Clinical characteristics and risk factors of diabetic foot ulcers with PAD.

OBJECTIVE: This study aimed to analyze the clinical characteristics of patients with diabetic foot ulcers combined with peripheral arterial disease (PAD) and the risk factors. PATIENTS AND METHODS: A retrospective study was conducted on 120 patients with diabetic foot ulcers in the Second Affiliated Hospital of Dalian Medical University from October 2018 to February 2021. The patients were divided into uncombined with the PAD group (42 cases) and combined with the PAD group (78 cases). The baseline information and clinical indicators were measured from two groups. Univariate and binary logistic regression was used to analyze the risk factors of PAD in patients with diabetic foot ulcers. RESULTS: The proportion of patients with age ≥ 60 years, Wagner grade 4-5 and smoking history in the combined group was higher than that in the uncombined group (p < 0.05). The diastolic blood pressure (DBP) of the combined group was lower than that of the uncombined group, while the C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and glycated hemoglobin (HbA1c) levels of the combined group were higher than those of the uncombined group (p < 0.05). Binary logistic regression analysis showed that age ≥ 60 years, high Wagner grade, smoking, elevated CRP, NLR and HbA1c levels were risk factors for patients with diabetic foot ulcer combined with PAD (OR > 1, p < 0.05). An elevated DBP level was the protective factor for PAD in patients with diabetic foot ulcer (OR < 1, p < 0.05). CONCLUSIONS: Patients with diabetic foot ulcer combined with PAD have the clinical characteristics of poor blood pressure control, long course of disease, and low ABI value. Age ≥ 60 years, high Wagner grade, smoking history, elevated CRP, NLR and HbA1c levels are the risk factors of PAD in patients with diabetic foot ulcer. Increased DBP is protective for PAD in patients with diabetic foot ulcer.

[Analysis of distribution characteristics of specific immunoglobulin E in 8 092 children with eczema and urticaria in a hospital of pediatric in Tianjin City].

To investigate the common specific immunoglobulin E(sIgE) in children with eczema and urticaria, compare the allergies in children with different diseases, genders and ages, and provide the scientific basis for the prevention, diagnosis and treatment. A retrospective study was conducted to analyze the children who were suspected of eczema and urticaria and tested for serum sIgE in the Tianjin Children's Hospital from December 2019 to August 2021. A total of 8 092 serum samples were tested for ten food allergens and ten inhaled allergens. The method was the enzyme-linked immune capture assay. The allergen epidemiological characteristics were statistically analyzed by Chi square test based on the children's characteristics and factors such as different sexes and ages and by the mass data. The results showed that the positive rate of eczema was 64.42%(5 213/8 092), and the urticaria was 35.58%(2 879/8 092). The positive rate of specific IgE was 66.65%(5 393/8 092), the food allergens was 61.74%(4 996/8 092), and the inhaled allergens was 34.85%(2 820/8 092). The top three positive rates of food allergens were egg 46.65%(3 775/8 092), milk 32.64%(2 641/8 092) and wheat flour 15.08%(1 220/8 092). The top three positive rates of inhaled allergens were house dust 21.40%(1 732/8 092), Alternaria 11.78%(953/8 092) and Dermatophagoides farinae 7.33%(593/8 092). The positivity of food allergens and inhaled allergens was significantly different in different age groups. The positive rates of food allergens in different age groups were 48.92%(947/1 936) in<1 year old, 72.28%(2 680/3 708) in 1-3 years old, 64.58%(919/1 423) in 4-6 years old and 43.90%(450/1 025) in>6 years old. The positive rates of inhaled allergens in different age groups were 17.67%(342/1 936) in<1 year old, 36.35%(1 348/3 708) in 1-3 years old, 46.38%(660/1 423) in 4-6 years old and 45.85%(470/1 025) in>6 years old. The top six positive rates of allergens of eczema were the same with urticaria, which were egg, milk, house dust, wheat flour, Alternaria and Dermatophagoides farinae. The allergens (greater than or equal to grade 4) differed in children with eczema and urticaria. Moreover, there were significant differences in the positive rates of Alternaria, egg, wheat flour, crab and shrimp. In conclusion, this study can reflect the epidemic characteristics of allergens in children with eczema and urticaria to a certain extent. There were significant differences in the positive rates of allergens between different age groups. It is necessary to reasonably avoid the high-risk allergens according to the epidemiological characteristics and clinical symptoms, which provide valuable information for the prevention, diagnosis and treatment of allergic diseases.

[Effect of goal-directed haemodynamic management on the postoperative outcome in elderly patients with fragile cardiac function undergoing abdominal surgery].

Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45). After anesthesia induction, in group G, the SVV and CI were monitored by Vigileo and according SVV (≤12%), CI (≥2.5 L·min-1·m-2) and MAP (maintain the base value of ±20%) to adjust the preloaded infusion fluid and give positive inotropic drugs and positive pressure drugs; in group E, fluid and vasoactive agent were used according to the experience of anesthesiologist.Multi-mode monitoring anesthesia management using BIS, TCI of propofol, low-tidal-volume lung protective ventilation management strategy, body temperature protection, and postoperative multimodal analgesia techniques was performed in the two groups.Values of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) were recorded before operation, at the end of operation, and postoperative 24 h. The incidence of myocardial infarction/angina, heart failure, arrhythmia and cerebral infarction, renal failure, length of hospitalization, and complications in 30-days after surgery were recorded by telephone follow-up. Results: Crystal, colloid, total liquid of group E were (1 110.20±332.00), (536.65±72.25), (1 677.20±424.44) ml and these of group G were (708.72±240.85), (414.41±74.31), (878.51±199.13) ml, respectively.Compared with group E, the fluid infusion were reduced in group G (t=6.057, 2.701, 9.742, all P<0.05). The lactic acid value of 24 hours after surgery in group G was significantly lower than that in group E [(0.89±0.31) mmol/L vs (1.11±0.43) mmol/L, t=-2.848, P<0.05]. Arterial partial pressure of oxygen at 24 hours after surgery in group G was higher than that in group E [(78.77±6.86) mmHg vs (76.46±10.96) mmHg, t=-1.108, P<0.05]. The length of hospitalization of group G was shorter than that of group E [(12.21±2.20) d vs (13.16±3.84) d, t=-1.341, P<0.05]. The incidence of total complication in hospital and in 30-days after surgery of group G were 10.26% and 5.13%, while these of group E were 29.73% and 24.32%, (χ2=4.545, 4.520, all P<0.05). ΔNT-proBNP1 (the base value of NT-proBNP's minus the value of NT-proBNP's at the end of the operation) and ΔNT-proBNP2 (the base value of NT-proBNP's minus the value of NT-proBNP's 24 hours postoperatively) of group G were 12.0(-291.0, 1 517.0) and 0(-6 770.0, 291.0), both higher than these of group E [0(-440.0, 200.0) and -12.0(-7 200, 22.0), (Z=-2.412, -2.163, all P<0.05)]. Conclusion: Goal-directed haemodynamic management based on SVV, CI and MAP could improve the outcome of the elderly patients with fragile heart function undergoing abdominal surgery.

Tumor vasculogenic mimicry predicts poor prognosis in cancer patients: a meta-analysis.

BACKGROUND: Vasculogenic mimicry (VM) is the formation of vascular channels by tumor cells or tumor cell-derived, trans-differentiated cells in highly aggressive, solid tumors. However, the disease features and prognostic value of VM for overall survival of cancer patients remain controversial. METHOD: To systematically investigate the roles of VM in cancer progression and its prognostic values, we performed a meta-analysis based on 36 studies (33 eligible articles) including 3609 patients. The pooled hazard ratios (HRs) with 95 % confidence intervals (95 % CIs) were used to assess the relationship between VM and overall survival in cancer patients. RESULTS: Vasculogenic mimicry was significantly associated with cancer differentiation, lymph node metastasis, distant metastasis, and TNM stage. The prognostic value of VM was significant in overall survival (HR 2.16; 95 % CI 1.98-2.38; P < 0.001). Analyses stratified by confounders, such as cancer type, ethnicity, VM detection methods, sample size, and Newcastle-Ottawa quality score, found similar significant results. CONCLUSIONS: The presence of VM predicts poorer survival outcomes in cancer patients.

Parity alternation of ground-state P(n)(-) and P(n)(+) (n = 3-15) phosphorus clusters.

The ground-state structures of neutral, cationic, and anionic phosphorus clusters P(n), P(n)(+), and P(n)(-) (n = 3-15) have been calculated using the B3LYP/6-311+G* density functional method. The P(n)(+) and P(n)(-) (n = 3-15) clusters with odd n were found to be more stable than those with even n, and we provide a satisfactory explanation for such trends based on concepts of energy difference, ionization potential, electron affinity, and incremental binding energy. The result of odd/even alternations is in good accord with the relative intensities of cationic and anionic phosphorus clusters observed in mass spectrometric studies.

[Zn8(SiO4)(C8H4O4)6]n: the firstborn of a metallosilicate-organic hybrid material family (C8H4O4 = isophthalate).

[Zn8(SiO4)(C8H4O4)6]n (C8H4O4 = isophthalate), synthesized by hydrothermal reaction, possesses a diamondoid framework structure constructed from hexahedron-like Zn8(SiO4) cores and C8H4O4 linkers and remains stable up to 500 degrees C in air, representing the first member of a new class of metallosilicate-organic hybrid materials.

Separation and identification of perchlorinated polycyclic aromatic hydrocarbons and fullerenes (C60, C70) by coupling high-performance liquid chromatography with ultraviolet absorption spectroscopy and atmospheric pressure chemical ionization mass spectrometry.

Simultaneous separation and identification of perchlorinated polycyclic aromatic hydrocarbons (PCPAHs) and fullerenes is of practical interest due to the growth mechanism of fullerenes involved with PCPAHs. Non-aqueous reversed-phase high-performance liquid chromatography (HPLC), with an ODS column and a gradient mobile phase of methanol-ethanol-cyclohexane mixtures, was combined with both rapid-scan ultraviolet spectrometry (UV) and atmospheric pressure chemical ionization mass spectrometry (APCI-MS) for the separation and identification of over 80 PCPAHs as well as fullerenes C60 and C70, that were synthesized in the discharge reaction of chloroform. PCPAH retention was found to depend on the number of aromatic rings and the degree of non-planarity of PCPAH structure. Based on the isotopic pattern of molecular ion or/and quasi-molecular ion peaks in corresponding mass spectra, molecular compositions of the PCPAH products were unambiguously determined. The results obtained from the HPLC-UV-MS analysis not only are helpful for the understanding of the fullerenes formation mechanism, but also contribute to the analytical technique capable of separating and identifying the complicated mixture of PCPAHs and fullerenes.

Separation and identification of perchlorinated polycyclic aromatic hydrocarbons by high-performance liquid chromatography and ultraviolet absorption spectroscopy.

High-performance liquid chromatography (HPLC) was coupled with ultraviolet absorption spectroscopy (UV) for the simultaneous separation and identification of a series of perchlorinated polycyclic aromatic hydrocarbons, such as perchlorobenzene (C6Cl6), perchloronaphthalene (C10Cl8), perchlorobiphenyl (C12Cl10), perchloroanthracene (C14Cl10), perchlorophenanthrene (C14C10), perchloroacenaphthylene (C12Cl8), perchloropyrene (C16Cl10) and perchlorofluoranthene (C16Cl10). HPLC was performed on an ODS column using methanol-hexane (80:20) as mobile phase at a flow-rate of 1.0 ml/min. UV absorption spectra of the elutes were detected in the region of 210-350 nm.