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1.
Chinese Journal of Biotechnology ; (12): 1307-1321, 2022.
Article in Chinese | WPRIM | ID: wpr-927782

ABSTRACT

Tetrapyrrole compounds are a class of compounds with important functions. They exist in living organisms and have been widely used in agriculture, food, medicine, and other fields. The cumbersome process and high cost of chemical synthesis, as well as the shortcomings of unstable quality of animal and plant extraction methods, greatly hampered the industrial production and applications of tetrapyrrole compounds. In recent years, the rapid development of synthetic biology has provided new tools for microorganisms to efficiently synthesize tetrapyrrole compounds from renewable biomass resources. This article summarizes various strategies for the biosynthesis of tetrapyrrole compounds, discusses methods to improve its biosynthesis efficiency and future prospects, with the aim to facilitate the research on biosynthesis of tetrapyrrole compounds.


Subject(s)
Biomass , Plants/genetics , Synthetic Biology , Tetrapyrroles
2.
Article in English | WPRIM | ID: wpr-927678

ABSTRACT

Objective@#The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been engendering enormous hazards to the world. We obtained the complete genome sequences of SARS-CoV-2 from imported cases admitted to the Guangzhou Eighth People's Hospital, which was appointed by the Guangdong provincial government to treat coronavirus disease 2019 (COVID-19). The SARS-CoV-2 diversity was analyzed, and the mutation characteristics, time, and regional trend of variant emergence were evaluated.@*Methods@#In total, 177 throat swab samples were obtained from COVID-19 patients (from October 2020 to May 2021). High-throughput sequencing technology was used to detect the viral sequences of patients infected with SARS-CoV-2. Phylogenetic and molecular evolutionary analyses were used to evaluate the mutation characteristics and the time and regional trends of variants.@*Results@#We observed that the imported cases mainly occurred after January 2021, peaking in May 2021, with the highest proportion observed from cases originating from the United States. The main lineages were found in Europe, Africa, and North America, and B.1.1.7 and B.1.351 were the two major sublineages. Sublineage B.1.618 was the Asian lineage (Indian) found in this study, and B.1.1.228 was not included in the lineage list of the Pangolin web. A reasonably high homology was observed among all samples. The total frequency of mutations showed that the open reading frame 1a (ORF1a) protein had the highest mutation density at the nucleotide level, and the D614G mutation in the spike protein was the commonest at the amino acid level. Most importantly, we identified some amino acid mutations in positions S, ORF7b, and ORF9b, and they have neither been reported on the Global Initiative of Sharing All Influenza Data nor published in PubMed among all missense mutations.@*Conclusion@#These results suggested the diversity of lineages and sublineages and the high homology at the amino acid level among imported cases infected with SARS-CoV-2 in Guangdong Province, China.


Subject(s)
Amino Acids , COVID-19/epidemiology , Genomics , Humans , Mutation , Phylogeny , SARS-CoV-2/genetics
3.
Article in Chinese | WPRIM | ID: wpr-878949

ABSTRACT

Network pharmacology, molecular docking and in vivo experiments were used to explore the pharmacodynamic basis and potential mechanism of Danggui Sini Decoction in the treatment of primary dysmenorrhea(PD). The chemical constituents of Danggui(Angelicae Sinensis Radix), Guizhi(Cinnamomi Ramulus), Tongcao(Tetrapanacis Medulla), Baishao(Paeoniae Radix Alba), Xixin(Asari Radix et Rhizoma), Gancao(Glycyrrhizae Radix et Rhizoma), and Dazao(Jujubae Fructus) from Danggui Sini Decoction were retrieved through TCMSP(Traditional Chinese Medicine Systems Pharmacology Database), and the action targets of Danggui Sini Decoction were collected through DrugBank. "Primary dysmenorrhea" and "dysmenorrhea" were used as the key words to search the corresponding targets in the GeneCards, OMIM and TTD databases, and then the intersection targets of Danggui Sini Decoction and the primary dysmenorrhea targets were taken for reverse screening to obtain the corresponding active ingredients. Cytoscape 3.6.1 software was used to construct a traditional Chinese medicine-compound-target-disease network; STRING database was used to build a protein-protein interaction(PPI) network; Gene ontology(GO) function enrichment analysis and Kyoto encyclopedia of genes and genomes(KEGG) pathway enrichment analysis were conducted by using DAVID database. The action mechanism of the intersection targets were then predicted, and a histogram chart and bubble chart were drawn for visualization. Then the top five targets in the PPI network were used for docking with the most compounds. In animal experiments, Sprague Dawley(SD) female rats were used to establish a primary dysmenorrhea model by intraperitoneal injection of diethylstilbestrol once a day. A total of 60 SD female rats were randomly divided into 6 groups, namely control group, model group, Danggui Sini Decoction low(1.5 g·kg~(-1)), medium(3.0 g·kg~(-1)), high(6.0 g·kg~(-1)) dose groups, and ibuprofen(20 mg·kg~(-1)) positive control group, with 10 rats in each group. From day 4, except for the control group, rats in the other groups were given intragastric administration of corresponding drugs, and the control group received intragastric administration of normal saline for 7 consecutive days. The number of writhing before and after the administration, the ute-rine contraction inhibition rate and the uterine index after administration were observed, and ELISA assay was used to detect the levels of prostaglandin-endoperoxide synthase 2(PTGS2) and vascular endothelial growth factor A(VEGFA) in the tissues of each group as well as the levels of serum inflammatory factors interleukin 1(IL-1), interleukin 6(IL-6), and tumor necrosis factor-alpha(TNF-α). According to network analysis, 7 Chinese medicines contained 114 active ingredients, 149 targets, and 30 common target genes with PD were obtained. The key targets included VEGFA, IL6, PTGS2, TNF, etc.; GO function enrichment analysis showed a total of 399 terms(P<0.05) were obtained, 353 of which were biological process(BP) terms, 21 were cell composition(CC) terms, and 25 were molecular function(MF) terms. In KEGG pathway enrichment analysis, 14 signaling pathways were obtained, 3 of which were related to inflammation, namely arachidonic acid metabolism, MAPK signaling pathway and NOD-like receptor signaling pathway. The compounds in Danggui Sini Decoction can play a therapeutic role in the treatment of PD by acting on VEGFA, IL-6, PTGS2, TNF and other targets to regulate arachidonic acid and inflammatory signaling pathways.


Subject(s)
Animals , Drugs, Chinese Herbal , Dysmenorrhea/drug therapy , Female , Humans , Molecular Docking Simulation , Rats , Rats, Sprague-Dawley , Vascular Endothelial Growth Factor A
4.
Chinese Journal of Digestion ; (12): 320-325, 2020.
Article in Chinese | WPRIM | ID: wpr-871468

ABSTRACT

Objective:To evaluate the safety, feasibility and operational performance of self-developed medical disposable portable endoscopy (YunSendo) for upper gastrointestinal endoscopy examination in Ba-Ma mini-pigs.Methods:A total of 10 Guangxi Ba-Ma mini-pigs were used in the experiment, and mucosal injury models were established in advance by biopsy forceps in esophagus, stomach, and duodenum. Each experimental animal underwent medical disposable portable endoscopy and Olympus endoscopy (GIF-Q260J) performed by two endoscopists separately. The time when the endoscope reached the duodenum, the number of detected mucosal injuries and endoscopic pictures of different parts with standard image acquisition were recorded. Endoscopic operational performance and endoscopic image quality were evaluated. Different endoscopists recorded experimental results with blind method. The procedures of the two endoscopic examinations were performed by coin-tossing method. The paired t test was used for statistical analysis. Results:There were no statistically significant differences in the insertion time and total operation time between medical disposable portable endoscopy and Olympus endoscopy ( (171.00±9.96) s vs. (164.00±17.84) s, (285.00±33.94) s vs. (273.40±23.46) s; t=1.289 and 1.281, P=0.230 and 0.232). There were no statistically significant differences in the percentage of time of clear visual field during endoscopy insertion and total operation between medical disposable portable endoscopy and Olympus endoscopy ((91.83±1.85)% vs. (91.52±1.51)%, (93.07±3.10)% vs. (92.06±2.57)%; t=0.401 and 0.689, P=0.698 and 0.508). Moreover, there were no statistically significant differences in the score of comprehensive operation performance, score of clear image number, score of image color recognition, score of image illumination, comprehensive score of image quality and number of detected mucosal injuries ((9.66±0.30) points vs. (9.86±0.15) points, (39.50±0.71) points vs. (39.30±1.06) points, (39.70±0.48) points vs. (39.40±0.70) points, (39.40±0.70) points vs. (39.50±0.71) points, (9.88±0.09) points vs. (9.85±0.20) points, 9.80±0.42 vs. 9.90±0.32; t=2.176, 1.000, 1.152, 0.317, 0.629 and 0.557, all P>0.05). There were no adverse events after operation in medical disposable portable endoscopy group and Olympus endoscopy group. Conclusions:The medical disposable portable endoscopy is safe and feasible for endoscopy examination in live animal models. Different parts of upper gastrointestinal tract and mucosal lesions can be clearly detected. The operational performance and the image quality are excellent, which is similar to Olympus endoscopy (GIF-Q260J).

5.
Chinese Critical Care Medicine ; (12): 632-635, 2020.
Article in Chinese | WPRIM | ID: wpr-866862

ABSTRACT

Blast injury is the main cause of injury in the battlefield, which also occurs frequently in the civil field and modern society. The damage caused by blast is more complicated than other types of trauma. Primary blast injury is a common type of blast injury, which can cause multiple organ damage with complex mechanism. Tissue and vascular endothelium damage and organ hypoperfusion are the consistent manifestations of most organ damage. However, due to the concealed damage caused by the primary blast injury, it is difficult to recognize it in time. The study of coagulation function and acid-base balance change after primary blast injury can bring benefits to its early diagnosis and intervention, thus improving the prognosis and mortality of blast injury. However, at present, the research on primary blast injury mostly focuses on single organ damage. Lack of research on systemic coagulation and acid-base balance changes calls for further research. Such research has a practical significance for the early diagnosis and optimization of tactical care for primary blast injury. This article reviews the injury characteristics, epidemiology, mechanism and the relationship with trauma-induced coagulopathy (TIC) in primary blast injury to provide reference for related researches.

6.
Article | WPRIM | ID: wpr-832365

ABSTRACT

Background@#To examine the prospective association between higher blood pressure (BP) and risk of type 2 diabetes mellitus (T2DM) in middle-aged and elderly Chinese adults. @*Methods@#A total of 9,642 middle-aged and elderly Chinese adults (≥45 years old; 47.30% men) without diabetes from the China Health and Retirement Longitudinal Study were included for analyses. Participants were categorized into three groups: normal BP, prehypertension, and hypertension, according to the 2010 Chinese Guidelines for the Management of Hypertension. The incidence of T2DM was determined by self-reported physician diagnosis during two follow-up surveys conducted in 2013 to 2014 and 2015 to 2016. @*Results@#During the 4-year follow-up, 429 participants (4.45%) developed T2DM, including 3.51% of the men and 5.29% of the women. The incidence rates of T2DM were 2.57%, 3.75%, and 6.71% in the normal BP, prehypertension, and hypertension groups, respectively. After adjustment for age, sex, education level, residence, smoking status, alcohol consumption, body mass index, waist circumference, and dyslipidemia, both prehypertension (odds ratio [OR], 1.32; 95% confidence interval [CI], 0.98 to 1.77) and hypertension (OR, 2.02; 95% CI, 1.54 to 2.64) were associated with increased risk of T2DM, compared to those with a normal BP. The ORs associated with T2DM were 1.08 (95% CI, 1.03 to 1.13) for an increase of 10 mm Hg in systolic BP and 1.06 (95% CI, 1.01 to 1.10) for an increase of 5 mm Hg in diastolic BP. @*Conclusion@#Higher BP is a risk factor for T2DM in middle-aged and elderly Chines. It may be a potential target for diabetes prevention.

7.
Article in Chinese | WPRIM | ID: wpr-787757

ABSTRACT

To analyze the association between the self-rated health (SRH) status and risk of cardiovascular disease (CVD) among the middle-aged and eldly Chinese. Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which enrolled 21 133 participants by using the probability proportional to size (PPS) sampling from 150 counties/districts of 28 provinces in China from 2011 to 2012. A total of 11 701 participants were included in the study. Basic information and SRH were obtained in the baseline survey via questionnaires. Information of CVD was self-reported during the follow-up. Cox proportional hazards modeling was used to analyze the association between the baseline SRH and risk of CVD. Subgroup analyses were performed by age, sex and body mass index (BMI), and their interactions with SRH for risk of CVD were examined by using the likelihood ratio test. A sensitivity analysis was conducted to test the robustness of the association. Participants were (57.9±9.7) years old, and men accounted for 48.1% (5 626). SRH was reported as the excellent, very good, good, fair and poor among 4.2% (487), 13.5% (1 583), 33.6% (3 932), 35.4% (4 147) and 13.3% (1 552), respectively. During 42 104 person-years of followed up, 590 cases of CVD were identified. Cox regression analyses showed that compared with the excellent/very good SRH, the (95) of CVD risk for the good, fair and poor SRH was 1.36 (1.02-1.80), 1.66 (1.26-2.19) and 1.89 (1.38-2.59), respectively. Subgroup analyses showed that compared with the excellent/very good SRH, (95) of CVD risk for poor SRH in the group of 45-59 years old, equal to or over 75 years old, men, women and normal BMI were 2.00 (1.32-3.04), 3.87 (1.04-14.46), 1.76 (1.07-2.91), 1.92 (1.27-2.91) and 2.30 (1.42-3.72), respectively. There were no interactions between age, sex, BMI and SRH (0.05). SRH is associated with risk of CVD among middle-aged and elderly Chinese. The CVD risk for good, fair and poor SRH is higher than that for excellent/very good SRH.

8.
Article in Chinese | WPRIM | ID: wpr-905423

ABSTRACT

Objective:To explore the effect of gymnastic exercise on sensory integration disorder (SID) in children aged three to six years. Methods:From March to June 2018, 27 children aged three to six years with SID were recruited from Chengdu U-Beller International Children Education Center (Pidu Campus), and were randomly divided into control group (n = 13) and experimental group (n = 14). The experimental group accepted gymnastic exercise, 60 minutes a time, three times a week, for 16 weeks. The control group received no intervention. They were assessed with Assessment Scale for Children Sensory Integration Development, for vestibular dysfunction, tactile defense and proprioception dysfunction. Results:After intervention, the SID improvement was better in the experimental group than in the control group (χ2 > 6.639, P < 0.05), several children with mild disorder returned to normal level, and several with severe disorder returned to mild level. There was no difference in the scores of vestibular dysfunction, tactile defense and proprioception dysfunction before and after intervention in the control group (P > 0.05), and the scores significantly improved in the experimental group (|t| > 7.015, P < 0.01), and was higher in the experimental group than in the control group after intervention (t > 2.193, P < 0.01). Conclusion:Gymnastic exercise can improve vestibular dysfunction, tactile defense and proprioception dysfunction for children with SID aged three to six years.

9.
Article in Chinese | WPRIM | ID: wpr-777931

ABSTRACT

The review clarifies the relation of representativeness to multicenter intervention design, heterogeneity, response rate, and loss to follow-up. In addition, the implications of representativeness in the era of precision medicine and big data-based epidemiological studies are further discussed. In summary, population health researchers should have a fair understanding of the function and role of representativeness in epidemiology in order to conduct scientifically plausible studies to generate the best evidence for practice.

10.
Article in Chinese | WPRIM | ID: wpr-777906

ABSTRACT

@# Representativeness has long been a contentious topic in epidemiology. The review starts with defining representativeness in epidemiology and describing fundamental epidemiological concepts including study population, source population, target population, internal validity, and external validity. In addition, it elaborates the role and practicality of representativeness in four major epidemiological study designs including cross-sectional, cohort, case-control, and intervention studies. In summary, representativeness is an important consideration in cross-sectional studies of investigating disease or health status in the target population, but cannot be overstated in epidemiological studies for causal inferences regarding exposure-outcome relationships or intervention effects.

11.
Article in Chinese | WPRIM | ID: wpr-744665

ABSTRACT

Medical big data is a hot research topic in China,and it is also the main research direction in the field of emergency medicine.The current situation of the construction of the first-aid big data platform and the construction of the first-aid clinical decision support system were analyzed,the problems existing in the development of the first-aid big data research field were enumerated,to explore the theoretical methods for promoting the development of domestic first-aid big data,so as to provide references for the research in related fields.

12.
Chinese Journal of Immunology ; (12): 207-212, 2019.
Article in Chinese | WPRIM | ID: wpr-744635

ABSTRACT

Objective: To investigate the expression and clinical significance of LMTK3 in patients with prostate carcer. Methods: Immunohistochemistry was used to detect the expression of LMTK3 and ERα in 55 cases of prostate cancer tissues and 25 cases of benign prostatic hyperplasia tissues. The relationship between the expression of LMTK3 and ERα and clinicopathological parameters was evaluated by square test and Fisher exact test. The association between LMTK3 and ERα expression was analyzed with Pearson and Spearman rank correlation. Results: The results of immunohistochemistry demonstrated that the LMTK3 and ERα protein positive expression rate in 55 cases of prostate cancer tissues was 36. 36% and 32. 73%, whereas was 64. 00% and 56. 00% in the benign prostatic hyperplasia, respectively, showed a significant difference of comparison within this result ( P < 0. 05). The expression of LMTK3 in prostate cancer tissues was inversely related with the level of Gleason grade ( P<0. 05), but no relation with the levels of age, TPSA, TNM stage and lymph node metastasis ( P>0. 05). Moreover, the expression of ERα in prostate cancer tissues was oppositely related with the levels of gleason grade and TPSA ( P<0. 05), but no relation with the levels of age, TNM stage and lymph node metastasis ( P>0. 05). Pearson and Spearman rank correlation analysis revealed, to some extent, there was positively correlated with the two proteins ( r = 0. 296, P<0. 05). Conclusion: The expression of LMTK3 in prostate cancer tissues was decreased compared with benign prostatic hyperplasia tissues and negatively related with the level of gleason grade. In some degree, there is a positively correlation between the LMTK3 and ERα proteins.

13.
Article in Chinese | WPRIM | ID: wpr-755118

ABSTRACT

Objective To study the impact on the use of branched vascular allografts in the prevention of left regional portal hypertension after pancreatic cancer operations.Methods This retrospective study included 25 patients who underwent pancreaticoduodenectomy for pancreatic head cancer which involved the portal vein,superior mesenteric vein and splenic venous confluence between January 2011 to December 2017 in the Beijing Chao Yang Hospital,Capital Medical University.These patients underwent "en bloc" resection of the spleno-mesenterio-portal (SMS) venous axis with replacement of a branched vascular allografts.They were studied to see whether gastroesophageal varices were found on gastroscopy and whether there were any changes in leukocyte,platelet and splenic volume before and after the operation to determine the incidence of left regional portal hypertension after operation.Results During the follow-up period,all the portal vein,superior mesenteric vein and splenic vein anastomoses were unobstructed and without any thrombosis.No new varices were found on gastroscopy.There were no significant differences in the white blood cell count,platelets count and splenic volume before and after the operations (all P>0.05).The 25 patients had no left regional portal hypertension.Survival time and one year survival rate of the patients were (20.2±3.7) months and 44.0%.Conclusion Branched vascular allografts effectively prevented the occurrence of left regional portal hypertension after radical pancreaticoduodenectomy with resection of SMP.

14.
Article in Chinese | WPRIM | ID: wpr-753001

ABSTRACT

Objective To investigate the clinical efficacy of total pancreaticoduodenectomy combined with portal vein resection and allograft vascular grafts for pancreatic cancer with vascular invasion.Methods The retrospective and descriptive study was conducted.The clinicopathological data of 9 patients with pancreatic cancer who underwent total pancreaticoduodenectomy combined with portal vein resection and allograft vascular grafts in the Beijing Chao Yang Hospital of Capital Medical University from January 2014 to September 2016 were collected.There were 4 males and 5 females,aged from 53 to 78 years,with a median age of 60 years.Involvement of portal vein (PV) and (or) superior mesenteric vein (SMV),splenic vein or convergence was detected in patients by preoperative evaluation,which indicated borderline resectable pancreatic cancer.Patients underwent complete surgical resection of tumor and involved portal veins,and then underwent vascular and digestive tract reconstruction.Observation indicators:(1) intraoperative situations;(2) postoperative situations;(3) follow-up.Patients were followed up by telephone interview and outpatient examination to detect survival of patients up to October 2018.Measurement data with normal distribution were represented as Mean±SD,measurement data with skewed distribution were expressed as M (range),and count data were expressed as absolute number.Results (1) Intraoperative situations:9 patients underwent total pancreaticoduodenectomy combined with portal vein resection and allograft vascular grafts successfully,including 1 undergoing total pancreaticoduodenectomy due to positive margin of pancreatic neck during pancreatico-duodenectomy for pancreatic head carcinoma,3 of pancreatic head carcinoma with portal vein involvement and atrophy of pancreatic body and tail,and 5 of carcinoma of pancreatic neck and body with portal vein involvement.The operation time,portal vein occlusion time,and volume of intraoperative blood loss were (573± 19) minutes,(21 ±4) minutes,and (717±33) mL.(2) Postoperative situations:4 of 9 patients had postoperative complications,including 2 with grade Ⅰ complication and 2 with grade Ⅱ complication.There was no grade Ⅲ or above complication.No anastomotic stenosis or thrombus formation after reconstruction for portal vein.The perioperative complications were cured after conservative treatment.Duration of postoperative hospital stay was 17 days (range,10-25 days).Nine patients underwent subcutaneous injection of insulin to control blood glucose during the period fasting for solids and liquids.After resuming the semi-liquid diet of diabetes,patients received subcutaneous injection of rapid acting insulin before meals combined with subcutaneous injection of long-acting insulin before bedtime,with a insulin need of 24-36 U/d.Patients had postprandial blood sugar level of 8-11 mmol/L,without unmanageable hyperglycemia orlong-term application of insulin pump.Patients received oral trypsin pancreatin instead of trypsin,with no gastrointestinal symptoms such as bloating and steatorrhea,no malnutrition.Of 9 patients,2 had well-differentiated adenocarcinoma,4 had moderately differentiated adenocarcinoma,and 3 had poor-differentiated adenocarcinoma.There were 3 patients with no vascular invasion,1 with endangidic invasion,5 with tumor infiltration of tunica adventitia vasorum.One of 9 patients was in IIA stage of TNM staging,3 were in the II B stage,and 5 were in IIIB stage.The negative rate of pathological sections for excised specimen margin was 8/9.(3) Follow-up:9 patients were followed up for 7-37 months,with a median follow-up time of 15 months.Four patients survived,4 died of tumor recurrence and metastasis,and 1 died of cerebrovascular accident.Conclusion Total pancreaticoduodenectomy combined with portal vein resection and allograft vascular grafts is safe and feasible for pancreatic cancer involving portal vein,splenic vein or junction.

15.
Chinese Critical Care Medicine ; (12): 609-612, 2018.
Article in Chinese | WPRIM | ID: wpr-703700

ABSTRACT

Objective To construct a database containing multiple kinds of diseases that can provide "real world"data for first-aid clinical research. Methods Structured or non-structured information from hospital information system, laboratory information system, emergency medical system, emergency nursing system and bedside monitoring instruments of patients who visited department of emergency in PLA General Hospital from January 2014 to January 2018 were extracted. Database was created by forms, code writing, and data process. Results Emergency Rescue Database is a single center database established by PLA General Hospital. The information was collected from the patients who had visited the emergency department in PLA General Hospital since January 2014 to January 2018. The database included 530 585 patients' information of triage and 22 941 patients' information of treatment in critical rescue room, including information related to human demography, triage, medical records, vital signs, lab tests, image and biological examinations and so on. There were 12 tables (PATIENTS, TRIAGE_PATIENTS, EMG_PATIENTS_VISIT, VITAL_SIGNS, CHARTEVENTS, MEDICAL_ORDER, MEDICAL_RECORD, NURSING_RECORD, LAB_TEST_MASTER, LAB_RESULT, MEDICAL_EXAMINATION, EMG_INOUT_RECORD) that containing different kinds of patients' information. Conclusions The setup of high quality emergency databases lay solid ground for scientific researches based on data. The model of constructing Emergency Rescue Database could be the reference for other medical institutions to build multiple-diseases databases.

16.
Chinese Critical Care Medicine ; (12): 531-537, 2018.
Article in Chinese | WPRIM | ID: wpr-703684

ABSTRACT

Objective To study the distribution of diseases in Medical Information Mart for Intensive Care Ⅲ(MIMIC-Ⅲ) database in order to provide reference for clinicians and engineers who use MIMIC-Ⅲ database to solve clinical research problems. Methods The exploratory data analysis technologies were used to explore the distribution characteristics of diseases and emergencies of patients (excluding newborns) in MIMIC-Ⅲ database were explored; then, neonatal gestational age, weight, length of hospital stay in intensive care unit (ICU) were analyzed with the same method. Results In the MIMIC-Ⅲ database, 46 428 patients were admitted for the first time, and 49 214 ICU records were recorded. There were 26 076 males and 20 352 females; the median age was 60.5 (38.6, 75.6) years, and most patients were between 60 and 80 years old. The first diagnosis in the disease spectrum analysis was firstly ranked by circulatory diseases (32%), followed by injury and poisoning (14%), digestive system disease (8%), tumor (7%), respiratory disease (6%) and so on. Patients with ischemic heart disease accounted for the largest proportion of circulatory disease (42%), the proportion of these patients gradually increased with age of 60-70 years old, then decreased. However, the proportion of patients with cerebrovascular disease declined first and then increased with age, which was the main cause of death of circulatory system disease (ICU mortality was 22.5%). Injury and poisoning patients showed a significant decrease with age. Digestive system diseases were younger than the general population (most people aged between 50 to 60 years), and non-infectious enteritis and colitis were the main causes of death (ICU mortality was 18.3%). Respiratory infections were predominant in infected patients (34%), but circulatory system infections were the main cause of death (ICU mortality was 25.6%). Secondly, in the neonatal care unit, premature infants accounted for the vast majority (82%). As the gestational age increased, the duration of ICU was decreased, and the mortality was decreased. Conclusions The diseases distribution of patients can be provided by MIMIC-Ⅲ database, which helps to grasp the overview of the volume and age distribution of the target patients in advance, and carry out the next step of research. Meanwhile, it points out the important role of exploratory data analysis in electronic health records analysis.

17.
Chinese Critical Care Medicine ; (12): 494-496, 2018.
Article in Chinese | WPRIM | ID: wpr-703680

ABSTRACT

To introduce Medical Information Mart for Intensive Care (MIMIC) database and elaborate the approach of critically emergent research with big data based on the feature of MIMIC and updated studies both domestic and overseas, we put forward the feasibility and necessity of introducing medical big data to research in emergency. Then we discuss the role of MIMIC database in emergency clinical study, as well as the principles and key notes of experimental design and implementation under the medical big data circumstance. The implementation of MIMIC database in emergency medical research provides a brand new field for the early diagnosis, risk warning and prognosis of critical illness, however there are also limitations. To meet the era of big data, emergency medical database which is in accordance with our national condition is needed, which will provide new energy to the development of emergency medicine.

18.
Article in Chinese | WPRIM | ID: wpr-702623

ABSTRACT

Objective To systematically review the safety and efficacy of enhanced recovery after surgery (ERAS) in perioperative management of pancreaticoduodenectomy.Methods A search was performed in databases (including PubMed,EMASE,Cochrane library,Sinomed,Wangfang,VIP,and CNKI) for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) up to September 2016 on use of ERAS in patients undergoing pancreaticoduodenectomy.After quality evaluation and data extraction,meta-analysis was performed using RevMan 5.3.Results Four RCTs and Twelve NRCTs involving a total of 2 828 patients were included.1 401 patients were in the ERAS group,and 1 427 in the control group.Meta-analysis results showed that compared with the control group,the ERAS group had shorter length of hospital stay (SMD =-0.36,95 % CI =-0.44--0.28,P< 0.05) and lower incidence of delayed gastric emptying (RR =0.61,95% CI=0.51-0.73,P<0.05).However,no significant differences were observed in pancreatic fistula rate,bile fistula rate,readmission rate,reoperation rate,and overall mortality morbidity rate between the two groups (all P>0.05).Conclusion It is reasonably safe and efficacious to adopt ERAS in periopetative management of patients undergoing pancreaticoduodenectomy.

19.
Journal of Stroke ; : 247-257, 2018.
Article in English | WPRIM | ID: wpr-714415

ABSTRACT

BACKGROUND AND PURPOSE: Self-rated health (SRH) is a consistent and strong predictor of all-cause and cardiovascular mortality in various populations. However, the associations between SRH measures and risk of first-ever or recurrent stroke were rarely explored. We thus aim to prospectively investigate the associations between SRH measures and risk of total and subtypes of stroke in Chinese population. METHODS: A total of 494,113 participants from the China Kadoorie Biobank without prior heart diseases or cancer (486,541 without stroke and 7,572 with stroke) were followed from baseline (2004 to 2008) until December 31, 2013. General and age-comparative SRH were obtained from baseline questionnaires. First-ever stroke or recurrent events were ascertained through linkage to disease registry system and health insurance data. RESULTS: We identified 27,662 first-ever stroke and 2,909 recurrent events during an average of 7.0 years of follow-up. Compared with excellent general SRH, the hazard ratios (HRs) and 95% confidence intervals (CIs) for first-ever stroke associated with good, fair, and poor general SRH were 1.04 (1.00 to 1.08), 1.19 (1.15 to 1.23), and 1.49 (1.42 to 1.56) in the multivariate model, respectively. Compared with better age-comparative SRH, the HRs (95% CIs) of same and worse age-comparative SRH were 1.13 (1.10 to 1.17) and 1.51 (1.45 to 1.58), respectively. The relations of SRH measures with ischemic stroke, hemorrhagic stroke, and recurrent stroke were similar to that with total first-ever stroke. However, the magnitude of associations was much stronger for fatal stroke than for non-fatal stroke. CONCLUSIONS: This large-scale prospective cohort suggests that self-perceived health status is associated with incident stroke, regardless of stroke subtype.


Subject(s)
Adult , Asians , China , Cohort Studies , Follow-Up Studies , Heart Diseases , Humans , Insurance, Health , Mortality , Prospective Studies , Stroke
20.
Article in Chinese | WPRIM | ID: wpr-710110

ABSTRACT

Objective To evaluate the feasibility and safety of the robot - assisted system YunSRobot for remote manipulation endoscopy. Methods When the master of YunSRobot was installed in the gastroenterology office in Chinese PLA General Hospital, the robot slave and upper gastrointestinal simulation model (Takahashi Lm103,Japan) were installed at the same time in the State Key Laboratory of Robotics, Shenyang Institute of Automation. Three physicians were trained to operate the master robotics and performed gastroscopy on the simulation model based on network cloud. Each physician performed 3 procedures of oesophagogastroduodenoscopy (EGD) by YunSRobot using traditional manual endoscopy, on-site operating mode, and remote manipulation mode, respectively. The operating time, lumenal anatomic exposure,man-machine interaction and other parameters were recorded. Results The number of standard pictures obtained by traditional manual endoscopy group, on-site operating group and remote manipulation group were 39.9±0.3, 39.8±0.4, 39.9±0.3, respectively. The images of all five lesions could be obtained by each operation. The operating time in the duodenum of remote group was longer than that of on-site group, with average time (78.2±16.0)s vs. (68.9±15.8)s (P=0.021) respectively. As to the operating time on other parts or total time, all three groups were comparable. Although there was a mean delay of (572.1±48.5) ms in remote operation group, the operation was still smooth. However, compared with on-site group, the percentage of clear view time in the duodenum was significantly shortened in remote group: [(77.8±8.2)% vs. (83.9 ± 6.4)% , P=0.024]. Statistically significant difference was detected in percentage of clear view time neither in other sites, nor was in the total operating time between two groups. The operating time in each part of remote group was obviously longer than that of manual group as followings, pharyngeal (27.3±4.2) s vs. (9.2±1.3)s (P<0.001), esophageal (29.7±6.4)s vs. (19.3±1.6)s (P=0.004), stomach (56.7±17.0)s vs. (40.3±7.0)s (P=0.003), pylorus (20.2±5.5)s vs. (9.3±1.3)s (P<0.001), duodenum (78.2±16.0)s vs. (29.3±5.6)s (P<0.001). Thus the total operating time was also longer in remote group as (559.0±87.2)s vs. (253.1±16.6)s (P<0.001). The respective time in pharynx, esophagus, stomach, pylorus, duodenum, or the overall time was all longer in remote group than that in manual group. Conclusions The soft endoscopy robot YunSRobot has satisfactory safety and stability. Remote upper gastrointestinal endoscopy can be completed based on common network and an endoscope simulation model with smooth operation. The inspection time by YunSRobot robot per part and the overall time are longer than those of manual operation on site, still, remote operating time meets the standard of upper gastrointestinal endoscopy.

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