Efficacy of emergency cervical cerclage in twin pregnancies and factors affecting the clinical effects of emergency cerclage.

OBJECTIVES: To estimate clinical effects of emergency cervical cerclage in twin pregnancies with cervical dilation ≥1.0 cm in mid-trimester of gestation and to identify risk factors after cerclage. METHODS: This retrospective cohort study included 99 twin pregnancies with cervical dilation ≥1cm in the mid-trimester of gestation at three institutions, from December 2015 through December 2021. The cases were treated with emergency cervical cerclage (52 cases) or expectant management (47 cases). Compare the pregnancy and neonatal outcomes of the two groups. Multiple logistic regression analysis was used to determine the independent risk factors associated with cerclage. RESULTS: Cerclage placement was associated with significantly longer gestation age and prolongation of the gestational latency (p < .05). In the cases, compared to expectant treatments, spontaneous preterm birth (sPTB) at <26, <28, <30, <32 weeks was significantly less frequent (p < .05). Pre-operation WBC > 11.55 × 109/L, CRP > 10.1 and cervical dilation >3.5 cm were found to be independent risk factors for delivery 28 weeks after cerclage. CONCLUSIONS: Cervical cerclage in twin pregnancies with cervical dilation ≥1.0 cm in mid-trimester of gestation may prolong pregnancy and gestation age, and improve pregnancy and neonatal outcomes compared with expectant management. The strongest predictor of sPTB before 28 weeks after ECC were pre-operation WBC >11.55 × 109/L, CRP > 10.1 and cervical dilation >3.5 cm.

Quantitative benefit and risk assessment of arsenic and nutrient levels in cooked and raw chinese mitten crab (Eriocheir sinensis) using an in vitro digestion model.

The safety and quality of aquatic foods are a public concern due to their content of pollutants, such as arsenic. A formula is derived for quantifying the benefit-risk ratio (HQ) of the essential polyunsaturated fatty acids vs. arsenic in Chinses mitten crabs. Among these arsenic species, the proportion of inorganic arsenic, which is extremely harmful to the human body, is<5%, and its level does not exceed the national standard limit. Meanwhile, comparing with the HQ from the original method, the HQs from groups 0 min, 5 min, 15 min are significantly higher(p < 0.05). This suggests the original assessment method could underestimate the risk of eating crabs. Eating steamed crabs is easier to digest essential fatty acids (EFAs) than eating raw crabs, and it also protects consumers against arsenic exposure. To achieve a good balance of dietary benefits and risks, the steaming duration of the crabs should exceed 30 min.

Intervention effect of logotherapy on anxiety and depression in patients with chronic glomerulonephritis / 中国实用护理杂志

Objective:To observe and analyze the intervention effect of logotherapy on anxiety and depression in patients with chronic glomerulonephritis (CGN).Methods:Selected 102 CGN patients from March 2019 to May 2020 in Beijing Tiantan Hospital Affiliated to Capital Medical University as the research objects, the general information of the patients was collected, and the patients were randomly divided into the observation group and the control group with 51 cases in each group. The control group was given routine nursing intervention for CGN patients, and the observation group was given logotherapy therapy intervention based on the intervention of the control group. The differences in the scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) between the two groups before and after 3 months of intervention.Results:There were no significant differences in SAS and SDS scores before and after intervention in the control group ( P>0.05). The SAS and SDS scores in the observation group after 3 months of intervention were (40.67 ± 4.17), (48.74 ± 5.01) points, which were significantly lower than (51.34 ± 5.04), (55.19 ± 5.49) points in the control group ( t=8.37, 3.32, both P<0.01). Conclusions:The positive psychological intervention of patients with logotherapy can effectively improve the anxiety and depression of patients with CGN.

COVID-19 Recurrent Varies with Different Combinatorial Medical Treatments Determined by Machine Learning Approaches

Various medical treatments for COVID-19 are attempted. After patients are discharged, SARS-CoV-2 recurring cases are reported and the recurrence could profoundly impact patient healthcare and social economics. To date, no data on the effects of medical treatments on recurrence has been published. We analyzed the treatment data of combinations of ten different drugs for the recurring cases in a single medical center, Shenzhen, China. A total of 417 patients were considered and 414 of them were included in this study (3 deaths) with mild-to-critical COVID-19. Patients were treated by 10 different drug combinations and followed up for recurrence for 28 days quarantine after being discharged from the medical center between February and May, 2020. We applied the Synthetic Minority Oversampling Technique (SMOTE) to overcome the rare recurring events in certain age groups and performed Virtual Twins (VT) analysis facilitated by random forest regression for medical treatment-recurrence classification. Among those drug combinations, Methylprednisolone/Interferon/Lopinavir/Ritonavir/Arbidol led to the lowest recurring rate (0.133) as compared to the average recurring rate (0.203). For the younger group (age 20-27) or the older group (age 60-70), the optimal drug combinations are different, but the above combination is still the second best. For obese patients, the combination of Ribavirin/Interferon/Lopinavir/Ritonavir/Arbidol led to the lowest recurring rate for age group of 20-50, whereas the combination of Interferon/Lopinavir/Ritonavir/Arbidol led to lowest recurring rate for age group of 50-70. The insights into combinatorial therapy we provided here shed lights on the use of a combination of (biological and chemical) anti-virus therapy and/or anti-cytokine storm as a potentially effective therapeutic treatment for COVID-19.

Recurrence of SARS-CoV-2 PCR positivity in COVID-19 patients: a single center experience and potential implications

IMPORTANCEHow to appropriately care for patients who become PCR-negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still not known. Patients who have recovered from coronavirus disease 2019 (COVID-19) could profoundly impact the health care system if a subset were to be PCR-positive again with reactivated SARS-CoV-2. OBJECTIVETo characterize a single center COVID-19 cohort with and without recurrence of PCR positivity, and develop an algorithm to identify patients at high risk of retest positivity after discharge to inform health care policy and case management decision-making. DESIGN, SETTING, AND PARTICIPANTSA cohort of 414 patients with confirmed SARS-CoV-2 infection, at The Second Affiliated Hospital of Southern University of Science and Technology in Shenzhen, China from January 11 to April 23, 2020. EXPOSURESPolymerase chain reaction (PCR) and IgM-IgG antibody confirmed SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURESUnivariable and multivariable statistical analysis of the clinical, laboratory, radiologic image, medical treatment, and clinical course of admission/quarantine/readmission data to develop an algorithm to predict patients at risk of recurrence of PCR positivity. RESULTS16.7% (95CI: 13.0%-20.3%) patients retest PCR positive 1 to 3 times after discharge, despite being in strict quarantine. The driving factors in the recurrence prediction model included: age, BMI; lowest levels of the blood laboratory tests during hospitalization for cholinesterase, fibrinogen, albumin, prealbumin, calcium, eGFR, creatinine; highest levels of the blood laboratory tests during hospitalization for total bilirubin, lactate dehydrogenase, alkaline phosphatase; the first test results during hospitalization for partial pressure of oxygen, white blood cell and lymphocyte counts, blood procalcitonin; and the first test episodic Ct value and the lowest Ct value of the nasopharyngeal swab RT PCR results. Area under the ROC curve is 0.786. CONCLUSIONS AND RELEVANCEThis case series provides clinical characteristics of COVID-19 patients with recurrent PCR positivity, despite strict quarantine, at a 16.7% rate. Use of a recurrence prediction algorithm may identify patients at high risk of PCR retest positivity of SARS-CoV-2 and help modify COVID-19 case management and health policy approaches. Key PointsO_ST_ABSQuestionC_ST_ABSWhat are the characteristics, clinical presentations, and outcomes of COVID-19 patients with PCR retest positivity after resolution of the initial infection and consecutive negative tests? Can we identify recovered patients, prior to discharge, at risk of the recurrence of SARS-CoV-2 PCR positivity? FindingsIn this series of 414 COVID-19 inpatients discharged to a designated quarantine center, 69 retest positive (13 with 2 readmissions, and 3 with 3 readmissions). A multivariable model was developed to predict the risk of the recurrence of SARS-CoV-2 PCR positivity. MeaningRate and timing of the recurrence of PCR positivity following strict quarantine were characterized. Our prediction algorithm may have implications for COVID-19 clinical treatment, patient management, and health policy.

Risk factors for postoperative nosocomial infections in the department of otorhinolaryngology / 中国感染与化疗杂志

Objective To analyze the risk factors for postoperative nosocomial infections in the department of otorhinolaryngology,and provide guidance on improving the quality of life for patients.Methods The clinical data of the patients tmdergoing surgical procedure in the department of otorhinolaryngology form January 2011 to December 2016 were reviewed to identify the potential risk factors of nosocomial infections.Chi-square test and multivariate logistic regression model were used for the analysis.Results A total of 152 (2.25％) cases of nosocomial infection were identified in 6 753 cases of surgical operation.Univariate analysis revealed that sex,age,length of stay,patient referral,class of surgical wounds,length of operation,and complications were related to postoperative nosocomial infections.The patients without nosocomial infection showed higher cure rate than those complicated with nosocomial infection (P＜0.05).Multivariate logistic regression analysis identified that male (OR=2.831,95％ CI:1.758-4.558),older (OR=5.833,95％ CI:4.491-7.577),patient referral (OR=1.790,95％ CI:1.008-3.178),higher class of surgical wound contamination (OR=34.866 for Class Ⅰ,OR=2 120.995 for Class Ⅱ,and OR=43 917.453 for Class Ⅲ wounds),and longer length of operation (OR=9.384,95％ CI:18.168-47.525) were the independent risk factors for postoperative nosocomial infections in the department of otorhinolaryngology.Conclusions Multiple risk factors are associated with postoperative nosocomial infections in the department of otorhinolaryngology.Integrated measures must be taken for prevention and control of nosocomial infections based on the specific conditions of the patient.

Recent Progress of DNAzyme-Nanomaterial Based Biosensors / 分析化学

DNAzymes, screened through in vitro selection, were artificial nucleic acids with catalytic function . They could cleave specific substrates in the presence of cofactors with unique characteristics, such as high catalytic activity, high specificity for cofactors, excellent stability, and easy to synthesize and modify. The combination of DNAzymes with nanomaterials could retain the DNAzyme activity and realize the functional integration of recognition and signal transduction, promoting rapid development of biosensors. In the current paper, we mainly reviewed the recent progress in DNAzyme-nanomaterial based biosensors, and the nanomaterials included gold nanoparticles, graphene, quantum dots, magnetic nanomaterials, and so on.

Genetic diagnosis and analysis of related genes for a pedigree with 2p25 and 12p13 cryptic rearrangements / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze chromosome aberration in a child with mental retardation and abnormalities and its parents.</p><p><b>METHODS</b>Chromosome G banding, multiplex ligation-dependent probe amplification, fluorescence in situ hybridization and single nucleotide polymorphisms array were employed for analysis.</p><p><b>RESULTS</b>Karyotype analysis revealed that the child was 46,XX and the father was 46,XY, while the mother was 46,XX, add (12)(p13). Subtelomeric region analysis with MLPA displayed that the child has reduced ACP1 gene copy number in 2p25 region and increased SLC6A12,KDM5A gene copy numbers in 12p11 region. SNP-array has fine mapped the duplication to 12p13.33-p12.3, a 15.142 Mb region, and a deletion to 2p25.3 for 3.194 Mb, which resulted in duplication of 9 genes including SLC6A12 as well as deletion of 11 genes including SNTG2, respectively. FISH analysis revealed that the child was 46,XX,ish,der(2),t(2;12)(p25;p13)mat, or partial monosomy 2p25 and partial trisomy 12p13. In addition,the mother was a carrier with cryptic balanced translocation chromosome, 46,XX,isht(2;12) (p25;p13). Mental abnormalities and retardation of the child may be attributed to heterozygous deletion of SNTG2, MYT1L genes and duplication of SLC6A12 gene.</p><p><b>CONCLUSION</b>Combined use of MLPA, FISH and SNP-array can facilitate accurate diagnosis of cryptic rearrangement at genomic level.</p>

Aplplication of quality control circle in the pass rate of PICC maintenance for discharged cancer children / 现代临床护理

Objective To explore the effect of quality control circle(QCC)on the maintenance of peripherally inserted central catheter(PICC)for discharged cancer children.Methods Ninety-seven discharged cancer children with PICC were nursed by QCC, including establishing activity theme,analyzing key factors,making objectives,and working out and manipulating coping strategy. This study also compared the pass rates of PICC maintenance before and after the implementation.Result The pass rate of PICC maintenance was increased from 44.4%before manipulation of PICC to 71.7%after its use(χ2=17.63,P<0.01).Conclusion By the application of QCC,the pass rate of PICC maintenance for discharged cancer children can be effectively raised and the teamwork spirits of nurses may be consolidated as well.

Impacts of screening programme on awareness of control and prevention of cervical cancer in women living in rural areas / 中华健康管理学杂志

Objective To explore the influence of screening programme on awareness of cervical cancer prevention among 30 to 59 years old women who live in rural areas of Beijing.Methods A face-to-face cross-sectional survey on women's knowledge on cervical cancer prevention was conducted in 2008 and 2009 among subjects recurited by three-stage stratified random sampling.ResultsUnivariate analysis showed that since the initiation of cervical cancer screening in Daxing District of Beijing,the overall awareness of cervical cancer was significantly increased among women residents,and the percentage of women with 5 or more correct answers was increased from 37.3％ to 51.0％ ( x2=62.06,P＜0.001).After adjusting confounding factors,multivariate analysis showedthat cervical cancer screening programme contributed to improved awareness of cervical cancer-related knowledge ( OR =1.853,95％ CI1.590 -2.159).In addition,current place of residence,education level,household income per-capita and screening history within 5 years were major factors affecting women's awareness of cervical cancer ( OR vales were 1.766,2.580,1.350 and1.676,respectively),and higher education level and personal income were correlated with increased awareness rate.ConclusionCervical cancer screening could improve general knowledge of cervical cancer,especially for those who have never participated in the screening programme.

Observation of the effect of multilevel anterior discectomy and fusion for aged patients with cervical spondylotic myelopathy / 中国基层医药

Objective To explore the efficacy of multilevel anterior cervical discectomy and fusion for aged patients with cervical spondylotic myelopathy. Methods 25 aged patients with cervical spondylotic myelopathy were treated by multilevel anterior cervical discectomy and fusion. Japanese Orthopedic Association (JOA) scores were evaluated,clinical results were graded from excellent to poor using Odoms criteria,and the sagittal alignment of fusion segements were measured using Cobb method. Bone fusion and complications was evaluated. Results The final follow up score according to Odoms criteria was excellent in 8 patients ,good in 14 patients,and fair in 3 patients ,with excellent and good rate of 88%. The JOA score at final follow up(7.8) was significantly higher than preoperative(12. 8),with average improvement rate of 54%. At final follow up,bone fusion rate was 100%. Conclusion Multilevel anterior discectomy and fusion for aged patients with cervical spondylotic myelopathy was effective.