Prevalence of heart failure in Chinese cognitive impairment patients： a meta-analysis / 上海预防医学

Objective:Heart failure （HF） and cognitive impairment have become serious medical problems in China. This study used meta-analysis to comprehensively evaluate the prevalence of cognitive impairment in patients with HF in China， and provided suggestions for intervention and prevention of cognitive impairment in this population. Methods:A systematic retrieval was conducted by searching relevant literatures regarding cognitive impairment in Chinese HF patients. These reports were published on CNKI， Wanfang， SinoMed， VIP and PubMed， from January 1， 1980 to July 10， 2020. The Agency for Healthcare Research and Quality （AHRQ） criteria and Newcastle-Ottawa Scale were used to evaluate the literature quality of cross-sectional studies and case-control studies， respectively. Stata16.0 was used for combined prevalence and effect value. Results:A total of 20 articles with medium quality were included. Six of them were case-control studies， with a total sample size of 933 people， and healthy people as controls. The Odds Ratios （OR） value of the prevalence of cognitive impairment in patients with HF was 2.77 （95% CI： 2.05-3.74）. 14 articles were cross-sectional studies with a total sample size of 3000. In China， the prevalence of cognitive impairment in patients with HF was 54.3% （95% CI： 0.43-0.65）. Subgroup analysis showed that the prevalence of cognitive impairment was increased with age， and women had a higher prevalence （58.4%） than that in men （48.4%）. The prevalence in studies using the Montreal Cognitive Assessment （MoCA）to evaluate cognitive impairment （63.6%） was higher than those using Mini-mental State Examination （MMSE）（41.7%）. The limitations of this study include the following： only used the relevant literature on cognitive impairment in patients with HF in China； failed to explain the source of heterogeneity， unable to determine the impact of the study area on heterogeneity， and unable to determine the causality of HF and cognitive impairment. Conclusion:The prevalence of cognitive impairment in patients with HF in China is high and significantly affected by age， gender and other factors. Appropriate measures should be taken for prevention and timely intervention.

Comparison of three different surgical approaches for treatment of thoracolumbar burst fracture / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>The main treatment method used for thoracolumbar fractures is open reduction and internal fixation. Commonly there are three surgical approaches: anterior, posterior and paraspinal. We attempt to compare the three approaches based on our clinical data analysis.</p><p><b>METHODS</b>A group of 94 patients with Denis type A or B thoracolumbar burst fracture between March 2008 and September 2010 were recruited in this study. These patients were treated by anterior-, posterior- or paraspinal-approach reduction with or without decompression. The fracture was fixed with titanium mesh and Z-plate via anterior approach (24 patients), screw and rod system via posterior approach (38 patients) or paraspinal approach (32 patients). Clinical evaluations included operation duration, blood loss, incision length, preoperative and postoperative Oswestry disability index (ODI).</p><p><b>RESULTS</b>The average operation duration (94.1 min +/- 13.7 min), blood loss (86.7 ml +/-0.0 ml), length of incision (9.3 mm +/- 0.7 mm) and postoperative ODI (6 +/- 0.5) were significantly lower (P less than 0.05) in paraspinal approach group than in traditional posterior approach group (operation duration 94.1 min +/- 13.7 min, blood loss 143.3 ml +/-28.3 ml, length of incision 15.4 cm +/- 2.1 cm and ODI 12 +/- 0.7) and anterior approach group (operation duration 176.3 min +/- 20.7 min, blood loss 255.1 ml +/- 38.4 ml, length of incision 18.6 cm +/- 2.4 cm and ODI 13 +/- 2.4). There was not statistical difference in terms of Cobb angle on radiographs among the three approaches.</p><p><b>CONCLUSION</b>The anterior approach surgery is convenient for resection of the vertebrae and reconstruction of vertebral height, but it is more complicated and traumatic. Hence it is mostly used for severe Denis type B fracture. The posterior approach is commonly applied to most thoracolumbar fractures and has fewer complications compared with the anterior approach, but it has some shortcomings as well. The paraspinal approach has great advantages compared with the other two approaches. It is in accordance with the concept of minimally invasive surgery and can replace most posterior approach operations.</p>

Detection and of peripheral blood B cell activating factor in warm autoimmune hemolytic anemia patients and its implication / 中华血液学杂志

<p><b>OBJECTIVE</b>To detect the B cell activating factor (BAFF) and explore its significance in patients with warm autoimmune hemolytic anemia (WAIHA).</p><p><b>METHODS</b>The levels of serum soluble BAFF (sBAFF) and BAFF mRNA in peripheral blood mononuclear cells (PBMCs) in 30 healthy volunteers (control group) and 43 patients with WAIHA were measured by ELISA and real-time quantitative polymerase chain reaction (RT-qPCR) respectively.</p><p><b>RESULTS</b>The levels of serum sBAFF and BAFF mRNA in PBMCs in pretreatment group \[2311 (825 approximately 6523) ng/L and 884 (463 approximately 2346) ng/L\] was significanly higher than those in posttreatment group\[1205(358 approximately 5014) ng/L and 446(138 approximately 2699) ng/L\] and control group\[1128 (590 approximately 3201) ng/L and 341 (102 approximately 965) ng/L\] (both P < 0.01), the difference between the posttreatment group and control group was not statistically significant. There was no significant difference between therapy responsive and nonresponsive groups before treatment. There was a significant difference between the pre- and post-treatment resuets in responsive group (P < 0.01), but not in nonresponsive group (P > 0.05). The serum levels of sBAFF was positively correlated with the levels of the BAFF mRNA in PBMCs both in pre- and post therapy group (both P < 0.05).</p><p><b>CONCLUSION</b>The levels of serum sBAFF and BAFF mRNA in PBMCs are increased in patients with WAIHA, their dynamic alterations may contribute to the development of WAIHA.</p>

Report of a case of congenital plasminogen activator inhibitor-1 deficiency / 中华血液学杂志

<p><b>OBJECTIVE</b>To report a patient with congenital plasminogen activator inhibitor-1 (PAI-1) deficiency and explore its molecular mechanism.</p><p><b>METHODS</b>The activities of tissue plasminogen activator (tPA), alpha(2) antiplasmin (alpha(2)AP) and PAI-1 were measured by the methods of chromogenic substrate, the antigens of tPA and PAI-1 were measured by ELISA. PAI-1 gene was studied by PCR product sequencing and restriction endonuclease ana-lysing.</p><p><b>RESULTS</b>In the present patient, the euglobulin clot lysis time was 70 minutes and was corrected to normal range after added 50 ng/ml PAI-1 to his plasma. The activities of t-PA, alpha(2)AP, and factor were normal; the activity and antigen of PAI-1 in plasma were both significantly decreased. Nucleotide sequence analysis revealed that the patient had a heterozygous missense mutation in exon 2, a G to A transition at nucleotide 43. The possibility of gene polymorphism was excluded by restriction endonuclease analysing.</p><p><b>CONCLUSIONS</b>It is the first patient with congenital PAI-1 deficiency reported in China. The PAI-1 deficiency in the patient may be caused by compound heterozygosity, one of which is the G to A transition at nt43, a new mutation in congenital PAI-1 deficiency.</p>