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OBJECTIVE To develop a questionnaire of the Knowledge-Attitude-Practice (KAP) for patients receiving oral anticoagulant therapy. METHODS Under the guidance of the theory of KAP, literature analysis and interview method were used to design the initial KAP questionnaire for patients treated with oral anticoagulants. Delphi method was adopted to consult the initial questionnaire and modify the questionnaire based on expert suggestions to form the final questionnaire. RESULTS Two rounds of consultation were conducted with 18 experts, and 18 questionnaires were sent out and recovered in each round, so the positive coefficient of experts was 100%. The expert authority coefficient was 0.94. The average importance scores for all dimensions, factors, and items of the questionnaire in both rounds were ≥4 points. The coefficient of variation was ≤0.25. The Kendall’s concordance coefficient for the overall questionnaire and the three dimensions of knowledge, attitude, and practice ranged from 0.09 to 0.34 (all P<0.05). Following the first round of expert consultation, four items were modified, two items were deleted, and five items were added; after the second round of expert consultation, ten items were modified. The final version of the questionnaire included three dimensions (knowledge, attitudes, and practice), 17 questionnaire factors, and 40 items. CONCLUSIONS The questionnaire has high reliability and scientific validity with relatively concentrated expert opinions. It is suitable for assessing the knowledge, attitudes, and practice status of patients receiving oral anticoagulant therapy.
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Objective:To investigate the correlation between Helicobacter pylori ( H.pylori) infection and albuminuria inphysical examination population. Methods:It was a cross-sectional study. All the adults who received physical examination and underwent 13C-urea breath test at the Physical Examination Center in Tongji Hospital in 2021 were selected as the study subjects. General data (such as demographic information and past medical history) were documented. The physical measurement and blood biochemical indicators were checked too. Multivariate analysis was used to analyze the relationship between H. pylori infection and albuminuria. Results:A total of 30 311 subjects were included in this analysis. There were 17 123 males and 13 188 females with an age of (44.51±12.17) years. The positive rate of H. pylori infection was 27.3%. The incidence of albuminuria in subjects with H. pylori infection was 6.7%, and it was 6.1% in the subjects without H. pylori infection ( P=0.031). After adjusting for the confounding factors such as gender, age, diabetes and hypertension, H. pylori infection was independently associated with the risk of albuminuria (odds ratio ( OR)=1.133, 95% CI: 1.018-1.261, P=0.022). Conclusion:H. pylori infection is positively correlated with the occurrence of albuminuria in the physical examination population.
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Objective To explore the impact of temperature and environmental factors on the risk of deaths from cardiovascular and cerebrovascular diseases (CVD) in Wuhan during the course of high temperature. Methods The daily CVD death data and meteorological and atmospheric pollutant concentration data during the high temperature process in Wuhan from 2014 to 2019 were collected. The generalized additive models (GAM) were used to obtain the characteristics of meteorological factors, atmospheric pollutant concentrations, high impact factors and thresholds affecting the relative risk of CVD death. Results The analysis results showed that: (1) When the maximum temperature reached 36.7°C and the lowest temperature reached 25.3°C, the relative risk of CVD death increased significantly; (2) The risk of CVD death during the first high temperature process was the largest, and the average CVD excess mortality rate during the first high temperature process from 2014 to 2019 reached 21.7%; and (3) The average temperature, maximum temperature and PM10 during the course of high temperature were important environmental factors that increased the risk of CVD deaths, and the relative risks were 1.14 (95% confidence interval (95% CI): 1.11-1.17), 1.11 (95% confidence interval (95% CI): 1.08-1.15, and 1.06 (95% confidence interval (95% CI): 1.02-1.09), respectively. Conclusion Temperature and PM10 are important environmental factors that increase the risk of death from CVD during the high temperature process in Wuhan from 2014 to 2019, with the first annual high temperature process having the greatest impact on the risk of CVD death.
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Objective:To investigate the relationship between liver function and arterial stiffness in the physical examination population.Methods:A total of 9 111 people who received physical examination in the Health Management Center of Wuhan Tongji Hospital from January to December 2017 with an age of 18 and above and complete clinical data were included in this study. The subjects were divided into arterial stiffness group (3 252 cases) and the normal group (5 859 cases) according to the results of brachial-ankle artery pulse wave velocity (baPWV) examination. The liver function indicators were checked in all the subjects, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and glutamyl transpeptidase γ (GGT). According to interquartile range of the liver function indicators, the subjects were divided into 4 groups (group Q1- Q4). Multivariate logistic regression analysis and restricted cubic spline functions were used to explore the relationship between liver function and risk of arterial stiffness. Results:When the subjects were grouped by ALT, after adjusted for age and gender, the risk of arterial stiffness in the Q2 to Q4 groups was 1.260 (95% CI:1.093-1.452, P<0.05), 1.571 (95% CI:1.355-1.822, P<0.001) and 2.436 (95% CI:2.097-2.830, P<0.001) times of that in the Q1 group, respectively, P for trend<0.001. And after adjusted for age, gender, body mass index, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C), the risk of arterial stiffness in the Q2 to Q4 groups was 1.158 (95% CI:1.003-1.338, P<0.05), 1.331 (95% CI:1.143-1.551, P<0.001) and 1.867 (95% CI:1.591-2.190, P<0.001) times of that in the Q1 group, respectively, P for trend <0.001. After adjusted for age, gender, body mass index, LDL-C, triglycerides, HDL-C, systolic blood pressure, diastolic blood pressure, heart rate, fasting blood glucose, blood uric acid, serum creatinine, with or without hypertension or diabetes, the risk of arterial stiffness in the Q2 to Q4 groups was 1.116 (95% CI:0.940-1.325, P=0.210), 1.241 (95% CI:1.036-1.488, P<0.05) and 1.598 (95% CI:1.322-1.932, P<0.001) times of that in the Q1 group, respectively, P for trend <0.001. Restricted cubic spline regression analysis showed a linear positive correlation between ALT and the risk of arterial stiffness. Similar results as ALT obtained with AST, ALP and GGT. Conclusions:The increase of liver function indicators is positively correlated with the risk of arterial stiffness.
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Objective:To analyse the relationship between serum electrolyte concentrations and risk of cardiovascular events in physical examination population.Methods:A cross-sectional study design was applied to survey 8 445 adults whose serum high-sensitivity cardiac tropon Ⅰ (hs-cTnⅠ) and serum electrolytes (chloride, phosphorus, calcium, sodium, potassium and magnesium) concentrations were measured at the health examination center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 1, 2018 to February 28, 2022. The risk of cardiovascular events was classified into three levels according to the serum hypersensitive cardiac troponin Ⅰ(hs-cTnⅠ) concentration: low, middle or high risk group. One-way analysis of variance was applied to compare the differences in serum electrolyte concentrations of participants with different risk levels of cardiovascular events. Ordered multi-category logistic regression was performed to analyze the correlation between serum electrolyte levels and the risk of cardiovascular events.Results:The concentration of potassium and magnesium ion in the subjects with low risk of cardiovascular events were both higher than those in the middle and high risk group [potassium ion (4.28±0.29) vs (4.24±0.34), (4.23±0.36) mmol/L, magnesium ion (0.88±0.06) vs (0.87±0.07), (0.87±0.07) mmol/L](both P<0.05), while the concentration of sodium ion was lower [(140.54±1.75) vs (140.88±1.73), (140.81±2.20) mmol/L]( P<0.001); the concentration of phosphorus ion in the high-risk group was lower than those in the middle and low risk groups [(1.04±0.17) vs (1.08±0.16), (1.05±0.15) mmol/L]( P=0.001); no significant difference was found in the concentrations of chloride and calcium ion among the three groups (both P>0.05). Compared to subjects with normal concentrations of electrolyte, the risk level of cardiovascular events in subjects with hypokalemia ( OR=6.96, 95% CI: 3.67-13.10) and hypomagnesemia ( OR=5.00, 95% CI: 1.01-24.50) was higher(both P<0.05). Within the normal range, sodium concentration was positively correlated with the risk of cardiovascular events ( OR=1.08, 95% CI: 1.03-1.14; P<0.001). Conclusions:The serum sodium, potassium and magnesium concentrations in health examination subjects are correlated with the risk of cardiovascular events. Maintaining the balanced concentration of serum potassium and magnesium, as well as low sodium levels within normal limits may help prevent cardiovascular events.
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Objective@#To explore the association between Helicobacter pylori (H. pylori) infection and overweight/obesity in a Chinese population.@*Methods@#This was a cross-sectional study that included all adult participants who underwent a 13C-urea breath test at the physical examination center in Tongji Hospital (Wuhan, China) in 2016. Data on demographic characteristics, anthropometric index, biochemical variables, and medical history were collected. Multivariate analyses were performed to assess the relationship between H. pylori infection and overweight/obesity, as well as body mass index (BMI).@*Results@#Of the 27 883 participants included, 17 585 were males and 10 298 were females. They were aged (43.94±11.31) years. The prevalence rate of H. pylori infection was 33.1%. The BMIs of subjects with and without H. pylori infection were (24.30±3.28) kg/m2 and (23.99±3.35) kg/m2, respectively (t=-7.28, P<0.001). After adjusting for age, sex, blood lipid levels, diabetes, and hypertension, the BMI of subjects with H. pylori infection was 0.120 kg/m2 (95% CI: 0.050-0.191, P=0.001), which was higher than that of subjects without H. pylori infection. Moreover, H. pylori infection was independently associated with a higher risk of prevalent overweight/obesity, with an odds ratio (OR) of 1.09 (95%CI: 1.03-1.16, P=0.004). The positive association between H. pylori infection and overweight/obesity was more evident among women, with an OR of 1.19 (95%CI: 1.07-1.31, P=0.001).@*Conclusion@#H. pylori infection was closely correlated with overweight/obesity. Control of H. pylori infection may be useful in reducing the heavy disease burden caused by overweight/obesity.
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Objective To investigate the clinical features and mechanism and feasibility of plasma exchange (PE) in treating systemic lupus erythematosus (SLE) complicated with acute pancreatitis (AP). Methods A retrospective analysis of SLE associated with AP was done based on the HIS in Tongji Hospital. Totally 24 SLEAP patients were admitted to Tongji hospital from March 2006 to May 2014. Patientsˊ serum amylase, lipase and interleukin (IL)-6 concentration were measured before and after plasma exchange. According to different therapy strategy, patients were divided into two groups. Fifteen patients treated with plasma exchange combination with glucocorticosteroid (GC) were classified as Group A, the other 9 patients who were treated with GC only were classified as group B. At baseline and after treatment, the serum lipid concentration, average daily glucocorticosteroid dosage between group A and B were compared with ANOVA and serum IL-6 concentration between roup A and B were compared with Wilcoxon rank test. Results SLEDAI score in group A patients at baseline (16 ±5) was no statistically different from that in group B (18 ±4) (t=1.31, P=0.320). Average daily GC dosage in group A 31.0 (20.50, 30.08)mg/d was significantly less than that in group B 47.85 (45.58, 59.23) mg/d (Z=35.50, P= 0.002). Serum IL-6 levels in group A and B at baseline was not significantly different 13.14 (11.12,16.57) mg/L vs 14.63 (11.37, 16.37) mg/L (Z=12.20, P=0.300), after 2 weeks treatment, IL-6 level, which was 9.16 (7.93, 10.75) mg/L, decreased significantly in group A while it didnˊt show tendency of decrease in group B, which was 13.62(9.29, 17.63) mg/L (Z=28.50, P=0.039). Serum lipid concentration after 2 weeks therapy in Group A [TC=(5.02 ±0.53) mmol/L, TG=(1.46 ±0.44) mmol/L] decreased significantly compared to baseline [TC=(6.11±0.50) mmol/L, TG=(2.14±0.65) mmol/L] (F=4.46, P=0.010; F=6.09, P=0.002), while similar tendency wasnˊt observed in group B (F=1.57, P>0.05). Conclusion PE combined with GC could lower serum IL-6 levels, reduce the amount of GC and lower serum lipid to improve prognosis. Therefore it might be a safe and effective way and is worthy of continuing to explore its feasibility.
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This paper discussed the ethical principles in the medical sci-tech journal editing work, namely, respect, fairness, equality, honesty, and combining with the particularity of medical journals, further discussed these principles during choosing manuscripts, inviting manuscripts, peer review, rejection, and so forth. This pa-per proposed that medical journal editors should adhere to in the work of ethical principles, and constantly improve their ethics quality.
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Objective To investigate the mRNA expression of a proliferation inducing ligand (APRIL) and its receptors including B cell maturation antigen (BCMA),transmembrane activator.calcium modulator and cyclophilin ligand interactor (TACI) in the peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SEE).Methods APRIL mRNA、BCMA mRNA and TACI mRNA in PBMCs were detected by real-time quantitative PCR in 66 SLE patients and 25 normal controls.Gene expression level was measured as 2-AACT.Results The expression levels of APRIL mRNA、BCMA mRNA and TACI-mRNA were significantly increased in both active SLE group and stable SLE group compared with those in the normal controls(P<0.01 for all).The expression levels of APRIL mRNA and TACI mRNA in active SLE group were significantly higher than those in stable SLE group(P<0.01,P<0.05,respectively).But there was no significant difierence in the expression levels of BCMA mRNA between the SLE stable and active groups-Beside,the expression levels of APRIL mRNA and TACI mRNA were significantly increased in patients with lupus nephritis (LN) compared to patients with non-LN (P<0.01 for all).Conclusion The expression levels of APRIL and its receptors are significantly elevated in SLE patients.It may suggest that APRIL and its receptors play an important role in the pathogenesis of SLE.
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Objective To investigate the mRNA expression level of neurogranin on peripheral blood mononuclear cells(PBMCs)from patients with systemic lupus erythematosus(SLE).Methods Top 20 tags of SLE PBMCs SAGE library were searched from normal lymphocytes SAGE library including navie-T,Th1,Th2, CD8+T, NK and B cells,and their abundance was compared.The mRNA expression level of neuro-granin,a differential over-expressed tag,was detected in 35 cases of SLE and 15 normal controls by reversetranscription-polymerase chain reaction (RT-PCR).Results Neurogranin tag could only be detected in SLE PBMCs SAGE library,but was hardly found in normal lymphocyte SAGE library.However,either SLE pa-tients or normal controls showed a detectable mRNA level of neurogranin on PBMCs by RT-PCR.The mRNA level of neurogranin in active SLE patients was significantly increased than those in controls(P<0.001).but only slightly increased in inactive SLE patients (P>0.05).Conclusion Neurogranin,as a novel proapototic factor,is overexpressed on PBMCs of SLE patients.It may be involved in the regulation of abnormal immune responses in lupus.
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To develop a method for identification of differential gene expression between different cell populations, several convenient techniques of molecular biology, including subtractive hybridization, suppression PCR, T/A cloning and sequencing, were used to identify genes expressed differentially in CD45+ and CD45- cells isolated from U266 cell line of multiple myeloma. Our results showed that the levels of abundant genes scale down 20 times through subtractive hybridization. Plasmid DNA from CD45- cell clones was hybridized with forward or backward cDNA probes synthesized from CD45- and CD45- cells, respectively. A few of differentially expressed genes reconfirmed by RT-PCR were identified from 500 expressed clones of CD45+ cells. It is concluded that a strategy for gene expression identification developed from conventional molecular biological methods can be used in different laboratories.