Relationship between human serum albumin and in-hospital mortality in critical care patients with chronic obstructive pulmonary disease.

Background: The relationship between human serum albumin levels and the prognosis of critical care patients with chronic obstructive pulmonary disease (COPD) remains controversial. Objective: To investigate the relationship between serum albumin levels and in-hospital mortality in critical care patients with COPD. METHODS: This study used a retrospective observational cohort from the Medical Information in Intensive Care database (MIMIC-IV) in the United States. Multivariate Cox regression analysis was used to assess the relationship between serum albumin levels and in-hospital mortality. A restricted cubic spline line was also used to explore nonlinear relationship. Results: A total of 3,398 critical care patients with COPD were included. The overall in-hospital mortality was 12.4%. We found a negative relationship between human serum albumin and in-hospital mortality (HR = 0.97, 95% CI 0.96-0.99, p = 0.002). Conclusion: In critical care patients with COPD, there was a negative association between human serum albumin and in-hospital mortality.

Phenolic glycosides from the stems of Homalium stenophyllum / 中国天然药物

The phytochemical investigation of the stems of Homalium stenophyllum afforded seven new phenolic glycosides (1-5 and 8-9) and two known compounds (6 and 7). Their structures were elucidated by comprehensive analyses of NMR spectroscopic, mass spectrometric data and chemical hydrolysis. Additionally, their anti-inflammatory activities against the NO production in LPS-induced macrophages were evaluated.

Effects of comprehensive intervention on glucose and lipid metabolism, liver and kidney function and cardiovascular function in obese adolescents / 中国学校卫生

Objective@#To investigate the effects of exercise combined with dietary intervention on glucose and lipid metabolism, liver and kidney function and cardiovascular function in obese adolescents.@*Methods@#Seventy-one obese adolescents were enrolled in this study. Six weeks of exercise combined with dietary intervention were performed to determine anthropometry, glucose and lipid metabolism, liver and kidney function and cardiovascular function before and after intervention.@*Results@#After 6 weeks of comprehensive intervention, in addition to significant improvement in anthropometry indicators, fasting insulin [(18.76±11.46 vs 11.32±6.54)uU/L], LDL-C [(2.96±0.69 vs 2.22±0.62)mmol/L], TG [(1.57±0.82 vs 0.89±0.37)mmol/L] and TC [(4.52±0.76 vs 3.53±0.62)mmol/L] decreased significantly and insulin resistance improved significantly. AST [(36.1±32.28 vs 22.89±7.27)U/L], ALT [(57.42±61.25 vs 27.86±22.12)U/L], blood urea nitrogen [(4.78±0.89 vs 3.44±0.79)mmol/L] and uric acid [(498.83±120.6 vs 471.07±120.96)mmol/L] were significantly decreased and the detection rates of fatty liver and kidney were significantly decreased(P<0.05), RHI(1.34±0.28 vs 1.69±0.45) and nitric oxide/ endothelin-1 (ET-1) (1.69±0.41 vs 2.67±0.86) significantly increased and atherogenic index (3.06±0.96 vs 2.58±0.80) significantly decreased(P<0.01).@*Conclusion@#The comprehensive intervention of exercise combined with diet can effectively improve anthropometry indicators, glycolipid metabolism, liver and kidney function as well as cardiovascular function of obese adolescents.

[Progress on diagnosis and treatment of proximal tibiofibular joint dislocation].

Dislocation of proximal tibiofibular joint(PTFJ) is relatively infrequent in clinic, it can be either isolated or associated with tibia fracture, fibular fracture and ankle injury and so on. Chronic symptomatic PTFJ instability are easily mixed with meniscal tears. It was easily neglected because of the mild clinical presentation and atypical change on radiography. Early diagnosis and treatment are crucial to prevent chronic knee pain and instability. The paper concluded the anatomy, classification, complication, diagnosis, treatment, clinical effect and insufficient of the dislocation of PTFJ, to direct the diagnosis and treatment of proximal tibiofibular joint dislocation in clinical work.

A meta-analysis of bisphosphonates for periprosthetic bone loss after total joint arthroplasty.

BACKGROUND: Periprosthetic bone loss, which is common after joint arthroplasty, may cause bone loosening and lead to failed prosthetic fixation. Two previous meta-analyses have confirmed the mid-term effect of bisphosphonates (BPs) in preventing bone loss after arthroplasty. To determine long-term efficacy and gender bias of BPs after joint arthroplasty, we conducted a meta-analysis based on 17 RCTs involving 781 patients to evaluate the effect of BPs. METHODS: Meta-analysis was conducted after a systematic search of Medline, Embase, the Cochrane Collaboration Central Register of Controlled Clinical Trials, CINAHL, and ISI Web of Science, and manual examination of references in selected articles and conference abstracts of key orthopedic journals. Methodological quality and abstracted relevant data were evaluated. In addition to analysis of bone mineral density (BMD), we also conducted systematic analysis of clinically relevant outcomes and bone biochemical markers. RESULTS: Seventeen trials involving a total of 781 patients were assessed. Significantly less periprosthetic bone loss occurred in the BP-treated group than in the control group at 6 and 12 months (p < 0.0001). This protective effect was not noted at 3 months (p = 0.11) nor from 24-72 months (p = 0.14). The efficacy of BPs in the gender balance, shorter duration, and the non-nitrogenous BPs groups was no different from that for controls. Biochemical bone markers were suppressed in the BPs group. However, clinically relevant outcomes in the BPs group and controls were similar at all times. CONCLUSIONS: The overall moderate-quality evidence from the RCTs confirmed the significant mid-term efficacy of BPs on periprosthetic bone loss after joint arthroplasty. Long-term efficacy of BPs was not observed, and the therapy was of more benefit to women, especially postmenopausal women. To achieve better efficacy, nitrogenous BPs and long duration of treatment may be recommended.

[The changes of chest imaging and clinical features in patients with severe infection of new influenza A (H1N1)].

OBJECTIVE: To study the clinical features and the pulmonary imaging changes of severe cases of new influenza A (H1N1). METHODS: This study included 10 severe cases with new influenza A (H1N1) infection in the Forth People's Hospital of Taiyuan from 20 Oct. 2009 to 22 Nov 2009.Six patients were males and 4 were females, with an average age of 19.3 years (range 5 - 41 years). The laboratory study included blood routine, blood gas analysis, liver and renal function tests, myocardium enzymology, chest radiograph and CT. RESULTS: The prominent clinical features included fever, cough and dyspnea. The pulmonary imaging changes were varied, including ground-glass opacity, consolidation, atelectasis, fluid pneumothorax and pleural effusion, and manifestations of acute pneumonia and interstitial pneumonia simultaneously. Extensive pulmonary infiltration developed quickly, and acute lung injury (ALI) occurred in 5 patients and acute respiratory distress syndrome (ARDS) in 3 cases. Oseltamivir, oxygen therapy and antibiotic therapy were effective for improvement of the disease and final recovery of all these patients. CONCLUSIONS: The severe cases of new influenza A (H1N1) infection has imaging manifestations of acute pneumonia and interstitial pneumonia. The disease progresses quickly and may lead to ALI/ARDS.