The effect of valve noise on the quality of life of patients after mechanical mitral valve replacement in a Chinese population.

OBJECTIVE: To investigate the effect of valve noise on the quality of life (QOL) in Chinese patients who underwent mechanical mitral valve replacement. METHODS: We enrolled a total of 103 patients who underwent mechanical mitral valve replacement (MVR, CM valve in 52 patients, SJM valve in 51 patients) from January 2016 to December 2016 in our institution and used the SF-36 as an instrument to assess patients' QOL. RESULTS: Patients' QOL improved over time. Patients who experienced disturbances due to valve noise had lower SF-36 scores in each scale, especially in general health, vitality, and mental health. Only 8.74% (n = 9) of patients complained of valve noise 1 year after the operation compared to 19.42% (n = 20) in the first month after the operation. The number of patients who experienced disturbances due to valve noise decreased over time, with a P value of 0.58. Logistic regression analysis showed that female patients those aged < 60 years old had a higher risk of experiencing disturbances due to valve noise. The valve type (CM vs SJM), body mass index (BMI) and valve size showed no significant differences in patients who experienced disturbances due to continuous valve noise. The SF-36 results were similar in the CM group and SJM group 1 year after the operation. CONCLUSIONS: QOL evaluated by the SF-36 improved over time in Chinese patients who underwent mechanical MVR. Age less than 60 years and female sex were high risk factors for experiencing disturbances due to valve noise. CM and SJM mechanical valves demonstrated similar valve noise levels and impact on QOL in patients who experienced mechanical MVR.

A meta-analysis of perventricular device closure of perimembranous ventricular septal defect.

BACKGROUND: To investigate the safety and efficacy of perventricular device closure of perimembranous VSD (pmVSD). METHODS: PubMed and Scopus were searched for studies in English focusing on perventricular device closure of pmVSD published up to the end of March 2019. We used a random-effects model to obtain pooled estimates of the success and complication rates. RESULTS: A total of 15 publications comprising 1368 patients with pmVSD were included. The median follow-up duration was 2 months to 5 years, with a mean patient age ranging from 2 months to 56 years. The pooled success rate was 0.95 (I2 = 86.2%, P = 0.000). The pooled rate of postoperative residual shunting was 0.02 (95% CI: 0.01-0.03, I2 = 87.3%, P < 0.001). The pooled rate of residual shunting in the follow-up period was 0.001 (95% CI:-0.001-0.002, I2 = 30.5%, P = 0.126). The pooled estimated rate of severe complications was 0.074 (95% CI: 0.046-0.102, I2 = 30.5%, P = 0.126). The pooled incidence of complete atrioventricular block (cAVB) was 0.002 (95% CI: 0.000-0.005, I2 = 0.0%, P = 0.577). CONCLUSIONS: Perventricular device closure may be an alternative to conventional surgical repair in selected patients with pmVSD. The success rate was stable regarding the publication year and sample size and suggested both the short learning curve of this technology and its potential for wide application. The incidence of severe arrhythmia, especially cAVB, was low. These good results may be limited by the number of enrolled patients, and a more detailed and larger sample is required for further analysis.

[Evaluation of the Cutoff of Anti-HCV Antibody Enzyme-Linked Immunosorbent Assay in 7 Blood Station Laboratories].

OBJECTIVE: To evaluate the necessity and suitability of the anti-HCV ELISA teot gray zone setted up by 7 blood station laboratories. METHODS: 7 blood station laboratories were coded as 1, 2, 3, 4, 5, 6 and 7 respectively; 8 kinds of ELISA reagents were coded as A, B, C, D, E, F, G and H respectively. 1 or 2 of 8 ELISA reagents produced by different manufactories were used to detect the anti-HCV in specimens of same group by 7 blood station laboratories; the Westen blot was used to detect the specimens with difference of detected results so as to difine the serological status of specimens. The true positive rate of specimens detected by laboratories and gray zone-comfirined positive rate of specimens were accounted so as to analyze the necessity of setting up the gray zone for anti-HCV ELISA test of 7 blood station laboratories; the optimal cut-off value for anti-HCV ELISA test was determined in 7 blood station laborafories by ROC curve and the changes of sensitivity and specificity of 3 different cut-off value(laboratory work cut-off value, manifactory-recommended cun-off value and optimal cut-off value) were compared so as to analyze the suitability of gray zone for anti-HCV ELISA test in 7 blood station laboratories. RESULTS: The true positive rate detected by 7 blood station laboratories, out of which coded 1 laboratory used 2 kinds of coded A, B reagents was 95.40%(1A), 99.23% (1B), 94.25% (2C), 96.17% (3D), 98.08% (4E), 96.93% (5F), 97.32%(6G) and 93.10%(7H). Except for 2C(94.25%) and 7H(93.10%), the true positive rate detected by laboratoies which not sutted up gray zone, the gray zone-con-firmed positive rate in 6 blood station laboratories setted up gray zone: was 0.00%, 0.00%, 21.43%, 0.00%, 0.00%, 0.00% and 38.89%. The comparison of 3 different cut-off valuces by ROC curve showed that the anti-HCV cut-off values in 5 laboratories(1B, 2C, 4E, 5F and 6G) were as follows: optimal cut-off value＞manufactory recommeded cut-off value＞laboratory work cut-off value, thus use of manufactory-recommeded cut-off value abreadly has reached the high sensitivity requinements for laboratory screening; however, the optimal cut-off value in laboratories 1A, 3B and 7H, thas the appropriate gray zone should be used. In 6 laboratories setting up gray zone, the gensitivity in 3D, 7H laboratories only a little improved (1.60% and 2.70% raspectively) in Eamparison between laboratory work cut-off value and manufactorg-recommeded cut-off value; moreover, the sensitivity in other laboratories not is changed, but the specificity decreased (0.20%-0.50%). CONCLUSION: In addition to setting up the appropriate gray zone in laboratories 1A, 3D and 5H, the gray zone in other laboratories may be cancelled. Even in the same laboratory, the setting up the gray zone also should be scientifically assessed, the same scale cannot be blindly used, thus appropniate strategies should be established.

[Evaluation of the Performance of Two Kinds of Anti-TP Enzyme-Linked Immunosorbent Assay].

OBJECTIVE: To evaluate the accuracy and precision of 2 kinds of anti-treponema pallidum (anti-TP) ELISA reagents in our laboratory for detecting the anti-TP in voluntary blood donors, so as to provide the data support for use of ELISA reagents after introduction of chemiluminescene immunoassay (CLIA). METHODS: The route detection of anti-TP was performed by using 2 kinds of ELISA reagents, then 546 responsive positive samples detected by anti-TP ELISA were collected, and the infections status of samples confirmed by treponema pallidum particle agglutination (TPPA) test was identified. The confirmed results of responsive samples detected by 2 kinds of anti-TP ELISA reagents were compared, the accuracy of 2 kinds of anti-TP ELISA reagents was analyzed by drawing ROC and comparing area under curve (AUC), and precision of 2 kinds of anti-TP ELISA reagents was compared by statistical analysis of quality control data from 7.1 2016 to 6.30 2017. RESULTS: There were no statistical difference in confirmed positive rate of responsive samples and weak positive samples between 2 kinds of anti-TP ELISA reagents. The responsive samples detected by 2 kinds of anti-TP ELISA reagents accounted for 85.53%(467/546) of all responsive samples, the positive rate confirmed by TPPA test was 82.87%. 44 responsive samples detected by anti-TP ELISA reagent A and 35 responsive samples detected by anti-TP ELISA reagent B were confirmed to be negative by TPPA test. Comparison of AUC showed that the accuracy of 2 kinds of anti-TP ELISA reagents was more high, the difference between 2 reagents was not statistically significant. The coefficient of variation (CV) of anti-TP ELISA reagent A and B was 14.98% and 18.04% respectively, which met the precision requirement of ELISA test. CONCLUSION: The accuracy and precision of 2 kinds of anti-TP ELISA reagents used in our laboratory are similar, and using any one of anti-TP ELISA reagents all can satisfy the requirements of blood screening.

Acupuncture for moderate to severe allergic rhinitis: A non-randomized controlled trial.

OBJECTIVE: To evaluate the effect and safety of acupuncture therapy on patients with moderate to severe allergic rhinitis. METHODS: A non-randomized controlled design was used to compare between the acupuncture group and the medication group. The acupuncture group received 8-week acupuncture therapy, and the medication group received budesonide nasal spray with cetirizine tablets for 8 weeks. The clinical symptoms and signs were analyzed before treatment, at 4 and 8 weeks after the start of treatment, and at 12 weeks after the end of treatment. Furthermore, the clinical efficacy and safety indicators were compared between the two groups. RESULTS: A total of 76 participants consisting of 38 in each of the two groups were enrolled. The scores of each clinical symptom and sign, including sneezing, runny nose, stuffy nose, nasal itching, and turbinate edema, and the total scores decreased over time in both groups (all P<0.05); and no difference was found in the scores between the two groups (P>0.05). There was no statistically significant difference in the effective rates of the acupuncture group at 4 and 8 weeks after the start of treatment as well as at 12-week follow-up compared with those of the medication group (83.3% vs. 91.2%, and 94.4 % vs. 85.3%; and 80.6 % vs. 82.4%, all P>0.05). Experimental items including blood routine, urine routine, aspartate transaminase, alanine aminotransferase, urea nitrogen and creatinine were all in the normal reference ranges during the treatment in the acupuncture group. CONCLUSIONS: Acupuncture therapy has a comparable effect to the medication treatment on patients with moderate to severe allergic rhinitis, and it is safe with no severe adverse effects.

Analysis of gamasid mites (Acari: Mesostigmata) associated with the Asian house rat, Rattus tanezumi (Rodentia: Muridae) in Yunnan Province, southwest China.

During a survey lasting from 1990 to 2008, we captured 4,113 Asian house rats, Rattus tanezumi Temminck 1844 (Rodentia: Muridae) from 28 counties of Yunnan Province in southwestern China. From these rats, a total of 19,304 gamasid mites (Acari: Mesostigmata) were collected and identified as comprising 50 different species. The species diversity of gamasid mites from this single rat species is higher than that reported previously from multiple hosts within a given geographical region. Of the 50 mite species, 31 species belonged to ectoparasites and 19 species belonged to free-living mites. The species diversity of the mites from rats trapped outdoors was much higher than from rats trapped indoors. The parameter K from the negative binomial distribution was used to measure the spatial distribution patterns of the dominant mite species and revealed that all the mites had an aggregated distribution among the rat hosts. Most mite species showed a predominantly female-biased population structure with many more females than males.

Host selection and niche differentiation in sucking lice (Insecta: Anoplura) among small mammals in southwestern China.

Understanding factors that shape host selection has been a classic issue in ecology, evolutionary biology, and epidemiological investigation. During the survey from 2000 to 2009, a total of 11,216 individuals of small mammals were captured from Yunnan Province in southwestern China. The captured small mammalian hosts belong to five orders, ten families, 35 genera, and 65 species and from their body surface, 38,885 individuals of ectoparasitic sucking lice were collected, which represent five families, seven genera, and 31 species. Based on niche overlap of dominant sucking lice on their primary hosts, we used hierarchical cluster analysis to sort different sucking louse species' resource utilizations of similar kind into respective categories. Given λ<5, there are only two groups clustered, however, sucking louse species' resource utilization was sorted into eight respective categories at λ=15. The results revealed that most species of sucking lice usually had high host specificity and a certain species of sucking louse usually restricted to one or few small mammalian species as their dominant hosts. Correspondence analysis was used to visualize associations between parasitic sucking lice and their small mammalian hosts, which suggested three different patterns of host resource utilization: species specialists, genera generalists, and multiple selections. For example, Sathrax durus (Johnson) only parasitized on species of Tupaia belangeri (Wagner), Hoplopleura edentula (Fahredholz) predominatly on genus of Eothenomys, and Polyplax reclinata (Nitzsch) on Family of Soricidae. Our results demonstrate that sucking lice have high host specificity and this might be due to coevolution between sucking lice and their hosts.

Comparison of dose responses and resistance ratios in four populations of the rice stem borer, Chilo suppressalis (Lepidoptera: Pyralidae), to 20 insecticides.

BACKGROUND: Chemical control is a major strategy for suppressing the rice stem borer, Chilo suppressalis (Walker). Owing to their high toxicity and increasing resistance development in the target insect, many insecticides will be phased out entirely in 2007 in China. Alternatives with relatively low toxicity are urgently needed to replace traditional chemicals for rice stem borer control. In this study, the authors examined four field populations of C. suppressalis for their toxicological responses to more than 20 insecticides, including a few low-toxicity organophosphates and many novel pesticides. Interpopulation resistance levels to 12 conventional insecticides were also compared. RESULTS: Based on LD(50) values, the rice stem borer was most sensitive to avermectins and fipronil (LD(50) < 1 ng larva(-1)). The stem borers exhibited the least sensitivity to endosulfan (LD(50) > 100 ng larva(-1)) and monosultap (LD(50) > 1000 ng larva(-1)). Insect growth regulators and chitin synthase inhibitors showed great efficacy against C. suppressalis, especially against populations that had developed resistance to conventional insecticides. Four field populations showed variable tolerance levels to many insecticides. LYG05 was the most susceptible population, only with a low level of resistance to monosultap (RR = 6.6). NC05 and GL05 populations exhibited intermediate tolerance levels with RR values up to 20.4 and 52.8 respectively. RA05 was the most resistant population to many insecticides, with resistance ratios up to 76.2. CONCLUSION: The results from this study provide valuable information for selection and adoption of new alternative insecticides and for resistance management of the rice stem borer.

Survey of susceptibilities to monosultap, triazophos, fipronil, and abamectin in Chilo suppressalis (Lepidoptera: Crambidae).

To provide a foundation for national resistance management of the Asiatic rice borer, Chilo suppressalis (Walker) (Lepidoptera: Crambidae), a study was carried out to determine dose-response and susceptibility changes over a 5-yr period in the insect from representative rice, Oryza sativa L., production regions. In total, 11 populations were collected from 2002 to 2006 in seven rice-growing provinces in China, and they were used to examine their susceptibility levels to monosultap, triazophos, fipronil, and abamectin. Results indicated that most populations had increased tolerance to monosultap. Several field populations, especially those in the southeastern Zhejiang Province, were highly or extremely highly resistant to triazophos (resistance ratio [RR] = 52.57-899.93-fold), and some populations in Anhui, Jiangsu, Shanghai, and the northern rice regions were susceptible or had a low level of resistance to triazophos (RR = 1.00-10.69). Results also showed that most field populations were susceptible to fipronil (RR < 3), but the populations from Ruian and Cangnan, Zhejiang, in 2006 showed moderate levels of resistance to fipronil (RR = 20.99-25.35). All 11 field populations collected in 2002-2006 were susceptible to abamectin (RR < 5). The tolerance levels in the rice stem borer exhibited an increasing trend (or with fluctuation) over a 5-yr period for different insecticides, and they reached a maximal level in 2006 for all four insecticides. Analysis of regional resistance ratios indicated that the history and intensity of insecticide application are the major driving forces for the resistance evolution in C. suppressalis. Strategic development of insecticide resistance management also is proposed.