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1.
Article in Chinese | WPRIM | ID: wpr-954530

ABSTRACT

Objective:To investigate the diagnostic and early-warning value of laboratory test indicators for sepsis-induced myocardial injury (SIMD).Methods:The clinical data of 183 patients with sepsis admitted to the Department of Emergency and Critical Care Medicine of Guangdong Provincial People's Hospital from August 2016 to October 2020 were collected. The patient's age, gender, past medical history, vital signs and pathogen culture results were extracted. Cardiac function, blood routine, liver function, renal function, inflammatory factors, coagulation function, APACHE Ⅱ and SOFA scores were recorded at enrollment and 72 h after admission. SIMD was defined as cTnT ≥300 pg/mL and NT-proBNP ≥1243 pg/mL twice in 72 h intervals between enrolled cases, and the early-warning factors of patients with SIMD were analyzed. The differences in various indicators between the two groups were compared, and Logistic regression analysis was used to explore the diagnostic efficacy of cTnT and NT-proBNP combined for SIMD, and the correlation between PCT/PLT ratio and the occurrence of SIMD.Results:Among 250 patients, 67 patients were excluded for lack of the main indicators, and 183 patients (including 62 patients with history of cardiac disease) were enrolled finally. Among 183 patients with sepsis, 105 patients (57.38%) with cTNT ≥300 pg/mL and NT-proBNP ≥1 243 pg/mL, were diagnosed as myocardial injury; after excluding 62 patients with history of cardiac disease, 59 patients (48.76%) with cTNT ≥300 pg/mL and NT-proBNP ≥1 243 pg/mL were diagnosed as myocardial injury. Logistic regression analysis showed that increased PCT/PLT ratio ( OR=1.585, 95% CI: 1.124-2.237, P=0.009) was an independent risk factor for early-warning of SIMD. The PCT/PLT ratio ( OR= 1.850, 95% CI: 1.103-3.102, P=0.020) could stably predict the occurrence of SIMD in patients without previous history of heart disease. ROC curve analysis showed that PCT/PLT ratio could effectively predict the occurrence of SIMD (AUC=0.693, 95% CI: 0.617-0.769, P<0.001), the optimal cut-off value was 0.177 (sensitivity: 65.7%, specificity: 66.7%). The PCT/PLT ratio was still effective in predicting the occurrence of SIMD after excluding patients with previous history of heart disease (AUC=0.733, 95% CI: 0.643-0.823, P<0.001), and the optimal cut-off value was 0.429 (sensitivity: 55.9%, specificity: 83.9%). Conclusions:The combination of cTnT and NT-proBNP has certain diagnostic value for SIMD, and the PCT/PLT ratio could warn the occurrence of SIMD.

2.
Article in Chinese | WPRIM | ID: wpr-934371

ABSTRACT

Nuclear magnetic resonance spectroscopy is one of the main analytical techniques for detecting metabolomics, which has the advantages of simple operation, rapid detection and non-invasive feature. By monitoring the changes of metabolites in the body, it is helpful to deeply understand the mechanism of disease and play a role in the diagnosis and treatment of diseases, but its clinical application has not yet been popularized. In recent years, the application of metabolomics in tumors has increasingly become a research hotspot. Therefore, in order to provide a reference for the research and clinical application of tumor metabolomics, the nuclear magnetic resonance spectroscopy and tumor metabolomics were introduced in this paper, and the application progress of metabolomics analysis based on this technique in early tumor screening, clinical diagnosis and prognosis evaluation were reviewed in this paper.

3.
Article in Chinese | WPRIM | ID: wpr-958626

ABSTRACT

Extracellular vesicles (EVs) can carry a variety of bioactive components including nucleic acids, proteins and small molecule metabolites, and their value in tumor diagnosis and treatment has been widely recognized. However, current studies on EV inclusions mainly focus on RNA and protein, and the role of small molecule metabolites that can most directly reflect the cell state in EV remains unclear. EV metabolomics in cancer research has gradually gained traction in recent years. There are still many challenges in EV metabolomics research due to the complexity of pretreatment and low content of metabolite, but its value in regulating tumor progression and serving as tumor markers has gradually emerged, which is expected to provide new targets for tumor diagnosis and treatment.

4.
Chinese Journal of Nephrology ; (12): 497-503, 2022.
Article in Chinese | WPRIM | ID: wpr-958052

ABSTRACT

Objective:To analyze the clinical features, efficacy and adverse reactions of enzyme replacement therapy (ERT) in patients with Fabry disease (FD).Methods:The clinical data of FD patients in Shandong Provincial Hospital Affiliated to Shandong First Medical University from June 2020 to September 2021 were collected and the clinical manifestations, laboratory examinations, gene mutations, and efficacy and adverse reactions of ERT were retrospectively analyzed.Results:Sixteen patients with FD were enrolled in this study, including 12 typical cases and 4 late-onset cases, with varied clinical manifestations. Compared with late-onset patients, typical patients had younger age of onset ( P=0.001), lower activity of plasma alpha-galactosidase A ( P=0.016) and higher globotriaosylsphingosine (lyso-GL-3, P=0.030). The typical patients [(13.50±10.08) years] and late-onset patients [(10.75±7.27) years] both had long delayed time of diagnosis. In 7 patients who underwent regular 6 ERT, lyso-GL-3 was significantly lower than before ( P=0.018); after 6 treatments, the pain of 5 patients was relieved than before. Three patients with irregular ERT had aggravated symptoms, and 1 case had stroke recurrence during regular treatment. No serious adverse reaction occurred with the use of agalsidase β and α. Conclusions:ERT can effectively reduce the level of plasma lyso-GL-3 in patients with FD and relieve symptoms, and has good safety. But the efficacy of ERT is dose-dependent, and clinical benefits require long-term observation and follow-up. Patients treated with ERT should have good compliance and can receive long-term regular treatment.

5.
Article in Chinese | WPRIM | ID: wpr-931735

ABSTRACT

Objective:To investigate the impact of nutrition supplementation (whey protein, fish oil and vitamin D) and physical exercise (resistance and aerobic exercise) on muscle mass and body fat metrics among community elderly with sarcopenia.Method:102 eligible sarcopenic participants per inclusion and exclusion criteria were randomized into the control group (routine consultation, n=34) or the groups receiving nutrition supplementation (Nutr, n=34) or nutrition supplementation combined with exercise (Nutr+Ex, n=34) for 12 weeks. Muscle and body fat related indicators were compared across groups pre- and post-intervention. Results:Analysis of covariance showed that all indicators were significantly different between groups (all P<0.05). Further pairwise comparisons showed that compared with controls, patients in Nutr group showed increased appendicular muscle mass (ASM) by 0.837 kg ( P=0.003, 95% CI: 0.301 to 1.372) and decreased fat mass by 2.876 kg ( P<0.01, 95% CI: -3.941 to -1.812), while patients in Nutr+Ex group showed increased ASM by 0.745 kg ( P=0.010, 95% CI: 0.180 to 1.311) and decreased fat mass by 2.928kg ( P<0.01, 95% CI: -4.408 to -1.808). Other muscle-related indicators also increased while fat-related indicators decreased in both Nutr and Nutr+Ex groups. However, there is no significant difference between Nutr and Nutr+Ex groups. Conclusions:Nutrition supplementation and physical exercise contribute to muscle mass and body fat improvement among sarcopenic elderly. Lifestyle intervention based on nutrition intervention is important for the community elderly with sarcopenia.

6.
Article in Chinese | WPRIM | ID: wpr-939668

ABSTRACT

A boy, aged 2 years and 5 months, had recurrent epistaxis, and the coagulation function examination showed that activated partial thromboplastin time (APTT) was significantly prolonged. Further laboratory examinations showed that the prolonged APTT was not immediately corrected in the APTT correction test, with positive lupus anticoagulant and low prothrombin activity. The boy was diagnosed with hypoprothrombinemia-lupus anticoagulant syndrome. The condition was improved after treatment with glucocorticoid, immunoglobulin, and vitamin K1. The boy has been followed up for 6 months, and no epistaxis was observed. Prothrombin activity returned to normal, and lupus anticoagulant remained positive. This is a relatively rare disease, and for patients with bleeding symptoms and coagulation disorders, it is recommended to perform the tests such as APTT correction test, lupus anticoagulant testing, and coagulation factor dilution test, which can improve the detection rate of this disease, so as to achieve early diagnosis, provide rational treatment in the early stage, and improve the prognosis.


Subject(s)
Antiphospholipid Syndrome/diagnosis , Blood Coagulation Disorders , Child, Preschool , Epistaxis/etiology , Humans , Hypoprothrombinemias/diagnosis , Lupus Coagulation Inhibitor , Male , Partial Thromboplastin Time , Prothrombin
7.
Chinese Journal of Biotechnology ; (12): 1124-1137, 2022.
Article in Chinese | WPRIM | ID: wpr-927768

ABSTRACT

Transglutaminase 2 (TGM2) is a ubiquitous multifunctional protein, which is related to the adhesion of different cells and tumor formation. Previous studies found that TGM2 is involved in the interaction between host cells and viruses, but the effect of TGM2 on the proliferation of influenza virus in cells has not been reported. To explore the effect of TGM2 during H1N1 subtype influenza virus infection, a stable MDCK cell line with TGM2 overexpression and a knockout cell line were constructed. The mRNA and protein expression levels of NP and NS1 as well as the virus titer were measured at 48 hours after pot-infection with H1N1 subtype influenza virus. The results showed that overexpression of TGM2 effectively inhibited the expression of NP and NS1 genes of H1N1 subtype influenza virus, while knockout of TGM2 up-regulated the expression of the NP and NS1 genes, and the expression of the NP at protein level was consistent with that at mRNA level. Virus proliferation curve showed that the titer of H1N1 subtype influenza virus decreased significantly upon TGM2 overexpression. On the contrary, the virus titer in TGM2 knockout cells reached the peak at 48 h, which further proved that TGM2 was involved in the inhibition of H1N1 subtype influenza virus proliferation in MDCK cells. By analyzing the expression of genes downstream of influenza virus response signaling pathway, we found that TGM2 may inhibit the proliferation of H1N1 subtype influenza virus by promoting the activation of JAK-STAT molecular pathway and inhibiting RIG-1 signaling pathway. The above findings are of great significance for revealing the mechanism underlying the interactions between host cells and virus and establishing a genetically engineering cell line for high-yield influenza vaccine production of influenza virus.


Subject(s)
Animals , Cell Proliferation , Dogs , Humans , Influenza A Virus, H1N1 Subtype/genetics , Influenza, Human , Madin Darby Canine Kidney Cells , Protein Glutamine gamma Glutamyltransferase 2
8.
Chinese Journal of Biotechnology ; (12): 882-892, 2022.
Article in Chinese | WPRIM | ID: wpr-927751

ABSTRACT

With the widespread application of genomics and transcriptomics in the genetics and cell biology of different species, synonymous codon usage bias has been gradually accepted and used to study the deep connection between biological evolution and biological phenotypes. It is an important part of the life activities that mRNA is expressed into proteins with normal biological activities. The synonymous codon usage patterns, which were named as 'the second genetic codon', can express genetic information carried by themselves at the levels of transcriptional regulations, translational regulations and metabolic activities through molecular mechanisms such as fine-tune translation selection. Some studies have shown that the length of mRNA half-life has significant impacts on mRNA activity and the process of transcription and translation. This review summarized the roles of synonymous codon usage patterns in transcription, translational regulation and post-translational modification, with the aim to better understand how organisms skillfully utilize the genetic effects caused by codon usage patterns to accurately synthesize different types of proteins, so as to ensure the growth or differentiation of the specific gene expression procedures to carry out smoothly and maintain the normal life cycle.


Subject(s)
Codon/genetics , Codon Usage , Half-Life , Protein Processing, Post-Translational , RNA, Messenger/genetics
9.
Article in Chinese | WPRIM | ID: wpr-884833

ABSTRACT

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.

10.
Article in Chinese | WPRIM | ID: wpr-884824

ABSTRACT

Objective:To the effects of testosterone replacement therapy on muscle strength and function among the elderly (≥65 years old).Methods:We searched English and Chinese databases of PubMed, SinoMed, etc, upto July 4, 2020. All retrieved literatures were reviewed according to inclusion and exclusion criteria in accordance with PICOS principles. The Cochrane risk bias assessment tool was used for quality evaluation. Two researchers extracted data and evaluated literature quality independently. The outcomes included muscle strength (assessed by handgrip strength, leg extension strength, etc) and function (assessed by walking speed according to 6-minute walking test, 6MWT). Review Manager 5.3 software was used for statistical analysis. The fixed or random effects model was used to merge data of upper-and lower-extremity strength or 6MWT to produce forest plot and funnel plot. The subgroup analyses were conducted based on the characteristics of included studies. The sensitivity analyses were conducted for excluding literatures with small sample size, etc.Results:A total of 15 relatively high quality researches (14 English literatures and 1 Chinese literature) were included. The results of this meta analyses showed TRT could improve upper-extremity (0.21[0.11, 0.32]) and lower-extremity (0.34[0.12, 0.55]) muscle strength while not physical function (17.62[-13.06, 48.31]) among the elderly men. Subgroup analyses showed that region, source of participants, administration route and intervention period, while not the baseline testosterone level had effect on the pooled effect size. Funnel plot suggested a certain degree of publication bias. Sensitivity analyses revealed that the meta analyses were robust.Conclusion:TRT can improve muscle strength while not physical function among elderly men.

11.
Article in Chinese | WPRIM | ID: wpr-921942

ABSTRACT

OBJECTIVE@#To explore the clinical efficacy of focused extracorporeal shock wave therapy with centrifugal exercise in the treatment of greater trochanteric pain syndrome.@*METHODS@#From September 2017 to June 2019, 53 eligible cases of greater trochanteric pain syndrome were randomly divided into observation group (29 cases) and control group (24 cases). In observation group, there were 8 males and 21 females, aged from 38 to 62 years old with an average of (49.96±6.39) years old; the course of disease ranged from 6 to 13 months with an average of (8.58±1.99) months;treated with focused extracorporeal shock wave therapy with centrifugal exercise. In control group, there were 5 males and 19 females, aged from 39 to 62 years old with an average of (52.79±5.86) years old;the course of disease ranged from 6 to 14 months with an average of (9.04±2.51) months;treated with centrifugal exercise alone. Visual analogue scale (VAS) and hip Harris score were measured before ESWT treatment and at 1, 2, and 6 months to evaluate relieve degree of pain and functional recovery of hip joint, respectively.@*RESULTS@#At 1 month after treatment, there were no significant differences in VAS, hip Harris score and treatment success rate (all @*CONCLUSION@#In treatment of greater trochanteric pain syndrome, focused extracorporeal shock wave therapy with centrifugal exercise could significantly relieve symptoms of lateral hip pain, improve functional recovery of hip joint with good safety. This treatment strategy is worthy of application and promotion in clinical practice.


Subject(s)
Adult , Arthralgia , Bursitis , Extracorporeal Shockwave Therapy , Female , Hip , Hip Joint , Humans , Male , Middle Aged , Treatment Outcome
12.
Article in Chinese | WPRIM | ID: wpr-907966

ABSTRACT

A patient with global developmental delay and facial abnormality treated in Hunan Maternal and Child Health Care Hospital in September 2018 was diagnosed as a typical Say-Barber-Biesecker/Young-Simpson syndrome (SBBYSS)accompanied with comprehensive clinical manifestations and genetic testing was carried out.The patient carries a heterozygous synonymous mutation of KAT6B gene (NM_012330.3)c.3147G>A (p.P1049P), thus leading to the formation of a new cleavage site (receptor) and forming a new truncated protein.In Chinese, this is the second typical SBBYSS that has been identified and the first prenatal genetic diagnosis has been performed.This study has broadened the mutation spectrum of SBBYSS caused by the mutation of KAT6B gene in Chinese population.

13.
Article in Chinese | WPRIM | ID: wpr-907734

ABSTRACT

Objective:To investigate the effect of plasma exchange (PE) and continuous blood purification(CRRT) on children with bee sting poisoning and multiple organ dysfunction syndrome (MODS).Methods:From January 2016 to September 2019, 37 children aged 9 months to 11 years with bee sting and MODS were treated with dexamethasone 0.5 mg/kg or methylprednisolone 3 mg-5 mg/kg anti allergic and anti-inflammatory and organ support. Among them, 26 cases were treated with plasma exchange and continuous blood purification (treatment group), and the rest 11 cases were only given conventional treatment, but did not receive blood purification treatment (control group).The critical illness score, liver and kidney functions, myolysis, pulmonary hemorrhage/pulmonary edema, coagulation disorders, shock, hemolysis, gastrointestinal failure and other organ damage, ICU stay time, mechanical ventilation time, organ dysfunction recovery time and clinical outcomes were retrospectively analyzed. In the treatment group, 18 cases started blood purification before 12 h after MODS (early treatment group) and 8 cases started blood purification after 12 h (delayed treatment group).Results:There was no significant difference in age, sex, child critical illness score, onset time and organ function damage between the treatment and control groups ( P>0.05). The cure rate of the treatment group was higher than that of the control group [(25/26 (96.15%) vs 8/11 (72.73%), P=0.036]. There was no significant difference in ICU stay between the control group and the treatment group [(10.03±7.74) d vs (12.01±6.95) d, P>0.05]. Among the 25 survivors in the treatment group, one patient had mild renal function damage and one patient had multiple necrosis of skin, subcutaneous and muscle tissue. Compared with 4 of the 8 survivors in the control group, the residual organ function damage in the treatment group was significantly less than that in the control group [(2/25 (8.00%) vs 4/8 (50.00%), P=0.031)].The recovery of liver function, renal function, myolysis and hemolysis in the treatment group was faster than those in the control group (all P < 0.05). The initiation of blood purification within 12 h after the occurrence of MODS required fewer times of plasma exchange and shorter CRRT time, ICU stay and ventilator time (all P < 0.05). Conclusions:In children with bee sting combined with MODS, plasma exchange and continuous blood purification can achieve better therapeutic effect and better clinical outcome.

14.
Article in Chinese | WPRIM | ID: wpr-907718

ABSTRACT

Objective:To explore the change of blood-brain barrier (BBB) permeability in septic rats.Methods:A rat model of sepsis was established by cecal ligation and puncture. Rats were randomly (random number) grouped according to the intervention time: sham-operated group, sepsis 1-day group, sepsis 4-day group, and sepsis 7-day group. Fluorescein sodium was used to test the permeability of the BBB. Western blot and immunofluorescence methods were applied to detect the expression of tight junction proteins including Claudin-5, Occludin and ZO-1.Results:Compared with the sham-operated group, rats in the sepsis group presented quick breath, slow response, decreased intake of food and water, obvious abdominal distension and loose stools. After abdominal anatomy of sepsis rats, we found mesenteric adhesions, dilatation of proximal intestinal, black cecum ligation site with purulent exudate, enlarged liver and diffused bloody exudate. Compared with the sham-operated group, body weight of sepsis rats was reduced remarkably ( P < 0.05). The body weight of rats of sepsis 7-day group was the lowest, which was significantly lower than that of rats of sepsis 4-day group ( P< 0.05) and 1-day group ( P< 0.05). Compared with the sham-operated group, the content of fluorescein sodium in sepsis 1-day rats was increased remarkably ( P< 0.05). The content of fluorescein sodium in rats of sepsis 7-day group was the highest, which was significantly higher than that in rats of sepsis 4-day group ( P< 0.05) and 1-day group ( P< 0.05). Compared with the sham-operated rats, the expression of Claudin-5, Occludin and ZO-1 in sepsis rats were decreased remarkably (all P < 0.05). The expression of Claudin-5, Occludin and ZO-1 were the lowest in rats of the sepsis 7-day group, which were significantly decreased than those of rats in the sepsis 4-day group (all P< 0.05) and rats in sepsis 1-day group (all P < 0.05). Conclusions:Sepsis rats showed increased permeability of the BBB, and the permeability of BBB increased continuously along with the duration of sepsis.

15.
China Pharmacy ; (12): 2911-2916, 2021.
Article in Chinese | WPRIM | ID: wpr-906661

ABSTRACT

OBJECTIVE:To investigate the pharmaceutical ca re for a child with refractory Stenotrophomonas maltophilia sepsis by clinical pharmacists ,and to provide reference for the treatment of children with this disease. METHODS :Clinical pharmacist participated in drug therapy for a child with refractory S. maltophilia sepsis. Based on the pathophysiological characteristics of the child and the PK/PD characteristics of the antimicrobials ,clinical pharmacists suggested that the anti-infection regimen should be adjusted as cefoperazone sodium and sulbactam sodium 160 mg/(kg·d),every 8 hours combined with levofloxacin 10 mg/kg, every 12 hours. For clinical manifestations of severe inflammatory reaction , the clinical pharmacist suggested receiving methylprednisolone sodium succinate 1 mg/kg additionally ,every 12 hours,for anti-inflammatory adjuvant therapy. At the same time, clinical pharmacist provided individualized pharmaceutical care (including the detection of blood concentration of cefoperazone sodium and sulbactam sodium ,the detection of ADR and medication education of oxygen atomization )during the treatment,and followed up the child for one year. RESULTS :The doctors adopted the suggestions of clinical pharmacists. The sepsis was controlled ,the child ’s condition were improved and then discharged. During the follow-up ,the child did not suffered from ADR ,such as cartilage and joint injury. CONCLUSIONS :Hypoimmunity,long stay in intensive care unit ,endotracheal intubation and malignant tumor are the high risk factors of S. maltophilia infection. The monitoring of therapeutic drugs of cefoperazone sodium and sulbactam sodium is very necessary in the treatment of severe infection in children. After weighing the advantages and disadvantages and meeting certain conditions ,children can use quinolones for anti-infection ;based on the effective anti-infection treatment ,low-dose glucocorticoid can reduce the systemic inflammatory respense in patients with sepsis.

16.
Chinese Medical Journal ; (24): 2564-2572, 2021.
Article in English | WPRIM | ID: wpr-921186

ABSTRACT

BACKGROUND@#Although there are few studies mentioned there may be some relationship between psoriatic arthritis (PsA) and osteoporosis, clinical data in real world still need to be clarified in China. The aim of this study was to assess the areal and volumetric bone mineral density (BMD), frequency of fracture, and risk factors in patients with PsA.@*METHODS@#A total of one hundred PsA patients who visited Peking University First Hospital and one hundred age- and sex-matched healthy controls with DXA data were enrolled in the study. Patients with clinical fractures confirmed by X-ray during follow-up were also recorded. Clinical characteristics of the patients were recorded and compared between the abnormal BMD group and the normal BMD group, as well as between the fracture and non-fracture groups. Risk factors for fracture and low BMD were analyzed.@*RESULTS@#Mean BMD at the total hip and femoral neck was significantly lower in PsA patients than that in healthy controls (0.809 ± 0.193 vs. 0.901 ± 0.152 g/cm2, P  = 0.041; 0.780 ± 0.146 vs. 0.865 ± 0.166 g/cm2, P  = 0.037, respectively). Moreover, lumbar spine BMD was negatively correlated with psoriasis duration, swollen joint count and DAS28-CRP (r = -0.503, -0.580, -0.438; P < 0.05). Total hip BMD and femoral neck BMD were negatively correlated with HAQ (r = -0.521, -0.335; P < 0.05). Fractures occurred in 29 patients during the follow-up period. Logistic regression analysis showed that older age (OR 1.132 [95%CI: 1.026-1.248), P < 0.05], higher HAQ score (OR 1.493, 95%CI: 1.214-1.836, P < 0.01), higher disease activity index for psoriatic arthritis (OR 1.033, 95% CI: 1.002-1.679, P < 0.05) and hip joint involvement (OR 6.401, 95% CI: 4.012-44.180, P < 0.05) were risk factors for fracture in the multivariate model.@*CONCLUSIONS@#Increased risks of osteoporosis and fracture were found in PsA patients compared to healthy controls. Besides age, high disease activity and hip joint involvement were risk factors for decreased BMD and fracture.


Subject(s)
Absorptiometry, Photon , Aged , Arthritis, Psoriatic/complications , Bone Density , Humans , Lumbar Vertebrae , Osteoporosis/etiology , Osteoporotic Fractures , Risk Factors
17.
Article in Chinese | WPRIM | ID: wpr-912491

ABSTRACT

The application of artificial intelligence (AI) technology in laboratory medicine has shown great potential, but it also has many challenges and difficulties. Understanding the basic principles, evaluation methods, application scenarios, advantages and limitations of artificial intelligence can facilitate its use in the working practice. In the near future, AI will be fully applied in clinical testing, enabling laboratory medicine to play a more accurate role in disease diagnosis, curative effect monitoring, prognositic judgment and other aspects. With the help of AI technology, laboratory medicine has a promising future.

18.
Article in Chinese | WPRIM | ID: wpr-910839

ABSTRACT

Objective:To explore the effect of the nutritional status on the clinical outcome and adverse effects of patients with concurrent radiochemotherapy for cervical cancer and analyze the cost-effectiveness of this treatment.Method:This study is a prospective, observational cohort study continuously enrolling patients with cervical cancer who received concurrent radiochemotherapy from 2018-05-01 to 2018-09-01 in Peking Union Medical College Hospital. According to the criteria, patients were divided into two groups: nutritional disorders and normal nutrition groups. There were 81 and 94 cases of abnormal and normal nutrition, respectively. Blood tests, liver function tests, treatment costs for adverse effects, and nutritional support were employed. We observed the incidence of vomiting, diarrhea, bone marrow suppression, infection, and other responses in the two groups, followed by clinical outcomes and the cost-effectiveness analysis.Results:Compared with the normal nutrition group, the infection rate (27.2% vs 14.9%, χ 2=4.007, P=0.045), the incidence of bone marrow suppression (86.4% vs 69.1%, χ 2=7.36, P= 0.007), the cost of bone marrow suppression treatment [324.0 (164.2-648.0) vs 587.8 (243.6-1 728.0), z=2.698, P=0.007), and the treatment cost [71.4 (45.2-123.7) vs 85.1 (57.0-198.9), z=1.994, P=0.030) significantly increased in the nutritional disorder group. There were more patients with poor clinical outcomes in the nutritional disorder group than in the normal group (29.6% vs 8.5%, χ 2= 12.987, P<0.001). Only 7.2% of the patients had visited a nutrition clinic, and the rate of nutrition intervention was extremely low. Conclusion:In patients with cervical cancer undergoing concurrent radiochemotherapy, there is a higher incidence of adverse effects, such as infection and bone marrow suppression, as well as higher treatment costs and worse clinical outcomes.

19.
Article in Chinese | WPRIM | ID: wpr-932991

ABSTRACT

Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.

20.
Article in Chinese | WPRIM | ID: wpr-931717

ABSTRACT

Objective:To investigate the impact of oat beta-glucans on blood levels of lipids, glucose, and inflammatory factors in patients with hyperlipemia/hyperglycemia.Methods:A total of 120 patients with hyperlipemia/hyperglycemia were randomized into intervention ( n = 60) and control groups ( n = 60). In addition to the routine nutritional consultation, two groups received oral oat beta-glucan at 3 g/d (intervention) or lotus root powder at 3 g/d (control), respectively. Blood levels of lipids, glucose, insulin and inflammatory factors, body composition and bowel movement were compared between the two groups after 12 weeks of study intervention. The treatment effect was represented by intention-to-treat analysis. Results:A total of 109 participants completed the study. The total cholesterol [(5.18±0.69) mmol/L vs (5.25±0.88) mmol/L, P=0.024] and fasting plasma glucose [(5.50±0.82) mmol/L vs (5.98±1.33) mmol/L, P=0.002] in the intervention group were significantly decreased compared with the control group. Conclusion:Oral oat beta-glucans could decrease the total cholesterol and fasting plasma glucose in participants with mild hyperlipemia/hyperglycemia.

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