 80 patients with papillary thyroid cancer who underwent total thyroid resection and central lymph node dissection were collected and analyzed from January 2021 to January 2022. According to whether PHPP occurred after surgery, the patients were divided into hypoparathyroidism group and normal parathyroid function group, and univariate and binary logistics regression were used to analyze the correlation between PTH and serum calcium levels and PHPP on the first day after surgery in two groups. The dynamic changes of PTH at different time points after operation were analyzed. The area under the receiver operating characteristic was used to evaluate the predictive power of PTH on the development of PHPP after surgery. Results:Among the 80 patients with papillary thyroid cancer, 10 cases developed PHPP, with an incidence rate of 12.5%. Binary logistics regression analysis showed that PTH on the first postoperative day（OR=14.534, 95%CI: 2.377-88.858, P=0.004） was an independent predictive risk factor for postoperative PHPP. Taking PTH=8.75 ng/L on the first postoperative day as the cut-off value, the AUC of the area under the curve was 0.874（95%CI: 0.790-0.958, P<0.001）, the sensitivity was 71.4%, the specificity was 100%, and the Yoden index was 0.714. Conclusion:PTH level on the first day after total thyroid papillary carcinoma surgery is closely related to PHPP, and is an independent predictor of PHPP.
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Humans , Calcium , Hypoparathyroidism/surgery , Parathyroid Glands , Parathyroid Hormone , Postoperative Complications/surgery , Thyroid Cancer, Papillary/surgery , Thyroid Neoplasms/complications , ThyroidectomyABSTRACT
Objective:To analyze drug resistance, virulence and molecular epidemiological characteristics of Staphylococcus aureus ( S. aureus) isolated from skin sites of suppurative infections, and to provide an experimental basis for clinical anti-infective therapies. Methods:Swab samples from suppurative skin lesions and nasal secretions were collected from inpatients in Department of Dermatology, the Affiliated Hospital of Inner Mongolia Medical University from May 2020 to December 2020, and subjected to bacterial isolation and culture. Suspected S. aureus colonies were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Drug sensitivity test was conducted by using the broth microdilution method. Virulence genes of S. aureus were amplified by PCR, and real-time fluorescence-based quantitative PCR was performed to determine the relative expression of 4 virulence genes including tsst-1, pvl, hla and clfA in S. aureus strains from different sources. S. aureus strains were genotyped by multilocus sequence typing. Drug resistance rates and detection rates of virulence genes were compared by using chi-square test or Fisher′s exact test, and measurement data among groups were compared by using t test or Mann-Whitney U test. Results:A total of 85 strains of S. aureus were isolated from 210 inpatients, including 54 isolates from skin sites of suppurative infections (case group) and 31 isolates from the nasal cavity (control group) . Drug sensitivity test showed that 14 strains of methicillin-resistant S. aureus (MRSA) were identified among 85 strains of S. aureus. The resistance rate to penicillin was the highest (90.59%, 77/85) in the 85 S. aureus strains; the resistance rates to clindamycin and erythromycin were 60.00% (51/85) and 61.18% (52/85) respectively; no strains showed resistance to rifampicin, vancomycin or linezolid. PCR showed that the detection rate of the pvl gene was 33.33% (18/54) in the case group, which was significantly higher than that in the control group (12.90%, 4/31; χ2= 4.28, P= 0.038) . Real-time fluorescence-based quantitative PCR showed that the relative expression level of the clfA gene was significantly higher in the control group (3.87[2.30, 5.94]) than in the case group (1.63[0.95, 2.62], P= 0.007) . A total of 17 ST types were identified among the 85 strains of S. aureus, and the dominant types were ST398-methicillin-susceptible S. aureus (20/71) and ST22-MRSA (9/14) . The detection rate of the virulence gene pvl was significantly higher in the ST22-MRSA strain (14/14) than in the non-ST22 MRSA strains (0, P < 0.001) . Conclusions:S. aureus strains isolated from the skin sites of suppurative infections were highly resistant to penicillin, clindamycin and erythromycin, so these antibiotics should not be used as the first-choice empiric treatment. The occurrence of cutaneous S. aureus infections may be associated with the virulence gene pvl, and the nasal colonization of S. aureus may be associated with the clfA gene.
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Objective:To explore the effect of electroencephalographic (EEG) biofeedback combined with buspirone on patients with schizophrenia with anxiety, in order to provide evidence-based reference for clinical treatment.Methods:From January 2018 to January 2020, 80 patients with schizophrenia and anxiety in Jinzhou Kangning Hospital were prospectively selected and divided into the study group and the control group by simple randomization, each group with 40 patients. The control group was given buspirone, and the study group was given EEG biofeedback combined with buspirone. Both were treated for 8 weeks. The efficacy, adverse reactions and the Positive and Negative Symptoms Scale (PANSS) and Hamilton Anxiety Scale (HAMA), the Pittsburgh Sleep Quality Scale (PSQI), Scale of Social Function in Psychosis Inpatients (SSPI), Barthel Index (BI) score, and serum neuroendocrine index thyroid stimulating hormone (TSH), cortisol (Cor) levels before treatment, 4 weeks and 8 weeks after treatment were compared between the two groups.Results:After 8 weeks of treatment, the total effective rate in the study group was higher than that in the control group: 95.0% (38/40) vs. 77.5% (31/40), the difference was statistically significant (χ 2 = 5.16, P<0.05). After 4, 8 weeks of treatment, the PANSS scores in the study group were lower than those in the control group: (49.57 ± 5.65) scores vs. (57.96 ± 6.48) scores, (37.69 ± 4.35) scores vs.(45.07 ± 5.74) scores, the differences were statistically significant ( P<0.05). After 4, 8 weeks of treatment, the HAMA and PSQI scores in the study group were lower than those in the control group, while the SSPI and BI scores were higher than those in the control group, the differences were statistically significant ( P<0.05). After 4, 8 weeks of treatment, the serum TSH and Cor levels in the study group were lower than those in the control group: after 4 weeks of treatment: (2.74 ± 0.84) mU/L vs. (3.35 ± 0.97) mU/L, (276.51 ± 45.96) μg/L vs. (346.42 ± 50.34) μg/L; after 8 weeks of treatment: (2.46 ± 0.72) mU/L vs. (2.82 ± 0.86) mU/L, (197.26 ± 36.84) μg/L vs. (264.19 ± 42.46) μg/L, the differences were statistically significant ( P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups during treatment ( P>0.05). Conclusions:EEG biofeedback combined with buspirone can enhance the therapeutic effect by regulating neuroendocrine, reduce the mental symptoms, anxiety and sleep disorders ofschizophrenia patients with anxiety. It can also improve social function and daily life ability, and have high safety.
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Inguinal incarcerated hernia in adults is a common acute abdomen in hernia and abdominal wall surgery. If not treated in time, it is easy to progress to constrictive hernia, lead to intestinal ischemic necrosis, cellulitis of tegmental tissue outside the hernia, hernia sac empyema, intestinal fistula, and even cause toxic shock, with significantly increased mortality. The types of incarceration are different and the corresponding management methods are different. Based on the proposal of the concept of musculopubic foramen hernia repair, inguinal incarcerated hernia includes incarcerated indirect hernia, incarcerated direct hernia, incarcerated femoral hernia, etc. At present, there is no uniform standard for the comprehensive treatment of different types of inguinal incarcerated hernia, and the clinical management strategies of adult inguinal incarcerated hernia still face serious challenges.
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OBJECTIVES@#To explore the relevant protective and risk factors that affect spontaneous supratentorial large volume intracerebral hemorrhage.@*METHODS@#Clinical data of hospitalized patients with spontaneous supratentorial intracerebral hemorrhage in Xiangya Hospital of Central South University from January 2014 to December 2018 were retrospectively analyzed. According to the amount of intracerebral hemorrhage (≥30 mL), the patients were divided into a large volume intracerebral hemorrhage group (255 cases) and a non-large volume intracerebral hemorrhage group (397 cases). Univariate and multivariate logistic regression analysis for the clinical data from the two groups of patients were performed.@*RESULTS@#Systolic blood pressure, diastolic blood pressure, white blood cell count, neutrophil count, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein cholesterol, calcium ion concentration, and international standard ratio between the large volume intracerebral hemorrhage group and the non-large volume intracerebral hemorrhage group were significantly different (all @*CONCLUSIONS@#The occurrence of spontaneous supratentorial large volume intracerebral hemorrhage is the result of combination of multiple factors. The increased white blood cell count, the increased systolic blood pressure, the increased high-density lipoprotein cholesterol, and the increased international standard ratio may increase its risk, while the increased LDL cholesterol and calcium concentration may reduce its risk.
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Humans , Blood Pressure , Cerebral Hemorrhage , Cholesterol, HDL , Retrospective Studies , Risk FactorsABSTRACT
Objective To assess the risk of public health incidents in the Hankou River Beach during the 7th World Military Games, and to provide reference for risk early warning and emergency preparedness. Methods An expert consultation meeting was held to determine the evaluation index and risk scores. Based on the Kaiser model, a public health risk assessment system suitable for Hankou River Beach was established, and the risk value of each risk event was calculated by the method of risk value calculation. The risk matrix method was used to evaluate the risk levels of different risk events in different areas of Hankou River Beach. Then, according to the calculated Borda values and order values of risk events in different regions, the different risks were ranked in each area. Results The calculation revealed that the risk values of schistosomiasis in the first, second, third and fourth stages of the river beach were 8.43%, 14.68%, 25.26% and 27.56%, respectively; the risk values of vector infectious diseases in each stage were 13.42%, 16.40%, 18.67% and 19.22%; the risk values of accidental injury and other events were 20.34%, 22.94%, 19.00% and 16.53%. According to the risk matrix, the first and second stages of schistosomiasis and vector borne infectious diseases, as well as the fourth stage of accidental injuries were located in the low-risk zone, while the other risk events were in the medium risk zone. The ranking results of Borda sequence value showed that the highest risk public health events in the first and second phases of the river beach were accidental injuries and others, in the third phase was schistosomiasis and accidental injuries, and in the fourth phase was schistosomiasis. Conclusion Considering the results of each evaluation method, the public health events with the highest risk in phase I and phase II of the river beach were accidental injuries, while in phase III and phase IV were schistosomiasis. It is suggested that relevant departments should formulate different strategies and take targeted measures to ensure the public health and safety of Hankou river beach during the Military Games.
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ObjectiveTo investigate the expression and significance of the ABAT gene in hepatocellular carcinoma (HCC) using related databases. MethodsThe Oncomine database and GEPIA were used to analyze the expression of ABAT in HCC tissue. GEPIA was used to investigate the correlation of ABAT mRNA with the survival time and pathological stage of HCC patients. The MethHC database was used to analyze the methylation level of ABAT promoter region. The String database was used to analyze the network of proteins interacting with ABAT protein. The Human Protein Atlas was used to analyze the expression of ABAT protein in HCC tissue and the influence of the protein expression of ABAT on prognosis. ResultsThe mRNA expression of ABAT in HCC tissue was significantly lower than that in normal liver tissue; patients with lower mRNA expression tended to have a poorer prognosis (log-rank, P=0.002 1) and a higher degree of malignancy (P=0.002 34). The protein expression of ABAT in HCC tissue was significantly lower than that in normal liver tissue, and patients with lower protein expression tended to have a poorer prognosis (log-rank, P=2.14×10-3). The methylation level of ABAT promoter region in HCC tissue was significantly higher than that in normal liver tissue (P＜0.005). The proteins interacting with ABAT included ALDH1A3, ALDH9A1, ALDH3A2, GAD1, and GAD2, which might be involved in cell functions such as cell apoptosis, redox, and neurotransmitter secretion. ConclusionData mining of tumor gene databases shows that there are low levels of mRNA and protein expression of ABAT in HCC tissue, which is associated with patient’s survival time. At present, database mining can provide a reference for the diagnosis and prognosis evaluation of HCC and a theoretical basis for tumor research in the future.
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ObjectiveTo investigate the expression and significance of the ABAT gene in hepatocellular carcinoma (HCC) using related databases. MethodsThe Oncomine database and GEPIA were used to analyze the expression of ABAT in HCC tissue. GEPIA was used to investigate the correlation of ABAT mRNA with the survival time and pathological stage of HCC patients. The MethHC database was used to analyze the methylation level of ABAT promoter region. The String database was used to analyze the network of proteins interacting with ABAT protein. The Human Protein Atlas was used to analyze the expression of ABAT protein in HCC tissue and the influence of the protein expression of ABAT on prognosis. ResultsThe mRNA expression of ABAT in HCC tissue was significantly lower than that in normal liver tissue; patients with lower mRNA expression tended to have a poorer prognosis (log-rank, P=0.002 1) and a higher degree of malignancy (P=0.002 34). The protein expression of ABAT in HCC tissue was significantly lower than that in normal liver tissue, and patients with lower protein expression tended to have a poorer prognosis (log-rank, P=2.14×10-3). The methylation level of ABAT promoter region in HCC tissue was significantly higher than that in normal liver tissue (P＜0.005). The proteins interacting with ABAT included ALDH1A3, ALDH9A1, ALDH3A2, GAD1, and GAD2, which might be involved in cell functions such as cell apoptosis, redox, and neurotransmitter secretion. ConclusionData mining of tumor gene databases shows that there are low levels of mRNA and protein expression of ABAT in HCC tissue, which is associated with patient’s survival time. At present, database mining can provide a reference for the diagnosis and prognosis evaluation of HCC and a theoretical basis for tumor research in the future.
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Chaetominine is a quinazoline alkaloid originating from the endophytic fungus Aspergillus fumigatus CY018. In this study, we showed evidence that chaetominine has cytotoxic and apoptotic effects on human leukemia K562 cells and investigated the pathway involved in chaetominine-induced apoptosis in detail. Chaetominine inhibited K562 cell growth, with an IC50 value of 35 nM, but showed little inhibitory effect on the growth of human peripheral blood mononuclear cells. The high apoptosis rates, morphological apoptotic features, and DNA fragmentation caused by chaetominine indicated that the cytotoxicity was partially caused by its pro-apoptotic effect. Under chaetominine treatment, the Bax/Bcl-2 ratio was upregulated (from 0.3 to 8), which was followed by a decrease in mitochondrial membrane potential, release of cytochrome c from mitochondria into the cytosol, and stimulation of Apaf-1. Furthermore, activation of caspase-9 and caspase-3, which are the main executers of the apoptotic process, was observed. These results demonstrated that chaetominine induced cell apoptosis via the mitochondrial pathway. Chaetominine inhibited K562 cell growth and induced apoptotic cell death through the intrinsic pathway, which suggests that chaetominine might be a promising therapeutic for leukemia.
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Humans , Apoptosis , Aspergillus fumigatus , Caspase 3 , Caspase 9 , Cell Death , Cell Line , Cytochromes c , Cytosol , DNA Fragmentation , Fungi , Inhibitory Concentration 50 , K562 Cells , Leukemia , Membrane Potential, Mitochondrial , MitochondriaABSTRACT
Objective To investigate clinical competence assessment in the graduation examination for surgical professional degree postgraduates and surgical residents in Beijing. Methods Data of clinical competence assessment of graduation examination for surgical postgraduates from Capital Medical University (CMU) and residents from Beijing surgical residency training programs in 2013 were summarized and ana-lyzed. SPSS 11.5 software was used to do t test and chi square test to the corresponding data line. Results There were 118 surgical postgraduates in clinical medicine from CMU and 274 residents from Beijing surgi-cal residency training programs, who attended final clinical competence assessment. There were significant differences between the postgraduate and resident clinical competence assessment system. The differences included their organization in charge of examination and the contents of assessment system. The assessment system of clinical competence for the surgical postgraduates did not involved communication skills, reading and analysis of laboratory tests and imaging investigation. The score of case analysis in the postgraduate group was higher than that in the resident group [(84.6±1.1) vs. (82.2±10.2), P=0.039], however the score of surgical skill assessment in postgraduate group was significantly lower than that of the resident group [(78.2 ±14.0) vs. (90.5 ±6.3), P=0.000]. In addition, the rate in the score being higher or equal to 70 of case note, case analysis and surgical skill assessment between postgraduates and residents was significantly different (P<0.05). Conclusion Clinical competence assessment system for the surgical postgraduates should be adapted to their training goal. In addition to the process assessment, the objective structured clinical skills examination (OSCE) can be as a reasonable postgraduate graduation examination mode.
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Objective To explore the expression and clinical relevance of metastasis-associated colon cancer-1 (MACC1) and C-MET proteins in hepatocellular carcinoma (HCC) tissue.Methods The expressions of MACC1 and C-MET were detected in 51 specimens of HCC and paraneoplastic liver tissue,normal liver tissue in 13 healthy cases using immunohistochemistry and Western blotting.The correlations of the expressions of MACC1 and C-MET proteins were evaluated,survival rates were observed,the relationship between the expression of MACC1,C-MET proteins and the clinicopathologic features of HCC were analyzed.Results The positive rate of MACC1 and C-MET proteins was 80.4％ and 76.5％ in HCC tissue,the relative expressions were 0.645 ± 0.047 and 0.504 ± 0.023 respectively,which was significantly different from those in paraneoplastic liver tissue and normal liver tissue (respectively F =173.308,252.817,all P =0.000).The survival analysis showed that the three-year survival rate in patients with positive MACC1 and C-MET expressions was significantly lower than that in patients with negative expressions (respectively x2 =3.934,4.439,all P ＜ 0.05),the positive rate and relative expressions of MACC1 and C-MET were significantly correlated with TNM stage,portal vein cancer thrombus and pathology typing (P ＜ 0.05).Conclusions The expression of MACC1 and C-MET is associated with the malignant progression of HCC.MACC1 may serve as a independent prognostic factor for advanced HCC and a possible therapy target for the treatment of HCC.
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Objective To evaluate the changes in plasma S-100β protein concentration in patients undergoing cardiac surgery performed with cardiopulmonary bypass (CPB).Methods ASA Ⅱ or Ⅲ patients aged 60-77 yr weighing 55-75 kg with national institutes of health stroke scale(NIHSS) ＜ 10 undergoing coronary artery bypass grafting with CPB were enrolled in this study.Cerebral function was evaluated and scored using NIHSS at 2 d after operation.The patients were divided into 3 groups according to NIHSS scores:group A uncomplicated (NIHSS score 0-9),group B mild brain injury (NIHSS score 10-19) and group C moderate and severe brain injury (NIHSS 20-45).Plasma S-100β protein concentration was measured before CPB,at 30 min of CPB,the end of CPB and 1 h,6 h,24 h after CPB.The duration of operation,CPB time,aortic cross-clamping time and length of ICU stay and hospital stay were recorded.Results Ten patients in groups A and B and 12 in group C completed the trial.Plasma S-100β protein concentration was significantly increased during and after CPB as compared with the baseline at T0 and peaked at T3 (groups A,B) and T4 (group C).The plasma S-100β protein concentration was highest in group C and lowest in group A.The duration of operation,CPB time,aortic cross-clamping time and length of ICU stay and hospital stay were longest in group C and shortest in group A.Conclusion Plasma S-100β protein concentration can be used as a marker of cerebral injury after cardiac surgery performed with CPB and the concentration measured at 6 h after CPB is more significant in evaluating the degree of cerebral injury and prognosis.
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Objective To investigate the accuracy of myeline base protein (MBP) in evaluation of brain injury in patients undergoing cardiac surgery performed under CPB. Methods Thirty-two ASA Ⅱ- Ⅳ patients of both sexes (20 males, 12 females) aged 59-76 yr weighing 52-72 kg undergoing coronary artery bypass grafting (CABG) under CPB were studied. Patients with history of neurological disease were excluded. Preoperative National Institute of Health stroke scale (NIHSS) score ≤ 9. According to postoperative NIHSS score on 2nd postoperative day, the patients were divided into 3 groups: group A no neurological deficit ( NIHSS score 0-9 );group B mild neurological deficit (NIHSS score 10-19) and group C moderate or severe neurological deficit (NIHSS score 20-45). Blood samples were taken from internal jugular vein before CPB (T0), at 30 min of CPB (T1), at the discontinuation of CPB (T2), and at 1, 6, 24 h after discontinuation of CPB (T3-5) for determination of the plasma MBP concentration. The duration of operation, CPB time, aortic cross-clamping time were recorded.Results In group B the plasma MBP level peaked at 6 h after CPB (T4) and then decreased rapidly while in group C the plasma MBP level exceeded the normal upper limit at T2 and kept increasing till 24 h after CPB (T5 ).The plasma MBP level decreased at T1-3.5 in group A as compared with the normal upper limit. The plasma MBPlevel was significantly higher at T3-5 in group B and at T1-5 in group C than in group A and at T1-5 in group C than in group B. Linear regression analysis indicated that there was positive correlation between plasma MBP level and CPB time at T5. NIHSS scores were positively correlated with plasma MBP level at T1 , T2, and T5. Conclusion MBP can early reflect the severity of brain injury in patients undergoing cardiac surgery under CPB.
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Objective To evaluate the therapeutic effectiveness of postoperative hemorrhage of cholejejunal or pancreato - jejunal anastomotic stoma after pancreato - duodenectomy by the way of fibercholedochoscopy. Meth- ods The drainge tube was extracted out of choledochojejunal anastomotic stoma. And fibercholedochoscopy was in- serted in fistula to affirm hemorrhagic position of choledochojejunal or pancreato - jejunal anastomotic stoma. And then local coagulation and microwave solidifying was proceeded with. Local spray of Galla - chineses compound solution was performed for hemostasis. Results We succeeded in hemorrhage of four choledochojejunal and six pancreato - jejunal anastomotic stoma One failed for frequent hemorrhage in pancreato - jejunal anastomotic stoma. Conclu- sion Fibercholedochoscopy is the first selective and effective method in the diagnosis and treatment of postoperative hemorrhoge of pancreato - jejunal or choledochojejunal anastomotic stoma after whipple operation.
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Objective:To compare the short-term result of one-stage resection and anastomosis for patients with acute complete obstruction of the right and left colonic carcinoma.Methods:The clinical data of 80 patients undergoing emergency one-stage resection and anastomosis of acute complete obstruction for left and right colonic carcinoma were retrospectively analyzed.Results:Thirty-seven patients were operated on for obstructive carcinoma of the right colon,the mortality was 5.4%(2/37),the rate of complication was 21.6%(8/37),the mean hospital stay and cost was(31.6?12.8)d and(52794.9?60804.3)Yuan RMB,respectively.Forty-three patients were operated on for obstructive carcinoma of the left colon.the mortality was 2.3%(1/43),the rate of complication was 25.6%(11/43),the mean hospital stay and cost was(29.6?14.8)d and(50 192.8 ?39 727.4) Yuan RMB respectively.There was one case of anastomotic leakage in both groups.There were no significant differences of mortality and the rate of complication of the two groups.Conclusions:One-stage resection and anastomosis of acute complete obstruction of left colonic carcinoma can be performed as safely as in those with acute obstruction of right.Intraoperative decompression should be considered seriously in left colonic obstruction prior to the anastomosis following colonic resection.