Comparison of non-intubated spontaneous breathing and endotracheal intubation with one-lung ventilation in uniportal thoracoscopic surgery in elderly patients / 中华老年医学杂志

Objective:To explore the practical value of general anesthesia with non-intubated spontaneous breathing in uniportal thoracoscopic surgery in elderly patients.Methods:Clinical data of 86 elderly patients undergone uniportal thoracoscopy surgery during hospitalization at our hospital between March 2020 and December 2021 were retrospectively reviewed and analyzed.Based on the anesthesia intubation method, they were divided into a non-intubated spontaneous breathing video-assisted thoracic surgery group(NI-VATS group)and a one-lung ventilation video-assisted thoracic surgery group(OLV-VATS group), with 43 cases in each group.Data were compared on the inflammatory indexes, preparation time for anesthesia, time to awakening after anesthesia, intraoperative lung collapse score, mediastinal flutter score, time to postoperative feeding, digestive tract complications, sore throat, postoperative pulmonary atelectasis, and hospitalization time.Results:Compared with the OLV-VATS group, the NI-VATS group had a shorter anesthesia preparation time [(19.8±2.6)min vs.(32.3±4.5)min, t=-15.77, P<0.001]and a shorter time to awakening [(6.8±2.1)min vs.(11.9±2.9)min, t=-9.485, P<0.001], slightly poorer operating field during surgery, an unfavorable lung collapse score [(2.5±0.7) vs.(1.8±0.7) t=4.704, P<0.001], worse mediastinal flutter [(2.1±0.6) vs.(1.3±0.5), t=6.514, P<0.001]. Lower procalcitonin(PCT)[(0.189±0.130)μg/L vs.(0.264±0.123)μg/L, t=-2.744, P=0.007), a shorter time to postoperative feeding [(3.4±1.0)h vs.(5.5±1.0)h, t=-9.55, P<0.001], and lower rates of digestive tract reactions(4.7% vs.20.9%, χ2=5.108, P=0.024)and throat pain(4.7% vs.23.3%, χ2=6.198, P=0.013), and a shorter length of hospital stay [(3.8±0.3)d vs.(4.9±0.8)d, t=-7.266, P<0.001]. Conclusions:For the elderly patients undergoing uniportal thoracoscopic surgery, non-intubated spontaneous breathing may somewhat obstruct the operating field, but it can shorten the time of anesthesia and the time to awakening, does not increase complications from anesthesia and surgery, favors rapid postoperative recovery for patients and therefore should be promoted.

Research progress on pelvic insufficiency fracture after radiotherapy for pelvic malignancies / 中华放射肿瘤学杂志

After radiotherapy for pelvic malignancies, pelvic insufficiency fracture (PIF), as a type of late injury event for pelvic bones, cannot be ignored, because it can exert a detrimental effect on patients' quality of life, and might make patients disabled and threaten their lives. Meanwhile, PIF is likely to be misdiagnosed with bone metastases. In this article, research progresses on potential pathogenesis, general characteristics, risk factors, diagnosis and treatment for PIF were reviewed.

China-Russia cooperation mechanism for pandemic prevention and control in the post-pandemic era / 上海预防医学

Since the outbreak of COVID-19， the governments of China and Russia have strengthened their responsibilities and actively implemented border control measures. Simultaneously， good results have been achieved in the prevention and control of the pandemic in both countries. After we entered the phase of regular pandemic prevention and control， exported cases are still an important factor that should not be neglected. We need to build a mechanism to strengthen the cooperation between China and Russia in pandemic prevention and control. The article proposes building effective systems for pandemic surveillance and early warning， medical resources sharing， health department meetings， information sharing， joint prevention， academic exchanges， and personnel training.

Effectiveness of automated machine learning models in predicting the risk of preeclampsia in the first trimester / 中华健康管理学杂志

Objective:To explore the application value of automated machine learning (autoML) model in predicting the risk of preeclampsia in the first trimester.Methods:From January 2017 to October 2020, 2 180 singleton pregnant women who were registered in Jinan Second Maternal and Child Health Hospital and underwent pregnancy examination at 12 weeks of gestation were selected. The pregnant women were divided into preeclampsia group (103 cases) and control group (2 077 cases) according to the occurrence of preeclampsia. The differences in clinical data and hematological indexes in the two groups were compared, and the correlation between each index and the risk of preeclampsia was analyzed too. All the pregnant women were randomly divided into training set and test set according to the ratio of 7∶3, and the autogluon autoML algorithm was used to build a variety of machine learning models, and training and cross-validation were performed in the training set to compare the accuracy of the different models. The importance of each index in the autoML model was analyzed, and the autoML model and the logistic regression model were used to predict the risk of preeclampsia in pregnant women in the test set respectively, and the receiver operating characteristic (ROC) curve was used to evaluate the prediction performance of the autoML and the logistic regression model.Results:The age, pre-pregnancy body mass index, body mass index at 12 weeks of gestation, waist circumference at 12 weeks of gestation, proportion of drinking history, high-sensitivity C-reactive protein (hs-CRP), triglyceride, low-density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST), platelet distribution width (PDW), mean platelet volume, thyroid stimulating hormone (TSH) and β-human chorionic gonadotropin were all significantly higher than those in the control group (all P<0.05), and the free tri-iodothyronine (free T3), free thyroxine (free T4), placental growth factor (PIGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and pregnancy-associated plasma protein-A (PAPP-A) were all significantly lower than those in the control group (all P<0.05). Correlation analysis showed that the correlation between pre-pregnancy body mass index, body mass index at 12 weeks gestation, waist circumference at 12 weeks gestation, hs-CRP, triacylglycerol, AST, TSH, free T3, free T4, β-HCG, PIGF, sFlt-1, PAPP-A and preeclampsia risk were obviously higher; but the correlation between each index were lower. A total of 18 models in 8 categories were constructed with the autoML model algorithm, and the neural network _L2 based on FastAI had the highest accuracy in the training set (0.963) and the validation set (0.971). The TSH, LDL-C, PDW, waist circumference at 12 weeks of gestation, sFlt-1, AST were more important in the model, while the free T4, total cholesterol, pregnancy times, drinking history, parity and family history of hypertension were less important indicators. The area under the ROC curve of the autoML model for predicting the risk of preeclampsia in the first trimester was significantly higher than that of the logistic regression model (0.984 vs 0.765, P=0.002), while there was no statistical difference in the prediction accuracy of the two prediction models in the training set ( P>0.05). The prediction accuracy and sensitivity of the autoML model in the test set were both significantly higher than those of the logistic regression model (99.54% vs 98.32%, 93.75% vs 75.00%, both P<0.05). Conclusions:Factors such as TSH, LDL-C, PDW, waist circumference, sFlt-1 and AST in the first trimester of pregnancy have a certain correlation with the risk of preeclampsia. The autoML model based on the indicators of the first trimester has a high predictive value for the risk of preeclampsia.

cGAS/STING signaling pathways induces the secretion of type Ⅰ interferon in porcine alveolar macrophages infected with porcine circovirus type 2 / 生物工程学报

In order to study the signal pathway secreting type Ⅰ interferon in porcine alveolar macrophages (PAMs) infected with porcine circovirus type 2 (PCV2), the protein and the mRNA expression levels of cGAS/STING pathways were analyzed by ELISA, Western blotting and quantitative reverse transcriptase PCR in PAMs infected with PCV2. In addition, the roles of cGAS, STING, TBK1 and NF-κB/P65 in the generation of type I interferon (IFN-I) from PAMs were analyzed by using the cGAS and STING specific siRNA, inhibitors BX795 and BAY 11-7082. The results showed that the expression levels of IFN-I increased significantly at 48 h after infection with PCV2 (P<0.05), the mRNA expression levels of cGAS increased significantly at 48 h and 72 h after infection (P<0.01), the mRNA expression levels of STING increased significantly at 72 h after infection (P<0.01), and the mRNA expression levels of TBK1 and IRF3 increased at 48 h after infection (P<0.01). The protein expression levels of STING, TBK1 and IRF3 in PAMs infected with PCV2 were increased, the content of NF-κB/p65 was decreased, and the nuclear entry of NF-κB/p65 and IRF3 was promoted. After knocking down cGAS or STING expression by siRNA, the expression level of IFN-I was significantly decreased after PCV2 infection for 48 h (P<0.01). BX795 and BAY 11-7082 inhibitors were used to inhibit the expression of IRF3 and NF-κB, the concentration of IFN-I in BX795-treated group was significantly reduced than that of the PCV2 group (P<0.01), while no significant difference was observed between the BAY 11-7028 group and the PCV2 group. The results showed that PAMs infected with PCV2 induced IFN-I secretion through the cGAS/STING/TBK1/IRF3 signaling pathway.

Research advances in hemophagocytic syndrome / 中华实用儿科临床杂志

Hemophagocytic syndrome (HPS) is a serious rapid-developing disease with high mortality, which is more commonly seen in children.The etiology and clinical manifestation of HPS are heterogenous.For the past few years, the understanding of HPS is greatly improved with advances in diagnosis and treatment.However, there are still a lot of refractory cases.This article describes the etiology, pathogenesis, diagnosis, treatment of HPS, in order to enhance understanding of this disease.

Predictive value of modified RACE score for large vessel occlusion in patients with acute anterior circulation ischemic stroke / 国际脑血管病杂志

Objective:To improve the Rapid Arterial Occlusion Evaluation (RACE) scale and to investigate its value in identifying large vessel occlusion (LVO) in patients with acute anterior circulation ischemic stroke (AIS).Methods:Consecutive patients with AIS treated in Liangxiang Hospital of Fangshan District, Beijing through stroke easy access from January 1, 2016 to December 31, 2018 were enrolled prospectively. The clinical data and multimodal CT examinations required to determine LVO were collected. The existing problems in the RACE score were modified. The patients were evaluated by the modified RACE score, RACE score, and National Institute of Health Stroke Scale (NIHSS). The receiver operator characteristic (ROC) curve was used to evaluate the predictive ability of the modified RACE score for LVO, and it was compared with the RACE score and NIHSS score. The ROC curves of LVO predicted by modified RACE score and NIHSS score in patients with left and right hemispheric lesions were compared.Results:A total of 184 patients were included, of which 66 (35.9%) had LVO. The age (64.8±11.7 vs. 60.5±10.8 years; t=2.483, P=0.014), baseline NIHSS score (13 [6.75-17] vs. 5 [2-9]; Z=-6.361, P<0.001) and the proportion of patients with gaze (37.9% vs. 17.4%; χ2=4.696, P=0.030) in the LVO group were significantly higher than those in the non-LVO group. ROC curve showed that the modified RACE score was more effective in identifying LVO than RACE score (area under the curve: 0.812 vs. 0.770; Z=4.654, P<0.001). The best cutoff value of the modified RACE score in predicting LVO was 5, and its predictive sensitivity and specificity were 75.8% and 75.4%, respectively, and the positive and negative predictive values were 63.3% and 84.8%, respectively. A comparison of patients with left hemispheric lesion and those with right hemispheric lesion showed that the ability of the modified RACE score in predicting LVO was more balanced (area under the curve: 0.826 vs. 0.796; Z=0.454, P=0.650), while there was a significant difference in NIHSS score (area under the curve: 0.856 vs. 0.703; Z=2.149, P=0.031). Conclusions:The modified RACE score is better than the original RACE score in the predictive value of LVO in patients with AIS, and its predictive power of LVO in patients with left and right hemisphere stroke is more balanced than the NIHSS score, which may help clinical discrimination and screening for patients suitable endovascular treatment.

Combination of orbicularis oculi muscular myolemma release and orbital septum reset to create double eyelid / 中华整形外科杂志

Objective@#To explore a surgical method for the reconstruction of naturally dynamic double eyelid by fully reserving orbicularis oculi muscle.@*Methods@#Incisional double eyelid blepharoplasty were performed on 352 patients. Orbicularis oculi muscle in incisional and pretarsal area were completely preserved. Muscle was elevated from plate by resecting deep muscular myolemma and muscles to form pretarsal myocutaneous flap. Thereafter, the orbital septum was completely exposed. The free end of muscle flap was fixed to a higher position of the levator aponeurosis. The orbital septum was repaired at the same time.@*Results@#From June 2009 to December 2017, 352 patients were performed double eyelid blepharoplasty using above technique. They are 337 females and 15 males. Fifty-two patients were followed up for 6-60 months, with the mean time of 27 months. All the incisions were uneventfully healed. The new double eyelid presented smooth appearance, and the so-called " sausage" phenomena were not noticed. There was no concave groove or step-like deformity when eyes closed. Forty-five patients were satisfied with the outcomes. Two patients had shallower supratarsal folds on one side, and 1 patient underwent secondary repair. Two patients complained about asymmetry. Two patients suffered from mild unilateral eyelash eversion (without need of reparation).@*Conclusions@#The combined application of deep and superficial myolemma release of the orbicularis oculi muscle, and orbital septum reset, could create a double eyelid with natural and dynamic appearance.

Combination of orbicularis oculi muscular myolemma release and orbital septum reset to create double eyelid / 中华整形外科杂志

Objective@#To explore a surgical method for the reconstruction of naturally dynamic double eyelid by fully reserving orbicularis oculi muscle.@*Methods@#Incisional double eyelid blepharoplasty were performed on 352 patients. Orbicularis oculi muscle in incisional and pretarsal area were completely preserved. Muscle was elevated from plate by resecting deep muscular myolemma and muscles to form pretarsal myocutaneous flap. Thereafter, the orbital septum was completely exposed. The free end of muscle flap was fixed to a higher position of the levator aponeurosis. The orbital septum was repaired at the same time.@*Results@#From June 2009 to December 2017, 352 patients were performed double eyelid blepharoplasty using above technique. They are 337 females and 15 males. Fifty-two patients were followed up for 6-60 months, with the mean time of 27 months. All the incisions were uneventfully healed. The new double eyelid presented smooth appearance, and the so-called " sausage" phenomena were not noticed. There was no concave groove or step-like deformity when eyes closed. Forty-five patients were satisfied with the outcomes. Two patients had shallower supratarsal folds on one side, and 1 patient underwent secondary repair. Two patients complained about asymmetry. Two patients suffered from mild unilateral eyelash eversion (without need of reparation).@*Conclusions@#The combined application of deep and superficial myolemma release of the orbicularis oculi muscle, and orbital septum reset, could create a double eyelid with natural and dynamic appearance.

Natural sideburn reconstruction with retroauricular expanded flap with original hairline / 中华整形外科杂志

Objective@#To introduce a reconstruction procedure of natural sideburn, with combined expanded retroauricular flap and scalp flap.@*Methods@#A retrospective study was produced in Plastic Surgery Hospital, PUMC, from January 2014 to December 2017. Twenty patients (21 sides) underwent sideburn reconstruction with combined expanded retroauricular flap and scalp flap (double pedicled flap, n=3; single pedicled flap, n=17) were included in this study. There were 12 male (12 sides) and 8 female (9 sides), with the mean age of (23.8±3.2) years. The sideburn defect was caused by burn in 19 patients, and it was resulted from hemangioma in 1 patient.@*Results@#The size of flaps ranges from 8 cm×12 cm to 10 cm×16 cm. Venous congestion at the distal end of the flap occurred in 1 patient, which was cured after dressing change, and the sideburn was not affected. The reconstructed sideburns are natural, symmetric, and without obvious scar. The follow-up time was 3-40 months. Fourteen patients were very satisfied with the reconstructed sideburn, and 6 patients were satisfied. No severe complication was observed during follow-up time.@*Conclusions@#The combined retroauricular flap and scalp flap is an alternative method for sideburn reconstruction, which provide natural hair distribution, inconspicuous scars and less complications.

Clinical characteristics and prognosis of brain-heart interaction in patients with acute severe stroke / 中华危重病急救医学

To investigate and analyze the clinical characteristics and prognosis of brain-heart interaction (BHI) in patients with acute severe stroke. Methods The patients with acute severe stroke admitted to Neurointensive Care Unit of Xuanwu Hospital, Capital Medical University from January 1st, 2015 to December 31st, 2017 were enrolled. The clinical data, indicators related to BHI and prognosis were collected. Patients were divided into BHI group and non-BHI group according to the presence or absence of BHI. The differences of each index were compared between two groups. The independent risk factors of BHI were analyzed using multivariate Logistic regression analysis. In addition, subgroup analysis was performed for patients in the BHI group based on the presence or absence of Takotsubo syndrome (TTS), and multivariate Logistic regression was used to analyze independent risk factors for TTS. Results 119 patients with acute severe stroke were analyzed, BHI occurred in 91 cases (76.5%), and 17 cases (14.3%) TTS were included in the BHI group. Compared with non-BHI group, BHI group had lower rates of cerebrovascular disease history (20.9% vs. 42.9%, P = 0.020), lower smoking history (25.3% vs. 50.0%, P = 0.013), lower statin use (16.5% vs. 50.0%, P = 0.000), lower total cholesterol [TC (mmol/L): 3.97±1.05 vs. 4.43±0.88, P =0.039], and lower low density lipoprotein [LDL (mmol/L): 2.30±0.76 vs. 3.00±0.84, P = 0.000]. Multivariate Logistic regression showed that the use of statins [odds ratio (OR) = 0.222, 95% confidence interval (95%CI) = 0.075-0.658, P =0.007] and the history of cerebrovascular diseases (OR = 0.321, 95%CI = 0.113-0.912, P = 0.033) were protective factors of BHI. Compared with non-TTS subgroup, TTS subgroup had a lower percentage of diabetes history (0% vs. 37.8%, P = 0.002), lower glycated hemoglobin [HbA1c: 0.055 (0.050, 0.056) vs. 0.064 (0.056, 0.075), P = 0.000], higher TC (mmol/L: 4.70±1.16 vs. 3.80±0.95, P = 0.001), first day mean arterial pressure [MAP (mmHg, 1 mmHg = 0.133 kPa):114 (98, 122) vs. 103 (94, 108), P = 0.042], third day diastolic blood pressure [DBP (mmHg): 82 (77, 94) vs. 67 (59, 86), P = 0.002], and third day MAP [mmHg: 106 (95, 114) vs. 94 (80, 106), P = 0.015]. Multivariate Logistic regression analysis showed that increased MAP on the third day of admission was an independent risk factor for TTS (OR = 11.833, 95%CI = 1.113-125.779, P = 0.040), increased HbA1c was protective factor of TTS (OR = 0.022, 95%CI = 0.001-0.345, P = 0.006). The rate of poor outcome at discharge of all the BHI patients were higher than those of the non-BHI patients (34.1% vs. 14.3%, P = 0.045). Conclusions Acute severe stroke patients with high incidence of acquiring BHI and having BHI is associated with poor outcome after discharge. Using statins, ischemic preconditioning and control blood pressure, the occurrence of BHI can be reduced and might be beneficial to patients.

Progress of correlation between bone marrow dose-volume parameters and acute hematologic toxicity in pelvic malignant tumor / 实用肿瘤学杂志

There is a high risk of myelosuppression in pelvic malignant tumors during concurrent chemoradiotherapy. The dose-volume relationship of pelvic exposed bone marrow( bone) is related to acute hematological toxicity during radiotherapy and chemotherapy,but lacks recognized parameters in this respect. The hematopoietic capacity of the bone marrow(bone)in different parts of the pelvic cavity is heterogeneous,and the pelvic bone marrow near the central axis has the strongest hematopoietic capacity,namely functional bone marrow. The relationship between dose-volume parameters of pelvic functional bone marrow and acute hematologic toxicity during chemoradiotherapy of pelvic malignant tumors may be the future direction.

Research on the rest functional magnetic resonance imaging before and after smoking cessation / 生物医学工程学杂志

The aim of this paper is to reveal the change of the brain function for nicotine addicts after smoking cessation, and explore the basis of neural physiology for the nicotine addicts in the process of smoking cessation. Fourteen subjects, who have a strong dependence on nicotine, have agreed to give up smoking and insist on completing the test, and 11 volunteers were recruited as the controls. The resting state functional magnetic resonance imaging and the regional homogeneity (ReHo) algorithm have been used to study the neural activity before and after smoking cessation. A two factors mixed design was used to investigate within-group effects and between-group effects. After 2 weeks' smoking cessation, the increased ReHo value were exhibited in the brain area of supplementary motor area, paracentral lobule, calcarine, cuneus and lingual gyrus. It suggested that the synchronization of neural activity was enhanced in these brain areas. And between-group interaction effects were appeared in supplementary motor area, paracentral lobule, precentral gyrus, postcentral gyrus, and superior frontal gyrus. The results indicate that the brain function in supplementary motor area of smoking addicts would be enhanced significantly after 2 weeks' smoking cessation.

From infection to immunotherapy:the immune response of bladder mucous membrane to host / 中国综合临床

Objective The pathogenesis of urinary tract infection and the preventive effect of Bacillus Calmette Guerin on bladder cancer imply the importance of bladder as a unique mucosal surface research. This article discussed that after bladder infected by bacteria,the way in which the microenvironment produce adaptive immunity. Once in the past, bladder is widely considered to be a sterile environment, the concept has been recently shaken. It is suggested that we should further study the influence of urinary tract pathogen infection or BCG immune response. In this paper, bladder biology has been illustrated, and bladder organ immunity is urgently needed to be explored and defined.

The application of Medpor Titan combined with Medpor in orbital floor reconstruction / 中华整形外科杂志

Objective@#To investigate the surgical treatment of orbital fractures and ocular traction deformities, and summarize the surgical results.@*Methods@#A retrospective study was conducted on 42 cases of monocular patients with orbital fractures and ocular fractures treated by Medpor Titan and Medpor. Preoperative CT scan and three-dimensional reconstruction were performed to evaluate the maxillofacial fractures, orbital wall defects, orbital content, shift incarceration. During surgery, the periorbital fracture and defect area were exposed, the periorbital shift bone were reduced, Medpor Titan was used to repair the orbital floor, Medpor to correct eyeball retraction. Follow-up observation of postoperative results and to assess the patient′s satisfaction rate, patient’s eyeballs, visual acuity and motor function.@*Results@#All patients had successful operation, the eye trapping deformity were significantly improved or corrected. Patient satisfaction rate was 92.9% (39/42); wound healingswere good, except for 1 infection (4 years after surgery), there was no rejection. Six months after the surgery, the ocular protrusion was reduced in 88.1% (37/42), the degree of diplopia was significantly improved in 90.5% (19/21) and the eye movement disorder corrected by 87.5% (14/16).@*Conclusions@#Medpor Titan combined with Medpor repair orbital wall fractures can achieve good results, with high satisfaction rate. Diplopia and eye movement dysfunction can be significantly improved.

Current opinions on refractory cytopenia of childhood / 国际儿科学杂志

Myelodysplastic syndromes are a group of malignant myeloid clonal diseases that originate from hematopoietic stem/progenitor cells.They are characterized by decreased peripheral blood cells,dysplasia of one or multiple lineages of myeloid hematopoietic cells,and prone to transform into acute myeloid leukemia.Refractory cytopenia of childhood is the most common clinical type of MDS in children.Its clinical manifestations include the decrease in one or multiple lineages of peripheral blood cells,abnormal development of the myeloid lineage,and the absence of excess blasts.This type was first introduced in WHO children's MDS in 2008.Considering the low incidence and lack of specific diagnostic methods,difficulty in early diagnosis and poor prognosis of RCC,we summarize the definition,clinical manifestations,laboratory tests,diagnosis and differential diagnosis,and treatment strategies of RCC in this review.

Relationship between DNA methylation of glucocort icoid receptor gene promotor and glucocorticoid receptor gene mRNA expression in systemic lupus erythematosus patients / 中华风湿病学杂志

Objective To investigate the relatio nship between the DNA methylation status of gluco-corticoid receptor (GR) gene promoter and mRNA expression level of GRα gene of peripheral blood mononuclear cells (PBMCs) in patients with systemic lupus erythematosus (SLE). Methods Fifteen new onset SLE patients and fifteen healthy controls were enrolled in this study. The DNA methylation status of GR gene promoter 1 of PBMCs was detected through bisulfite sequencing polymerase chain reaction (PCR). The mRNA expression of GRα, DNA methyltransferases, growth arrest and DNA damage-induced 45α (GADD45α) of PBMCs was detected using the quantitative real-time polymerase chain reaction method. T-test and χ2-test were used to detect the differences between the two groups, Pearson's correlation coefficient was used to analyze the linear correlation between two variables. Results Compared with healthy controls, the mRNA expression of GRα was signi-ficantly declined in SLE patients (10±5, 17±7, t=2.69, P<0.05), and the mRNA expression of DNMT1 and GADD45α was significantly elevated in SLE patients (t=3.11, P<0.05 and t=2.98, P<0.05). The overall mean methylation status of the 142 CpG islands of the four promoters was significantly elevated in SLE patients [(16±8)%vs (11±6)%, t=2.75, P<0.05]. The global methylation status of PBMCs in SLE patients was obviously lower than healthy controls (t=4.39, P<0.05). Conclusion Hypermethylation of GRα promoter may result in GRαgene low expression in PBMCs of patients with SLE.

Related factors for severe liver fibrosis in chronic hepatitis C patients with remunerated blood donation history in Jurong of Jiangsu province / 中华流行病学杂志

Objective The incidence of liver fibrosis in patients with chronic hepatitis C is high.Without effective treatment,it would lead to liver cirrhosis.This study is to identify the related factors for the incidence of liver fibrosis in patients with chronic hepatitis C in order to make early intervention treatment and reduce the case fatality rate.Methods This cross-sectional survey was conducted in adults aged ≥50 years with local residence for more than 5 years in Jurong of Jiangsu province from March to May in 2015,the patients infected with hepatitis C virus through remunerated blood donation were screened and included in the analysis.Descriptive statistical analysis was done to compare the differences in the incidence of liver fibrosis among the patients with different age,sex and education level or co-infected with hepatitis B virus or not.The risk factors for severe liver fibrosis were identified with univariate and multivariate logistic regression analysis.Liver fibrosis was diagnosed by using FIB-4 index method.Results A total of 719 patients with chronic hepatitis C were surveyed.Severe liver fibrosis developed in 285 of the 719 patients,in whom 21.84％ was males.Multivariate logistic regression analysis showed that the patients with higher education level (OR=0.65,95％CI:0.47-0.90) and with access of antiviral therapy (OR=0.33,95％ CI:0.22-0.49) had lower risk for severe liver fibrosis,the patients with high fasting blood glucose level (OR=1.80,95％CI:1.19-2.77) and abnormal white blood cell count (OR=2.77,95％CI:1.95-3.90) had higher risk for severe liver fibrosis.Conclusions The incidence of severe liver fibrosis in patients with hepatitis C was affected by many factors.Higher education level and antiviral therapy were the protective factors,but high fasting blood glucose level and abnormal white blood cell count were the risk factors.

Related factors for severe liver fibrosis in chronic hepatitis C patients with remunerated blood donation history in Jurong of Jiangsu province / 中华流行病学杂志

Objective The incidence of liver fibrosis in patients with chronic hepatitis C is high.Without effective treatment,it would lead to liver cirrhosis.This study is to identify the related factors for the incidence of liver fibrosis in patients with chronic hepatitis C in order to make early intervention treatment and reduce the case fatality rate.Methods This cross-sectional survey was conducted in adults aged ≥50 years with local residence for more than 5 years in Jurong of Jiangsu province from March to May in 2015,the patients infected with hepatitis C virus through remunerated blood donation were screened and included in the analysis.Descriptive statistical analysis was done to compare the differences in the incidence of liver fibrosis among the patients with different age,sex and education level or co-infected with hepatitis B virus or not.The risk factors for severe liver fibrosis were identified with univariate and multivariate logistic regression analysis.Liver fibrosis was diagnosed by using FIB-4 index method.Results A total of 719 patients with chronic hepatitis C were surveyed.Severe liver fibrosis developed in 285 of the 719 patients,in whom 21.84％ was males.Multivariate logistic regression analysis showed that the patients with higher education level (OR=0.65,95％CI:0.47-0.90) and with access of antiviral therapy (OR=0.33,95％ CI:0.22-0.49) had lower risk for severe liver fibrosis,the patients with high fasting blood glucose level (OR=1.80,95％CI:1.19-2.77) and abnormal white blood cell count (OR=2.77,95％CI:1.95-3.90) had higher risk for severe liver fibrosis.Conclusions The incidence of severe liver fibrosis in patients with hepatitis C was affected by many factors.Higher education level and antiviral therapy were the protective factors,but high fasting blood glucose level and abnormal white blood cell count were the risk factors.

HCV infection status and risk factors in remunerated blood donors in Jiangsu province / 中华流行病学杂志

Objective To investigate the infection status of HCV in remunerated blood donors and risk factors in Jiangsu province.Methods A Cross-sectional study was conducted among people aged ＞50 years.Questionnaires were used to collect the information about their demographic characteristics and risk behaviors,and venous blood samples were collected from them to detect HCV anti-body,HCV-RNA and other biochemical indicators.EpiData and Stata were used for data entry and statistical analysis.Results The overall HCV sero-prevalence rates were 22.55％ and 61.05％ among remunerated blood donors.Data firom multiple stepwise regression analysis showed that alanine aminotransferase (ALT) (adjusted OR=1.38,95％CI:1.18-1.62) and aspartate aminotransferase (AST) (adjusted OR=l.30,95％CI:1.10-1.54) were associated with the outcomes of HCV infection,and fasting plasma glucose (adjusted OR=1.17,95％CI:1.01-1.35) were associated with HCV RNA viral loads.Conclusion The prevalence of HCV infection in remunerated blood donors was high,clinical ALT,AST and fasting plasma glucose levels were associated with the risk for HCV infection and HCV RNA viral load.