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Objective:To investigate the spatial distribution characteristics of Keshan disease in Shandong Province, and to provide evidence for prevention and control of Keshan disease.Methods:The incidence data of Keshan disease in Shandong Province from 1960 to 2018 were collected from Shandong Provincial Institute for Endemic Disease Control and Prevention, and a spatial database was built. Global and local spatial autocorrelation (Moran's I) were analyzed by ArcGIS 10.2 and GeoDa 1.14 softwares, respectively. Local indicators on spatial association (LISA) aggregation graph was drawn. This allowed us to investigate the spatial autocorrelation and cluster range of the distribution of Keshan disease in Shandong Province. Results:A total of 4 172 cases of Keshan disease were reported in Shandong Province with an annual incidence rate of 0 to 51.4/10 000 of the population at the township-level from 1960 to 2018. Global spatial autocorrelation analysis on the incidence of Keshan disease at the township-level showed that global Moran's I values ranged from 0.020 to 0.429 in 1962 - 1964, 1969 - 1985, 1989, 1995, 1998 - 2001 and 2004 - 2016 ( P < 0.05), thus indicating significant spatial autocorrelation overall. LISA analysis further revealed that high-high clusters of Keshan disease existed in 1960, 1962 - 1964, 1969 - 1985, 1989, 1998 - 2000 and 2002 - 2016. These clusters were predominantly distributed in three areas: Zoucheng City, Pingyi County and Sishui County in the southwest of Shandong Province; Wulian County and Ju County in the southeast of Shandong Province; and Qingzhou City, Linqu County and Yishui County in the central and middle-south of Shandong Province. Conclusions:Keshan disease exhibits significant spatial autocorrelation in Shandong Province. High-high clusters are mainly located in certain townships in the southwest, southeast, central and middle-south of Shandong Province.
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Objective To investigate the role and regulatory mechanism of lncRNAs PCAT-1 in the sensitivity of cervical cancer cells to DDP. Methods The expressions of PCAT-1 in human cervical cancer cell lines (HeLa and SiHa) and DDP-resistant cell lines (HeLa/DDP and SiHa/DDP) were analyzed by real-time PCR. After PCAT-1 silencing and overexpression in HeLa/DDP and SiHa/DDP cells, CCK-8 and flow cytometry were used to detect cell viability ability and cell cycle, respectively. Western blot was used to detect the protein expression of STAT3 and PTEN. Results The DDP resistance index of HeLa/DDP cells to HeLa cells was 4.49, while that of SiHa/DDP cells to SiHa cells was 6.87. The expression levels of PCAT-1 in HeLa/DDP and SiHa/DDP cells were significantly higher than those in HeLa and SiHa cells, respectively (P < 0.05). The overexpression of PCAT-1 reduced the sensitivity of HeLa/DDP and SiHa/DDP cells to DDP, enhanced the proportion of S phase in cell cycle, and decreased the proportion of G0-G1 and G2-M phases (P < 0.05). The silencing of PCAT-1 increased the sensitivity of HeLa/DDP and SiHa/DDP cells to DDP, decreased the proportion of S phase in the cell cycle, and enhanced the proportion of G0-G1 and G2-M phase (P < 0.05). Overexpression of PCAT-1 promoted STAT3 protein expression but inhibited PTEN protein expression in HeLa/DDP and SiHa/DDP cells (P < 0.05). The silencing of PCAT-1 inhibited STAT3 protein expression but promoted PTEN protein expression in HeLa/DDP and SiHa/DDP cells (P < 0.05). Conclusion PCAT-1 is upregulated in HeLa/DDP and SiHa/DDP cells. PCAT-1 reduces the sensitivity of HeLa/DDP and SiHa/DDP cells to DDP by upregulating the expression of STAT3 and downregulating the expression of PTEN.
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Objective:To investigate the characteristics of fragility fractures of pelvis(FFP) in the elderly and compare the clinical efficacy between conservative treatment and minimally invasive surgery.Methods:A retrospective study was conducted in the 56 elderly FFP patients who had been treated at Department of Orthopaedics, The General Hospital of Chinese People＇s Liberation Army from January 2017 to January 2019. They were 16 males and 40 females, with an age of 73.4 years (from 65 to 93 years). By the American Society of Anesthesiologists (ASA) classification, there were 12 cases of grade Ⅰ, 16 cases of grade Ⅱ, 20 cases of grade Ⅲ, and 8 cases of grade Ⅳ; by the FFP classification, there were 6 cases of type Ⅰ, 10 cases of type Ⅱ, 36 cases of type Ⅲ, and 4 cases of type Ⅳ. The morphological characteristics and injury mechanisms of FFP were analyzed. According to the treatment methods, the patients were divided into a conservative treatment group of 32 cases and a minimally invasive surgery group of 24 cases. The 2 groups were compared in terms of complication incidence, mortality and the Koval attenuation rate of walking ability after one-year follow-up.Results:There were mostly the fractures of pubic branches on both sides of the pubic symphysis and compression fractures of the sacral wing caused by lateral crush injury. The 2 groups were comparable due to no significant differences in the preoperative general data between them other than FFP classification ( P>0.05). By one year after treatment, the conservative treatment group had a complication incidence of 34.4% (11/32), a mortality of 9.4% (3/32) and a Koval attenuation rate of walking ability of 13.8% (4/29) while the minimally invasive surgery group had a complication incidence of 20.8% (5/24), a mortality of 4.2% (1/24) and a Koval attenuation rate of walking ability of 8.7%(2/23), showing no significant difference between the 2 groups ( P>0.05). Conclusions:The injury mechanism of geriatric FFP is mostly lateral compression injury. The fracture sites are mostly located on both sides of the pubic symphysis, pubic branches and the sacral wing of anterior and posterior rings simultaneously. Although there may be no significant difference in complication incidence, mortality or Koval attenuation rate of walking ability between conservative treatment and minimally invasive surgery after one year, the minimally invasive surgery deals with more unstable fracture types.
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Objective:To explore the predictors of recovery of normal left ventricular ejection fraction (LVEF) in patients with chronic Keshan disease (CKD) after standard anti-heart failure treatment.Methods:From June 2013 to October 2017, CKD patients were selected as the research subjects in 8 Keshan disease counties (cities) in Shandong Province. Demographic data and clinical indicators related to the recovery of normal LVEF were collected at the initial diagnosis, and the patients were given standard anti-heart failure treatment. Follow-up was carried out until October 2019 or until all-cause death. Patients were divided into recovery group and non-recovery group according to whether LVEF returned to normal (LVEF≥50% was normal) by group design, and multi-factor logistic regression was used to analyze the predictors of recovery of normal LVEF.Results:A total of 98 CKD patients were included in this study, their average age was (47.51 ± 12.84) years old; body mass index (BMI) was (23.18 ± 4.92) kg/m 2; LVEF was (39.54 ± 8.26)%; male accounted for 65.31% (64/98); the New York Heart Association (NYHA) heart function grade Ⅱ and grade Ⅲ accounted for 46.94% (46/98) and 53.06% (52/98), respectively. The median follow-up time was 26 months, the LVEF of 28 patients (28.57%) returned to normal, and the LVEF increased from (43.27 ± 7.85)% of the baseline to (58.74 ± 6.07)%, the difference was statistically significant ( t=8.25, P < 0.01); LVEF did not return to normal in 70 patients (71.43%), and the LVEF increased from (37.84 ± 6.93)% of the baseline to (42.94 ± 7.31)%, the difference was statistically significant ( t=4.24, P < 0.01). The median recovery time of 28 patients with normal LVEF recovery was 14 months, of which 4 patients (14.29%), 6 patients (21.43%) and 15 patients (53.57%) recovered at follow-up of 6, 12 and 18 months, respectively, and 27 patients (96.43%) recovered within 3 years. The results of multivariate logistic regression analysis showed that disease course [odds ratio ( OR)=0.81, 95% confidence interval ( CI): 0.70-0.95, P < 0.05], electrocardiogram QRS wave duration ( OR=0.88, 95% CI: 0.79-0.98, P < 0.05), LVEF ( OR=1.26, 95% CI: 1.13-1.42, P < 0.01), and left ventricular end-diastolic diameter (LVEDD, OR=0.79, 95% CI: 0.66-0.90, P < 0.01) were independent predictors of recovery of normal LVEF. Conclusions:LVEF can return to normal after anti-heart failure treatment in some CKD patients. Patients with shorter disease course, shorter electrocardiogram QRS wave duration, higher baseline LVEF and lower LVEDD are more likely to recover from LVEF.
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Objective The echocardiography of patients with chronic Keshan disease (CKD) in the plateau and plain areas was compared,to analyze the specific manifestations of echocardiography in patients with high altitude CKD,to provide a reference for imaging diagnosis.Methods From October 2014 to December 2016,34 patients with CKD were selected in the Tibet Autonomous Region [18 males,16 females,aged (44.5 ± 5.6) years old] as plateau group;45 patients with CKD were selected in Shandong Province [21 males,24 females,age (47.3 ± 6.9) years old] as a plain group.Echocardiography was performed on the observed subjects,and cardiac morphology,hemodynamics and cardiac function were analyzed.Results The left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD),and left ventricular mass (LVM) of the plateau group were (39.2 ± 4.8),(56.5 ± 6.3) mm and (232.4 ± 40.2) g,respectively,which were lower than those of the plain group [(48.3 ± 5.7),(65.2 ± 7.8) mm,(283.7 ± 38.3) g,t =-7.52,-5.30,-5.74,P ＜ 0.01].The right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD) and right ventricular lateral wall thickness (RVWT) of the plateau group were (47.6 ± 8.5),(50.4 ± 7.3) and (4.8 ± 1.1) mm,respectively,which were higher than those of the plain group [(42.3 ± 7.2),(42.7 ± 6.8),(3.3 ± 0.7) mm,t =2.99,4.81,7.36,P ＜ 0.01].The early diastolic filling velocity (E),the early diastolic peak velocity of the mitral annular (Em) of the plateau group were lower than those of the plain group,E/Em of the plateau group was higher than that of the plain group (t =-2.64,-2.35,2.07,P ＜ 0.05).The fractional area change (FAC) of right ventricular,tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S') of the plateau group [(24.9 ± 2.8)％,(13.2 ± 1.2) mm,(6.8 ± 1.0) cm/s] were lower than those of the plain group [(26.3 ± 3.2)％,(14.5 ± 1.3) rmm,(7.5 ± 1.2) cm/s,t =-2.02,-4.53,-2.74,P ＜ 0.05 or ＜ 0.01].The tricuspid annular diastolic velocity (e') of the plateau group was lower than that of the plain group,and tricuspid annular blood flow early diastolic filling velocity maximum (e)/e'was higher than that of the plain group (t =-2.07,2.09,P ＜ 0.05).The systolic pulmonary artery pressure (SPAP) of the plateau group [(48.5 ± 12.3) mmHg,1 mmHg =0.133 kPa] was higher than that of the plain group [(41.6 ± 13.3) mmHg,t =2.34,P ＜ 0.05].Conclusion Compared with CKD patients in plain area,CKD patients in plateau area have showed more obvious right heart enlargement and right ventricular failure,and combined with higher SPAP.
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Objective To analyze the difference of echocardiography in patients with chronic Keshan disease (CKD) at different altitudes areas,explore the effects of altitude on the structure and functional of right heart in CKD patients,and provide a reference for imaging diagnosis of CKD.Methods According to the three step distribution of the terrain in China,30 cases of CKD patients in the first step (altitude ＞ 4 000 m) of Tibet autonomous region were randomly selected as the Tibetan plateau group.In the second step (altitude:1 000-2 000 m),31 cases were randomly selected in Gansu Province as the Loess plateau group.In the third step (altitude ＜ 500 m),42 cases were randomly selected in Shandong Province as the plain group.Echocardiography was used to analyze the morphology,hemodynamics and function of right heart.Results Right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD),right ventricular lateral wall thickness (RVWT) and main pulmonary artery diameter (MPAD) of the Tibetan plateau group,the Loess plateau group and the plain group (mm:49.75 ± 8.40,45.64 ± 7.63,43.56 ± 7.34;50.89 ± 7.13,46.56 ± 5.62,43.27 ± 6.01;4.75 ± 1.02,3.53 ± 0.61,3.37 ± 0.51;32.87 ± 3.62,28.93 ± 2.12,28.44 ± 2.71) were significant differences among the three groups (F =5.36,12.91,37.08,23.33,P ＜ 0.01).The above indexes of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).RVTD of Loess plateau group was higher than that of plain group (P ＜ 0.05).The fractional area change [FAC,(24.85 ± 2.75)％,(26.26 ± 3.42)％,(26.73 ± 3.14)％],tricuspid annular plane systolic excursion [TAPSE,(12.87 ± 1.12),(14.59 ± 1.63),(14.13 ± 1.31) mm] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =3.36,13.47,P ＜ 0.05 or ＜ 0.01);the above indexes of the Tibetan plateau group were lower than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index (0.87 ± 0.18,0.78 ± 0.16,0.71 ± 0.14),tricuspid flap diastolic maximum filling speed/tricuspid annulus early diastolic peak velocity (E/E',9.48 ± 1.22,8.64 ± 0.91,8.12 ± 1.13),systolic pulmonary artery pressure [SPAP,(49.58 ± 11.76),(44.35 ± 11.41),(42.67 ± 12.13) mmHg,1 mmHg =0.133 kPa] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =12.89,13.99,3.12,P ＜ 0.01 or ＜ 0.05);the Tei index and E/E'of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index,E/E'of the Loess plateau group were higher than those of the plain group (P ＜ 0.05).Conclusions The right heart structure and function of CKD patients are affected by the altitude of their residence.With the increase of altitude,the right heart is enlarged,the right ventricular systolic and diastolic functions are decreased,and SPAP is increased in CKD patients.
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Objective To investigate the current condition and risk factors of Keshan disease (KD) in Shandong Province,and to provide a scientific basis for prevention and control of KD.Methods Based on the 2014 scheme of KD surveillance,residents in 38 surveillance sites of 19 counties (cities,districts) were surveyed by questionnaire survey,physical examination,electrocardiograms (ECG),X-ray or echocardiography.At the same time,some residents' hair,grain and soil samples were collected,and the content of selenium in the internal and extemal environment was tested.KD was evaluated in Shandong Province based on the "National Standard of Evaluation Method for Key Endemic Disease Control and Elimination".Results ①In 38 monitoring sites,16 168 residents were surveyed and 164 cases of KD were detected (in which 149 cases of potential,15 cases of chronic),the detection rate was 1.014％.② Totally 2 497 samples of hair (n =763),food (wheat:n =687,corn:n =751) and soil (n =296) were collected and the selenium contents in hair was (0.379 ± 0.120) mg/kg,in wheat and corn were (0.025 ± 0.009) mg/kg and (0.016 ± 0.007) mg/kg,and in soil was (0.132 ± 0.046) mg/kg.③According to the national standard of evaluation content and decision criteria for KD,6 counties achieved the elimination index and 13 counties were in the control level in Shandong Province,the county proportion of eliminating KD was 31.58％ (6/19).Conclusions ①The current condition of KD in Shandong Province remains relatively stable.Internal environment selenium content is increased significantly due to improvement of people's living standard and dietary nutrition.②There is still a gap between the number of counties eliminated KD and the "elimination targets" required by the state in Shandong Province.It is recommended to continue to strengthen the team construction in prevention and control of KD and to enhance the investment of money,at the same time,to establish a long-term working mechanism in prevention and control of KD.
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Objective To investigate the differences in gene expression profiles of peripheral blood from patients with Keshan disease (KD) and the apoptosis mechanism in KD,to obtain diagnostic markers and establish diagnostic centroids plot for KD.Methods RNA was isolated from ten patients with KD diagnosed according to the clinical criteria for KD in China and ten health controls.The expression profiles were evaluated by Agilent 4 ×44K Whole Human Genome density oligonucleotide microarray analysis.The data were extracted by Agilent Feature Extraction Software t test,Pathway studio analysis and prediction analysis for microarray (PAM) were used to identify differently expressed genes,gene pathways,diagnostic markers and establish diagnostic centroids plot.Results Totally 1 570 up-regulated genes and 1 498 down-regulated genes were identified.Thirty-eight enrichment pathways were also identified,and the highest ranked by Pathway studio analysis was related to apoptosis.Six genes involved in apoptosis pathway were up-regulated in KD included ataxia telangiectasia mutated (ATM),cAMP-dependent protein kinase,protein kinase A (PKA),baculoviral IAP repeat-containing 2 (BIRC2),NLR family,apoptosis inhibitory protein (NAIP),BCL2-1ike 11 (Bim),BCL2-related protein A1 (BCL2A1) and down-regulated were 7 which included caspase 8 (CASP8),BCL2 binding component 3 (BBC3),BCL2--associated athanogene (BAG1),BCL2-associated X protein (BAX),BCL2-1ike 1 (BCL2L1),BCL2-related ovarian killer (BOK),and caspase 6 (CASP6).Forty-two diagnostic markers were obtained through PAM analysis.Conclusions Apoptosis related to genes and pathways might play an important role in the pathogenesis of KD.Forty-two markers could be used as molecular markers for the diagnosis of KD,which is important to the diagnosis of KD.
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Objective To explore health-related quality of life (HRQOL) in patients with chronic Keshan disease in China and the influence factors.Methods According to the Diagnosis of Keshan Disease (WS/T 210-2011),146 patients with chronic Keshan disease were selected from the follow-up chronic Keshan disease patients with standard treatment in Shandong.The HRQOL was assessed in those patients by use of the Chinese version of SF-36.Correlation analysis and multiple linear regression were used to analyse the influence factors of HRQOL.Results All dimension scores were significantly lower than those of general population (t =-5.12--13.13,all P ＜ 0.01).There were significant differences in Role-Physical dimensions (RP,F =47.09,P ＜ 0.01) and Physiological Function dimension (PF,F =31.49,P ＜ 0.01) between patient groups with different severity of left ventricular ejectio,n fraction (LVEF),RP dimension (F =8.47,P ＜ 0.01) and Vitality dimension (VT,F =11.29,P ＜ 0.01) in patients varies with left ventricular end-diastolic dimension (LVEDD).The scores of some dimensions were correlated with age,family income,course of disease,LVEF and LVEDD,heart function grading,labor ability (r =-0.49-0.36,P ＜ 0.05 or ＜ 0.01).The multivariate linear regression analysis indicated that the influencing factors of physiological status were NYHA cardiac function classification,course of disease,family income and body mass index (BMI).The influencing factor of mental health states was NYHA cardiac function classification.The influencing factors of the total HRQOL score were NYHA cardiac function classification,course of disease and family income.Conclusions The HRQOL of patients with chronic Keshan disease is significantly declined as compared with the general population and the lowest is RP.NYHA functional class,course of disease and family income are relative dominant predictor of patients HRQOL among all variables.
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Objective To conduct in‐depth job analysis and needs assessment on advanced midwifery practitioner (AMP) set up at a tertiary hospital .Methods The appraisal structure was designed by the needs assessment framework .Information on AMP′s job needs was collected via in‐depth interviews ,field notes and midwives′diaries .Colaizzi analysis method was used to sort out and analyze all the data .Results Seven themes through AMP′s job needs assessment were presented in the form of6W1H ,including :(1) who was AMP ;(2) whom did AMP serve;(3) what was AMP′s job content ;(4) what scope did AMP work in ;(5) how was the AMP′s practice model ;(6) where was the practical site;(7) why was the job post launched .Conclusions AMP practice at current stage is in its embryonic form of exploration but with huge potential demand ,which still needs to be improved using the needs assessment framework so that a scientific and standard job description can be formed to guide the AMP clinical practice .
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Objective To explore what cause the screw loosening after the internal fixation with thoracic and lumbar pedicle screws in the elderly and to develop the preventive measures.Methods Retrospective analysis were used to collect the clinical data from patients ager 60 years and over who had undergone surgeries of thoracolumbar pedicle screw internal fixation in our hospital during May 2011 and May 2013.Totally 187 cases were included in this study.According to whether there was a loosening of the screws, patients were divided into fixtion-loose and-well groups.The operation time and blood loss volume in the two groups were recorded.Visual analogue scale (VAS), Oswestry disability index (ODI), the rate of screw loosening were compared at 6 months after operation and the last follow-up.The causes of screw loosening were analyzed.Results The main causes for the thoracic and lumbar pedicle screw internal fixation were thoracolumbar kyphoscoliosis, fractures,spondylolisthesis, cancer and degenerative diseases, etc.Patients were followed up for an average of (35.2±8.7) months.13 patients (7.0％) were found screw loosening, 5 males and 8 females, with the mean age of (78.4 ± 3.5) years.The screw loosening occurred 3 months to 1 year after the surgery, (7.6±3.7) months on average.Among the 13 patients with screw loosening, 1 patient suffered screw loosening in single segment, 3 patients in two segments, and 9 patients in three segments or above.Osteoporosis combined with screw loosening.appeared in 10 patients VAS and ODI scores in all subjects had statistically differences at 6 months after operation and the last follow up versus preoperation (P＜0.05 for all), but no statistical difference versus the last follow-up(P＞ 0.05).There were significant differences in gender and preoperative osteoporosis rate between the two groups (P＜0.05 for both).Conclusions Osteoporosis is one of the reasons for the screw loosening in elderly patients after pedicle screw internal fixation.The increased probability of the screw loosening in long segment may be related with the change of the older spine mechanics.Further randomized controlled trials are still required to confirm whether elderly osteoporosis patients need to receive bone cement augmentation treatment.
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Objective To provide more valuable information for diagnosis of dilated cardiomyopathy (DCM),we detected differentially expressed proteins in serum from patients with DCM and healthy people and protein biomarkers were selected.Methods During the period from march 2011 to may,a total of 29 samples of resident patients with DCM from Qilu Hospital of Shandong University,Jinan Central Hospital and Jinan First Peoples Hospital and 30 local healthy people in Jinan were selected as DCM and control groups,respectively.Serum samples from these patients with DCM and controls were detected by ClinProt MALDII-TOF-MS.ClinProTools 2.2 software was used to get mass spectrometric data.The ClinPrott discrimination model was established to screen out differentially expressed proteins as potential biomarkers.Results Via comparing proteins/polypeptides peaks of DCM patients and healthy controls,57 of all 73 peaks were found to be significantly different between the two groups.Compared with the control group,35 peaks were up-expressed while the other 22 peaks were downexpressed.Five peaks were screened out as protein biomarkers.They were mass-to-charge ratio (m/z):4 247.95,4 209.37,1 058.69,1 074.78,and 2 364.71.The sensitivity and specificity of ClinPrott discrimination model was 99.14％ and 99.16％,respectively.Conclusion Patients with DCM have expressed serum proteins differently and we have found five protein markers which might have some value for diagnosis of DCM.
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Objective To investigate the clinical diagnostic value and pathogenesis of serum protein identification in Keshan disease (KD).Methods A total of 65 chronic KD patients were selected as the patient group in KD endemic areas,while 29 cases of dilated cardiomyopathy (the DCM group),62 healthy cases from KD endemic areas (control 1 group) and 28 healthy cases from non-endemic areas (control 2 group) were selected as controls.Liquid chip time of flight mass spectrometry (ClinProtTM MALDI-TOF-MS) was used to determine the expression of proteins/peptide peaks.ClinProTools 2.2 software was used to analyze the protein profiles to determine differentially expressed proteins/peptide peaks.The Genetic Algorithm (GA),QuickClassifer Algorithm (QC) and Supervised Neural Network Algorithm (SNN) methods were used to screen marker proteins.Matrix-assisted laser desorption/ionization time-of-flight Mass Spectrometry technique (MALDI-TOF/TOF) was also used as a secondary mass spectrometry to identify differentially expressed peptides.Results Between the KD and control 1 groups,34 differentially expressed proteins/peptides and 5 marker proteins were identified,while 52 differentially expressed proteins/peptides and 5 marker proteins were identified between the KD and control 2 groups,and there were 67 differentially expressed proteins/peptides and 5 marker proteins between the KD and DCM groups.During secondary mass spectrometry,two peptides for mass-to-charge ratio (m/z) 2 079 and 1 465 were obtained,peptide of matching β-globin showed low expression while peptide of matching fibrinogen showed high expression in the KD patients.Conclusions Serum marker proteins can be used as biomarkers for diagnosis and differentiation of KD.β-globin and fibrinogen play an important role in the development of KD myocardial injury.
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Objective To explored high-risk HPV genotyping PCR testing whether as a feasible means for the early screening of cervical cancer and precancerous lesions. Methods From January 2013 to June 2014, 15 192 outpatients in China-Japan Friendship Hospital voluntary were tested by high-risk type HPV genotyping PCR. The average age of them were (33±8) years old. High-risk HPV types genotyping PCR tested by fluorescence PCR technology,in which 13 kinds of high-risk HPV subtypes were detected, including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68. A total of 4 315 cases of them were tested by the liquid-based cytology (LCT), among them with positive of high-risk HPV genotyping tested by PCR (n=2 366) were biopsy under colposcope (648 cases) in those LCT results were positive or LCT negative but HPV16 positive or LCT negative but had the clear clinical symptoms or and non-HPV16 positive but with clear clinical symptoms. (1) Analysis high-risk HPV infection status of 15 192 women.(2)As the pathological diagnosis was the gold standard in the diagnosis of cervical lesions, analysis of the relationship among high-risk HPV infection,virus loads and cervical lesions. (3) To evaluated the value of high-risk HPV genotyping PCR tested method in screening of cervical cancer and precancerous lesions. Results ⑴ Of 15 192 cases tested by high-risk HPV genotyping PCR, 2 366 cases were HPV positive (HPV infection), the overall infection rate was 15.57%(2 366/15 192), in which a single subtype of HPV infection in 1 767 cases, infection rate was 11.63%(1 767/15 192), and multiple subtypes of HPV infection (two and more subtypes HPV infection) in 599 cases, infection rate was 3.94%(599/15 192). The HPV16, 52 and 58 infections were the most common HPV subtypes in 13 subtypes, the infection rate was 3.95% (600/15 192), 2.86%(435/15 192) and 2.67% (406/15 192), respectively. (2) The most relevant subtypes with cervical intraepithelial neoplasia (CIN)Ⅱand even higher lesion were HPV16, 52 and 58, accounted for 57.7%(154/267) of all above CINⅡlesions. The most relevant subtype with the cervical glandular intraepithelial neoplasia (CGIN) Ⅱ or above lesions was HPV18, 3 cases with CGIN Ⅱ or above lesions were all single HPV18 infection. The pathologic examination positive percentage of patients which HPV virus loads≤103 copys/104 cells was 18.2%(25/137), while the pathologic examination positive proportion was 33.3%(247/742) which HPV virus loads≥104 copys/104 cells , there was statistically significant difference between them (χ2=27.06, P=0.000).(3)Sensitivity, specificity, positive predictive value and negative predictive value for detection of CINⅡ or above using HPV genotyping PCR were 96.11%, 85.76%, 30.94% and 99.70%, respectively. Conclusions There were a guiding significance for high-risk HPV genotyping PCR tested in screening of cervical cancer and precancerous lesion. HPV16, 52 and 58 were related to the severe cervical squamous epithelial lesions, while HPV18 was related to cervical severe glandular cell pathological changes. HPV genotyping is feasible and economical as the first choice of opportunistic screening in tertiary hospitals.
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Objective To investigate the characteristics of chronic Keshan disease (CKD) and ischemic cardiomyopathy ( ICM ) and provide a basis for differential diagnosis . Methods Forty-two cases of CKD were randomly sampled from 6 Keshan disease districts in Sishui, Zoucheng, Juxian, Wulian, Yishui and Qingzhou Counties of Shandong Province, as CKD group. Thirty-one cases of ICM were selected from Qianfushan Hospital as ICM group. Echocardiography was used to analyze the cardiac morphology , hemodynamic and function. Results Left atrial internal diameter(LA), left ventricular(LV), end-diastolic internal diameter(LVd), right ventricular diameter(RV) and right atrial transverse diameter(RAtd) of the CKD group[(45.14 ± 6.93),(68.48 ± 6.24),(28.90 ± 3.14),(52.79 ± 6.62)mm] were higher than those of ICM group[(40.68 ± 5.12),(60.55 ± 4.07),(24.35 ± 2.12), (47.68 ± 8.53)mm , t = 3.03, 6.55, 7.38, 2.88, all P < 0.01]. In CKD group, several atrioventricular carities were enlarged, and the ventricular wall tended to become thin. In ICM group, left atrioventricular cavities were enlarged, and the apex of LV was thin spherical. The LV ejection fraction(LVEF) and fractional shortening of LV (LVFS) of the CKD group [(40.50 ± 10.68)%, (22.81 ± 6.24)%] were lower than those of the ICM group [(54.61 ± 6.58)%, (30.71 ± 4.29)%, t = - 6.957, - 5.976, all P < 0.01]. Diffuse hypokinetic motion of LV reduced in 85.7%(36/42) of CKD patients, and 83.9%(26/31) of ICM patients had segmental LV dyskinesia. Slight regurgitation of single valve was common in ICM group , but several regurgitation of multiple valves were more common in CKD group. Conclusion Echocardiography is a valuable noninvasive technology for differentiating CKD and ICM.
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Objective To observe the dilated cardiomyopathy ( DCM ) in non-Keshan disease areas in Shandong Province and assess scientifically the effectiveness of prevention and control measures on Keshan disease (KSD). Methods According to the scheme of DCM condition survey of our country in non-Keshan disease areas, seven representative counties(cities, areas) were chosen by their similarities in natural environment, production and life style to KSD areas; one or two townships ( towns ) were chosen in each county ( city , area ); one village was selected as a survey point in each township ( town ) . In each survey point , about four hundred and twenty natural populations were checked by asking detailed history, physical examination, and electrocardiography (ECG) tracings, and suspicious people were taken chest X-ray examination and cardiac ultrasound(UCG). The samples of inside and outside environmental were collected in partial residents and the selenium contents were detected by 2,3-diaminonaphthalene fluorometric method. At the same time the income, food of inhabitant and other basic information were collected. Results ① In 13 survey villages, sixty-four hundred and sixty-three residents were surveyed and 2 DCM cases and 111 similar potential KSD cases were detected, the detection rate was 1.75%(113/6 463). ② Sixty-four hundred and sixty-three residents were traced by ECG and the incidence of abnormal ECG was 20.4%(1 318/6 463), and sinus bradycardia, T-wave changes, sinus tachycardia, ST-T changes, occasional ventricular beating earlier, complete right bundle branch block, left anterior branch block, room premature beat, left ventricular high voltage, auriculo-ventricular block, et al were common. ③Samples of hair(260), wheat(260), corn (240) and soil (104) were collected, and the selenium contents were (0.353 ± 0.082), (0.035 ± 0.009), (0.024 ± 0.008) and (0.164 ± 0.019)mg/kg, respectively. Annual per capita income of each survey point was 2 500-8 670 yuan, and the residents’ main staple food was flour. Conclusion The results of DCM condition in non-Keshan disease areas of Shandong Province are stable and have provided a scientific basis for drawing up the national standard of eliminating KSD.
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Objective To investigate characteristics of cervical cytology and management in pregnant women. Methods From Aug. 2006 to Jan. 2010, 5152 pregnant women who received antenatal and postpartum examination underwent cervical cytological screening by liquid-based cytological test (LCT)in China-Japan Friendship Hospital. The cytological diagnosis was in accordance with the Bethesda system (TBS) 2001 diagnosis and classification system.The abnormal LCT results were followed up at 3 months after postpartum. The diagnosis of high-grade squamous intraepithelial lesions (HSIL) and squamous cell carcinoma (SCC) were based on colposcopic examination and biopsy during pregnant. The diagnosis of atypical glandular cells(AGC) was based on curettage and biopsy at postpartum 6 weeks. The histopathology of biopsy were compared and analyzed. Results ( 1 ) Cervical cytological changes related with pregnancy:among 5152 cases, it was found navicular cells in 3215 cases (62. 40% ), decidual cells in 783 cases ( 15.20% ), reactive glandular cells in 369 cases (7. 16% ), and trophoblastic cells in 55 cases (1.07%). (2) LCT results: among 5152 cases, the normal samples were 4125 cases (80.07%), the inflammatory samples were 542 cases (10.52%), and the samples of abnormal epithelial cells were 485cases (9.41%). Among those abnormal cases, 291 cases (5.65%) were in atypical squamous cells (ASC), 153 cases (2. 97%) were in low-grade squamous intraepithelial lesions (LSIL), 33 cases (0. 64%) were in HSIL, 1 case ( 0. 02% ) were in SCC and 7 cases (0. 14% ) were in AGC. (3)Histological pathology results: all women with HSIL and SCC underwent colposcopic examination and biopsy,it was found 28 cases in cervical intraepithelial neoplasia (CIN) Ⅱ - Ⅲ, 1 cases in adenosquamous carcinoma. 7 women underwent curettage and biopsy at postpartum 6 weeks which were diagnosed by AGC,the histopathological diagnosis was all negative. The concordance rate of cytopathologic and histopathologic diagnosis was 71%(29/41). (4) Follow-up: 485 women with abnormal LCT results were all followed up to 3 months at postpartum. Women with HSIL, SCC and AGC undergoing biopsy showed normal LCT results during follow-up. Those women with ASC and LSIL did not undergo colposcopic examination and biopsy. The regression rate was 72.3% (321/444) at postpartum 3 months. Conclusions The navicular cells were primarily morphological characteristics of cytology during pregnant and postpartum women. Some changes were easily confused with malignant lesions. It should be careful discrimination, and avoid excessively diagnosis and misdiagnosis. It suggested that we should follow up those women closely and expand the indication of colposcopic biopsy.
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Objective It is to study the influence of atorvatatin on serum C-reactive protein(CRP)level in acute cer- ebral infarction patients and to analyze its clinical significance.Methods 62 patients with acute cerebral infarction di- agnosed by CT or MRI were chosen and divided into two groups randomly.Both the groups were treated with normal method and the treatment group was given atorvastatin 20mg per day.Serum CRP levels in the two groups were measured by immunnturbidimetry within24h after final diagnosis and at two weeks the level decreased obviously in treatment.Re- slllts Serum CRP levels all increased in the patients.After treatment for two weeks the level decreased obviously in treatment group.The difference was significant compared with control group.Conclusion Atorvastatin can markedly reduce the serum CRP level in acute cerebral infarction patients and has important significance for the pathogenetic condi- tion change and prognosis of cerebral infarction.
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Objective To study the effects of supplying iodine on thyroid autoimmunity in iodine deficiency subjects. Methods The levels and abnormal rates of immunoglobulins (IgA, IgG, IgM), complement C 3, and thyroid autoantibodies such as thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyrotropin receptor antibody (TRAb) and thyroid stimulating antibody(TSAb) were observed in inhabitants in iodine deficiency area before and after oral iodized oil capsules were administered. Results The levels of IgA, IgG and C 3 increased after iodine supplying for three months, the proportions of IgG and C 3 which exceeded upper limit of the normal range reached to 38..9% and 62.0% respectively. The levels of IgA and IgG began to decrease markedly six months after iodine supplying. The levels of TPOAb, TGAb and their positive rates after iodine supplying were all higher than those before administration, and reached the highest level between three to six months after iodine supplement. And 7 cases out of 79 or 64 subjects with 2 kinds of positive autoantibodies were observed 3 or 6 months after iodine supplying respectively. The cases were all adult women with the average age of 27.6 yr, and had no clinical symptoms. The levels of TRAb and TSAb after iodine supplying were much higher than that before iodine supplying. The rate of positive TRAb was increasedmarkedlyandreachedto24.4% twelve months later. Conclusion Iodine supplying for the subjects with iodine deficiency seems to induce immune reaction, increase the levels of autoantibodies, and might develop autoimmune thyroid diseases.
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Aim To study the effect and molecular mechanism of pretreatment with COPP on hypoxia/reoxygenation injury of H9c2 myocytes.Methods H9c2 myocytes model of hypoxia/reoxygenation injury was established and H9c2 myocytes were given COPP pretreatment before hypoxia/reoxygenation.Treatment with Znpp and all-trans retinoic acid(ATRA)inhibited HO-1 and Nrf2-ARE respectively.The level of LDH and CK in cell supernatants were measured.HO-1mRNA expression was analyzed by RT-PCR.HO-1 and Nrf2 protein expressions were analyzed by Western blot.Results Compared with hypoxia/reoxygenation group,the level of LDH and CK in COPP pretreatment groups decreased significantly and the level of HO-1mRNA,HO-1 protein expression and Nrf2 protein expression in the nucleus significantly increased.Znpp abolished protective effect of COPP pretreatment.ATRA blocked the nuclear accumulation of Nrf2 and decreased HO-1 protein expression that COPP pretreatment induced.Conclusions COPP can induce HO-1 overexpression which has protective effect on hypoxia/reoxygenation injury of H9c2 myocytes.Its mechanism is related to Nrf2-ARE signaling pathway.