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Spine fractures represent a critical health concern with far-reaching implications for patient care and clinical decision-making. Accurate segmentation of spine fractures from medical images is a crucial task due to its location, shape, type, and severity. Addressing these challenges often requires the use of advanced machine learning and deep learning techniques. In this research, a novel multi-scale feature fusion deep learning model is proposed for the automated spine fracture segmentation using Computed Tomography (CT) to these challenges. The proposed model consists of six modules; Feature Fusion Module (FFM), Squeeze and Excitation (SEM), Atrous Spatial Pyramid Pooling (ASPP), Residual Convolution Block Attention Module (RCBAM), Residual Border Refinement Attention Block (RBRAB), and Local Position Residual Attention Block (LPRAB). These modules are used to apply multi-scale feature fusion, spatial feature extraction, channel-wise feature improvement, segmentation border results border refinement, and positional focus on the region of interest. After that, a decoder network is used to predict the fractured spine. The experimental results show that the proposed approach achieves better accuracy results in solving the above challenges and also performs well compared to the existing segmentation methods.
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The banana Fusarium wilt (BFW) caused by Fusarium oxysporum f. sp. cubense tropical race4 (FocTR4) is difficult to control worldwide, which causes a huge economic losse to banana industry. The purpose of this study was to screen Trichoderma strains with antagonistic activity against FocTR4, to isolate and purify the active compound from the fermentation broth, so as to provide important biocontrol strains and active compound resources. In this work, Trichoderma strains were isolated and screened from the rhizosphere soil of crops, and the strains capable of efficiently inhibiting FocTR4 were screened by plate confrontation, and further confirmed by testing inhibition for the conidial germination and mycelial growth of FocTR4. The phylogenetic tree clarified the taxonomic status of the biocontrol strains. Moreover, the active components in the fermentation broth of the strains were separated and purified by column chromatography, the structure of the most active component was analyzed by nuclear magnetic resonance spectroscopy (NMR), the BFW control effect was tested by pot experiments. We obtained a strain JSHA-CD-1003 with antagonistic activity against FocTR4, and the inhibition rate from plate confrontation was 60.6%. The fermentation broth of JSHA-CD-1003 completely inhibited the germination of FocTR4 conidia within 24 hours. The inhibition rate of FocTR4 hyphae growth was 52.6% within 7 d. A phylogenetic tree was constructed based on the ITS and tef1-α gene tandem sequences, and JSHA-CD-1003 was identified as Trichoderma brevicompactum. Purification and NMR identification showed that the single active compound was trichodermin, and the minimum inhibitory concentration (MIC) was 25 μg/mL. Pot experiments showed that the fermentation broth of strain JSHA-CD-1003 was effective against BFW. The control rate of leaf yellowing was 47.4%, and the rate of bulb browning was 52.0%. Therefore, JSHA-CD-1003 effectively inhibited FocTR4 conidial germination and mycelium growth through producing trichodermin, and showed biocontrol effect on banana wilt caused by FocTR4, thus is a potential biocontrol strain.
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Fusarium , Musa , Phylogeny , Trichodermin , HypocrealesABSTRACT
Oligoasthenozoospermia is the main cause of male infertility， with complex and diverse causes. Currently， there are still some unclear causes of oligoasthenozoospermia in clinical practice， known as idiopathic oligoasthenozoospermia. With the development of high-throughput sequencing technology， it has been found that intestinal microbiota disorder may be an important promoting factor for the onset of oligoasthenozoospermia. Traditional Chinese medicine believes that "deficiency of kidney essence" is the core pathogenesis of oligoasthenozoospermia. In clinical practice， the method of tonifying the kidney and strengthening the essence has a significant therapeutic effect on oligoasthenozoospermia， but its mechanism of action has not been fully elucidated. Based on the basic theories of traditional Chinese medicine and molecular biology research， it has been found that there is a similarity between "kidney essence" and intestinal microbiota. During the onset of oligoasthenozoospermia， the disorder of intestinal microbiota has similarities with the pathogenesis of "deficiency of kidney essence" in traditional Chinese medicine. Moreover， traditional Chinese medicine for tonifying the kidney and strengthening the essence can regulate the disorder of intestinal microbiota， which may be one of the effective mechanisms for the treatment of oligoasthenozoospermia with the Bushen Yijing method. Based on this， this article explored the mechanism of Bushen Yijing method of traditional Chinese medicine in treating oligoasthenozoospermia from the perspective of intestinal microbiota， so as to provide new ideas for the treatment of oligoasthenozoospermia with traditional Chinese medicine.
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Trials within cohorts （TwiCs） are design methods derived from randomized controlled trials （RCTS）. They have been widely used in chronic disease areas such as tumors and cardiovascular diseases. The basis of the TwiCs design is a prospective cohort of specific diseases. When RCTS need to be implemented， some patients meeting the inclusion and exclusion criteria are randomly sampled from the cohort to receive "trial interventions"， while the remaining patients in the cohort who meet the inclusion and exclusion criteria continue to receive conventional treatment as control groups. By comparing the efficacy differences between the intervention measures of the trial group and the control group， the efficacy of intervention measures was evaluated. Within the cohort， the same process could be repeated to carry out multiple RCTS， so as to evaluate different intervention measures or compare the efficacy of different doses or timing of interventions. Compared with classical RCTS， TwiCs make it easier to recruit patients from the cohort and have higher external validity， providing a new research paradigm for improving the efficiency and applicability of RCTS in clinical practice. However， TwiCs may also face the challenge of poor compliance of patients in the cohort. Researchers need to take effective measures to control these patients in the design and operation of TwiCs. This article focused on the methodological key points during the implementation of TwiCs， including multi-stage informed consent （patients are informed of consent at three stages： entering the cohort， entering the trial group， and after the trial）， randomization procedures （only random sampling of patients from the cohort to receive "trial interventions"）， sample size calculation， and statistical analysis methods. The article also compared the differences between TwiCs and traditional RCTS and illustrated TwiCs research design and analysis with examples， so as to provide new research ideas and methods for clinical researchers.
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To develop a traditional Chinese medicine （TCM） diagnostic scale for type 2 diabetes mellitus with turbid-toxin accumulation syndrome and to validate the performance of the scale. A candidate pool was established through literature review and expert consultation， and a clinical case information collection form was developed accordingly. Patients with type 2 diabetes mellitus admitted to the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from July 2021 to January 2022 were investigated， and 312 valid clinical case information collection forms were obtained， which were randomly divided into 235 cases in the study group and 77 cases in the validation group. Four statistical methods， namely， differentiation analysis， Cronbach's coefficient， correlation coefficient， and stepwise regression， were used to screen out the candidate items， and Logistic regression analysis and factor analysis were used to assign weights to the items， and the final diagnostic model was determined by the receiver operating characteristic （ROC） curve， and the diagnostic thresholds were calculated for the Yoden index. The final TCM diagnostic scale for type 2 diabetes mellitus was composed of 8 items： turbid dirt coating （with a weight value of 23， the same below）， sticky stools （16）， fullness in the epigastrium and abdomen （12）， dark complexion （12）， irritability （11）， brown spots on the skin （11）， heaviness of head （10）， and chest stuffiness （5）， and the degree score was 0， 0.5， 1.0， and 1.5 points corresponding to no， mild， moderate and severe symptoms， respectively. The total score was the sum of the degree score multiplied by the weighted value of each item， and when the total score reached 33 points， it is diagnosed as the turbid-toxin accumulation syndrome. The established scale was tested and evaluated in the study group and the validation group， and the results showed that the sensitivity of the study group and the validation group was 89.38% and 89.47%， with the specificity of 95.90% and 89.74%， the Yoden index of 0.85 and 0.79， the positive predictive value of 95.28% and 89.47%， the negative predictive value of 90.70% and 89.74%， the diagnostic advantage ratios of 198.18 and 72.67， and the Kappa values of 0.86 and 0.79， which indicated that the TCM diagnostic scale for turbid-toxin accumulation syndrome of type 2 diabetes mellitus showed good diagnostic ability.
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BRICS-Plus countries (Brazil, Russia, India, China, South Africa, and 30 other countries) is a group of 35 countries with emerging economies making up more than half of the world's population. We explored epidemiological trends of cardiovascular disease (CVD) mortality attributable to modifiable risk factors and its association with period and birth cohort effects and sociodemographic index (SDI) across BRICS-Plus countries by using joinpoint regression and age-period-cohort modeling from 1990 to 2019. Between 1990 and 2019, the all-ages CVD deaths increased by 85.2% (6.1 million to 11.3 million) across BRICS-Plus countries. The CVD age-standardized mortality rate attributable to dietary risks and smoking significantly decreased across BRICS-Plus countries, with some exceptions. However, four-fifths of BRICS-Plus countries observed a remarkable increasing trend of high body mass-index (BMI)-related CVD deaths, in particular, among younger adults (25-49 years). Early birth cohorts and individuals aged greater than 50 years showed a higher risk of CVD mortality. Both the China-ASEAN FTA and Mercosur regions stand out for their successful sociodemographic transition, with a significant reduction in CVD mortality over the study period. Singapore and Brazil achieved great progress in CVD mortality reduction and the other BRICS-Plus countries should follow their lead in adopting public health policies and initiatives into practice.
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Cardiovascular Diseases , Cardiovascular System , Adult , Humans , Aged , Risk Factors , Smoking , Birth CohortABSTRACT
During the oocyte growth, maturation and zygote development, chromatin structure keeps changing to regulate different nuclear activities. Here, we reported the role of SMC2, a core component of condensin complex, in oocyte and embryo development. Oocyte-specific conditional knockout of SMC2 caused female infertility. In the absence of SMC2, oocyte meiotic maturation and ovulation occurred normally, but chromosome condensation showed defects and DNA damages were accumulated in oocytes. The pronuclei were abnormally organized and micronuclei were frequently observed in fertilized eggs, their activity was impaired, and embryo development was arrested at the one-cell stage, suggesting that maternal SMC2 is essential for embryonic development.
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Cell Nucleus , Chromosomes , Animals , Female , Mice , Pregnancy , Cell Cycle , Cell Nucleus/physiology , Embryonic Development/genetics , Meiosis/genetics , Oocytes/physiology , ZygoteABSTRACT
The high-flash heat generated by direct contact at asperity tips under high contact stress and shear significantly promotes the tribocatalytic reaction between a lubricating medium and a friction interface. Macroscale superlubricity can be achieved by using additives with good lubrication properties to promote the decomposition and transformation of a lubricating medium to form an ultralow shear interface during the friction process. This paper proposed a way to achieve self-adaptive oil-based macroscale superlubricity on different tribopairs, including steel-steel and steel-DLC (diamond-like carbon), which is based on the excellent lubricating performance of black phosphorus with active oxidation and the catalytic cleavage behavior of oil molecules on the surface of oBP. This work potentially expands the industrial application of superlubricity.
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PURPOSE: To evaluate the safety and efficacy of a novel hyperthermic intravesical chemotherapy (HIVEC) device in combination with gemcitabine. MATERIALS AND METHODS: A pilot clinical trial was performed on patients with high-risk non-muscle invasive bladder cancer (NMIBC), who received HIVEC via the novel device (BR-PRG). Treatment regimen included eight weekly instillations of intravesical GEM (3 g in 150 mL normal saline [NS]) at a temperature of 45 °C for 60 min. Assessment of adverse events (AEs) was the primary objective of the trial. Disease recurrence and the thermal stability of GEM were also analyzed. RESULTS: A total of 116 HIVEC treatments were delivered. Fifteen and eighteen patients were included in the effectiveness and safety analysis, respectively. Median follow-up was 12 months; five patients experienced a disease recurrence. One-year cumulative incidence of recurrence was 23.8% in EORTC intermediate risk group and 37.5% in high-risk group. Ten patients experienced at least one AE, with the most common being acute urinary tract infection, followed by urinary tract pain, and hematuria. Two patients experienced acute cystitis (grade 3 AE) and instillations were postponed until full recovery. Other AEs were minor, and no systemic toxicity was observed. The contents of GEM in solution of 0.9% NS or NS mixed with artificial urine were stable at 25 °C, 37 °C, 43 °C, 45 °C, 47 °C and 50 °C for 2 h. CONCLUSION: GEM can be an ideal drug for use in HIVEC due to its good thermal stability. BR-PRG, combined with GEM was safe and effective in administering HIVEC.
Subject(s)
Hyperthermia, Induced , Urinary Bladder Neoplasms , Humans , Gemcitabine , Hyperthermia, Induced/adverse effects , Incidence , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Urinary Bladder Neoplasms/drug therapy , Pilot ProjectsABSTRACT
ObjectiveTo construct the physical activity intervention effect category and framework for college students with mental and behavioral health and functioning problems based on International Classification of Functioning, Disability, and Health (ICF). MethodsThe typical mental and behavioral health and functioning condition of college students were systematically analyzed using ICF. Relevant literatures about the health and functioning outcomes of college students participating in physical activity were retrieved from the databases of PubMed, Web of Science, EBSCO, and CNKI, from the establishment to August 20th, 2022, and reviewed systematically. ResultsTen English literatures were included, involving ten randomized controlled trials with 848 participants aged 15 to 34 years from seven countries, mainly from the journals of rehabilitation science, sports rehabilitation, rehabilitation psychology and health psychology, and were mainly published after 2016. The typical mental and behavioral health and functioning problems of college students mainly focused on stress, anxiety, depression, sleep disorders, learning fatigue, mobile phone addiction, alcohol drinking disorder, sedentary behavior and physical inactivity. Physical activity interventions included Biodanza, Hatha Yoga, Tai Chi, basketball, Baduanjin, cycling, swimming, roller skating, baseball, skill training, stretching exercise, resistance training, and aerobic exercise, etc. The frequency of interventions was mainly a long-term (four to 14 weeks, one to three times per week) program of high-, moderate-, or low-intensity physical activity. The health outcomes included improving cognitive function, relieving stress, anxiety, depression and learning fatigue, reducing negative automatic thinking, enhancing mindfulness, reducing loneliness and deficiency, improving sleep quality, improving upper limb muscle endurance; promoting the development of exercise habits, increasing physical activity participation, improving activity performance and academic performance, reducing sedentary behavior, drinking behavior and problematic mobile phone use; increasing social interaction, improving health perception and psychosocial function, enriching and improving recreation and campus life, and improving the quality of interpersonal relationships, quality of life and well-being. ConclusionA conceptual framework of physical activity participation of college students with mental and behavioral health and functioning problems is constructed using ICF. The typical mental and behavioral health and functioning problems of college students are mainly classified as mental health and functioning problems, behavioral health and functioning problems. The intervention types of physical activity are divided into physical fitness category, skill category, sports category and combination category. Health outcomes can be reflected in three dimensions: physical and mental health, activity and behavioral health, and overall functioning and quality of life.
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Objective:To study the risk of malignant tumor in medical X-ray workers in Shanghai and provide scientific data for the study on occupationally exposed population.Methods:A retrospective cohort study was conducted to investigate the risk of cancer. Totally, 715 physicians in radiology departments during 1950-1980 in Shanghai were selected as exposure group, while 738 with non-radiology departments in the same hospital in the same time period as control group. The basic information on the selected physicians and associated cancer incidence were collected. The comulative number of individuals with cancer from 1980 to 2021 was calculated. The relative risk ( RR) of cancer was analyzed using logistic regression model in terms of gender, birth year, and work starting year. As well, stratified analysis based on confounding factors was conducted. Results:A total of 1 369 individuals were followed up, including 668 in exposure group and 701 in control group. The cumulative person-year of observed individuals was 52 980. As of 31 December 2021, a total of 199 patients with various malignant tumors were identified. The results of the logistic regression analysis showed that the risk of malignant tumors in exposure group was significantly higher than that in control group. The adjusted RR of solid cancer and total cancer was 1.49 (95% CI: 1.08-2.05, P=0.015) and 1.40 (95% CI: 1.02-1.92, P=0.036), respectively. In addition, the risk of thyroid cancer in exposure group was significantly higher than that in control group ( RR=10.06, 95% CI: 2.05-49.62, P=0.005). Stratified analysis showed that the exposure group had a higher risk of total cancer both for femals and workers taking their jobs at age of 21-25. Conclusions:The risk of thyroid cancer, solid cancer and total cancer in the medical X-ray workers was significantly higher than that in control group. It is suggested that radiation protection in medical practice should be strengthened for the occupationally exposed workers, especially for femals and workers taking their jobs at low age.
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The widespread application of 3D printing and computer technologies in the medical field has opened up opportunities for digital and automated fabrication of body immobilization tools for radiotherapy, thus making it possible to get rid of the original complex manual fabrication process. As the most widely used technique for body immobilization, body membrane immobilization has always attracted much attention. This review outlines the development of the body membrane immobilization technology in different radiotherapy stages. Moreover, the advances in the application of 3D-printed body membranes were introduced, as a development direction of body immobilization technology, in the field of radiotherapy. This technology can be utilized as a reference for clinical application and research.
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Objective:To evaluate a novel distraction reductor in the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution.Methods:From January 2019 to December 2020, 27 patients with unstable distal radius fracture complicated with metaphyseal volar comminution were treated at Department of Orthopaedics, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences. They were 6 males and 21 females, with an age of (69.4±9.4) years. All fractures were unilateral and closed, involving the right side in 17 cases and the left side in 10 cases. All patients were treated by internal fixation with an anatomical locking plate through the volar approach and the novel distraction reductor was used to reduce the fracture ends. Regular imaging examinations were performed to evaluate the reduction, maintenance and union of fractures after surgery. One year after operation, the curative efficacy was assessed by evaluation of the range of wrist motion, Disabilities of the Arm, Shoulder and Hand (DASH) score, Gartland-Werley score and Bartra radiology score.Results:All the operations went on successfully with a duration of (92.3±8.9) min. All the incisions healed primarily. The follow-up time was (15.9±2.9) months. The radial height, palmar tilt, ulnar inclination and articular surface step-off immediately after operation [(11.23±1.51) mm, 12.10°±3.44°, 20.54°±3.44°, and (0.95±0.42) mm] were not significantly lost compared with those one year after operation [(11.22±1.55) mm, 12.07°±3.44°, 20.51°±3.33°, and (0.93±0.40) mm] (all P>0.05). One year after operation, the range of wrist motion was good with dorsiflexion of 59.7°±5.5°, palm flexion of 63.0°±9.1°, pronation of 66.5°±5.5°, supination of 61.2°±5.6°, radial deviation of 22.7°±4.8°, and ulnar deviation of 30.3°±6.1°; DASH score was 13.5±5.5; Bartra radiology score was 88.6±6.5, giving an excellent and good rate of 88.9% (24/27);Gartland-Werley score was 2.7±2.1, giving an excellent and good rate of 92.6% (25/27). Follow-ups observed no poor fracture healing, internal fixation failure, tendon or nerve injury or traumatic arthritis. Conclusion:In the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution, the novel distraction reductor can lead to ideal reduction of displaced fractures and effectively correct the shortening caused by volar cortex comminution to achieve satisfactory functional effects in clinic.
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Objective:To establish a rat model of transverse tibial bone transfer on the diabetic foot.Methods:A diabetic model was created by intraperitoneal injection of streptozotocin into 40 SD rats after 5 weeks of high-fat feeding, taking random blood glucose ≥16.7 mmol/L as the criterion for successful modeling. Changes in body weight, food intake, water intake, faecal output and blood glucose were monitored every week after the acclimatization period until random blood glucose ≥16.7 mmol/L was observed for 3 running weeks. After the blood glucose was stabilized, 34 surviving diabetic rats were divided into 2 groups using a random number table. In the experimental group, a transverse transfer outer frame was installed and transverse tibial bone transfer performed after removal of the skin over the dorsal foot; in the control group, a transverse transfer outer frame was installed and the skin over the dorsal foot removed but no transverse tibial bone transfer performed. The wound changes were recorded on the 1, 5, 10, 15 and 20 days after installation of the transverse transfer outer frame. After completion of transverse tibial bone transfer (24 days after modeling of transverse tibial bone transfer), one rat was randomly chosen from each of the 2 groups for angiography while the rest rats were sacrificed for observation of the skin changes on the lower limbs. The densitometric values of CD31 immunohistochemical staining were compared between the 2 groups.Results:The random blood glucose increased from (6.89±1.03) mmol/L before modeling to (25.91±6.42) mmol/L at the last test, keeping at ≥16.7 mmol/L for 3 running weeks. The percentages of ulcer healing of the foot dorsal wound in the experimental group on days 5, 10, and 20 were significantly higher than those in the control group ( P<0.05). Gross observation and angiography found more abundant vessels in the lower extremity on the side of transverse transfer in the experimental group. The immunohistochemical staining of the lower limb skin tissue for CD31 found an AOD value of 0.60±0.23 in the experimental group, significantly higher than that in the control group (0.37±0.13) ( t=3.722, P=0.001). Conclusion:A rat model of transverse tibial bone transfer has been successfully established through installation of a self-designed transverse transfer outer frame on the basis of a successful rat model of diabetic foot, characterized by improved microcirculation in the lower limbs.
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Glioblastoma(GBM)is a lethal cancer with limited therapeutic options.Dendritic cell(DC)-based cancer vaccines provide a promising approach for GBM treatment.Clinical studies suggest that other immu-notherapeutic agents may be combined with DC vaccines to further enhance antitumor activity.Here,we report a GBM case with combination immunotherapy consisting of DC vaccines,anti-programmed death-1(anti-PD-1)and poly I:C as well as the chemotherapeutic agent cyclophosphamide that was integrated with standard chemoradiation therapy,and the patient remained disease-free for 69 months.The patient received DC vaccines loaded with multiple forms of tumor antigens,including mRNA-tumor associated antigens(TAA),mRNA-neoantigens,and hypochlorous acid(HOCl)-oxidized tumor lysates.Furthermore,mRNA-TAAAs were modified with a novel TriVac technology that fuses TAAs with a destabilization domain and inserts TAAs into full-length lysosomal associated membrane protein-1 to enhance major histo-compatibility complex(MHC)class Ⅰ and Ⅱ antigen presentation.The treatment consisted of 42 DC cancer vaccine infusions,26 anti-PD-1 antibody nivolumab administrations and 126 poly I:C injections for DC infusions.The patient also received 28 doses of cyclophosphamide for depletion of regulatory T cells.No immunotherapy-related adverse events were observed during the treatment.Robust antitumor CD4+and CD8+T-cell responses were detected.The patient remains free of disease progression.This is the first case report on the combination of the above three agents to treat glioblastoma patients.Our results suggest that integrated combination immunotherapy is safe and feasible for long-term treatment in this patient.A large-scale trial to validate these findings is warranted.
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Objective:To explore the effect of different blood sodium levels on the condition and prognosis of patients with severe craniocerebral injury.Methods:A retrospective cohort study was conducted on 150 cases of severe craniocerebral injury admitted to Zhangye People′s Hospital Affiliated to Hexi University from January 2020 to October 2022. According to the five blood sodium values measured on the first day after admission and during the peak period of brain edema (2-4 days after injury) and 7 days after injury, 102 cases of blood sodium metabolic disorder, 43 cases of low sodium group: average blood sodium value<135 mmol/L, 59 cases of high sodium group: average blood sodium value>145 mmol/L. The characteristics of sodium ion metabolism imbalance and the relationship between serum sodium level and Glasgow coma score (GCS), Glasgow prognosis score (GOS) and APACHE Ⅱ score at 2 weeks after injury were analyzed. Measurement data with normal distribution were represented as mean±standard deviation ( ± s), and comparison between groups was conducted using the t-test. count data were expressed as cases or percentages(%), and comparison between groups was conducted using the Chi-square test. Results:The imbalance rate of sodium metabolism in the acute phase after injury was 68.00%(102/150), including 57.84%(59/102) of hypernatremia and 42.16%(43/102) of hyponatremia. The imbalance rate of sodium metabolism at 7 days after injury was significantly higher than that immediately after injury. Hypernatremia occurred earlier than hyponatremia and lasted longer than hyponatremia ( P<0.05). There was no correlation between the low sodium group and the scores of GCS ( R=0.523), GOS ( R=0.367), APACHE Ⅱ ( R=-0.453) ( P>0.05), but the scores of GCS ( R=-0.448) and GOS ( R=-0.486) were negatively correlated with the blood sodium level of the high sodium group ( P<0.05), and the high sodium group was positively correlated with the scores of APACHE Ⅱ ( R=0.477, P<0.05). Conclusions:Patients with severe craniocerebral injury are often accompanied by blood sodium disorder. Hyponatremia can be corrected in a short time and has no effect on the patient′s condition and prognosis. However, hypernatremia seriously affects the recovery of consciousness, prognosis and quality of life of the injured.
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BACKGROUND@#China bears the biggest atrial fibrillation (AF) burden in the world. However, little is known about the incidence and predictors of AF. This study aimed to investigate the current incidence of AF and its electrocardiographic (ECG) predictors in general community individuals aged over 60 years in China.@*METHODS@#This was a prospective cohort study, recruiting subjects who were aged over 60 years and underwent annual health checkups from April to July 2015 in four community health centers in Songjiang District, Shanghai, China. The subjects were then followed up from 2015 to 2019 annually. Data on sociodemographic characteristics, medical history, and the resting 12-lead ECG were collected. Kaplan-Meier curve was used for showing the trends in AF incidence and calculating the predictors of AF. Associations of ECG abnormalities and AF incidence were examined using Cox proportional hazard models.@*RESULTS@#This study recruited 18,738 subjects, and 351 (1.87%) developed AF. The overall incidence rate of AF was 5.2/1000 person-years during an observation period of 67,704 person-years. Multivariable Cox regression analysis indicated age (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.06-1.09; P < 0.001), male (HR, 1.30; 95% CI: 1.05-1.62; P = 0.018), a history of hypertension (HR, 1.55; 95% CI: 1.23-1.95; P < 0.001), a history of cardiac diseases (HR, 3.23; 95% CI: 2.34-4.45; P < 0.001), atrial premature complex (APC) (HR, 2.82; 95% CI: 2.17-3.68; P < 0.001), atrial flutter (HR, 18.68; 95% CI: 7.37-47.31; P < 0.001), junctional premature complex (JPC) (HR, 3.57; 95% CI: 1.59-8.02; P = 0.002), junctional rhythm (HR, 18.24; 95% CI: 5.83-57.07; P < 0.001), ventricular premature complex (VPC) (HR, 1.76; 95% CI: 1.13-2.75, P = 0.012), short PR interval (HR, 5.49; 95% CI: 1.36-22.19; P = 0.017), right atrial enlargement (HR, 6.22; 95% CI: 1.54-25.14; P = 0.010), and pacing rhythm (HR, 3.99; 95% CI: 1.57-10.14; P = 0.004) were independently associated with the incidence of AF.@*CONCLUSIONS@#The present incidence of AF was 5.2/1000 person-years in the studied population aged over 60 years in China. Among various ECG abnormalities, only APC, atrial flutter, JPC, junctional rhythm, short PR interval, VPC, right atrial enlargement, and pacing rhythm were independently associated with AF incidence.
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Humans , Male , Middle Aged , Aged , Atrial Fibrillation/epidemiology , Prospective Studies , Incidence , Atrial Flutter/complications , Risk Factors , China/epidemiology , ElectrocardiographyABSTRACT
Aim To explore the protective effects of ganoderma lucidum polysaccharides (GLPS) on experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS) and the underlying mechanism. Methods Thirty C57BL/6 mice were randomly divided into three groups: normal control group, EAE model group and GLPS group (5 mg • kg
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Inflammatory bowel disease (IBD), as an idiopathic inflammatory disease of the intestinal tract, consisting mainly of Crohns disease and ulcerative colitis, which can involve the rectum, colon and ileum, and whose pathogenesis is still not fully understood. The initiation of intestinal inflammation associated with IBD and its chronieity begins with increased intestinal permeability caused by intestinal epithelial barrier disruption. The anti-permeability of the intestinal epithelial barrier is maintained by tight junction in the apical region of the intestinal epithelial cells, and disruption of the tight junction structure is closely associated with intestinal epithelial barrier damage and the development of IBD. Therefore, it is significant to find drugs for the prevention and treatment of IBD using tight junctions as regulatory targets. In recent years, many small molecules of natural product origin have been reported to improve the effects of IBD. In particular, we review the compounds that have the function of repairing intestinal epithelial barrier and protecting tight junction structure, in order to provide research ideas for the design and development of new drugs for the prevention and treatment of IBD.
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Objective: To investigate the clinical presentation and genetic characteristics of malignant infantile osteopetrosis. Methods: This was a retrospective case study. Thirty-seven children with malignant infantile osteopetrosis admitted into Beijing Children's Hospital from January 2013 to September 2022 were enrolled in this study. According to the gene mutations, the patients were divided into the CLCN7 group and the TCIRG1 group. Clinical characteristics, laboratory tests, and prognosis were compared between two groups. Wilcoxon test or Fisher exact test were used in inter-group comparison. The survival rate was estimated with the Kaplan-Meier method and the Log-Rank test was used to compare the difference in survival between groups. Results: Among the 37 cases, there were 22 males and 15 females. The age of diagnosis was 0.5 (0.2, 1.0) year. There were 13 patients (35%) and 24 patients (65%) with mutations in CLCN7 and TCIRGI gene respectively. Patients in the CLCN7 group had an older age of diagnosis than those in the TCIRGI group (1.2 (0.4, 3.6) vs. 0.4 (0.2, 0.6) years, Z=-2.60, P=0.008). The levels of serum phosphorus (1.7 (1.3, 1.8) vs. 1.1 (0.8, 1.6) mmol/L, Z=-2.59, P=0.010), creatine kinase isoenzyme (CK-MB) (457 (143, 610) vs. 56 (37, 82) U/L, Z=-3.38, P=0.001) and the level of neutrophils (14.0 (9.9, 18.1) vs. 9.2 (6.7, 11.1) ×109/L, Z=-2.07, P=0.039) at diagnosis were higher in the CLCN7 group than that in the TCIRG1 group. However, the level of D-dimer in the CLCN7 group was lower than that in the TCIRGI group (2.7 (1.0, 3.1) vs. 6.3 (2.5, 9.7) μg/L, Z=2.83, P=0.005). After hematopoietic stem cell transplantation, there was no significant difference in 5-year overall survival rate between the two groups (92.3%±7.4% vs. 83.3%±7.6%, χ²=0.56, P=0.456). Conclusions: TCIRGI gene mutations are more common in children with osteopetrosis. Children with TCIRGI gene mutations have younger age, lower levels of phosphorus, CK-MB, and neutrophils and higher level of D-dimer at the onset. After hematopoietic stem cell transplantation, patients with CLCN7 or TCIRGI gene mutations have similar prognosis.
