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1.
Journal of Clinical Hepatology ; (12): 397-401, 2022.
Article in Chinese | WPRIM | ID: wpr-920892

ABSTRACT

Objective To investigate the differences in UGT1A1 gene mutation sites, haplotypes, and diplotypes between patients with Gilbert syndrome (GS) and those with Crigler-Najjar syndrome type Ⅱ (CN-2). Methods A retrospective analysis was performed for the clinical data of 138 patients with GS or CN-2 who attended Beijing YouAn Hospital, Capital Medical University, from January 1, 2010 to December 31, 2019, with 109 patients in the GS group and 29 patients in the CN-2 group, and the differences in mutation sites were analyzed between the two phenotypes. The Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. SNPStats software was used to perform linkage disequilibrium (LD) and haplotype analyses of mutation sites. Strong LD was defined as both | D ′| and r 2 > 0.8, and moderate LD was defined as | D ′| > 0.8 and r 2 > 0.4. Results UGT1A1 gene detection was performed for all patients, and mutations mainly included -3279T > G mutation (104 patients, 75.36%) and -3152G > A mutation (82 patients, 59.42%) in the upstream promoter PBREM region, a promoter TATA box TA insertion mutation (88 patients, 63.77%), and c.211G > A mutation in Exon 1 of the coding region (66 patients, 47.83%). Compared with the CN-2 group, the GS group had a significantly higher proportion of PBREM region -3279T > G mutation (82.57% vs 48.28%, χ 2 =14.508, P A mutation (68.81% vs 24.14%, χ 2 =18.955, P (TA) 7 mutation (72.48% vs 31.03%, χ 2 =17.027, P 0.8, r 2 > 0.8) between (TA) 6 > (TA) 7 and -3152G > A and moderate LD (| D ′| > 0.8, r 2 > 0.4) between (TA) 6 > (TA) 7 and -3279T > G, between -3152G > A and -3279T > G, between (TA) 6 > (TA) 7 and c.211G > A, and between -3279T > G and c.211G > A. Haplotype frequency analysis showed that compared with the CN-2 group, the GS group had a significantly higher frequency of haplotype -3279G—-3152A—(TA) 7 (45.72% vs 17.24%, χ 2 =7.833, P =0.005) and significantly lower frequencies of c.1456G (4.10% vs 16.48%, χ 2 =4.873, P =0.027) and c.211A—c.1456G (1.86% vs 24.90%, χ 2 =15.210, P < 0.001). The diplotype analysis showed that diplotypes consisting of haplotype c.1456G or c.211A—c.1456G were associated with a higher level of total bilirubin (TBil). Conclusion There are differences in common mutation sites and major haplotypes of the UGT1A1 gene between patients with GS and those with CN-2, and the common diplotypes of CN-2 correspond to a higher level of TBil.

2.
Article in Chinese | WPRIM | ID: wpr-911935

ABSTRACT

Objective:To describe the characteristics and management of right-sided infective endocarditis (RSIE) during pregnancy.Methods:The clinical manifestation, blood culture, echocardiography, diagnosis, treatment, and maternal and infant outcomes of seven patients with RSIE during pregnancy from Capital Medical University Affiliated Beijing Anzhen Hospital from January 2009 to March 2020 were retrospectively collected and described.Results:The incidence of RSIE during pregnancy was 0.27‰ (7/25 832). All patients had a history of congenital heart disease, with a mean age of (26.0±2.7) years and a mean gestational age at onset of (28.7±6.6) weeks. Cardiac murmur, fever, dyspnea, cough, expectoration, and pulmonary rales were the common symptoms. Seven cases were complicated by anemia, seven with hypoproteinemia, six with hypoxemia, five with pulmonary hypertension, and five with positive blood culture. Echocardiography indicated that vegetations were mainly attached to the pulmonary valves (four cases), followed by the tricuspid valves (three cases) and the right ventricular outflow tract (three cases). Four patients were diagnosed with septic pulmonary embolism by chest X-ray. All patients were treated with intravenous antibiotics. Cesarean section was performed on five cases in the third trimester and one in the second trimester due to intrauterine death. The other case underwent vaginal delivery in the third trimester. Cardiac surgery was conducted during the hospitalization in four cases and not in the other three. The mean length of stay was 26 days (12-76 days). Six cases were cured, and one died after discharge. Among the six neonates, one had asphyxia and was died after withdrawal of treatment. The remaining five infants survived and developed well during the follow-up of 5 years (3-10 years).Conclusions:Pregnancy complicated by RSIE is a rare and critical condition, requiring early diagnosis to make optimal treatment strategies, reducing maternal and infant fatality.

3.
Chinese Journal of Geriatrics ; (12): 1178-1183, 2021.
Article in Chinese | WPRIM | ID: wpr-910988

ABSTRACT

Objective:To explore the correlation between fish intake and cognitive function in the elderly.Methods:Based on data for Hubei province of the Chinese Health and Nutrition Survey 2015, 335 participants aged 60 and over were included in the study.Face-to-face cognitive screening was used to evaluate cognitive function.Fish intake was converted into four classifications: 0 g/d, 0-50 g/d, 50-100 g/d, and >100 g/d.The multiple linear regression model was used to analyze the correlation between fish intake and cognitive function in the elderly.Results:There were 335 subjects, including 142 males(42.4%)and 193 females(57.6%). In the overall population( F=4.19, P=0.006)and females( F=2.30, P=0.079), cognitive scores of the elderly increased with increased fish intake, but no increase was found in males( F=1.99, P=0.119). After adjusting for confounding factors such as age, sex, urban and rural living, education level, marital status, smoking, alcohol consumption, daily total energy intake, dietary fat-to-energy intake ratio, BMI, history of hypertension and stroke, fish intake >100 g/d in the elderly was positively correlated with the cognitive score( β=2.68, 95% CI: 0.38-4.98), compared with the lowest fish intake group(0 g/d); gender-stratified analysis showed that the regression coefficient was 4.26(95% CI: 1.23-7.30)for women and 1.70(-1.76-5.15)for men. Conclusions:Increased fish intake is positively correlated with improved cognitive function in elderly women, but the same is not true in elderly men.Increasing fish intake may be beneficial in preventing cognitive decline in elderly women.

4.
Article in Chinese | WPRIM | ID: wpr-907973

ABSTRACT

Objective:To investigate the relationship between platelet aggregation function changes in children with sepsis and its prognosis.Methods:This was a prospective observational study involving 53 children with sepsis and platelet count of > 100×10 9/L who were admitted in the Pediatric Intensive Care Unit (PICU) of Children′s Hospital Affiliated to the Capital Institute of Pediatrics from January 2017 to December 2018.During the same period, 53 age-matched healthy children were selected as the healthy control group.Platelet aggregation function was detected in each participant, and the differences between the two groups were compared.In addition, 53 children with sepsis were sub-divided into risk group (≤80 grades) and non-risk group (>80 grades) according to pediatric critical illness scores (PCIS). They were further divided into sepsis survival group and sepsis death group according to the prognosis within 24 hours of admission.Platelet aggregation function test was performed on the 1 st and 3 rd day of admission, conventional coagulation function and clinical data were detected as well.Their differences between risk group and non-risk group, and sepsis survival group and sepsis death group were compared, so as to analyze the correlation between platelet aggregation function and clinical prognosis of children with sepsis. Results:No significant differences in the gender and age were found between sepsis group and the healthy control group (all P>0.05). In sepsis group, no significant differences in the gender and age were found between risk group and non-risk group (all P>0.05). There were 44 cases (83%) in sepsis survival group and 9 cases (17%) in sepsis death group.Platelet aggregation function was significantly worse in sepsis death group than in the healthy control group (47.4% vs.79.9%, P<0.001). Compared with non-risk group, platelet aggregation function in risk group significantly decreased (32.5% vs.53.4%, P<0.05). Fibrinogen (FIB) and platelet count in risk group were significantly lower than those of non-risk group (3.28 g/L vs.4.53 g/L and 215×10 9/L vs.346×10 9/L, respectively, all P<0.05). Fibrin degradation products (FDP) in risk group was higher than non-risk group(12.1 mg/L vs.6.0 mg/L, P<0.05). There were no significant differences in the prothrombin time, activated partial thromboplastin time and D-Dimer between risk group and non-risk group (all P>0.05). Platelet aggregation function in the death group was significantly lower than that of survival group (11.1% vs.59.7%, P<0.001). On the 1 st and 3 rd day of admission, platelet aggregation function of died children in risk group continued to be low (11.1%, 10.9%), while platelet aggregation function of survival children was relatively high (59.7%, 65.7%). Platelet aggregation function was positively correlated with FIB, Ca 2+ levels and PCIS ( P<0.05, P<0.05 and P<0.001, respectively). Logistic regression analysis showed that platelet aggregation function was a contributing factor to the mortality of children with sepsis.According to receiver operating characteristic curve of platelet aggregation function in predicting the mortality of children with sepsis, area under curve was 0.889, cut-off value was 18.3%, sensitivity was 88.6%, and specificity was 77.8% ( P<0.001), suggesting that a lower than 18.3% of platelet aggregation function predicted an increased risk of death in children with sepsis. Conclusions:In children with sepsis, there is a decrease in platelet aggregation function, while the platelet count has not decreased.Platelet aggregation function in children with sepsis is correlated with the severity of the disease.In detail, reduced platelet aggregation in early sepsis is an alarm of a poor prognosis in children with sepsis.

5.
Article in Chinese | WPRIM | ID: wpr-907329

ABSTRACT

Objective:To investigate the predictive value of high-sensitive C-reactive protein (hs-CRP) for early hematoma enlargement in patients with primary intracerebral hemorrhage.Methods:Patients with intracerebral hemorrhage admitted to the Department of Neurosurgery, the First Affiliated Hospital of Zhengzhou University from January 2014 to January 2019 were enrolled retrospectively. The patients were sent to hospital within 6 h after onset, and the diagnosis of cerebral hemorrhage was confirmed by head CT. The head CT was reexamined within 24 h after the first head CT. Hematoma enlargement was defined as hematoma volume increase >6 ml or relative volume increase >33%. Multivariate logistic regression analysis was used to investigate the independent risk factors for influencing early hematoma enlargement. Receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of hs-CRP for hematoma enlargement. Results:A total of 154 patients with intracerebral hemorrhage were included, including 99 males (64.3%), aged 58.7±11.1 years. The median baseline Glasgow Coma Scale score was 13. The time from onset to first CT scan was 2.92±1.35 h. The time from the first CT to the second one was 16.05±4.40 h. The baseline volume of hematoma was 21.82±11.08 ml. Among them, 27 patients (17.5%) had hematoma that broke into the ventricle, 40 (26.0%) had hematoma enlargement. The average hs-CRP level at admission in the enlarged hematoma group was significantly higher than that in the non-enlarged hematoma group (11.56±3.72 mg/L vs. 9.51±4.31 ml; t=-2.669, P=0.008). Multivariate logistic regression analysis showed that hs-CRP at admission (odds ratio [ OR] 1.123, 95% confidence interval [ CI] 1.017-1.241; P=0.022), irregular hematoma shape ( OR 4.160, 95% CI 1.714-10.098; P=0.002) and the time from onset to the first CT scan ( OR 0.510, 95% CI 0.323-0.803; P=0.004) were significantly correlated with hematoma enlargement. Pearson correlation analysis showed that hs-CRP was positively correlated with baseline hematoma volume ( r=0.237, P=0.003). ROC curve analysis showed that the area under the curve of hs-CRP predicting hematoma enlargement was 0.678 (95% CI 0.584-0.772). The optimal cut-off value was 10.55 mg/L. The sensitivity and specificity for predicting hematoma enlargement were 86.9% and 60.0%, respectively. Conclusion:For patients with hs-CRP ≥10.55 mg/L at admission, irregular hematoma shape, and the time from admission to the first CT scan <3 h, should be focused the management and be alert to the occurrence of early hematoma enlargement.

6.
Article in Chinese | WPRIM | ID: wpr-906498

ABSTRACT

Objective:To obtain ancient traditional Chinese medicine(TCM)literatures relating to tumor and visual analysis by an automatic framework tool, in order to systematically sort out the development of ancient Chinese medicine oncology. Method:Based on the database platform of ancient TCM books,names of tumor-related diseases in ancient TCM books were retrieved by Selenium WebDriver, an automation framework tool under Python 3.8. Lxml's etree library was used to parse the data. Statistics was made for "classification", "authors", "completion time" and "summary" of relevant ancient books automatically. After the data was checked and processed, Tableau 2019.2 software was used for data visualization analysis. And ancient Chinese medicine literatures relating to tumor were consulted at the database manually,with the dynasties as the clue,and the symptoms,etiology,pathogenesis and prognosis as the emphasis,this paper explores the development process of TCM oncology. Result:A total of 774 349 bytes of text data of 1 128 entries in 242 ancient books were included automatically. According to the findings, there were simple classification and time distribution of tumor diseases in ancient TCM books in the pre-Qin period, with a simple view on the pathogenesis of tumor diseases. From the Han dynasty to the Tang dynasty, the number of relevant literature records and the types and disease names had gradually increased,which further enriched the cognition of tumor nature,signs,classification methods,differential diagnosis;in Song and Ming dynasties,the proportion of Chinese prescription books and surgery books had increased gradually,with the largest number of abdominal organ tumor names among all dynasties;from Qing dynasty to the Republic of China,literatures relating to tumor name and classification were the most improved,and then the TCM tumor syndrome differentiation and treatment system had been formed. Conclusion:It was found that TCM oncology originated in the pre-Qin dynasty,and was improved in the Han and Tang dynasties, mature in the Song and Ming dynasties and completed in the Qing dynasty and the Republic of China. The data visualization method with integrated automation framework and parsing tools is helpful to analyze the subdivision characteristics of ancient TCM literatures,which is convenient,efficient and innovative,in the expectation to provide a classic reference for contemporary TCM studies.

7.
Article in Chinese | WPRIM | ID: wpr-905952

ABSTRACT

Objective:To observe the effect of Yinhuotang (YHT) on the depression-like behavior of mice with bilateral ovariectomy (OVX) induced by chronic stress and explore its action mechanism based on estradiol (E<sub>2</sub>)-estrogen receptor <italic>β </italic>(ER<italic>β</italic>) pathway. Method:The experiment was divided into two parts. In the first part, mice were randomly divided into the sham operation (Sham) group, model (OVX) group, positive drug (E<sub>2</sub>, 0.13 mg·kg<sup>-1</sup>) group, and YHT (23.4 g·kg<sup>-1</sup>) group. The OVX model was reproduced by OVX combined with chronic unpredictable mild stress (CUMS). On the 8th day after OVX, the mice in each group were exposed to CUMS and treated with drugs. The changes in immobility time, horizontal movement score, and vertical movement score of mice in each group were observed in forced swimming test (FST), tail suspension test (TST) and open-field test (OFT), respectively. Serum and brain E<sub>2</sub> levels were detected by enzyme-linked immunosorbent assay (ELISA), the aromatizing enzyme (Cyp19) mRNA expression by real-time fluorescence polymerase chain reaction (Real-time PCR), the expression of ER<italic>α</italic> and ER<italic>β</italic> in dentate gyrus of hippocampus by immunohistochemistry (IHC), and the total ER<italic>α</italic> and ER<italic>β</italic> levels in the brain by Western blotting. In the second part, the mice were divided into the Sham group, OVX group, YHT group, and blocker (Y+B, 23.4 g·kg<sup>-1</sup>+100 μg·kg<sup>-1</sup>) group. Mice in the Y+B group were first treated with intragastric administration of YHT and then with intraperitoneal injection of ER<italic>β</italic> blocker (PHTPP) on the next day. The changes in immobility time, horizontal motor score, and vertical motor score were observed in the three behavioral tests. Result:Compared with the Sham group, the OVX group displayed significantly increased immobility time, decreased horizontal and vertical movement scores (<italic>P</italic><0.01), down-regulated serum and brain E<sub>2 </sub>levels (<italic>P</italic><0.01) and Cyp19 mRNA expression in the brain (<italic>P</italic><0.01), and up-regulated total ER<italic>β</italic> in dentate gyrus and brain (<italic>P</italic><0.01). However, there was no significant change in total ER<italic>α</italic> expression in the dentate gyrus or brain. As revealed by comparison with the OVX group, the immobility time of the E<sub>2</sub> group was decreased significantly, while the horizontal and vertical movement scores were increased significantly (<italic>P</italic><0.01). The E<sub>2</sub> levels in the serum was significantly elevated (<italic>P</italic><0.01). The Cyp19 mRNA expression in the brain and the total ER<italic>α</italic> expression in the dentate gyrus and brain were not significantly changed, while the expression levels of total ER<italic>β</italic> in dentate gyrus and brain were significantly increased (<italic>P</italic><0.01). In the YHT group, the immobility time declined significantly, and the horizontal and vertical movement scores rose significantly (<italic>P</italic><0.01). The serum E<sub>2</sub> did not increase, whereas the brain E<sub>2</sub> increased significantly (<italic>P</italic><0.01). The expression of Cyp19 gene in the brain was significantly increased (<italic>P</italic><0.05,<italic>P</italic><0.01). There was no significant change in the total ER<italic>α</italic> of dentate gyrus and brain, but the expression levels of total ER<italic>β</italic> in dentate gyrus and brain were significantly increased (<italic>P</italic><0.05,<italic>P</italic><0.01). PHTPP reversed the effects of YHT on OVX mice in FST, TST and OFT. Conclusion:YHT promotes the synthesis and release of endogenous estrogen in brain and improves the depression-like behavior of OVX mice induced by chronic stress, which is possibly related to the activation of E<sub>2</sub>/ER<italic>β</italic> pathway.

8.
Article in Chinese | WPRIM | ID: wpr-905826

ABSTRACT

Objective:To explore the protective effect of Gegen Qinliantang on the intestinal mucosal epithelial barrier function of ulcerative colitis (UC) mice, and to explore its mechanism of action in the treatment of ulcerative colitis via matrix metallopeptidase-9 (MMP-9)/p38 mitogen-activated protein kinase (p38 MAPK) signaling pathway. Method:The 48 female C57BL/6 mice were randomly divided into normal group, model group, sulfasalazine group (0.3 g·kg<sup>-1</sup>) and Gegen Qinliantang high, medium and low dose groups (2.84,1.42,0.71 g·kg<sup>-1</sup>). The UC murine model was established by 3% dextran sulfate sodium (DSS). Gegen Qinliantang and sulfasalazine were intragastrically administered on the 8<sup>th</sup> day after the model was established for 7 days, and the normal group was treated with the same amount of normal saline. Colon tissues were collected after the last administration, and the pathological changes of colon tissues were detected by hematoxylin-eosin (HE) staining. The expression of tight junction (TJ) proteins such as Occludin and zonula occludens-1(ZO-1) in colon tissues was detected by immunohistochemistry (IHC), and the expression levels of tumor necrosis factor-alpha (TNF-<italic>α</italic>), interleukin-1<italic>β</italic> (IL-1<italic>β</italic>), and MMP-9 mRNA in colon tissues were detected by Real-time polymerase chain reaction (Real-time PCR). The expression of phosphorylated p38 MAPK (p-p38 MAPK), p38 MAPK and MMP-9 protein in colon tissues was detected by Western blot. Result:Compared with normal group, the body weight of mice decreased (<italic>P</italic><0.01) and disease activity index (DAI) score increased significantly (<italic>P</italic><0.01) in model group, the colon tissues of the model group were damaged more obviously, the expression of occludin and ZO-1 proteins in model group was significantly reduced (<italic>P</italic><0.01), and the relative expression levels of TNF-<italic>α</italic>, IL-1<italic>β</italic>, and MMP-9 mRNA in model group were significantly increased (<italic>P</italic><0.01), the expression of p-p38 MAPK and MMP-9 in model group was significantly increased (<italic>P</italic><0.01). Compared with model group, the body mass and DAI score of the sulfasalazine group and Gegen Qinliantang group were significantly improved (<italic>P</italic><0.05,<italic>P</italic><0.01), the colonic tissues damage were significantly improved, and the expression of Occludin and ZO-1 protein was significantly increased (<italic>P</italic><0.05,<italic>P</italic><0.01), the relative expression levels of TNF-<italic>α</italic>, IL-1<italic>β</italic>, and MMP-9 mRNA were significantly decreased (<italic>P</italic><0.01), and the expression of p-p38 MAPK and MMP-9 was significantly decreased (<italic>P</italic><0.01). The changes in the middle dose group were the most obvious among the various dose groups of Gegen Qinliantang. Conclusion:Gegen Qinliantang repairs the intestinal mucosal barrier function by inhibiting the expressions of MMP-9 and inflammatory cytokines such as TNF-<italic>α</italic> and IL-1<italic>β</italic>, blocking the activation of the p38 MAPK signaling pathway, and increasing the expressions of tight junction protein.

9.
Frontiers of Medicine ; (4): 740-749, 2021.
Article in English | WPRIM | ID: wpr-922503

ABSTRACT

Stroke is one of the most serious diseases that threaten human life and health. It is a major cause of death and disability in the clinic. New strategies for motor rehabilitation after stroke are undergoing exploration. We aimed to develop a novel artificial neural rehabilitation system, which integrates brain-computer interface (BCI) and functional electrical stimulation (FES) technologies, for limb motor function recovery after stroke. We conducted clinical trials (including controlled trials) in 32 patients with chronic stroke. Patients were randomly divided into the BCI-FES group and the neuromuscular electrical stimulation (NMES) group. The changes in outcome measures during intervention were compared between groups, and the trends of ERD values based on EEG were analyzed for BCI-FES group. Results showed that the increase in Fugl Meyer Assessment of the Upper Extremity (FMA-UE) and Kendall Manual Muscle Testing (Kendall MMT) scores of the BCI-FES group was significantly higher than that in the sham group, which indicated the practicality and superiority of the BCI-FES system in clinical practice. The change in the laterality coefficient (LC) values based on μ-ERD (ΔLC


Subject(s)
Electric Stimulation , Electric Stimulation Therapy , Electroencephalography , Humans , Recovery of Function , Stroke/therapy , Stroke Rehabilitation
10.
Journal of Biomedical Engineering ; (6): 1219-1228, 2021.
Article in Chinese | WPRIM | ID: wpr-921864

ABSTRACT

With the rapid development of artificial intelligence technology, researchers have applied it to the diagnosis of various tumors in the urinary system in recent years, and have obtained many valuable research results. The article sorted the research status of artificial intelligence technology in the fields of renal tumors, bladder tumors and prostate tumors from three aspects: the number of papers, image data, and clinical tasks. The purpose is to summarize and analyze the research status and find new valuable research ideas in the future. The results show that the artificial intelligence model based on medical data such as digital imaging and pathological images is effective in completing basic diagnosis of urinary system tumors, image segmentation of tumor infiltration areas or specific organs, gene mutation prediction and prognostic effect prediction, but most of the models for the requirement of clinical application still need to be improved. On the one hand, it is necessary to further improve the detection, classification, segmentation and other performance of the core algorithm. On the other hand, it is necessary to integrate more standardized medical databases to effectively improve the diagnostic accuracy of artificial intelligence models and make it play greater clinical value.


Subject(s)
Algorithms , Artificial Intelligence , Humans , Male , Prognosis , Prostatic Neoplasms/diagnosis , Technology
11.
Cancer Research and Clinic ; (6): 87-92, 2021.
Article in Chinese | WPRIM | ID: wpr-886013

ABSTRACT

Objective:To investigate the relationship between the expression of serum exsomal miRNA-155-5p (miR-155-5p) and prognosis in patients with esophageal squamous cell carcinoma (ESCC).Methods:A total of 336 samples from ESCC patients in Fujian Provincial Cancer Hospital from October 2014 to December 2015 were collected. The relative expression levels of serum exsomal miR-155-5p were detected by using real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). Cut-off value of the expression levels of serum exsomal miR-155-5p was determined by using X-tile software. Based on the optimal cut-off value, patients were divided into miR-155-5p low expression group and miR-155-5p high expression group. The survival curve was drawn by using Kaplan-Meier method and Cox proportional hazards regression model was used to make survival analysis.Results:The cut-off value of serum exsomal miR-155-5p expression level was 2.340. According to the cut-off value, patients were divided into miR-155-5p low expression group (<2.340) of 51 cases and miR-155-5p high expression group (≥2.340) of 285 cases. There were no statistical differences in age ( χ2 = 0.020, P = 0.887), gender ( χ2 = 0.283, P = 0.595), tumor location ( χ2 = 0.063, P = 0.977), differentiation grade ( P = 0.474), clinical staging ( χ2 = 3.996, P = 0.136) and surgery treatment ( χ2 = 0.941, P = 0.332) of patients in both groups. ESCC patients in serum exsomal miR-155-5p high expression had a higher risk of death compared with patients in miR-155-5p low expression group ( HR = 1.763, 95% CI 1.049-2.961, P = 0.032). Conclusion:The high expression level of serum exsomal miR-155-5p is associated with poor prognosis in ESCC patients and it could be used as a prognostic new marker in ESCC patients.

12.
Article in Chinese | WPRIM | ID: wpr-885377

ABSTRACT

A survey on professional knowledge levels was conducted from April to October 2019 among 388 general practitioners (GPs) from 46 community health service centers and 30 township health centers of 6 provinces selected by stratified random sampling method. The overall knowledge test score was 31.82—84.09(56.94±9.19) points, and the pass rate was 36.3% (141/388). There were significant differences in test scores among participants with different types of work units, regions, provinces, marital status, educational background, professional titles, types of employment, length of service, and training status (all P<0.05). Multivariate regression analysis showed that educational background ( B=-2.835), professional title ( B=-8.867), and participation in professional course training ( B=2.214) were the influencing factors of knowledge level (all P<0.05). The pass rates in knowledge of prevention/health management (13.7%, 53/388) and policies and regulations (12.1%, 47/388) were low. The results show that the levels of professional knowledge among GPs working in grassroots health institutions are relatively low, and suggest that continuing education should be strengthened to improve the professional knowledge level of GPs in primary care institutions, particularly, knowledge of health policies and regulations, disease prevention and health management.

13.
Chinese Journal of Urology ; (12): 226-228, 2021.
Article in Chinese | WPRIM | ID: wpr-884993

ABSTRACT

It is important to investigate the mechanical effects of morphology of prostatic urethra (PU) for benign prostatic hyperplasia (BPH). PU and bladder neck transverse diameter ratio (RPU-1), which related to vortex, and their influence on urine flow were observed by CFD. The results showed that vortexes appeared and expanded with increasing RPU on both sides of PU when RPU-1>0.79, and velocity of external urethral orifice decreased gradually. CFD is an available method for urodynamics research. The quantitative simulation of the relationship between RPU-1 and vortex was proposed for the first time, providing a new idea for advancing theory of PU lumen repair in BPH.

14.
Chinese Journal of Geriatrics ; (12): 305-310, 2021.
Article in Chinese | WPRIM | ID: wpr-884885

ABSTRACT

Objective:To analyze the effects of proton pump inhibitors(PPIs)on the prevention of stress ulcers(SU)in elderly patients with acute respiratory distress syndrome(ARDS), and to analyze related factors for the risk of short-term death.Methods:This study was a multicenter retrospective cohort study.Two hundred elderly ARDS patients diagnosed and treated at Peking University International Hospital, Anzhen Hospital and Ezhou Central Hospital from November 2017 to December 2019 were continuously included.These patients were treated with PPIs(omeprazole, pantoprazole, rabeprazole, lansoprazole and esomeprazole)within 48 hours after ICU admission to prevent SU and were considered as the PPI group.According to the propensity score matching method, 200 elderly ARDS patients admitted to the hospitals with similar ages, medical history and sequential organ failure assessment(SOFA)scores who did not use PPIs were selected as the control group.All patients were followed up for 30 days.Kaplan-Meier survival analysis and the log-rank test were used to compare the 30-day mortality risk between the two groups.Cox regression analysis was used to analyze the relevant factors affecting the 30-day mortality.The 30-day mortality risk and the incidence of clinically significant gastrointestinal bleeding were evaluated among patients using different PPIs.Results:The average time of PPI use was 8.4±4.4 d in the PPI group.In the control group, 38.0% of patients were treated with H 2 receptor antagonists, and the average time of use was 8.1±5.2 days.There was no significant difference in the 30-day all-cause mortality risk between the two groups(20.5% or 41 cases vs.23.5% or 47 cases, P>0.05). The incidences of clinically significant upper gastrointestinal tract bleeding(2.5% or 5 cases vs.7.0% or 14, P<0.05), gastrointestinal bleeding(5.5% or 11 cases vs.12.5% or 25 cases, P<0.05)and hospital-acquired pneumonia(9.0% or 18 vs.4.0% or 8 cases, P<0.05)had significant differences between the PPI group and the control group.Multivariate Cox regression analysis showed that age>70 years( HR=1.845, 95% CI: 1.131-3.010, P<0.05), arterial oxygen partial pressure <78.0 mmHg(1 mmHg=0.133 kPa, HR=2.143, 95% CI: 1.317-3.487, P<0.01), SOFA score>14( HR=3.603, 95% CI: 1.741-7.456, P<0.01)and blood lactic acid>3.8 mmol/L( HR=2.725, 95% CI: 1.437-5.167, P<0.01)were related factors for the 30-day mortality.Compared with the control group, there was no significant difference in 30-day mortality between the five subgroups taking different PPIs including omeprazole, pantoprazole, rabeprazole, lansoprazole and esomeprazole( P>0.05), and the incidence of clinically significant gastrointestinal bleeding was significantly reduced( P<0.05), but there was no significant difference between the five PPIs subgroups( P>0.05). Conclusions:Although PPIs have no effect on short-term death in elderly ARDS patients, it can increase the risk of hospital acquired pneumonia while reducing the occurrence of gastrointestinal bleeding.With PPI use, advanced age, low arterial oxygen partial pressure, high SOFA score and high blood lactate are risk factors for the 30-day mortality.

15.
Article in Chinese | WPRIM | ID: wpr-883168

ABSTRACT

Objective:To explore the early clinical features and the prognostic factors of children with septic shock in PICU.Methods:A retrospective analysis was conducted at PICU of the Children′s Hospital, Capital Institute of Pediatrics from January 2016 to November 2018, totally 56 children diagnosed as septic shock were enrolled in the study.According to the prognosis of 28 days, the patients were divided into death group and survival group; according to the lowest pediatric critical score (PCIS) within 24 hours after admission to PICU, the children were divided into non-critical group (>80 points), critical group (70-80 points) and extremely critical group (<70 points). The clinical characteristics of early stage in each group were analyzed and compared.Results:Of the 56 children with septic shock, 32 were males and 24 were females, and the mean age was 12.0(1.0, 180.0) months.The overall mortality rate was 37.5%(21/56). The mortality of non-critical group, critical group and extremely critical group were 12.5%(2/16), 16.7%(1/6) and 52.9%(18/34), respectively.There were no statistically significant differences between survival group and death group in gender and age, PICU stay time, heart rate, mean arterial pressure at 1 hour and 24 hours, ventilator using and the duration of mechanical ventilation(all P>0.05). The vasoactive-inotropic score(VIS) at 6 hours and 24 hours of death group were significantly higher than those in survival group[19.0(5.0-29.5) vs.5.0(0.0-10.0), 22.5(3.5-43.8) vs.5.3(0.0-13.5)]. The scores of PCIS in death group were less than that in survival group(57.3±10.7 vs.72.8±12.0)( t=4.85, P<0.001). The lactate level in survival group before resuscitation was statistically lower than that in death group[1.8(1.3-2.8) mmol/L vs.4.5(2.4-8.4)mmol/L]( Z<-3.70, P<0.05). At 1 hour, 6 hours and 24 hours after treatment, fluid resuscitation volume in death group were markedly higher than that in survival group[1 hour: (41.8±5.8)ml/kg vs.(38.5±5.3)ml/kg, t=-2.22, P<0.05; 6 hours: (69.5±4.4)ml/kg vs.(59.9±3.5)ml/kg, t=-8.96, P<0.05; 24 hours: (122.3±19.6)ml/kg vs.(111.7±16.2)ml/kg, t=-2.20, P<0.05]. Multiple sample comparisons found significant differences between the non-critical group[(60.0±3.5) ml/kg] and the extremely critical group[(65.3±6.0) ml/kg, P<0.05], and pairwise comparison of fliud intake within 1 h and 24 h showed no statistically differences( P>0.05). In the univariate analysis, variables significantly associated with death in septic shock were lactic acid before resuscitation and the 24 h lactate clearance rate, VIS 6 h, VIS 24 h, procalcitonin, ejection fraction, PCIS, 6 h-fluid resuscitation volume and multiple organ dysfunction (MODS). The Logistic regression showed that 6 h-fluid resuscitation volume, PCIS, lactic acid and MODS were independent risk factors.ROC curve analysis showed the AUCs of 6 h-fluid resuscitation volume, PCIS, early lactic acid and MODS for predicting death of septic shock children were 0.947, 0.835, 0.797 and 0.761, respectively. Conclusion:The mortality of septic shock is high, and decreased PCIS, elected serum lactic acid level and early fluid resuscitation, and MODS are risk factors associated with the death of septic shock.

16.
Article in Chinese | WPRIM | ID: wpr-882695

ABSTRACT

Objective:To investigate the relationship between previous bleeding history and poor prognosis of patients with acute upper gastrointestinal bleeding.Methods:This study was a prospective multicentre real-world study (Acute Upper Gastrointestinal Real-word study, AUGUR study). The data of patients with UGIB who were admitted to the emergency department of 20 tertiary hospitals in China from June 30, 2020 to February 10, 2021 were collected. According to the number of previous bleeding history, the patients were divided into three groups (0 time, 1-3 times, and≥4 times). Based on the patient’s demographic data, clinical characteristics, laboratory data, treatment, and outcomes, univariate and logistic regression analysis were performed to investigate the correlation between the number of previous bleeding and the 90-day mortality and rebleeding of patients with gastrointestinal bleeding.Results:A total of 1 072 patients with acute UGIB were included in this study. The all-cause mortality and rebleeding rate of all patients were 10.9% (117/1 072) and 11.8% (129/1 072), respectively. Among them, 712 patients (66.42%) had no previous bleeding, 297 patients (27.71%) had previous bleeding 1-3 times, and 63 patients (5.88%) had previous bleeding≥4 times. In univariate analysis, age, vital signs and consciousness on admission, history of liver cirrhosis, onset with hematemesis, admission hemoglobin, varicose veins bleeding, peptic ulcer bleeding, red blood cell infusion, tracheal intubation and the use of vasopressors after admission were risk factors for the 90-day mortality and rebleeding rate. Multivariate logistic regression analysis showed that patients with previous bleeding≥4 times had a higher risk of the 90-day mortality ( OR=2.17, 95% CI: 1.04-4.57, P=0.040) and rebleeding ( OR=2.32, 95% CI: 1.19-4.53, P=0.013). Conclusions:The history of previous bleeding≥ 4 times can be used as an independent risk factor for the 90-day mortality and rebleeding in patients with acute UGIB.

17.
International Journal of Surgery ; (12): 264-268, 2021.
Article in Chinese | WPRIM | ID: wpr-882481

ABSTRACT

Malignant tumors usually have no obvious clinical symptoms in the early stage. Most patients are already in the advanced stage when they are diagnosed. Some patients have lost the opportunity for operation, resulting in poor prognosis. Therefore, how to find the best therapeutic target for such patients and improve the prognosis of patients has gradually become the focus of scholar′s attention. Recently, Kruppel-like factor (KLF) is a transcriptional regulator that can bind to the target DNA, and its family plays an important role in the occurrence and development of malignant tumors. It has also been confirmed that the KLF family affects the proliferation, differentiation and migration of tumor cells, but the specific mechanism is still not fully elucidate. Consequently, in order to further explored the effect of the KLF family on tumors, this study intends to briefly review the roles and regulatory mechanisms of the KLF family in the cell proliferation, differentiation and migration of malignant tumors, hoping to provide new target for the biological treatment of tumors.

18.
International Eye Science ; (12): 1213-1220, 2021.
Article in Chinese | WPRIM | ID: wpr-877387

ABSTRACT

@#AIM: To evaluate the diagnostic value of optical coherence tomography angiography(OCTA)in detecting the choroidal neovascularization(CNV)of wet age-related macular degeneration(wARMD).<p>METHODS: PubMed, Embase, Web of science, Cochrane library, CNKI, Wanfang, CBM and VIP databases were searched from inception to October 27, 2020 in diagnosing CNV of wARMD by OCTA. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by QUADAS-2 standard. Meta-analysis was performed by Meta-Disc 1.4 and Stata 16.0 softwares.<p>RESULTS: A total of 11 studies involving 995 eyes were included. The results of Meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic ratio, the AUC of sROC and the positive post-test probability were 0.88 \〖95%<i>CI </i>(0.83, 0.92)\〗, 0.95 \〖95%<i>CI </i>(0.85, 0.99)\〗, 18.45 \〖95%<i>CI </i>(5.36, 63.52)\〗, 0.12 \〖95%<i>CI </i>(0.08, 0.18)\〗, 152.73 \〖95%<i>CI </i>(36.39, 641.05)\〗, 0.95 \〖95%<i>CI </i>(0.92, 0.96)\〗 and 0.96 respectively.<p>CONCLUSION: OCTA has significant diagnostic value for CNV of wARMD, especially for patients with early wARMD.

19.
Journal of Clinical Hepatology ; (12): 570-574, 2021.
Article in Chinese | WPRIM | ID: wpr-873800

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ObjectiveTo investigate the association of common clinical indices and noninvasive liver fibrosis scores with hepatic-type Wilson’s disease (WD) in Chinese patients and their ability to identify advanced liver fibrosis. MethodsA retrospective analysis was performed for the clinical data of 236 Chinese patients with WD who were diagnosed and treated in Beijing YouAn Hospital and China-Japan Friendship Hospital from May 1996 to April 2020. A total of 26 patients with hepatic-type WD who underwent liver pathological examination and had complete clinical data were enrolled; the METAVIR score was used to determine liver fibrosis stage, and the patients were divided into advanced liver fibrosis (F3 and F4 stages) group and non-advanced liver fibrosis (F0, F1, and F2 stages) groups. Three noninvasive liver fibrosis scores [Sheth index, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) index] were calculated for both groups, and the above indices and related clinical indices were compared between the two groups. The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the Fisher’s exact test was used for comparison of categorical data between two groups. The Spearman rank correlation test was used for further analysis of indices with statistical significance, and the clinical indices and scoring criteria correlated with liver fibrosis degree were screened out; the receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated. ResultsMost of the patients in this study developed the disease in childhood and adolescence, and among these patients, 10 (38.5%) had positive K-F ring and 17 (65%) were in the stage of advanced liver fibrosis. There were significant differences between the advanced liver fibrosis group and the non-advanced liver fibrosis group in white blood cell count (WBC) (Z=-2.102, P=0.036), hemoglobin (Hb) (t=-2.860, P=0009), platelet count (PLT) (t=-4.053, P<0.001), direct bilirubin (DBil) (Z=-2.130, P=0.033), albumin (Alb) (t=-2.875, P=0.008), and Sheth index (Z=-3.369, P=0.001). WBC, Hb, PLT, and Alb were negatively correlated with liver fibrosis degree in WD patients (r=-0.587, -0.610, -0.656, and -0.411, all P<0.05), and DBil and Sheth index were positively correlated with liver fibrosis degree (r=0.486 and 0.711, both P<0.05). The ROC curve analysis showed that WBC, DBil, Sheth index, Hb, PLT, and Alb had an AUC of >0.7, among which Sheth index had the largest AUC of 0.908, with a sensitivity of 70.6%, a specificity of 100.0%, a positive predictive value of 100.0%, and a negative predictive value of 64.3%. ConclusionSheth index has a better diagnostic efficiency than the other clinical indices alone and can well identify advanced liver fibrosis in Chinese patients with hepatic-type WD.

20.
Article in Chinese | WPRIM | ID: wpr-873566

ABSTRACT

We summarized the experiences of construction and management of vaccine safety surveillance systems in different countries and regions by using literature review, and then made the recommendations of strengthening vaccine surveillance system in China. In the study, we found that multiple existing national and regional vaccine surveillance systems, such as VAERS and EudraVigilance, can ensure vaccine safety through multi-sectoral surveillance, identification of adverse signals, and promotion of awareness of active reporting. However, the monitoring systems have some limitations, such as reporting bias and system decentralization. Therefore, China's vaccine monitoring system should establish an effective vaccine surveillance system, which achieves multi-sectoral, active, open to the public surveillance.

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