RESUMO
Hepatitis B vaccination is the most economical and effective way to prevent HBV infection. The advances in molecular biology and genetic engineering have continuously improved the manufacturing process of vaccines, and hepatitis B vaccine has gradually developed from the initial plasma-derived vaccine to the currently used recombinant vaccine. Preventive hepatitis B vaccine has been clinically tested in patients with HBsAg seroclearance to increase the level of anti-HBs, with certain safety and efficacy. As one of the multiple targets for new drugs in the treatment of chronic hepatitis B, a therapeutic hepatitis B vaccine based on HBsAg is already in the stages of research and development and clinical trial.
RESUMO
Objective:To analyse the clinical characteristics and antiviral therapy in immunosuppressed hospitalized patients with influenza.Methods:The clinical data of 273 patients with positive influenza A or B virus nucleic acid admitted in Peking University People’s Hospital from November 2015 to March 2022 were retrospectively analyzed. Among them, 123 were immunosuppressed and 150 were non-immunosuppressed. The clinical characteristics and antiviral therapy in immunosuppressed patients with influenza were analyzed. SPSS 22.0 software was used to analyze the data.Results:Chemotherapy for malignancies was the most common cause of immunosuppression (61.8%, 76/123), followed by haemopoietic stem cell transplantation (24.4%, 30/123). The common symptoms were fever (93.5%, 115/123) and cough (41.5%, 51/123). The proportions of co-infections (22.8%, 28/123) and complications (43.9%, 54/123) in immunosuppressed hospitalized patients were higher than those in non-immunosuppressed patients ( χ2=9.365 and 7.496, both P<0.01). Compared with single drug therapy, combination of antiviral drugs did not shorten the fever time, negative conversion time of virus nucleic acid and the length of hospital stay, and reduce the death ( U/ χ2=312.5, 356.0, 749.5 and 0.185, all P>0.05). Compared to patients without corticosteroids use, the use of corticosteroids did not increase mortality in immunosuppressed patients ( χ2=2.508, P=0.113). Conclusions:Classical symptoms may be absent in immunosuppressed patients with influenza, and early detection of influenza virus is still an important means of early diagnosis. Co-infections and complications are more common in immunosuppressed influenza patients. Immunosuppressed influenza patients did not benefit from the combination of antiviral therapy.
RESUMO
@#Objective To investigate the relationship between miR-3187-5p in peripheral blood and pericardial drainage after coronary artery bypass grafting (CABG) and postoperative atrial fibrillation (POAF). Methods Patients who underwent CABG in the Heart Center of Beijing Chao-Yang Hospital from March to May 2022 were enrolled. Peripheral blood and pericardial drainage were collected at 0 h after surgery (immediate time for patients to return to ICU from operating room) to detect miR-3187-5p, and perioperative confounding factors were also collected. The miR-3187-5p was measured by quantitative real-time PCR and its regulated target genes were analyzed by bioinformatics. Results A total of 15 patients were enrolled, including 9 males and 6 females with an average age of 65.6±8.2 years. The incidence rate of POAF was 40.0%. miR-3187-5p in pericardial drainage at 0 h after surgery was an independent predictor for POAF. A total of 1 642 target genes of miR-3187-5p were predicted. GO function enrichment analysis and KEGG signal pathway enrichment analysis showed that target genes of miR-3187-5p were enriched in TGF-β, MAPK, Wnt and other classical collagen metabolic signal pathways, which might activate collagen metabolism by negatively regulating SMAD6 and other inhibitors of the pathways. Conclusion This study is the first to find that miR-3187-5p in pericardial drainage at 0 h after surgery is a potential, novel, and predictive factor for POAF, which may be related to the regulation of myocardial fibrosis signal pathways like TGF-β, MAPK and Wnt pathways, promoting the early collagen metabolism imbalance after CABG, increasing the collagen deposition in the atrium, and then promoting the early structural reconstruction after CABG and leading to the occurrence of POAF. The result provides a research basis for the accurate prediction and prevention of clinical POAF.
RESUMO
ABSTRACT Introduction: Badminton is a sport that demands quick decision-making and abrupt changes of direction, demanding high performance in the explosive strength of the players' lower limbs. It is believed that the exercise of resistance in the players' lower limbs may reflect a better performance on the court. Objective: Study the lower limbs resistance exercise effects on badminton players' performance. Methods: 24 active badminton players were selected and randomly divided into control and experimental groups. While the control group continued the practice of existing training methods, the experimental group included lower limb strength exercise, with increased lower limb resistance with an elastic band completing the lower limb resistance exercise. Results: Before the experiment, the execution time of four points at the center of gravity was 16.83 ± 0.75 s in the experimental group and 17.15 ± 0.62 s in the control group, resulting in 15.40 ± 0.21s in the experimental group and 15.82 ± 0. 48s in the control group. The hurdle test period also changed from 10.21 ± 0.65s to 10.02 ± 0.62s in the experimental group, and from 10.82 ± 0.29s to 10.46 ± 0.32s in the control group. Conclusion: The addition of lower-limb resistance training to the daily training of badminton players can effectively improve the training efficiency and fitness of its players. Level of evidence II; Therapeutic studies - Investigation of treatment outcomes.
RESUMO Introdução: O badminton é um esporte que exige uma rápida tomada de decisão e mudanças bruscas de direção, demandando alto desempenho na força explosiva dos membros inferiores dos praticantes. Acredita-se que o exercício de resistência nos membros inferiores dos jogadores possa refletir uma melhor performance em quadra. Objetivo: Estudar os efeitos do exercício de resistência de membros inferiores sobre o desempenho dos praticantes de badminton. Métodos: Foram selecionados 24 praticantes ativos de badminton, divididos aleatoriamente em grupo controle e experimental. Enquanto o grupo controle continuou a prática dos métodos existentes de treinamento, ao grupo experimental foi incluído o exercício de força dos membros inferiores, com aumento da resistência dos membros inferiores com uma faixa elástica completando o exercício de resistência dos membros inferiores. Resultados: Antes do experimento, o tempo de execução de quatro pontos no centro de gravidade foi de 16.83 ± 0.75 s no grupo experimental e 17,15 ± 0,62 s no grupo de controle, resultando em 15,40 ± 0,21s no grupo experimental e 15,82 ± 0,48s no grupo controle. O período do teste de salto em obstáculos também sofreu alterações de 10,21 ± 0,65s para 10,02 ± 0,62 s no grupo experimental, e de 10,82 ± 0,29 s para 10,46 ± 0,32 s no grupo controle. Conclusão: A adição do treinamento de resistência para os membros inferiores no treinamento diário dos praticantes de badminton pode efetivamente melhorar a eficiência do treinamento e a aptidão física de seus jogadores. Nível de evidência II; Estudos terapêuticos - Investigação dos resultados de tratamento.
RESUMEN Introducción: El bádminton es un deporte que exige rapidez en la toma de decisiones y cambios bruscos de dirección, demandando un alto rendimiento en la fuerza explosiva de los miembros inferiores de los practicantes. Se cree que el ejercicio de resistencia en los miembros inferiores de los jugadores puede reflejar un mejor desempeño en la cancha. Objetivo: Estudiar los efectos del ejercicio de resistencia de los miembros inferiores en el rendimiento de los jugadores de bádminton. Métodos: Se seleccionaron 24 practicantes activos de bádminton y se dividieron aleatoriamente en grupo de control y grupo experimental. Mientras que el grupo de control continuó con la práctica de los métodos de entrenamiento existentes, al grupo experimental se le incluyó ejercicio de resistencia de miembros inferiores, con aumento de la resistencia de miembros inferiores con una banda elástica completando el ejercicio de resistencia de miembros inferiores. Resultados: Antes del experimento, el tiempo de ejecución de cuatro puntos en el centro de gravedad fue de 16,83 ± 0,75 s en el grupo experimental y de 17,15 ± 0,62 s en el grupo control, resultando de 15,40 ± 0,21s en el grupo experimental y de 15,82 ± 0. 48s en el grupo control. El período de la prueba de vallas también cambió de 10,21 ± 0,65 s a 10,02 ± 0,62 s en el grupo experimental, y de 10,82 ± 0,29 s a 10,46 ± 0,32 s en el grupo de control. Conclusión: La adición del entrenamiento de resistencia de las extremidades inferiores al entrenamiento diario de los jugadores de bádminton puede mejorar eficazmente la eficacia del entrenamiento y la forma física de sus jugadores. Nivel de evidencia II; Estudios terapéuticos - Investigación de los resultados del tratamiento.
RESUMO
Web-based survey data collection has become increasingly popular, and limitations on in-person data collection during the COVID-19 pandemic have fueled this growth. However, the anonymity of the online environment increases the risk of fraud, which pose major risks to data integrity. As part of a study of COVID-19 and the return to in-person school, we implemented a web-based survey of parents in Maryland, USA, between December 2021 and July 2022. Recruitment relied, in part, on social media advertisements. Despite implementing many existing best practices, the survey was challenged by sophisticated fraudsters. In this paper, we describe efforts to identify and prevent fraudulent online survey responses and provide specific, actionable recommendations for identifying and preventing online survey fraud. Some strategies can be deployed within the web-based data collection platform such as Internet Protocol address logging to identify duplicate responses and comparison of client-side and server-side time stamps to identify responses that may have been completed by respondents outside of the surveys target geography. Additional approaches include the use of a 2-stage survey design, repeated within-survey and cross-survey validation questions, the addition of "speed bump" questions to thwart careless or computerized responders, and the use of optional open-ended survey responses to identify irrelevant responses. We describe best practices for ongoing survey data review and verification, including algorithms to simplify aspects of this review.
RESUMO
@#Objective To investigate the changes of fibrinogen and classical markers of collagen metabolism [carboxy-terminal propeptide of type Ⅰ procollagen (PICP) and carboxy-terminal cross-linked peptide of type Ⅰ collagen (ICTP)] in peripheral blood and pericardial drainage after coronary artery bypass grafting (CABG) and/or heart valve replacement (VR), and to evaluate their relationship with postoperative atrial fibrillation (POAF) after cardiac surgery. Methods Patients who underwent CABG and/or VR in the Heart Center of Beijing Chao-Yang Hospital from March to June 2021 were included. Peripheral blood and pericardial drainage fluid samples were collected before surgery and at 0 h, 6 h, 24 h and 48 h after surgery to detect PICP, ICTP and fibrinogen levels, and preoperative, intraoperative and postoperative confounding factors were also collected. PICP, ICTP and fibrinogen levels were measured by enzyme-linked immunosorbent assay (ELISA). Results A total of 26 patients with 125 blood samples and 78 drainage samples were collected. There were 18 males and 8 females with an average age of 64.04±7.27 years. The incidence rate of POAF was 34.6%. Among the factors, the fibrinogen level in pericardial drainage showed two peaks within 48 h after operation (0 h and 24 h after operation) in the POAF group, while it showed a continuous downward trend in the sinus rhythm (SR) group, and the change trend of fibrinogen in pericardial drainage was significantly different over time between the two groups (P=0.022). Fibrinogen in blood, PICP and ICTP in blood and drainage showed an overall decreasing trend, and their trends over time were not significantly different between the two groups of patients (P>0.05). Univariate analysis showed that fibrinogen at 24 h and 48 h after pericardial drainage, fibrinogen in preoperative blood, PICP immediately after surgery and right atrial long axis diameter were significantly higher or longer in the POAF group than those in the SR group. Multiple regression showed that fibrinogen≥11.47 ng/mL in pericardial drainage 24 h after surgery (OR=14.911, 95%CI 1.371-162.122, P=0.026), right atrial long axis diameter≥46 mm (OR=10.801, 95%CI 1.011-115.391, P=0.049) were independent predictors of POAF. Conclusion This study finds the regularity of changes in fibrinogen and collagen metabolic markers after CABG and/or VR surgery, and to find that fibrinogen in pericardial drainage 24 h after surgery is a potential novel and predictive factor for POAF. The results provide a new idea for exploring the mechanism of POAF, and provide a research basis for the accurate prediction and prevention of clinical POAF.
RESUMO
At present, antiviral therapy for chronic hepatitis B (CHB) has a low clinical cure rate and hardly remove cccDNA. With the progress of medical science, more and more new drugs are in the stage of research and development. This article focuses on the research and development of representative drugs with relatively detailed clinical trial data. Rapid progress has been made in the new drugs such as small-interfering RNA and core protein allosteric modulators in recent years. The results of clinical trials show that it still takes some time for new drugs to enter clinical use, and multi-drug combination therapy may become the trend of treatment in the future.
RESUMO
@#Objective To evaluate the relationship between four classic inflammatory biomarkers, including C-reactive protein (CRP), white blood cell (WBC), IL (interleukin family), tumor necrosis factor-α (TNF-α), and postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) and valve replacement (VR) surgeries. Methods We searched PubMed, EMBase, the Cochrane Library, Ovid, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, VIP database and WanFang database from the inception to April 2020. Studies on the relationship between POAF and the above four inflammatory biomarkers were analyzed. Two researchers independently reviewed the literature, extracted data and evaluated the quality of the literature. RevMan 5.3 software was used for meta-analysis. Results A total of 47 articles were included, covering 10 711 patients. The levels of preoperative CRP (SMD=0.38, 95%CI 0.14-0.62, Z=3.12, P=0.002) and postoperative CRP (SMD=0.40, 95%CI 0.06-0.74, Z=2.33, P=0.02), IL-6 (SMD=1.34, 95%CI 0.98-1.70, Z=7.26, P<0.001) and TNF-α (SMD=−0.33, 95%CI −0.65-−0.01, Z=2.02, P=0.040) were related to POAF, while preoperative IL-8 (SMD=−0.05, 95%CI −0.28-0.18, Z=0.42, P=0.68) and TNF-α (SMD=−0.43, 95%CI −1.22-0.36, Z=1.07, P=0.28), postoperative WBC (WMD=1.16, 95%CI −0.09-2.42, Z=1.82, P=0.07) and IL-10 (SMD=0.21, 95%CI −0.35-0.77, Z=0.73, P=0.46) were not related to POAF. The relationships between preoperative WBC and IL-10, postoperative IL-8 and POAF were inclusive, which needed further verification. Furthermore, the relationship between postoperative CRP and POAF were not consistent, as they were not significantly correlated in sub-group analysis. Conclusion The inflammatory substrate before the surgery and inflammatory reaction induced by the operation is related to the occurrence and maintenance of POAF. Compared with preoperative inflammatory status, postoperative inflammatory factors may have a greater predictive value for POAF. Preoperative CRP, postoperative IL-6 and TNF-α levels are reliable biomarkers of POAF.
RESUMO
Background:China's accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts.This study reported the detailed development and evaluation of an international consulting training for global health workforce.Methods:Based on Kirkpatrick's model,a mixed-methods approach was used to evaluate the effectiveness of the training.Quantitative and qualitative data on participants' reaction,learning,and application of the learned knowledge and skills were collected by a training evaluation survey at the ending of training and a follow-up interview in three months after the training.Results:Thirty-six participants attended the training and 34 of them completed quantitative investigation.The training satisfaction evaluations were positive,for which participants rated the training program highly and over 90% of them agreed with the usefulness of the training.About knowledge and skills change,participants showed improved consulting knowledge and skills from pre-to post-training (P < 0.001).A total of 23 participants accepted follow-up interview,and most participants applied knowledge and skills learned from the training in their daily work or study.However,only 30.4% of participants applied their learning in the consulting program.The largest barrier of application was the lack of consulting opportunities.In addition,almost all the participants reported that they would be glad to attend more training courses in the future.Conclusion:The international consulting training program was well-received,and was feasible to improve the consulting service competence of global health professionals.According to participants' feedback,it is essential to develop and expand consulting training in the field of global health.
RESUMO
<p><b>OBJECTIVE</b>To investigate the correlation of serum osteoprotegerin (OPG) with the progression of nonalcoholic fatty liver disease (NAFLD) and the noninvasive prediction and diagnosis of nonalcoholic steatohepatitis (NASH).</p><p><b>METHODS</b>A total of 136 patients with NAFLD were enrolled, and their tissue samples for liver biopsy and serum samples obtained at 1 week after liver biopsy were collected; 83 healthy subjects without the symptoms of fatty liver disease proved by ultrasound examination were enrolled as controls. The physiological indicators including height, body weight, and waist circumference were measured, and body mass index was calculated. The biochemical parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST/ALT, alkaline phosphatase, gamma-glutamyl transferase, total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were measured. Double-antibody sandwich enzyme-linked immunosorbent assay was used to determine the serum level of OPG. The rank sum test, chi-square test, t-test, one-way analysis of variance, Spearman correlation analysis, least significant difference test, and receiver operating characteristic (ROC) curve were applied for statistical analysis of various data.</p><p><b>RESULTS</b>Serum OPG level was correlated with AST and TG (P < 0.05), and was highly correlated with hepatocyte fatty degeneration, ballooning degeneration, intralobular inflammation, portal inflammation, and fibrosis degree (P < 0.01). With the increasing NAFLD activity score (NAS), serum OPG level decreased, and there was a highly negative correlation between them (r = -0.928, P < 0.01). Serum OPG level was significantly lower in NASH patients than non-NASH patients. The area under the ROC curve of serum OPG level was 0.963, and according to the Youden index, its optimal sensitivity and specificity were 96.1% and 97.4%, respectively, at an optimal cut-off value of 242.96 ng/L, which suggested a high diagnostic power.</p><p><b>CONCLUSION</b>In NASH patients, serum OPG level decreases significantly. Serum OPG level can be used as an independent predictive factor to evaluate NASH and its severity, as well as a noninvasive diagnostic index for NASH.</p>
Assuntos
Humanos , Alanina Transaminase , Sangue , Fosfatase Alcalina , Sangue , Aspartato Aminotransferases , Sangue , Biópsia , Índice de Massa Corporal , Estudos de Casos e Controles , Colesterol , Sangue , Progressão da Doença , Ensaio de Imunoadsorção Enzimática , Fibrose , Inflamação , Patologia , Fígado , Patologia , Hepatopatia Gordurosa não Alcoólica , Sangue , Diagnóstico , Osteoprotegerina , Sangue , Curva ROC , Triglicerídeos , Sangue , gama-Glutamiltransferase , SangueRESUMO
Objective To investigate the current status of self-management action of patients with chronic kidney disease (CKD) during early-mid stage and its influencing factors. Methods 80 patients were recruited in a tertiary hospital in Beijing from March to June 2011.They were surveyed with a self-designed self-management action questionnaire of patients with CKD. Results The total score of self-management action in patients with CKD was(69.10±5.63 ).1.25% patients with CKD had bad self-management ability and 88.75% patients had moderate self-management ability,only 10.00% patients had good self-management ability.Patients of younger age,with higher education level,ever attending lectures or having inpatient experience had better self-management ability.And the methods of payment also had significant influence on the self-management of patients with CKD. Conclusions When taking care of patients with CKD,health care providers should be more individual case-based,especially paying more attention to those who are older,with low education degree,never have attended health education lectures and do not have inpatient experience,in order to increase patients' self-management ability and help them improve their health status.