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BACKGROUND@#Transcription factor (TF) can bind specific sequences that either promotes or represses the transcription of target genes, and exerts important effects on tumorigenesis, migration, invasion. Staphylococcal nuclease-containing structural domain 1 (SND1), which is a transcriptional co-activator, is considered as a promising target for tumor therapy. However, its role in lung adenocarcinoma (LUAD) remains unclear. This study aims to explore the role of SND1 in LUAD.@*METHODS@#Data from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), Clinical Proteomic Tumor Analysis Consortium (CPTAC), and Human Protein Atlas (HPA) database was obtained to explore the association between SND1 and the prognosis, as well as the immune cell infiltration, and subcellular localization in LUAD tissues. Furthermore, the functional role of SND1 in LUAD was verified in vitro. EdU assay, CCK-8 assay, flow cytometry, scratch assay, Transwell assay and Western blot were performed.@*RESULTS@#SND1 was found to be upregulated and high expression of SND1 is correlated with poor prognosis of LUAD patients. In addition, SND1 was predominantly present in the cytoplasm of LUAD cells. Enrichment analysis showed that SND1 was closely associated with the cell cycle, as well as DNA replication, and chromosome segregation. Immune infiltration analysis showed that SND1 was closely associated with various immune cell populations, including T cells, B cells, cytotoxic cells and dendritic cells. In vitro studies demonstrated that silencing of SND1 inhibited cell proliferation, invasion and migration of LUAD cells. Besides, cell cycle was blocked at G1 phase by down-regulating SND1.@*CONCLUSIONS@#SND1 might be an important prognostic biomarker of LUAD and may promote LUAD cells proliferation and migration.
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Humanos , Pronóstico , Proteómica , Neoplasias Pulmonares/genética , Oncogenes , Adenocarcinoma del Pulmón/genética , Biomarcadores , Endonucleasas/genéticaRESUMEN
ObjectiveTo investigate the role and mechanism of action of Yinchenhao Decoction in inhibiting ferroptosis of hepatocytes in mice with autoimmune hepatitis. MethodsA total of 18 specific pathogen-free female C57BL/6 mice were selected and divided into normal group， model group， and treatment group using a random number table， with 6 mice in each group. The mice in the model group and the treatment group were injected with concanavalin A （Con A） via the caudal vein to establish a mouse model of autoimmune hepatitis， and those in the normal group were injected with normal saline. The mice in the treatment group were given prophylactic treatment with Yinchenhao Decoction （4.68 g crude drug/kg） by gavage at 14 days before modeling， and Con A was injected after the last gavage. The levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， interferon gamma （IFN-γ）， tumor necrosis factor-α （TNF-α）， iron ion， glutathione （GSH）， reactive oxygen species （ROS）， adenosine triphosphate （ATP）， and malondialdehyde （MDA） were measured； liver index and spleen index were calculated； the expression levels of GPX4 and SLC7A11 were measured； liver histopathological changes were compared between groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between three groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the normal group， the model group had significant increases in liver index， spleen index， ALT， AST， IFN-γ， TNF-α， iron ion， ROS and MDA （all P<0.05） and significant reductions in the content of GSH and ATP and the protein expression levels of GPX4 and SLC7A11 （all P<0.05）. Compared with the model group， the treatment group had significant reductions in liver index， spleen index， ALT， AST， IFN-γ， TNF-α， iron ion， ROS and MDA （all P<0.05） and significant increases in the content of GSH and ATP and the protein expression levels of GPX4 and SLC7A11 （all P<0.05）. HE staining showed that compared with the normal group， the model group showed massive hepatocyte degeneration and necrosis and inflammatory cell aggregation at the portal area， and compared with the model group， the treatment group had alleviation of liver necrosis and inflammatory infiltration. ConclusionLiver injury induced by Con A may be associated with ferroptosis. Yinchenhao Decoction can increase the protein expression levels of SLC7A11 and GPX4 protein and thus inhibit ferroptosis of hepatocytes induced by Con A.
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ObjectivesTo compare the clinical efficacy and complications of anatomic locking titanium plate （hereinafter referred to as “titanium plate screw”） and intramedullary nail in the treatment of distal tibial fractures.Methods From September 2019 to September 2021， 32 patients diagnosed with AO-A fracture of distal tibia at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were included in this study. Of these， 15 cases were treated with titanium plate screws and 17 cases were treated with intramedullary nails. General surgical indexes， fracture healing time and postoperative operation were compared between the two groups.ResultsAll patients were followed up for 10 to 20 months， with an average of 12 months. The operative time and intraoperative fluoroscopy times of intramedullary nail group were longer than those of titanium plate screw group， but the preoperative waiting time and hospitalization days was less or were fewer than those of titanium plate screw group， the difference was statistically significant （P < 0.05）. There was no significant difference in fracture healing time between the two groups （P> 0.05）. At 6 weeks after operation， VAS scores in both groups were lower than those before operation， with statistically significant difference （P<0.05）. There was no significant difference in VAS scores between the intramedullary nail group and the titanium plate screw group （P> 0.05）. AOFAS scores 6 months after surgery， ankle joint motion and complication rate 1 year after surgery in intramedullary screw group were better than those in titanium plate screw group， and the differences were statistically significant （P< 0.05）. There was no significant difference in AOFAS scores between the two groups at 1 year after operation （P> 0.05）.ConclusionTitanium plate screw and intramedullary nail are both effective methods for the treatment of distal tibial AO-A fracture， and there is no significant difference in long-term clinical efficacy. Intramedullary nail has fewer soft tissue complications， less impact on ankle motion， faster recovery and higher safety， while titanium plate screw has a higher probability of postoperative soft tissue infection. We suggest that in clinical work， preoperative evaluation of patients should be done well. Under the premise of grasping the indications， intramedullary nail has fewer complications and certain advantages.
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It is believed that all kinds of gynaecological diseases are mostly related to deficiency and stagnation of qi and blood. Medicinal insects are good at running and scurrying， with the effectiveness of activating blood circulation and dispelling blood stasis， moving qi and relieving pain， searching and dredging collaterals， attacking hardness and dissipating mass， and purging foetus and resolving mass， etc. Appropriate prescriptions can enhance the effectiveness of the formula in eliminating blood stasis and eliminating stagnation. In the treatment of menstrual disorders， chronic pelvic inflammatory disease， uterine cavity disease， incomplete miscarriage， ectopic pregnancy， and other gynaecological diseases， medicinal insects including Quanxie （Scorpio）， Wugong （Scolopendra）， Tubiechong （Eupolyphaga/Steleophaga）， Jiuxiangchong （Coridius chinenses）， Shuizhi （Hirudo）， Mangchong （Tabanus）， Dilong （Pheretima） and other insects for medicinal purposes could be used， and the self-prescribed empirical formulas such as Sanhuang Decoction （三黄汤）， Hongteng Decoction （红藤汤）， Penning Decoction （盆宁方）， Shapei Decoction （杀胚方）， and Gongwaiyun Decoction （宫外孕方） and so on， were all applied medicinal insects and showed effective in clinic.
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Small molecule fluorescent probes have gained widespread attention for their advantages of high selectivity, sensitivity, and easy to operate, and have played a critical role in the detection of various species. They have also demonstrated great potential in the field of biomedical research. Iron, as the most abundant transition metal in the human body, plays a vital role in many physiological functions. Due to the influence of the reductive microenvironment of cell, ferrous ion (Fe2+) is the main component of labile iron in living cells. Heme, consisting of Fe2+ and protoporphyrin IX, is one of the main signaling molecules that wrap biological iron in the human body, and also participates in many physiological and pathological processes. Therefore, the development of small molecule fluorescent probes for detecting Fe2+ and heme as effective monitoring tools will help to further understand their pathological and physiological functions, with potential applications in other fields. This review summarizes the research progress of small molecule fluorescent probes for Fe2+ and heme detection in recent years, and provides insights into future directions for their development.
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In this study, the mechanism of Xiaoyan Lidan formula (XYLDF) against 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-collidine (DDC)-induced chronic intrahepatic cholestasis (CIHC) in mice was investigated based on metabolomics, molecular docking and pharmacological methods. In the pharmacodynamics study, a dosage of 5 g·kg-1 (clinical equivalent) XYLDF was administered in DDC-induced mice, then the effect of XYLDF against CIHC was evaluated by measuring the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP) as well as total bilirubin (TBIL) in serum and observing liver histopathological changes. All experiments were approved by the Ethical Committee Experimental Animal Center of Guangzhou University of Chinese Medicine (ZYD-2021-001). The serum metabolites of mice in each group were detected and identified based on ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry, and the relevant biological pathways and molecular key targets were further enriched. Molecular docking technology was used to further evaluate the binding activity of the main active ingredients of XYLDF with potential targets. Subsequently, the in vitro experiment was conducted for the validation of the vital target. The results showed that compared with the model group, XYLDF significantly decreased the levels of ALT, AST, AKP and TBIL in the serum of CIHC mice, as well as alleviated inflammatory infiltration and hepatocyte necrosis in liver tissue. According to the metabonomic study, a total of 35 differential metabolites was identified as biomarkers associated with cholestasis, 12 of which were significantly recovered by XYLDF treatment. These biomarkers were involved in the pathways of primary bile acid biosynthesis and linoleic metabolism, which are closely related to the mechanism of XYLDF against CIHC. Protein-protein interaction network indicated that cytochrome P450 3A4 (CYP3A4) and cytochrome P450 1A1 (CYP1A1) are significant potential targets with good binding properties with six major active ingredients of XYLDF. Furthermore, it was found that 4-methoxy-5-hydroxycanthin-6-one, dehydroandrographolide and isodocarpin, three of the main active components in XYLDF, markedly induced the expression of CYP3A4 mRNA in vitro. This study revealed that XYLDF mainly mediates the biosynthesis of bile acids in CIHC mice to improve liver tissue lesions and bile efflux disorders, among which, CYP3A4 is the key target in the protection of XYLDF against CIHC. This research provides a reference for further elucidation of the pharmacological mechanism of XYLDF.
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Polysaccharide of Balanophora involucrata Hook. f. (BPS), the major component of Balanophora involucrata Hook. f., was confirmed the protective effect on liver injury in our previous study. This research aimed to investigate the protective mechanism of BPS on experimental liver injury by attenuating cell ferroptosis through modulating solute carrier family 7 member 11/glutathione peroxidase 4 (SLC7A11/GPX4) pathway. The animal experiment was approved by the Experimental Animal Ethical Committee of Hubei Minzu University and all rats had received human care in compliance with the institutional animal care guidelines. Rats were given intraperitoneal injection of (D-galactosamine, D-GalN) solution (800 mg·kg-1) one time to establish the acute liver injury model. The results showed aspartate amino transferase (AST), alanine aminotransferase (ALT) and 4-hydroxynonenal (4-HNE) levels in serum were decreased, and the contents of reactive oxygen species (ROS), Fe2+, malondialdehyde (MDA) and lipid peroxide (LPO) in liver tissues also decreased and glutathione (GSH) level increased after BPS administration with 200 mg·kg-1. Besides, BPS reduced iron deposition and increased the expression of SLC7A11 and GPX4 proteins in liver tissue. In conclusion, BPS ameliorated experimental liver injury by alleviating cell ferroptosis through SLC7A11/GPX4 pathway. The present study pointed to the possibility of utilizing BPS for protection against liver injury in clinic.
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OBJECTIVE To evaluate the incidence of nephrotoxicity in patients with drug-resistant Gram-negative bacterial infections after the use of polymyxin， and to provide evidence-based reference for clinical rational drug use. METHODS PubMed， Embase， Web of Science， the Cochrane Library， Wanfang database， CNKI， VIP and SinoMed were searched to collect randomized controlled trials （RCTs） or cohort studies about the polymyxin （trial group） versus other antibiotics （control group） or polymyxin B （trial group） versus polymyxin E （control group）. After literature screening， data extraction and quality evaluation， RevMan 5.4.1 software was used for meta-analysis. RESULTS A total of 37 studies were included， including 4 RCTs and 33 cohort studies， with a total of 5 871 patients. The meta-analysis results showed that in RCT [RR＝2.64，95%CI （1.43，4.87），P＝0.002] and in cohort studies [RR＝1.59， 95%CI （1.27， 1.98）， P＜0.000 1]， the incidence of nephrotoxicity in the trial group was significantly higher than control group. The results of the subgroup analysis of cohort studies showed that the incidence of nephrotoxicity in the trial group （receiving polymyxin） was significantly higher than control group （receiving new β-lactam and β-lactamase inhibitors and tigecycline）； when Kidney Disease Improving Global Outcomes （KDIGO）， renal replacement therapy or 0.5 times increase in serum creatinine were used as the standard of nephrotoxicity， the incidence of nephrotoxicity in the trial group was significantly higher than the control group （P＜0.05）. The incidence of nephrotoxicity in patients receiving polymyxin E was significantly higher than those using polymyxin B [RR＝0.57， 95%CI （0.39，0.84）， P＝0.005]. CONCLUSIONS In the treatment of drug-resistant Gram-negative bacteria infections， the incidence of nephrotoxicity caused by polymyxin is relatively high. The TYU108F）； incidence of nephrotoxicity caused by polymyxin E is higher than polymyxin B.
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OBJECTIVE To explore the mechanism of Kuaisong yin in the prevention and treatment of constipation. METHODS Slow transit constipation （STC） model was established with Compound difenoxylate tablet in mice and rats. Two batches of mice were divided into blank group， model group， positive control group （Maren soft capsule， 0.64 g/kg）， Kuaisong yin low-dose， medium-dose and high-dose groups （3.2， 6.4， 12.8 g/kg）， with 10 mice in each group. The effect of Kuaisong yin on constipation in mice was evaluated by intestinal propulsion experiment and defecation experiment. Rats were divided into blank group， model group， positive control group （Maren soft capsule，0.36 g/kg）， Kuaisong yin low-dose and high-dose groups （2.4， 4.8 g/kg）， with 7 or 8 rats in each group. They were given relevant medicine once a day for 1 week. The metabonomics of serum and urine of rats were analyzed by UPLC-Q-TOF-MS/MS technology. RESULTS Compared with model group， the ink propulsion rate and 5 h defecation volume of mice in Kuaisong yin high-dose group were significantly increased （P＜0.05）； the first defecation time of mice in Kuaisong yin medium-dose and high-dose groups was significantly shortened， and the quality of defecation was significantly reduced within 5 h （P＜0.05 or P＜0.01）. Serum metabonomics screened 16 compounds （such as proline， propionylcarnitine， hemolytic phosphatidylcholine， etc.） and 6 metabolic pathways （such as sphingomyelin metabolism， arginine and proline metabolism， sphingolipid biosynthesis-lactose and neolactone series）. Urine metabonomics screened 20 different metabolites （such as prostaglandin A2， L-valine， phosphatidylcholine， sphingomyelin， etc.） and 8 metabolic pathways （such as valine， leucine and isoleucine biosynthesis， sphingomyelin metabolism， pyruvate metabolism， etc.）. CONCLUSIONS Kuaisong yin can play a role in improving constipation by regulating different metabolites such as hemolytic phosphatidylcholine， phosphatidylcholine， prostaglandin A2， L-valine， proline， and regulating metabolic pathways such as multiple amino acid metabolism， sphingomyelin metabolism， etc.
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Immunoglobulin G4-related diseases(IgG4-RD)are chronic, systemic diseases that have received much attention in recent years. IgG4-RD can affect almost all tissues of the body, mainly manifested by swelling and space-occupying changes in the involved sites. It is called IgG4-related ophthalmic disease(IgG4-ROD)when the lesions invade the ocular area. The disease mainly invades the lacrimal glands, orbital fat, infraorbital nerve, extraocular muscles, and eyelids. At present, the main treatment modalities for IgG4-ROD include medication, surgery, and radiation therapy, etc. With the enhanced understanding of the disease and the increasing cure rate in recent years, this article reviews the latest progress in the epidemiological characteristics, clinical manifestations, imaging features, diagnosis and treatment of IgG4-ROD.
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Objective:To analyze the status of neonatal respiratory distress syndrome (RDS) management in 10 hospitals in Northwest China over the past five years and to investigate the strategies for improving the prevention and treatment of RDS.Methods:This retrospective study involved premature infants with RDS who were admitted to the neonatal intensive care units (NICU) of 10 hospitals (six in Shaanxi Province, three in Gansu Province, and one in Xinjiang Uygur Autonomous Region) of the Northwest China Neonatal Collaborative Group within 3 d after birth from January 1 to December 31, 2016, and from January 1 to December 31, 2021. Basic information, perinatal condition, treatment approaches, complications, and prognosis of the patients were compared. T-test, rank sum, and Chi-square tests were used for statistical analysis. Result:(1) This study enrolled 322 premature infants with RDS in 2016 and 349 in 2021. Premature infants at the gestational age of 30 to 33 weeks were mainly affected, and the majority were male [64.3% (207/322) and 57.3% (200/349)]. The average maternal age in 2021 was older than that in 2016 [(30.6±4.8) years vs (28.6±5.4) years, t=24.02, P<0.001], and the proportion of women at advanced maternal age was also higher in 2021 [19.2% (67/349) vs 12.4% (40/322), χ2=4.18, P<0.05]. (2) The proportions of pregnancies conceived with assisted reproductive technologies [11.7% (41/349) vs 1.9% (6/322), χ2=25.12], underwent routine prenatal examinations [58.5% (204/349) vs 30.4% (98/322), χ2=53.33], exposed to steroids [62.2% (217/349) vs 28.6% (92/322), χ2=82.58] and delivered by cesarean section or elective cesarean section [73.6% (257/349) vs 51.6% (166/322), χ2=35.06; 24.1% (84/349) vs 6.5% (21/322), χ2=39.07], as well as the ratio of cesarean scar pregnancy [7.4% (26/349) vs 3.4% (11/322), χ2=5.23] were all higher in 2021 than those in 2016 (all P<0.05). Moreover, the incidence of fetal distress [30.1% (105/349) vs 20.2% (65/322), χ2=8.68], gestational hypertension [24.6% (86/349) vs 13.0% (42/322), χ2=14.59], premature rupture of membranes [16.0% (56/349) vs 10.2% (33/322), χ2=4.89], meconium-stained amniotic fluid [12.6% (44/349) vs 5.6% (18/322), χ2=9.83], placental abruption [10.3% (36/349) vs 5.3% (17/322), χ2=5.84], gestational diabetes mellitus [10.3% (36/349) vs 1.6%(5/322), χ2=22.41], chorioamnionitis [4.6%(16/349) vs 0.9% (3/322), χ2=8.12], thyroid dysfunction [4.3% (15/349) vs 0.6% (2/322), χ2=7.88] and heart disease [4.3% (15/349) vs 0.3% (1/322), χ2=9.17] were higher in 2021 than in 2016 (all P<0.05). (3) In 2021, the rate of pulmonary surfactant (PS) usage, the dosage of porcine PS, and the proportion of bovine PS usage were all significantly higher than those in 2016 [73.6% (257/349) vs 67.1% (216/322), χ2=11.62; (178.5±38.0) mg/kg vs (165.2±42.8) mg/kg, t=7.85; 47.9% (123/257) vs 19.4% (42/216), χ2=41.72; all P<0.01]. No significant difference in the incidence of intubation-surfactant-extubation (INSURE), early PS administration (≤2 h after birth), or the arterial blood gas values before and after PS treatment was found between the cases enrolled in 2021 and 2016. The duration of antibiotic treatment [7.0 d (5.0-14.0 d) vs 5.0 d (1.0-8.0 d), Z=7.55] and assisted ventilation [144 h (81-264 h) vs 73 h (47-134 h), Z=8.20] and the median hospital stay [24 d(14-42 d) vs 16 d (10-25 d), Z=6.74] were significantly longer in 2021 than in 2016 (all P<0.01). More patients required nasal intermittent positive pressure ventilation [29.6% (100/338) vs 1.0% (3/306), χ2=97.81] and conventional ventilation [42.6% (144/338) vs 30.1% (92/306), χ2=10.87] in 2021 as compared with those five years ago (both P<0.01). (4) In 2021, the incidence of patent ductus arteriosus [15.5% (54/349) vs 6.2% (20/322), χ2=63.40], bronchopulmonary dysplasia [9.2% (32/349) vs 2.8% (9/322), χ2=12.88], persistent pulmonary hypertension [5.4% (19/349) vs 0.6% (2/322), χ2=12.85], periventricular leukomalacia [4.3% (15/349) vs 1.2% (4/322), χ2=7.52] and pneumothorax [3.4% (12/349) vs 0.3% (1/322), χ2=9.68] increased as compared with those in 2016 (all P<0.05), while the incidence of nosocomial infection decreased significantly [7.4% (26/349) vs 19.6% (63/322), χ2=21.37, P<0.001]. (5) The cure rate of premature infants with RDS was 70.8% (247/349) in 2021, which was significantly higher than that in 2016 [56.2% (181/322), χ2=15.37, P<0.001]. Moreover, the rate of withdrawing treatment and the total mortality rate was lower in 2021 than in 2016 [7.7% (27/349) vs 14.3% (46/322), χ2=7.41; in-hospital: 1.4% (5/349) vs 5.6% (18/322), χ2=8.74; out of hospital: 8.3% (29/349) vs 13.7% (44/322), χ2=4.96; all P<0.05]. Conclusions:The clinical management of RDS in premature infants in the involved hospitals has been improved. However, there is room for improvement in prenatal examinations.
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Objective:To survey the knowledge,attitude and practice (KAP) for diabetic retinopathy (DR) among diabetic patients in Shanghai suburb, and to analyze the related influencing factors.Methods:A cross-sectional survey on KAP for diabetic retinopathy was conducted from January to January 2022,a total of 260 diabetic patients were selected from Huacao Town of Shanghai Minhang District by stratified cluster random sampling method as the investigation subjects. The gender, age, height, weight, education level, occupation, frequency of exercise or outdoor sports, medical insurance status, comorbid chronic diseases, diabetic retinopathy in direct relatives were documented;the KAP of diabetes retinopathy prevention and treatment was investigated by a self-designed questionnaire. The influencing factors were analyzed by univariate and multivariate regression analysis.Results:A total of 260 valid questionnaires were received with a recovery rate of 100.0%. The survey showed that the knowledge awareness rate, attitude positive rate and behavior execution rate were 25.38% (66/260), 50.76% (132/260) and 14.61% (38/260), respectively; scores of knowledge,attitude,behavior and medication compliance of the subjects were 13.74±4.55, 10.40±3.23 and 14.92±4.51, respectively. Univariate analysis showed that the knowledge was significantly related to occupations,frequency of exercise or outdoor exercise,chronic disease, direct relatives with DR( F=5.03, 8.77, 5.08, 32.37,all P<0.05);the attitude was significantly related to age, education level, chronic disease, direct relatives with DR and awareness level of DR( F=2.12, 2.09, 2.75, 3.28,all P<0.05); the behavior was significantly related to age, frequency of exercise or outdoor exercise, direct relatives with DR( F=2.30, 2.70, 3.11,all P<0.05). Multiple stepwise linear regression analysis showed that the knowledge awareness score was significantly associated with age,education levels,direct relatives with DR( t=2.83, 2.46, 6.24,all P<0.05),and the age, chronic disease, awareness score were significantly associated with the attitude toward DR prevention and treatment ( t=3.70, 3.42, 6.03,all P<0.05).Patients with insufficient awareness had worse behavior of DR prevention and treatment( t=11.00, P<0.05). Conclusions:The KAP status of DR prevention and treatment in diabetes patients in Huacao Town is less satisfactory. In order to prevent the occurrence of diabetic retinopathy, it is necessary to strengthen health education, improve self-management ability, enhance lifestyle intervention, and increase the frequency of exercise or outdoor exercise in diabetic patients.
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Objective:To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD).Methods:A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as xˉ±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results:The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU ( OR=1.23, 95% CI 1.12-1.35) and macroalbuminuria ( OR=1.86, 95% CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions:The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.
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Objective:To compare the efficacy between olecranon sled fixation and tension band wiring fixation in the treatment of Mayo ⅡA olecranon fractures.Methods:A retrospective study was conducted to analyze the data of 54 patients with Mayo ⅡA olecranon fracture who had been admitted to Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital from October 2018 to February 2021. There were 20 males and 34 females with an age of (45.5±17.7 years), and 36 left and 18 right sides. They were divided into 2 groups according to different methods of internal fixation. Group A (25 cases) was subjected to olecranon sled fixation and group B (29 cases) to tension band wiring fixation. Preoperative data, operation time, reoperations and complications during follow-up were recorded and compared between the 2 groups. In both groups at the last follow-up, the range of the elbow motion, the Mayo elbow performance score (MEPS) and the Disabilities of the Arm, Shoulder and Hand (DASH) score were recorded to evaluate the elbow function.Results:The 2 groups were comparable because there were no significant differences in all their preoperative demographic data ( P>0.05). There were no significant differences between the 2 groups either in follow-up time [(32.8±8.9) months for group A and (35.8±9.0) months for group B] or in operation time [60.0 (60.0, 82.5) min for group A and 60.0 (60.0, 67.5) min for group B] ( P>0.05). At the last follow-up in group A and group B, respectively, the flexion and extension of the elbow was 141.0°±8.4° and 140.0 (140.0, 150.0)°, the pronation-supination 180.0 (175.0, 180.0)° and 180.0 (175.0, 180.0)°, the MEPS score 100.0 (85.0, 100.0) and 100.0 (92.5, 100.0), and the DASH score 4.2 (1.7, 6.3) and 5.8 (1.3, 8.3), all showing no statistically significant differences between the 2 groups ( P>0.05). Olecranon skin irritation occurred in 5 patients (20.0%,5/25) in group A and in 15 patients (51.7%,15/29) in group B, and 7 patients (28.0%,7/25) in group A and 21 patients (72.4%,21/29) in group B underwent removal of internal fixation, both showing statistically significant differences between the 2 groups ( P<0.05). Conclusion:In the treatment of Mayo ⅡA olecranon fractures, compared with tension band wiring fixation, olecranon sled fixation may lead to comparable efficacy in fixation and functional recovery, but significantly reduced rates of complications and internal fixation removal.
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Objective:To investigate the prevalence of positive hepatitis C virus (HCV) antibody, HCV RNA and genotype distribution of HCV in high-risk populations in Pudong New Area, Shanghai City, so that to provide evidence for making "hepatitis C micro elimination" strategies in Shanghai area.Methods:A survey with proportional sampling method was conducted among the high-risk populations, including people who inject drugs (PWID), voluntarily or compulsorily accepted drug detoxification or methadone treatment, human immunodeficiency virus voluntary counseling and testing (HIV VCT) outpatients, sexually transmitted disease (STD) outpatients, and commercial sex workers, who participated in the routine physical examination activities held by the community health service centers and public hospitals of Pudong New Area from July 2021 to November 2022. The residual plasma samples were collected from medical examinations. HCV antibody was tested in all samples. HCV RNA and HCV genotype were tested in samples with positive HCV antibody results.Results:A total of 1 000 HCV high-risk people were screened, including 453 PWID, 166 human immunodeficiency virus (HIV) infectors, 245 STD outpatients, and 136 commercial sex workers. The positive rates of HCV antibody in the four categories of personnel were 21.85%(99/453), 1.81%(3/166), 1.22%(3/245) and 0(0/136), respectively. The positive rate of HCV RNA was 42.68%(35/82) among HCV antibody positive people in high-risk populations. As much as 74.29%(26/35) of HCV RNA positive people had junior high school education or less, and 77.14%(27/35) of them were not married. Among the 12 samples tested for HCV genotype, five were genotype 3, five were genotype 6, and two were subtype 1b.Conclusions:PWID is the main high-risk HCV infection population, who should be the target of the following "hepatitis C micro elimination" strategies. The proportions of genotype 3 and genotype 6 are high in the high-risk HCV infection populations, and the pan-genotype direct-acting antiviral agent treatment may be more suitable in this situation. HCV infected persons in high-risk groups have low education level and marriage rate, which indicates that education and care in community are needed.
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Objective:To compare the therapeutic effects of percutaneous transhepatic choledochoscopic lithotripsy (PTCSL) and traditional open hepatectomy (OH) on regional hepatolithiasis with biliary cirrhosis.Methods:From January 2020 to August 2022, 110 cases of regional hepatolithiasis complicated with biliary cirrhosis treated in the hepatology department of Hunan Provincial People′s Hospital were retrospectively collected. According to the surgical methods of treating hepatolithiasis, the patients were divided into minimally invasive group and laparotomy group. The minimally invasive group received PTCSL, and the laparotomy group received OH. The clinical data of the two groups were compared and analyzed, and the postoperative exhaust time, gastrointestinal function recovery time, operation time and intraoperative bleeding volume were observed. The levels of alanine aminotransferase (ALT), γ-glutamyltransferase(GGT) and aspartate aminotransferase (AST) before and after operation were compared between the two groups. The incidence of complications and stone removal rate of the two groups were recorded.Results:The postoperative exhaust time (11.12±2.09)h, gastrointestinal function recovery time (25.76±4.28)h, operation time (108.51±16.19)h, intraoperative blood loss (20.16±3.59)ml and postoperative exhaust time (29.35±4.83)h and gastrointestinal function recovery time in the minimally invasive group were less than those in the laparotomy group (36.91±6.35)h, operation time (116.27±21.54)h and intraoperative blood loss (38.03±6.22)ml (all P<0.05). The levels of ALT (77.82±16.25)U/L, GGT (248.16±24.83)U/L and AST (65.42±16.82)U/L in the minimally invasive group after operation were lower than those in the laparotomy group [ALT (102.37±25.64)U/L, GGT (345.45±32.60)U/L and AST (96.30±22.17)U/L] (all P<0.05). The incidence of postoperative complications was 7.27%(4/55) in the minimally invasive group and that in the laparotomy group was 29.09%(16/55), with statistically significant difference ( P<0.05). The stone removal rate was 61.82%(34/55) in the minimally invasive group and 92.73%(51/55) in the laparotomy group, with statistically significant difference ( P<0.05). Conclusions:PTCSL and OH are effective in the treatment of regional hepatolithiasis complicated with biliary cirrhosis. The traditional OH has a high stone removal rate, and PTCSL has little influence on liver function, small complication rate and fast postoperative recovery.
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This study combines self-learning with a set of online and offline teaching and learning methods such as lecture teaching, case discussion and experimental method. In addition, this study designs a five-step blended teaching mode as well as a multi-tool and multi-dimensional comprehensive evaluation system of the whole process. Both the blended teaching mode and the comprehensive evaluation system have achieved good results after the implementation. The chapter test results show that the students' test scores applying this kind of blended teaching mode are significantly higher than that applying the traditional teaching mode; the ability test results show that under the high complexity blended teaching mode, the students' ability has been improved more effectively, which is more conducive to the realization of the core competence goals in the professional training objectives and teaching objectives.
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Objective:To investigate the value of LASSO regression prediction of lymph nodes around hepatic artery metastasis based on blood routine index in patients with distant gastric cancer.Methods:The clinical data of 110 patients with distant gastric cancer from June 2018 to February 2022 in Jieshou People′s Hospital were retrospective analyzed. Among them, 43 patients had lymph nodes around hepatic artery metastases (metastasis group), and 67 patients have not lymph nodes around hepatic artery metastases (non-metastasis group). The basic clinical data were recorded; the routine blood test was detected, the indexes including white blood cell count, neutrophil percentage, lymphocyte count, platelet count, lymphocyte percentage, acidophil count, basophils count, hemoglobin, red blood cell distribution width (RDW), platelet distribution width (PDW) and neutrophil to lymphocyte ratio (NLR). The R language 4.1.0 software "grpreg" package was used to establish a Group LASSO Logistic regression analysis model to finally select the factors predicting lymph node around hepatic arterial metastasis in patients with distal gastric cancer. Nomogram were made using R language 3.5.3 software package and rms program package, calculated the consistency index (C-index), and the accuracy of the model was evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.Results:The white blood cell count, neutrophil percentage, NLR and lymphocyte percentage in metastasis group were significantly higher than those in non-metastasis group: (12.16 ± 1.62) × 10 9/L vs. (9.38 ± 2.64) × 10 9/L, (73.36 ± 6.94)% vs. (52.21 ± 6.23)%, 3.23 ± 0.63 vs. 2.35 ± 0.13 and (48.62 ± 3.64)% vs. (31.02 ± 2.94)%, the acidophil count and basophils count were significantly lower than those in non-metastasis group: (0.31 ± 0.03) × 10 9/L vs. (0.36 ± 0.04) × 10 9/L and (0.08 ± 0.01) × 10 9/L vs. (0.09 ± 0.02) × 10 9/L, the degree of differentiation and TNM stage were also worse than those in non-metastasis group, and there were statistical differences ( P<0.01). The nomogram was constructed to predict lymph nodes around hepatic artery metastasis based on the degree of differentiation, TNM stage, white blood cell count, neutrophil percentage, NLR, lymphocyte percentage, acidophil count and basophils count in patients with distant gastric cancer, the scores of each indexes were 20.64, 26.42, 32.83, 25.78, 38.46, 35.65, 29.06 and 18.26 scores, the total score (227.10 scores) was the incidence of the nomogram model (29.82%). The validation result showed C-index of 0.819 and 0.806 (95% CI 0.785 to 0.864 and 0.779 to 0.816), and the correction curves for both sets were fitted well to the ideal curve with AUC of 0.801 and 0.810 (95% CI 0.784 to 0.826 and 0.795 to 0.852), and the decision curve showed high net benefit value with threshold probability from 1% to 9%. Conclusions:LASSO regression model combined with white blood cell count, neutrophil percentage, NLR, lymphocyte percentage, acidophil count and basophils count is ideal to predict lymph nodes around hepatic artery metastasis in patients with distant gastric cancer.
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Objective:To study the clinical features, genetic characteristics and prognosis of neonatal diabetes mellitus (NDM).Methods:From January 2015 to January 2022, neonates with NDM admitted to the Department of Neonatology of our hospital were retrospectively reviewed.Their clinical manifestations, biochemical data, genetic tests, treatments and outcomes were analyzed.Results:A total of 6 cases with NDM were included, with 3 males and 3 females. All 6 cases were full-term infants, 5 were low birth weight infants and 1 had family history of diabetes. High blood glucose were found on 1~11 d (average 4 d) after birth. 3 cases were diagnosed during blood glucose screening for low birth weight and 3 cases were diagnosed due to infection and/or diabetic ketoacidosis. Blood C-peptide levels were below normal range in all 6 cases. Blood insulin levels were decreased in 5 cases and remained at the lower limit of normal range in 1 case. All infants received genetic tests and 4 showed abnormal results, including 2 cases of ABCC8 gene mutation [c.2060C>T (p.T687M), not reported; c.674T>C (p.L225P), reported], 1 case of KCNJ11 gene mutation [c.602G>A (p.Arg201His), not reported] and 1 case of paternal uniparental disomy (UPD)6q24 (reported). All 6 cases were treated with insulin. Glibenclamide was experimented to replace insulin in 3 cases and 1 case was successful. During follow-up (at the age 4 months~5 years old), 4 cases were diagnosed with transient NDM, 1 case with permanent NDM and 1 case died at the age of 4 months without classification. 1 case showed psychomotor and language delay and the others had otherwise normal development.Conclusions:Most NDM infants are low birth weight infants with reduced blood insulin and C-peptide.Transient NDM are common. Proactive genetic testing may help treatment.
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As a special mode of tumor metastasis, perineural invasion has been paid more and more attention. It is closely related to prognosis, recurrence and metastasis of tumor after surgery. As the most common malignancy of the biliary tract, perineural invasion is also an inde-pendent prognostic risk factor for gallbladder cancer due to its anatomical location, lymphatic reflux, blood perfusion and innervation. However, there are few studies on perineural invasion in gallbla-dder cancer, especially on its mechanism. By analyzing the general situation and recent progress of perineural invasion in gallbladder cancer, the authors mainly introduce the perineural invasion mechanism, perineural invasion rate of gallbladder cancer, relationship between perineural invasion and the clinical pathologic characteristic, the correlation with the prognosis, relationship with surgi-cal procedures and postoperative adjuvant therapy.