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Objective:To analyze the clinical phenotypic characteristics and therapeutic effect of cutaneous anthrax patients in Ningxia Hui Autonomous Region (referred to as Ningxia).Methods:A retrospective analysis was conducted on the medical records of 76 confirmed patients with cutaneous anthrax in three prefecture level hospitals in Ningxia from 2017 to 2022. According to the length of hospital treatment, the patients were divided into a disease course ≥7 d group ( n = 54) and a disease course < 7 d group ( n = 22), and the clinical phenotypic characteristics (including patients' general condition, clinical symptoms, and laboratory tests) and therapeutic effects (the effect of hormone use and the choice of antibiotics) of the two groups were analyzed by methods such as χ 2 test. Results:Among 76 patients with cutaneous anthrax, males accounted for 81.6% (62/76) and females accounted for 18.4% (14/76), with a statistically significant difference in gender composition ratio (χ 2 = 5.71, P = 0.017). Among the 76 patients, 73 caces (96.1%) achieved clinical cure. There was no statistically significant differences between the groups in clinical characteristics such as temperature, pain, pruritus, edema, and site of onset ( P > 0.05). There were no statistically significant differences between groups in laboratory tests such as blood routine, liver function, hypersensitive C-reactive protein, secretion culture, PCR, etc. ( P > 0.05). There was a statistically significant difference in the distribution of edema resolution time between patients using hormone or not (χ 2 = 17.01, P = 0.002). There was no statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when using hormone (χ 2 = 5.43, P = 0.143). There was a statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when no using hormone (χ 2 = 108.46, P < 0.001). Conclusions:The majority of cutaneous anthrax patients in Ningxia from 2017 to 2022 are males. Early use of hormones can affect the duration of edema in patients. For patients who have not received hormone therapy, different treatment plans can affect the patient's course of disease.
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Objective To explore the efficacy and safety of enhanced external counterpulsation(EECP)in elderly patients with acute ischemic stroke(AIS)complicated by coronary heart dis-ease(CHD).Methods A total of 65 AIS patients with CHD admitted in our hospital from Janu-ary to June 2023 were recruited and randomly divided into a control group(drug secondary pre-vention,n=32)and a treatment group(drug combined with EECP therapy,n=33).Their NIHSS score,mRS score and Canadian Cardiovascular Society(CCS)angina grade were evaluated before and after treatment and compared between the two groups.The incidences of recurrent ischemic stroke,new hemorrhagic stroke and major adverse cardiovascular events(MACE)were also recor-ded during treatment.Results The NIHSS score and mRS score were significantly decreased in both groups after treatment(P＜0.01).After treatment,the NIHSS score(2.67±1.63 vs 3.56± 1.83),mRS score[1.0(0.0,1.0)vs 2.0(1.0,2.0)]and CCS grade[1.0(1.0,2.0)vs 2.0(1.0,2.0)]were obviously lower in the treatment group than the control group(P＜0.05,P＜0.01).There were no statistical differences in the incidence rates of recurrent ischemic stroke,new-onset hem-orrhagic stroke,and MACE between the control group and the treatment group(9.4％vs 6.1％,6.3％vs 3.0％,12.5％vs 6.1％,P＞0.0 5).Conclusion EECP is a safe and effective treatment option for elderly AIS patients with CHD.
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ObjectiveTo investigate the regulatory effect of miRNA-933 on the apoptosis and proliferation of human hepatic stellate cell line LX-2 and its mechanism. MethodsFirstly， with human liver tissue for research， gene microarray technology was used to detect the differentially expressed genes in liver tissue between liver cirrhosis/chronic hepatitis B tissue and normal liver tissue， among which the significantly differentially expressed miRNAs were identified， and thus miRNA-933 was determined as the research object. Then， with the human hepatic stellate cell line LX-2 for research， miRNA-933 mimic and inhibitor （miRNA-933 siRNA） were used to construct the LX-2 models of overexpression and knockdown， and the cells transfected with mimic-NC （overexpression） or siRNA-NC （knockdown） were established as the negative control group. Quantitative real-time PCR and Western blot were used to measure the expression levels of miRNA-933 and activation biomarkers； techniques such as cell proliferation assay and flow cytometry were used to investigate the effect and mechanism of miRNA-933 on cell apoptosis， proliferation， and activation. The independent-samples t test was used for comparison of continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and Bonferroni correction was also performed. ResultsA total of 18 significantly differentially expressed miRNAs were obtained based on the results of gene microarray， among which miRNA-933 was significantly downregulated （P<0.05）. After LX-2 cells were transfected with miRNA-933 mimic or siRNA， compared with the negative control group， miRNA-933 siRNA significantly downregulated the expression of miRNA-933 （P=0.000 7）， while miRNA-933 mimic significantly upregulated the expression of miRNA-933 （P=0.000 3）. Western blot and quantitative real-time PCR showed that miRNA-933 siRNA significantly upregulated the expression of collagen I and α-SMA （P<0.001）， while miRNA-933 mimic significantly inhibited the expression of collagen I and α-SMA （P<0.05）. Flow cytometry showed that compared with the negative control group， miRNA-933 siRNA significantly downregulated the apoptosis rate of LX-2 cells （P=0.031 9）， and miRNA-933 mimic significantly upregulated the apoptosis rate of LX-2 cells （P=0.005 5）. Western blot showed that compared with the negative control group， miRNA-933 siRNA could inhibit the expression of Caspase-3 （P=0.006 7） and poly（ADP-ribose） polymerase-1 （PARP-1） （P=0.003 0） and upregulate the expression of B-cell lymphoma-2 （Bcl-2） in LX-2 cells （P=0.002 0）， while miRNA-933 mimic could significantly upregulate the expression of Caspase-3 （P=0.011 8） and PARP-1 （P=0.049 5） and downregulated the expression of Bcl-2 （P=0.002 1）. Cell proliferation assay showed that compared with the negative control group， miRNA-933 siRNA could promote the proliferation of LX-2 cells （P=0.011 5）， while on the contrary， miRNA-933 mimic could inhibit the proliferation of LX-2 cells （P=0.001 2）. Western blot and quantitative real-time PCR showed that miRNA-933 siRNA significantly inhibited the expression of Kruppel-like factor 6 （KLF6） and downregulated the expression of activating transcription factor 4 （ATF4）， activating transcription factor 3 （ATF3）， and C/EBP homologous protein （CHOP）， while miRNA-933 mimic promoted the expression of the above proteins （all P<0.05）. ConclusionThis study shows that miRNA-933 may promote cell apoptosis and inhibit cell activation and proliferation by promoting the activation of the KLF6/ATF4/ATF3/CHOP/Bcl-2 signal axis in LX-2 cells.
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Objective To investigate the diagnostic value of high-resolution magnetic resonance im-aging(HRMRI)in elderly patients with non-cardioembolic acute ischemic stroke(NCAIS).Meth-ods A retrospective analysis was conducted on 101 elderly NCAIS patients having HRMRI in our hospital from July 2022 to July 2023.Stroke subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment(TOAST)system and the Chinese Ischemic Stroke Sub-classification(CISS)system.The constituent ratio distribution of each subtype classification was compared before and after HRMRI in both classification systems.Results TOAST system identi-fied 8 cases of small-artery occlusion(SAO),1 case of other determined etiology(SOE),5 cases of undetermined etiology(SUE)and then reclassified as large artery atherosclerosis(LAA),1 case of SUE which was reclassified as SAO,and 7 cases of LAA and 4 cases of SUE being reclas-sified as SOE after HRMRI.In total,the diagnosis of 26 cases(25.74％)was modified.In the CISS system,10 cases of penetrating artery disease(PAD),1 case of other etiologies(OE),and 4 cases of undetermined etiology(UE)were reclassified as LAA.Furthermore,9 cases of LAA and 3 cases of UE were reclassified as OE after HRMRI.In total,the diagnosis of 27 cases(26.73％)was modified.There were statistical differences in the constituent ratio before and after HRMRI in both TOAST(x2=15.425,P＜0.01)and CISS(x2=17.300,P＜0.01)systems.Conclusion HRMRI is of diagnostic value and significance in accurately diagnosing the etiology of AIS in eld-erly patients without cardioembolic causes.
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Objective:To compare the clinical efficacy and safety of conventional transcatheter arterial chemoembolization (TACE) with drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE) in treatment of patients with unresectable hepatocellular carcinoma.Methods:The data of patients with unresectable hepatocellular carcinoma who underwent hepatic artery chemoembolization at General Hospital of Ningxia Medical University from July 2019 to April 2020 were retrospectively analyzed. Of 282 patients who were enrolled, there were 233 males and 49 females, aged (55.9±10.0) years. The groups were divided into the conventional TACE group ( n=179) and the DEB-TACE group ( n=103) based on the treatments. The efficacy of the two groups was compared according to the modified response evaluation criteria in solid tumors. Postoperative adverse effects and liver function between the two groups were compared. Results:The differences in comparing the preoperative and postoperative liver function indexes between the two groups were not statistically significant. Patients who died and were lost to follow-up at 6 months after surgery were excluded and 240 patients were excluded in the efficacy analysis, with 148 patients in the conventional TACE group and 92 patients in the DEB-TACE group. At 6 months after treatment in the conventional TACE group, there were 64 patients (43.2%) with complete remission, 18 patients (12.2%) with partial remission, 27 patients (18.2%) with stable disease, and 39 patients (26.4%) with disease progression. In the DEB-TACE group, the corresponding figures were 38 patients (41.3%), 17 patients (18.5%), 26 patients (28.3%), and 11 patients (12.0%), respectively. The efficacy of DEB-TACE was better than conventional TACE with statistically significant differences between the 2 groups (χ 2=8.96, P=0.030). The incidence of postoperative embolic syndrome was 53.1% (95/179) in the conventional TACE group, which was significantly higher than the 34.0% (35/103) in the DEB-TACE group (χ 2=7.34, P=0.007). Conclusion:The efficacy and safety of DEB-TACE for unresectable hepatocellular carcinoma were superior to those of the conventional TACE group.
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In order to cope with increasingly severe global population aging, WHO defines "healthy ageing" as the process of developing and maintaining the functional ability required for healthy living of the elderly.Functional ability is related to the interaction between intrinsic capacity(IC)and the environment.IC refers to the sum of all the physical and mental abilities of the individual.Unlike frailty and disability, IC focuses on the functional aspects of the elderly, longitudinally tracking a person's life, rather than on health conditions of the individual at a certain time.Evaluation of IC, including cognitive function, psychological status, sensory function, vitality and locomotor function, is expected to become crucial to predict outcomes and risks of care dependence in the elderly.Starting from screening for IC declines of the elderly in the community, integrated care is formulated taking older people and their caregivers into consideration to improve the quality of life of the elderly to the greatest extent and reduce the social burden.
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Immobility in older people refers to the loss of mobility, including walking, driving and using public or other forms of transport, and reflects the declining ability of older people to carry out their daily lives.The physical and psychological problems caused by immobility, such as high morbidity rates, worse quality of life and even social isolation, will present serious challenges to the health of older people.Research has shown that disease, exercise & muscle, diet & nutrition, society and other factors all contribute to the onset of immobility in older people.This review focuses on the influencing factors of immobility in older adults.
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Ageing and a sedentary lifestyle are associated with declines in muscle function and cardiopulmonary fitness in older adults and may eventually lead to reduced capabilities to conduct daily activities and independent living.Exercise plays an important role in maintaining physical function and mental health, preventing and treating chronic diseases, reducing mortality, and improving the quality of life in older people.In 2021, the International Conference of Frailty and Sarcopenia Research(ICFSR)proposed international expert consensus guidelines on exercise recommendations for older people.It mainly introduces two aging phenotypes and six recommended exercise modalities and discusses the effects of exercise on maintaining physical health and preventing common chronic diseases and geriatric syndromes.It aims to provide suggestions for older adults to maintain physical fitness and prevent disease progression and disability via exercise.We intend to interpret the important contents of the guidelines to provide a reference for exercise research and practical applications in the elderly in China.
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Objective:To investigate the effect of single nucleotide variation of osteoprotegerin (OPG) gene on the occurrence of osteoporosis (OP) in patients with gestational diabetes mellitus (GDM) .Methods:From Apr. 2018 to Apr. 2022, 276 pregnant women with GDM who underwent prenatal examination and gave birth in Linyi People’s Hospital were collected for analysis, general data were collected and bone mineral density was tested. According to the bone mineral density test results, they were divided into normal group and OP group. The OPG genotype was tested, and the general information, OPG genotype and allele frequency of the two groups were compared. The differences in bone mineral density among different genotypes of OPG were compared, and the genotypes affecting the risk of OP in GDM patients were analyzed.Results:There was no significant difference in the general data of the two groups of patients (all P>0.05). The allelic distribution of the rs3134069 and rs2073618 loci of the OPG gene in the two groups of patients conformed to the Hardy-Weinberg equilibrium law (all P>0.05). There was a statistically significant difference in the frequency of the AC genotype at rs3134069 between the two groups ( χ2=7.75, P=0.005). Taking patients with the AA genotype as a reference, patients with the AC genotype had a lower risk of developing OP ( OR=0.15, 95% CI: 0.03-0.59). There was a statistically significant difference in the frequency of CC genotype at rs2073618 between the two groups ( χ2=11.30, P=0.001). Taking patients with GG genotype as a reference, patients with CC genotype had a higher risk of developing OP ( OR=7.42, 95% CI: 2.19-27.18). Comparing rs3134069 and rs2073618 loci, there was no significant difference in bone mineral density at each part of the three genotypes (all P>0.05). The multivariate Logistic regression model showed that the AC genotype of rs3134069 ( OR=0.18, 95% CI: 0.03-0.70, P=0.029) was a protective factor for the induction of OP, while GC genotype of rs2073618 ( OR=6.86, 95% CI: 1.57-27.15, P=0.007) were the risk factors for OP in GDM patients. Conclusion:The CC genotype of rs2073618 is significantly positively correlated with the susceptibility to OP in GDM patients.
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Objective:To investigate the effects of ursolic acid (UA) on proliferation, migration and iron death of ectopic endometrial stromal cells (EESCs) and its mechanism.Methods:Mouse model of endometriosis was established and the primary EESCs were isolated. The cells were treated with UA at different concentrations (0, 2.5, 5, 10, 20, 40, 50, 80, 100, 200 μmol/L). The cells were divided into Control group (normal culture), 2.5 μmol/L UA group (2.5 μmol/L UA treatment), 5.0 μmol/L UA group (5.0 μmol/L UA treatment), 10.0 μmol/L UA group (10 μmol/L UA treatment), and UA+DUSP19 group (10 μmol/L UA+50 μmol/L JAK2/STAT3 signal pathway activator DUSP19 treatment). Cell survival rate was detected by CCK-8 method. Cell proliferation was detected by plate cloning method. Transwell chamber assay was used to detect cell migration. The levels of Fe 2+ and the contents of malondialdehyde (MDA), reactive oxygen species (ROS) and superoxide dismutase (SOD) were detected by kit. Protein expression levels of Ki67, PCNA, CyclinD1, p-JAK2, p-STAT3, JAK2 and STAT3 were detected by western blot. Results:The number of clones in Control, 2.5 μmol/L UA, 5.0 μmol/L UA and 10.0 μmol/L UA groups were as follows: 152.22±15.47, 121.22±11.54, 92.00±5.54, 66.44±6.88; Ki67 protein expression was 1.08±0.10, 0.73±0.07, 0.61±0.06, 0.45±0.02, respectively; The expression of PCNA protein was 0.85±0.07, 0.64±0.05, 0.41±0.03, 0.31±0.05, respectively; CyclinD1 protein expression levels were 0.98±0.11, 0.65±0.06, 0.51±0.05, 0.42±0.07, respectively. The migration numbers were 92.78±6.27, 62.22±2.20, 50.22±4.59 and 39.11±4.33, respectively; Fe 2+ levels were (1.06±0.07) μmol/g, (1.21±0.11) μmol/g, (1.33±0.08) μmol/g, (1.47±0.09) μmol/g, respectively; MDA content was (0.48±0.06) μmol/g, (0.65±0.07) μmol/g, (0.85±0.08) μmol/g, (1.03±0.11) μmol/g, respectively; ROS contents were (19.85±1.21) %, (24.83±2.79) %, (29.04±1.86) %, (33.87±2.45) %, respectively; SOD content were (36.41±3.56) U/mg, (31.03±2.81) U/mg, (25.63±2.84) U/mg, (19.62±1.67) U/mg, respectively; p-JAK2 protein expression was 0.85±0.10, 0.75±0.06, 0.53±0.05, 0.31±0.03, respectively; p-STAT3 protein expression was 1.08±0.11, 0.79±0.06, 0.63±0.07, 0.42±0.03, respectively. The p-JAK2 protein content in UA group and UA+DUSP19 group was 0.38±0.05 and 0.75±0.08, respectively; p-STAT3 protein expression was 0.46±0.04 and 0.80±0.03, respectively; The cell survival rates were (52.55±2.44) % and (82.18±4.72) %, respectively; Fe 2+ levels were (1.57±0.06) μmol/g and (1.21±0.13) μmol/g, respectively. The differences in the above indicators between the Control group and the 2.5 μmol/L UA group, 5.0 μmol/L UA group and 10.0 μmol/L UA group were statistically significant ( P<0.05). There were statistically significant differences among 2.5 μmol/L UA group, 5.0 μmol/L UA group and 10.0 μmol/L UA group ( P<0.05). There were statistically significant differences in p-JAK2, p-STAT3, cell survival rate and Fe 2+ levels between UA group and UA+DUSP19 group ( P<0.05) . Conclusion:Ursolic acid can inhibit the proliferation and migration of EESCs cells and induce iron death by regulating JAK2/STAT3 signaling pathway, thus playing a protective role in endometriosis.
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OBJECTIVE@#The current fertilization methods for Chinese yam are uneconomic and unfriend to environment. A rational one is very important to achieve desired balance of high yield of Chinese yam, economic and friend to environment. Here, we studied the effects of nitrogen (N), phosphorus (P), and potassium (K) fertilizers on the yield of 'Qinfeng' Chinese yam in shallow-groove directional cultivation.@*METHODS@#The experiments were conducted in Dehua County, Fujian Province, China using a "3414" optimal design. Overall, three fertilizer factors (N, P, and K) were evaluated at the following four levels: 0, no fertilizer; 1, 0.5-fold the typical rate; 2, typical fertilization rate; and 3, 1.5-fold the typical rate. There were 14 different fertilization treatments.@*RESULTS@#Treatment 6 (N2P2K2) produced the longest (75.6 cm) and thickest tubers (4.9 cm) with the highest tuber fresh weight (1311.9 g) and yield (41 015.9 kg/hm2), whereas, treatment 1 produced the shortest (65.6 cm) and thinnest tubers (3.9 cm) with the lowest fresh weight (953.4 g) and yield (28 532.8 kg/hm2) among the 14 fertilizer combinations. The experimental data could be fitted to single-variable quadratic and binary quadratic models but not to a ternary quadratic polynomial model. Appropriate N, P, and K fertilizer application rates increased Chinese yam yield. However, excessive fertilization lowered the yield. Chinese yam yield was significantly and strongly correlated with the amounts of N, P, and K fertilizer applied.@*CONCLUSION@#Based on the single variable quadratic and binary quadratic models, we propose that the quantities of N, P, and K fertilizer used to grow 1 hm2 'Qinfeng' Chinese yam should be 360-388.3, 90-100.95, and 416.3-675 kg, respectively.
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【Objective】 To construct a prediction model of severe obstructive sleep apnea (OSA) risk in the general population by using nomogram in order to explore the independent risk factors of severe OSA and guide the early diagnosis and treatment. 【Methods】 We retrospectively enrolled patients who had been diagnosed by polysomnography and divided them into training and validation sets at the ratio of 7∶3. Patients were divided into severe OSA group and non-severe OSA group according to apnea hypopnea index (AHI)>30. Variables entering the model were identified by least absolute shrinkage and selection operator regression model (Lasso), and logistic regression (LR) method. Then, multivariable logistic regression analysis was used to establish the nomogram, and the area under the receiver operating characteristic curve (AUC) was used to evaluate the discriminative properties of the nomogram model. Finally, we conducted decision curve analysis (DCA) of nomogram model, STOP-Bang questionnaire and Berlin questionnaire to assess clinical utility. 【Results】 Through single factor and multiple factor logistic regression analyses, the independent risk factors for severe OSA were screened out, including moderate and severe sleepiness, family history of hypertension, history of smoking, drinking, snoring, history of suffocation, sedentary lifestyle, male, age, body mass index (BMI), waist and neck circumference. Lasso logistic regression identified smoke, suffocation time, snoring time, waistline, Epworth sleepiness scale (ESS) and BMI as predictive factors for inclusion in the nomogram. The AUC of the model was 0.795 [95% confidence interval (CI): 0.769-0.820] . Hosmer-Lemeshow test indicated that the model was well calibrated (χ2=3.942, P=0.862). The DCA results on the visual basis confirmed that the nomogram had superior overall net benefits within a wide, practical threshold probability range which displayed the nomogram was higher than that of STOP-Bang questionnaire and Berlin questionnaire, which is clinically useful. The Clinical Impact Curve (CIC) analysis showed the clinical effectiveness of the prediction model when the threshold probability was greater than 82% of the predicted score probability value. The prediction model determined that the high-risk population with severe OSA was highly matched with the actual population with severe OSA, which confirmed the high clinical effectiveness of the prediction model. 【Conclusion】 The model performed better than STOP-Bang questionnaire and Berlin questionnaire in predicting severe OSA and can be applied to screening. And it can be helpful to the early diagnosis and treatment of OSA in order to reduce social burden.
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Objective:To explore the multimorbidity patterns in older inpatients adults, and their differences between Northern and Southern China.Methods:A total of 4 348 elderly patients aged 60 and above from the geriatrics departments of 12 grade A tertiary hospitals in 7 cities in China were investigated.Factor analysis was used to explore the comorbidity patterns and analyze the differences in comorbidity patterns between Southern and Northern China.Results:The study population consisted of 4 348 patients over the age of 60, with an average age of(74.15±8.01)years.The total sample had a Kaiser-Meyer-Olkin(KMO)sampling adequacy index of 0.657 and a cumulative variance percentage of 43.97%.Factor analysis revealed there were five major multimorbidity patterns in the patients.These were: the metabolic pattern; the liver-kidney pattern; the degenerative pattern; the neuropsychiatric pattern; dementia.Further factor analysis for the South and the North was conducted.Older inpatients in Southern regions had a KMO sampling adequacy index of 0.654 and a cumulative variance percentage of 43.50%.In Southern China, the multimorbidity patterns were similar to the overall patterns.In Northern regions, older inpatients had a KMO sampling adequacy index of 0.648 and a cumulative variance percentage of 45.16%.The liver-kidney pattern, metabolic disease pattern, lung-dementia pattern, degenerative disease pattern, and neuropsychiatric pattern were the main multimorbidity patterns in Northern China.Conclusions:Multimorbidity patterns were different between Northern and Southern China and should be differentiated in their management.In the North, older adults should pay more attention to the prevention and management of respiratory system diseases and dementia, while in the South, older adults should pay more attention to the prevention and management of degenerative disease.Early disease prevention based on multimorbidity patterns is one of the approaches to the reduction of chronic diseases in older adults.
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Frailty is a geriatric syndrome characterized by declines in multisystem functions, decreased functional reserve, and increased vulnerability to adverse health events, and affects the quality of life in older adults.However, the underlying mechanisms of frailty are still unclear.Rodents share homology with humans and are commonly used as animal models to study human diseases.Rodent frailty models can promote frailty research and intervention in humans.We reviewed research progress on rodent frailty models in this article.
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The global population aging problem is increasingly serious.For this reason, WHO proposed the goal of "Healthy Ageing" in 2015, that is to maintain and develop the functional ability of the individuals in order to achieve happiness in old age.At the same time, WHO introduced the relationship between functional ability, intrinsic capacity and the surrounding environment in which older adults live and acquire assistance, providing a new way for solving population aging. "Decade of Healthy Ageing: Baseline Report" was published by WHO in January 2021.It took advantage of existing national studies on ageing in 42 countries to assess the global status of healthy ageing at the start of the decade.And then it outlooks ten years ahead, to 2030, what level we can achieve, and what needs to improve ten years from now.
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Objective:To evaluate the feasibility and effectiveness of parathyroid autotransplantation in subcutaneous tissue of upper abdomen after total parathyroidectomy in patients with severe secondary hyperparathyroidism (SHPT).Methods:From January 2018 to January 2020, retrospective reviews were conducted for clinical data of 29 patients with secondary hyperparathyroidism undergoing epigastric parathyroid autotransplantation after total parathyroidectomy.Clinical and biochemical characteristics were recorded.Serum levels of calcium, phosphorus, parathyroid hormone and alkaline phosphatase before and after operation were analyzed by paired sample t-test and the difference was statistically significant ( P<0.01). The follow-up period was 1, 3, 6 and 12 months post-operation and yearly after 12 months. Results:All operations were successful.The postoperative levels of calcium[(2.25±0.32) vs.(2.49±0.24) mmol/L], phosphorus[(1.72±0.65) vs. (2.09±0.75) mmol/L], alkaline phosphatase[(199.02±77.68) vs.(384.21±154.5) U/L]and parathyroid hormone (PTH)[(8.01±7.00) vs.(1 930.64±620.51) pg/ml]were significantly lower than the preoperative levels ( P<0.01). And the differences were statistically significant.And 17/18 hypertensive patients improved post-operation; postoperative improvement was not obvious for 21 anemic patients, 17 patients improved within 1 year.Among 26 cases with bone pain, 16 cases disappeared immediately postoperatively, 5 disappeared within 1 month and 5 within 3 months.Among 13 cases with skin itch, 10 cases disappeared immediately and 3 cases at 1 month post-operation.The level of PTH recovered at different follow-up timepoints with an average recovery time of (4.45±2.31) months. Conclusions:Autologous transplantation of parathyroid gland in epigastric subcutaneous tissue after parathyroidectomy is both safe and effective for secondary hyperparathyroidism.
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Objective:To analyze the clinical phenotype of adult patients with epidemic encephalitis B (encephalitis B) in Ningxia Hui Autonomous Region, and to explore the influence of related factors of the development of encephalitis B.Methods:The medical records of confirmed patients with encephalitis B admitted to the General Hospital of Ningxia Medical University from August to November 2018 were collected, and the general data of patients and the results of laboratory indexes such as blood routine examination and cerebrospinal fluid routine examination were analyzed. Logistic regression analysis and survival curve were used to evaluate the risk factors of the development of encephalitis B.Results:Totally 97 patients with encephalitis B were included, 32 of them died, with a case fatality rate of 32.99%. There were 63 males and 34 females, and the age of onset was (59.13 ± 14.70) years old. There were statistically significant differences in case distribution rate between different sexes and ages (χ 2 = 97.00, 291.00, P < 0.001). The most common clinical type was extremely severe (43 cases), followed by mild (27 cases), severe (15 cases) and ordinary (12 cases). The results of laboratory tests showed that the number of neutrophils, lymphocytes and monocytes in the blood of patients increased; and the white blood cells number in cerebrospinal fluid increased significantly, while neutrophils ratio increased slightly. There were significant differences in cerebrospinal fluid glucose level and neutrophil ratio among patients with different clinical types of encephalitis B ( H = 4.21, 2.74, P < 0.05). There were statistically significant differences in death, hypertension, cerebrovascular diseases, and pulmonary infection among patients with different clinical types of encephalitis B (χ 2 = 34.22, 16.97, 9.91, 15.59, P < 0.05). Logistic regression analysis showed that hypertension [ OR (95% CI) = 5.544 (1.450-21.191)] and pulmonary infection [ OR (95% CI) = 6.490 (1.887-22.325)] were risk factors for the development of encephalitis B patients ( P = 0.012, 0.003). Pulmonary infection was the influencing factor for the death of encephalitis B patients (χ 2 = 18.88, P < 0.001). The survival curve showed that the survival status of encephalitis B patients with cerebrovascular disease and pulmonary infection was significantly worse than that of patients without comorbidity or complications (χ 2 = 6.45, 20.33 , P < 0.05). Conclusions:The majority of encephalitis B patients in this outbreak are the elderly people, and the patient's nervous system has inflammatory reaction. Complicated pulmonary infection is an important factor for the aggravation and death of encephalitis B patients.
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Background/Aims@#To investigate postpartum hepatic flares and associated factors in highly viremic pregnant patients in the immune tolerance phase who adopted telbivudine (LdT) treatment in the last trimester to reduce vertical transmission of hepatitis B virus. @*Methods@#Hepatitis B e antigen (HBeAg)-positive, highly viremic pregnant women were recruited for this prospective study. Treatment with LdT was started from 28 weeks of gestation. Virological and biochemical markers were examined before LdT treatment, antepartum and postpartum. Serial blood samples at the same time were collected to detect cytokines and cortisol (COR). @*Results@#Fifty-six of 153 patients (36.6%) had postpartum hepatic flares, defined as a 2-fold increase in alanine aminotransferase 6 weeks after delivery. Age and the antepartum alanine aminotransferase and postpartum HBeAg levels were independent influencing factors of postpartum hepatic flares. Cytokines showed no regularity during or after pregnancy. Compared with the patients with no postpartum flares, the patients with flares had lower baseline interferon γ and COR levels (p=0.022 and p=0.028) and higher postpartum interferon γ levels (p=0.026). @*Conclusions@#A high proportion of highly viremic and immune-tolerant pregnant patients treated with LdT in the last trimester had postpartum hepatic flares, which implied that these patients entered the immune clearance phase after delivery. Thus, this may create an appropriate opportunity for re-antiviral therapy.
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Frailty syndrome is an age-related clinical state of the physiological homeostasis imbalance and the declines in physiological functions.However, the mechanism of frailty is still not clear, and it can only be diagnosed by assessment tools in the clinical research setting without stable and reliable biomarkers.As a new tool, omics platform has made a lot of progress in the field of frailty biomarkers.In this paper, we will review the research status of frailty biomarkers from four aspects including genomics, transcriptomics, proteomics and metabolomics.
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Frailty is a geriatric syndrome characterized by increased vulnerability to degenerative changes and various chronic diseases, and is associated with a series of negative clinical events.The pathogenesis of frailty is unclear, and population cohort and observational research has made progress in understanding the biological characteristics of frailty, especially about the hypothalamic-pituitary-adrenal axis and neuroendocrine dysfunction, chronic inflammation and immune system ageing, cell senescence, energy metabolism dysfunction, social environmental psychological factors and chronic diseases, among others.This article reviews the pathogenesis of frailty in the elderly.