Asymptotic profile of endemic equilibrium to a diffusive epidemic model with saturated incidence rate.

We study the existence and asymptotic profile of endemic equilibrium (EE) of a diffusive SIS epidemic model with saturated incidence rate. By introducing the basic reproduction number R0, the existence of EE is established when R0 > 1. The effects of diffusion rates and the saturated coefficient on asymptotic profile of EE are investigated. Our results indicate that when the diffusion rate of susceptible individuals is small and the total population N is below a certain level, or the saturated coefficient is large, the infected population dies out, while the two populations persist if at least one of the diffusion rates of the susceptible and infected individuals is large. Finally, we illustrate the influences of the population diffusion and the saturation coefficient on this model numerically.

Long non-coding RNA THRIL predicts increased acute respiratory distress syndrome risk and positively correlates with disease severity, inflammation, and mortality in sepsis patients.

BACKGROUND: This present study aimed to investigate the correlation of long non-coding RNA THRIL (lnc-THRIL) with acute respiratory distress syndrome (ARDS) risk, disease severity, inflammation, and mortality in sepsis patients. METHODS: A total of 109 sepsis patients admitted to intensive care units were consecutively recruited, and their blood samples were collected. After admission, patients were supervised and screened daily to identify the occurrence of ARDS. Clinical characteristics, routine laboratory testing, and disease severity were recorded, and all enrolled patients were followed up until death in the hospital or discharge for mortality records. Lnc-THRIL was detected by quantitative polymerase chain reaction, and inflammatory cytokine levels were measured by human enzyme-linked immunoassay. RESULTS: A total of 32 (29.4%) sepsis patients occurred ARDS and 77 (71.6%) did not. Lnc-THRIL was upregulated in ARDS group compared with non-ARDS group, and it had good value in distinguishing ARDS from non-ARDS in sepsis patients (AUC: 0.706; 95%CI: 0.602-0.809). Besides, lnc-THRIL, smoke, and chronic obstructive pulmonary disease independently predicted increased risk of ARDS. As for disease severity, lnc-THRIL positively correlated with APACHE II score and SOFA score in sepsis patients. Regarding inflammation, lnc-THRIL was positively associated with CRP, PCT, TNF-α, and IL-1ß levels in sepsis patients. Additionally, the mortality rate was 30.2%, and lnc-THRIL was upregulated in non-survivors compared with survivors, presenting a good value (AUC: 0.780; 95%CI: 0.683-0.876) in predicting mortality in sepsis patients. CONCLUSION: Lnc-THRIL predicts increased risk of ARDS and positively correlates with disease severity, inflammation, and mortality in sepsis patients.

Coexistence and bistability of a competition model in open advective environments.

The community composition in open advective environments, where individuals are exposed to unidirectional flow, is formed by the complex interplays of hydrological and biological factors. We investigate the coexistence mechanism of species by a reaction-diffusion-advection competition model proposed by Lutscher et al. in [19]. It turns out that the locations of two critical curves, which separate the stable region of the semi-trivial solutions from the unstable one, determines whether coexistence or bistability happens. Furthermore, the analytical and numerical results suggest a tradeoff driven coexistence mechanism. More precisely, there is a tradeoff between the dispersal strategy and growth competence which allows the transition of competition outcomes, including competition exclusion, coexistence and bistability. This shifting may have an effect on the community composition in aquatic habitat.

Long-term prognosis of patients with acute non-ST-segment elevation myocardial infarction undergoing different treatment strategies.

BACKGROUND: In cardiology, it is controversial whether different therapy strategies influence prognosis after acute coronary syndrome. We examined and compared the long-term outcomes of invasive and conservative strategies in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and characterized the patients selected for an invasive approach. METHODS: A total of 976 patients with acute NSTEMI were collected from December 2006 to October 2012 in the First Affiliated Hospital of Dalian Medical University Hospital. They are divided into conservative strategy (586 patients) and invasive strategy (390 patients) group. Unified follow-up questionnaire was performed by telephone contact (cut-off date was November, 2013). The long-term clinical events were analyzed and related to the different treatment strategies. RESULTS: The median follow-up time was 29 months. Mortality was 28.7% (n = 168) in the conservative group and 2.1% (n = 8) in the invasive management at long-term clinical follow-up. The secondary endpoint (the composite endpoint) was 59.0% (n = 346) in the conservative group and 30.3% (n = 118) in the invasive management. Multivariate analysis showed that patients in the conservative group had higher all-cause mortality rates than those who had the invasive management (adjusted risk ratio [RR] = 7.795; 95% confidence interval [CI]: 3.796-16.006, P < 0.001), and the similar result was also seen in the secondary endpoint (adjusted RR = 2.102; 95% CI: 1.694-2.610, P < 0.001). In the subgroup analysis according to each Thrombolysis in Myocardial Infarction risk score (TRS), log-rank analysis showed lower mortality and secondary endpoint rates in the invasive group with the intermediate and high-risk patients (TRS 3-7). CONCLUSIONS: An invasive strategy could improve long-term outcomes for NSTEMI patients, especially for intermediate and high-risk ones (TRS 3-7).

A meta-analysis of the clinical remission rate and long-term efficacy of tonsillectomy in patients with IgA nephropathy.

BACKGROUND: We wished to evaluate the clinical remission rate and long-term efficacy of tonsillectomy for patients with IgA nephropathy. METHODS: We searched a number of databases, including PubMed, CNKI, Wanfang and others, for clinical case-control studies of tonsillectomy in patients with IgA nephropathy. We then performed a meta-analysis of these studies. After evaluating total clinical remission rates, we compared the remission rates for specific treatments: tonsillectomy plus steroid pulse, tonsillectomy plus normal-dose steroid, and general treatment using neither tonsillectomy nor steroids. We also compared the rates of end-stage renal failure (ESRF) at last follow-up to estimate the long-term renal survival rate associated with each treatment. RESULTS: Seven retrospective studies met the inclusion criteria and were included. These included a total of 858 patients, in which 534 underwent tonsillectomy and 324 did not. The total clinical remission rate was higher in the operative group, while the ESRF rate was higher in the non-operative group. The clinical remission rate in patients who underwent tonsillectomy remained higher than in the non-operative group at both 5- and 10-year follow-up. The clinical remission rate in patients who underwent tonsillectomy plus steroid pulse was higher than in those treated with steroid pulse alone, normal-dose steroids or general treatment alone (P < 0.05). However, the clinical remission rate of simple tonsillectomy was not higher than that of general treatment (P > 0.05). CONCLUSIONS: Whereas neither tonsillectomy nor steroid treatment alone increased remission rates in patients with IgA nephropathy, tonsillectomy combined with either normal steroid or steroid pulse treatment resulted in higher remission rates with favourable long-term efficacy.