Diagnostic value of a combined serology-based model for minimal hepatic encephalopathy in patients with compensated cirrhosis / 中华检验医学杂志

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Effect and Its Mechanism of Plantago asiatica Polysaccharide on the Proliferation ，Migration and Invasion of Breast Cancer Cells / 中国药房

OBJECTIVE：To study the effects of Plantago asiatica polysaccharide on the proliferation ，migration and invasion of breast cancer cells ，and to investigate its mechanism preliminarily. METHODS ：Using human breast cancer cell MDA-MB- 231 as subjects ，MTT method was adopted to detect the effects of different concentrations of P. asiatica polysaccharide（8，16，32，64 mg/L）on the cell proliferation ability ，and survival rate of the cells was calculated. Scratch test and Transwell invasion test were used to detect the effects of different concentrations of P. asiatica polysaccharide（8，16 mg/L）on cell migration ability and invasion ability. Western blot assay was used to detect the expression of epithelial-mesenchymal transition （EMT）-related proteins [matrix metalloproteinase- 2（MMP-2），MMP-9，E-cadherin，N-cadherin，vimentin]. RESULTS ：Results of MTT assay showed that survival rate of the cells in 32，64 mg/L P. asiatica polysaccharide groups were significantly lower than control group （P＜0.05 or P＜0.01），so that 8，16 mg/L，which did not affect the cell survival rate ，were used as the follow-up drug concentrations. Compared with control group ，relative mobility （12，24 h），relative invasion rate and relative expression of MMP- 2，MMP-9， N-cadherin and vimentin protein were decreased significantly in 8，16 mg/L P. asiatica polysaccharide groups （P＜0.05 or P＜ 0.01），while relative expression of E-cadherin protein was increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：P. asiatica polysaccharide can inhibit the proliferation of breast cancer cells MDA-MB- 231，and inhibit the migration and invasion of the cells by regulating the expression of metastasis and EMT-related proteins.

Epidemiological and spatial-temporal distribution of several natural focus diseases in Gansu province, 2014-2018 / 中华流行病学杂志

Objective@#To analyze the epidemiological and spatial-temporal distribution of Brucellosis, epidemic encephalitis B and hemorrhagic fever with renal syndrome (HFRS) in Gansu province during 2014-2018 so as to provide evidence for the prevention and control of those diseases.@*Methods@#A database was established in Gansu province from 2014 to 2018, using the geographical information system. A spatial distribution map was drawn, with trend analysis and space-time clustering used to study the 3-dimention of the diseases, by using both ArcGIS 10.5 and SaTScan 9.6 softwares.@*Results@#Results from the trend surface analysis showed that the incidence of Brucellosis decreased gradually from north to south parts while the U type curve could reflect the distribution from the east to the west areas. Incidence of epidemic encephalitis B decreased significantly from south to north areas in the province, with incidence higher in the eastern than in the mid-west region. Difference on the incidence of HFRS was not significantly visible in the eastern and western regions, while the incidence was slightly higher in the southern than the northern parts of the province. Spatial and space-time clustering did exist among the 3 diseases in Gansu from 2014 to 2018. The areas with clusters of Brucellosis appeared in the eastern parts during 2014-2015, including 19 counties. The areas with secondary clusters of Brucellosis were seen in the Hexi district, including 4 counties, during 2017-2018. The areas with high incidence of epidemic encephalitis B were clustered in the middle and southeast areas, including 32 counties, during 2017-2018. Areas with most clusters of HFRS appeared in Min county of Dingxi city in 2018, with the areas of secondary clusters in 8 counties of the eastern areas in 2018.@*Conclusions@#The overall incidence rates of the 3 natural focus diseases were in a upward trend and showing obvious characteristics on spatial clustering. According to the distributive characteristics, effective measures should be developed accordingly.

Study on early warning threshold values for 7 common communicable diseases in Gansu province, 2016 / 中华流行病学杂志

Objective To optimize the warning threshold values of common communicable diseases in Gansu province,and improve the early warning effect.Method An early warning model was set up for influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method.By calculating the sensitivity,specificity,predictive value of positive test,predictive value of negative test,Youden'index and receiver-operating characteristic curve,the optimum early warning threshold values for communicable diseases in Gansu were selected.Results The optimum early warning boundary values of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,and viral hepatitis type E were P90,P80,P95,P90,P80 and P90 respectively.The optimum early warning parameters of HFMD were k =1.2,H=5σ.Under the optimum early warning boundary values/parameters,the early warning sensitivities of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and HFMD were 86.67％,100.00％,91.67％,100.00％,100.00％,100.00％ and 100.00％,the specificities were 86.49％,62.22％,75.00％,100.00％,97.92％,89.13％ and 74.47％.The predictive values of positive test were 72.22％,29.17％,52.38％,100.00％,80.00％,54.55％ and 29.41％,and the predictive values of negative test were 94.12％,100.00％,96.77％,100.00％,100.00％,100.00％ and 100.00％,and the Youden'indexes were 0.73,0.62,0.67,1.00,0.98,0.89 and 0.74.Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram.Conclusion The early warning thresholds of influenza,other infectious diarrheal diseases,dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.

Study on early warning threshold values for 7 common communicable diseases in Gansu province, 2016 / 中华流行病学杂志

Objective To optimize the warning threshold values of common communicable diseases in Gansu province,and improve the early warning effect.Method An early warning model was set up for influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method.By calculating the sensitivity,specificity,predictive value of positive test,predictive value of negative test,Youden'index and receiver-operating characteristic curve,the optimum early warning threshold values for communicable diseases in Gansu were selected.Results The optimum early warning boundary values of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,and viral hepatitis type E were P90,P80,P95,P90,P80 and P90 respectively.The optimum early warning parameters of HFMD were k =1.2,H=5σ.Under the optimum early warning boundary values/parameters,the early warning sensitivities of influenza,scarlet fever,other infectious diarrheal diseases,dysentery,typhoid and paratyphoid,viral hepatitis type E and HFMD were 86.67％,100.00％,91.67％,100.00％,100.00％,100.00％ and 100.00％,the specificities were 86.49％,62.22％,75.00％,100.00％,97.92％,89.13％ and 74.47％.The predictive values of positive test were 72.22％,29.17％,52.38％,100.00％,80.00％,54.55％ and 29.41％,and the predictive values of negative test were 94.12％,100.00％,96.77％,100.00％,100.00％,100.00％ and 100.00％,and the Youden'indexes were 0.73,0.62,0.67,1.00,0.98,0.89 and 0.74.Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram.Conclusion The early warning thresholds of influenza,other infectious diarrheal diseases,dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.

Study on the classification of dominant pathogens related to febrile respiratory syndrome, based on the method of Bayes discriminant analysis / 中华流行病学杂志

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

Study on seasonal characteristics and pathogenic distribution of influenza in Gansu province of China / 中华流行病学杂志

Objective To study the epidemiologic characteristics of influenza in Gansu province of China and to optimize the related vaccination program.Methods Weekly influenza surveillance data from the first week of 2010 to the fortieth week of 2016 were collected,in Gansu province.x2 test was used to compare the differences of nucleic acid positive rate and the virus types in the four seasons.Time series seasonal decomposition (TSSD) was used to explore seasonal patterns and characteristics of influenza epidemics in Gansu.Results 59 791 specimens were tested,with 8 501 positive for influenza virus and positive rates as 14.22％.Types A(H1N1)pdm09,A(H3N2) and type B were accounted for 98.76％ of all the positive specimens.Proportions of the positive rate of influenza virus appeared in spring,summer,autumn and winter were 15.12％,0.98％,4.02％ and 24.26％ respectively.The predominant type of virus in autumn and winter was A(H3N2),with B mainly in spring.Influenza in Gansu province showed typical single-peak type distribution,with epidemic peak appeared from December to next January.The type A(H3N2) related peak appeared the earliest,followed by A(H1N1)pdm09,with type B the latest.Conclusions Peaks and the duration of influenza seasonal epidemics were related to the types of dominant strains.Annual influenza vaccination campaigns should start in October,to provide effective protection during the epidemic period.

Study on the classification of dominant pathogens related to febrile respiratory syndrome, based on the method of Bayes discriminant analysis / 中华流行病学杂志

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

Study on seasonal characteristics and pathogenic distribution of influenza in Gansu province of China / 中华流行病学杂志

Objective To study the epidemiologic characteristics of influenza in Gansu province of China and to optimize the related vaccination program.Methods Weekly influenza surveillance data from the first week of 2010 to the fortieth week of 2016 were collected,in Gansu province.x2 test was used to compare the differences of nucleic acid positive rate and the virus types in the four seasons.Time series seasonal decomposition (TSSD) was used to explore seasonal patterns and characteristics of influenza epidemics in Gansu.Results 59 791 specimens were tested,with 8 501 positive for influenza virus and positive rates as 14.22％.Types A(H1N1)pdm09,A(H3N2) and type B were accounted for 98.76％ of all the positive specimens.Proportions of the positive rate of influenza virus appeared in spring,summer,autumn and winter were 15.12％,0.98％,4.02％ and 24.26％ respectively.The predominant type of virus in autumn and winter was A(H3N2),with B mainly in spring.Influenza in Gansu province showed typical single-peak type distribution,with epidemic peak appeared from December to next January.The type A(H3N2) related peak appeared the earliest,followed by A(H1N1)pdm09,with type B the latest.Conclusions Peaks and the duration of influenza seasonal epidemics were related to the types of dominant strains.Annual influenza vaccination campaigns should start in October,to provide effective protection during the epidemic period.

Spatial-temporal distribution of hepatitis B in Gansu province, 2009-2014 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the hot/cold spots and the spatial-temporal clustering of hepatitis B in Gansu province during 2009-2014 by using spatial statistics, and provide scientific evidence for the prevention and control of hepatitis B.</p><p><b>METHODS</b>The spatial hot/cold spots and its trend, and the time frame and areas of its spatial-temporal clustering of hepatitis B in Gansu were analyzed by using the county specific incidence of hepatitis B from 2009 to 2014 and spatial statistical software GeoDa and SatScan.</p><p><b>RESULTS</b>The incidences of hepatitis B from 2009 to 2014 in Gansu were spatial autocorrelated respectively. Local G scan statistics indicated that the number of hot spots was in decline in Hexi area, while the hot spots was in increase in Linxia Hui autonomous prefecture and Gannan Tibetan autonomous prefecture. There was no obvious pattern in cold spots. Temporal-spatial scan statistics showed that the areas with high hepatitis B incidence most likely clustered in Hexi area during 2009-2011, and the areas with low hepatitis B incidence most likely clustered in eastern Gansu during 2012-2014.</p><p><b>CONCLUSIONS</b>The spatial and temporal clustering of hepatitis B was observed in Gansu from 2009 to 2014. The number of hot spots in Hexi area was in decline, while the numbers of hot spots in Linxia and Gannan were in increase, suggesting that the hepatitis B control and prevention in these areas should be strengthened.</p>

Study on early warning method for influenza epidemic in Gansu province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the appropriate early warning method for influenza epidemic in Gansu province.</p><p><b>METHODS</b>By using simple control chart, moving percentile method, exponential smoothing method and cumulative sum control chart method, the annual incidence data of influenza-like illness in Gansu province during 2014-2015 were analyzed, and the sensitivities, specificities, positive predictive values, Jorden indexes and Kappa values of the 4 methods were evaluated and compared.</p><p><b>RESULTS</b>The 2014-2015 seasonal influenza epidemic occurred in the fiftieth week of 2014 in Gansu, and the epidemic peak lasted for 6 weeks. Cumulative sum control chart method had the best early warning effect with the sensitivity of 66.67% and specificity of 93.48%.</p><p><b>CONCLUSION</b>It is feasible to use cumulative sum control chart method to give early warning of influenza epidemic in Gansu.</p>

Spatial temporal distribution of mumps in Gansu, 2009-2013 / 中华流行病学杂志

Objective To detect the spatial temporal distribution of mumps in Gansu by means of spatial statistics.Methods The county-based incidence of mumps from 2009 to 2013 was used to calculate the global Moran' s I and local G statistics, and analyze its spatial temporal distribution characteristics.Results The incidence of mumps in Gansu were spatial auto-correlated from 2009 to 2013 respectively (P＜0.001), and the hot spots were mainly distributed in Hexi area,while the cold spots were distributed in Tianshui, Longnan and Qingyang.Spatial temporal analysis showed that the high incidence of mumps was most likely to be detect in Hexi area (RR=3.05, LLR=4 670.995, P＜0.001), and the low incidence was most likely to be detect in Longdong area (RR=0.36,LLR=1 980.686,P＜0.001).Conclusion The spatial and spatial temporal clustering of mumps existed in Gansu from 2009 to 2013, the results can be used in the development of mumps prevention and control measure in Gansu.

Implantation of intraocular lens for traumatic cataract caused by sports injury / 中国组织工程研究

OBJECTIVE: To explore the materials and design of intraocular lens for traumatic cataract caused by sports injuries.METHODS: The databases of Medline and CNKI were retrieved by computer with key words of "sports injury, cataract, and intraocular lens". The languages were restricted as Chinese and English. By searching, 12 literatures concerning intraocular lens for traumatic cataract caused by sports injuries were selected, including 3 written in English and 9 in Chinese.RESULTS: One of the causes for cataract is sports injury. Every year, thousands of cases suffered eye damages in China due to sports. Here, first, a brief introduction of the causes of cataract was presented, and then the suitable intraocular lens implantation for athletes was prepared, finally, the materials and design of intraocular lens was discussed.CONCLUSION: The intraocular lens is developed fast both in basic theory and clinic, which exhibit good features in biocompatibility, visual function, regulatory ability, as well as photoprotection following transplantation. The widening of intraocular lens can provide more choices for physicians, and the life quality of patient was obviously improved.