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PURPOSE: The characteristics of cytokine/chemokine(CK) profiles across different courses of chronic hepatitis B virus infection and the effects of NAs antiviral therapy on cytokine profiles remain unclear. METHODS: This report provides evidence from 383 patients with chronic HBV infection. The Luminex multiple cytokine detection technology was used to detect CK profiles. The predictive power of CKs across course of disease was assessedusing univariate analyses and with receiver operating characteristic (ROC) curves. RESULTS: Compared to healthy control (HC), expression levels of interleukin 6 (IL)-6, IL-8, IL-21, matrix metalloproteinases (MMP)-2 and tumor necrosis factor receptor (TNFR)-1 showed a significant increasing trend during chronic HBV infection. IL-23 and IL-33 increased respectively in chronic hepatitis B patients (CHB). interferon (IFN)-gamma and TNF-α changed significantly only in liver cirrhosis (LC) patients. Whereas, myeloid-related markers decreased dramatically in those with hepatocellular carcinoma (HCC). The ROC result suggests that combining IL-6, IL-8, CXCL9 and CXCL13 into a nomogram has closely correlation with HCC during chronic HBV infection. In addition, nucleotide analogues (NAs) antiviral treatments are capable of recoveringnormal liver functions and significantly reducing the viral loads, however, they seem to have a limited effect in changing CKs, especially specific antiviral factors. CONCLUSION: The differential CK and virological markers may serve as potential indicators of distinct immune statuses in chronic HBV infection. They also underscore the varying efficacy and limitations of NAs antiviral therapies. This next step would to break new ground in the optimization of current anti-HBV treatment programs although this requires further research.
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Carcinoma Hepatocelular , Hepatitis B Crónica , Neoplasias Hepáticas , Humanos , Virus de la Hepatitis B , Nucleótidos , Interleucina-8 , Citocinas/metabolismo , Antivirales/uso terapéuticoRESUMEN
OBJECTIVES: This study aims to construct and apply a training course system which was scientific and comprehensive to foster the core competence of infectious disease specialist nurses. DESIGN: A two-round Delphi consultation survey was carried out to collect feedback from experts on constructing the training course system of core competence for infectious disease specialist nurses. Besides, a non-randomized controlled experimental study was adopted to check the application effect of the courses. METHODS: This study adopted a series of methods including group discussion, theoretical analysis and Delphi consultation to draft the training course content of core competence of infectious disease specialist nurses. Twenty-one Chinese experts were invited to participate in the Delphi consultation from November 2021 to December 2021. From October 2022 to January 2023, a total of 105 infectious disease specialist nurses from two training bases were selected by the convenience sampling method, of which the nurses in one training base were the control group and the nurses in the other training base were the observation group. The observation group was trained by the constructed core competence training course. Questionnaire evaluation was used to compare the core competence of infectious disease specialist nurses and the training effect. RESULTS: The experts, regarded as the authorities on the subject, were highly motivated in this study. Besides, they reached a consensus on the results. The final training course system of core competence for infectious disease specialist nurses focused on 5 competence modules and was composed of 12 categories of courses with 66 classes and corresponding objectives. The core competence scores of the observation group were significantly higher than those in the control group after training (P < 0.05), which proved the training system can effectively enhance the core competence of infectious disease specialist nurses. CONCLUSIONS: The research methods embodied scientific and precise properties. The course system was comprehensive in content and reliable in results. It could serve as a reference for training infectious disease specialist nurses.
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Competencia Clínica , Enfermedades Transmisibles , Humanos , Técnica Delphi , Proyectos de Investigación , Encuestas y CuestionariosRESUMEN
BACKGROUND: With the development of information technology, information has been an important resource in clinical medicine, particularly within the emergency department. Given its role in patient rescue, the emergency department demands a high level of information literacy from nurses to effectively collect, analyze, and apply information due to the urgency and complexity of emergency nursing work. Although prior studies have investigated the information literacy of nursing staff, little has been undertaken in examining the patterns of information literacy and their predictors among emergency department nurses. AIM: To clarify the subtypes of information literacy among nurses in the emergency department and explore the factors affecting profile membership. METHODS: A cross-sectional study was conducted among a convenience sample of 2490 nurses in the emergency department from April to June 2023. The clinical nurses completed the online self-report questionnaires including the general demographic questionnaire, information literacy scale, self-efficacy scale and social support scale. Data analyses involved the latent profile analysis, variance analysis, Chi-square tests and multivariate logistic regression. RESULTS: Four latent profiles were identified: 'Low information literacy (Class 1)', 'Moderate information knowledge (Class 2)', 'High information knowledge and support (Class 3)' and 'High information literacy (Class 4)', accounting for 20.14%, 42.11%, 23.36% and 14.39%, respectively. Each profile displayed unique characteristics representative of different information literacy patterns. Age, years of work, place of residence, hospital grade, title, professional knowledge, using databases, reading medical literature, participating in information literacy training, self-efficacy, and social support significantly predicted information literacy profile membership. CONCLUSIONS: Information literacy exhibits different classification features among emergency department nurses, and over half of the nurses surveyed were at the lower or middle level. Identifying sociodemographic and internal-external predictors of profile membership can aid in developing targeted interventions tailored to the needs of emergency department nurses. Nursing managers should actively pay attention to nurses with low information literacy and provide support to improve their information literacy level. RELEVANCE TO CLINICAL PRACTICE: Insights from the current study of the latent profile analysis are beneficial to hospital managers in understanding the different types of emergency department nurses' information literacy. These insights serve as a reference for managers to enhance nurses' information literacy levels.
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OBJECTIVES: The benefits of professional dental treatment for oral diseases have been widely investigated. However, it is unclear whether professional dental treatment provides additional benefits for improving general health. MATERIALS AND METHODS: Data were obtained from the US National Health and Nutrition Examination Survey (NHANES) 1999 to 2004 and 2011 to 2018 cycles. A total of 36,174 participants were included and followed-up for mortality until December 31, 2019. Dental visit behavior was defined as the time interval of last dental visit (TIDV, < 0.5 year, 0.5-1 year, 1-2 years, 2-5 years, and > 5 years) and the main reasons of the last dental visit (treatment, examination, and other reasons). The Cox proportional risk model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS: Compared with participants with time interval of less than 0.5 year, the multivariate-adjusted HRs and 95%CI for participants with time interval of more than 5 years were 1.45 (1.31, 1.61) for all-cause mortality (P trend < 0.0001), 1.49 (1.23, 1.80) for cardiovascular diseases mortality (P trend = 0.0009) and 1.53 (1.29, 1.81) for cancer mortality (P trend = 0.013). Compared with dental visit for examination, participants who had their dental visit for treatment had higher risk for mortality. For participants with dental visit for examination, TIDV of less than 1 year showed lower risk for mortality, whereas TIDV of less than 0.5 year is recommend for population with dental visit for treatment. CONCLUSIONS: Poor dental visit behavior is associated with an increased risk of mortality. Further well-designed studies are needed to confirm the association between professional dental visit and mortality. CLINICAL RELEVANCE: This study highlights the potential benefits of regular dental visits in maintaining general health.
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Enfermedades Cardiovasculares , Humanos , Encuestas Nutricionales , Estudios Longitudinales , Estudios de Cohortes , Modelos de Riesgos ProporcionalesRESUMEN
BACKGROUND AND OBJECTIVES: This study aimed to investigate the association of vitiligo with metabolic syndrome (MetS) and its relevant components. MATERIAL AND METHODS: We searched PubMed, Web of Science, Cochrane Library and Embase databases from inception to March 30, 2021, for relevant studies. Cross-sectional and case-control studies that reported either the prevalence or odds ratio [OR] of MetS or its components in vitiligo patients were included. Data were pooled using either random-effects model or fixed-effects model according to the heterogeneity. RESULTS: Thirty studies with a total of 28,325 vitiligo patients were included. Significant associations were found between vitiligo and diabetes mellitus (pooled OR, 3.30; 95 % confidence interval [CI], 2.10-5.17) and between vitiligo and obesity (pooled OR, 2.08; 95 % CI, 1.40-3.11). The overall prevalence of hypertension in the patients with vitiligo was 19.0 % (95 % CI, 2.0 %-36.0 %). CONCLUSIONS: Our findings suggest the association of vitiligo with diabetes mellitus, obesity, and hypertension. It is recommended for dermatologists to take these associations into account so as to identify potential comorbidities promptly in vitiligo patients. Additionally, vitiligo patients are advised to monitor the indexes including BMI, blood glucose, and blood pressure levels and the consultation with specialists is necessary upon abnormal changes of these indexes.
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Diabetes Mellitus , Hipertensión , Síndrome Metabólico , Vitíligo , Estudios Transversales , Humanos , Síndrome Metabólico/epidemiología , Obesidad/epidemiología , Vitíligo/epidemiologíaRESUMEN
HINTERGRUND UND ZIELE: Ziel dieser Studie war die Untersuchung des Zusammenhangs zwischen Vitiligo und dem metabolischen Syndrom (MetS) sowie dessen relevanten Komponenten. MATERIAL UND METHODEN: Die Datenbanken PubMed, Web of Science, Cochrane Library und Embase wurden von deren Beginn bis zum 30. März 2021 nach relevanten Studien durchsucht. Querschnitts- und Fall-Kontroll-Studien, die entweder die Prävalenz oder die Odds-Ratio [OR] des MetS oder seiner Komponenten bei Vitiligo-Patienten berichteten, wurden eingeschlossen. Die Daten wurden entsprechend der Heterogenität entweder mit einem Zufallseffektmodell oder einem Modell mit festen Effekten gepoolt. ERGEBNISSE: Es wurden 30 Studien mit insgesamt 28.325 Vitiligo-Patienten eingeschlossen. Signifikante Zusammenhänge wurden zwischen Vitiligo und Diabetes mellitus (gepoolte OR, 3,30; 95 %-Konfidenzintervall [KI], 2,10-5,17) sowie zwischen Vitiligo und Adipositas (gepoolte OR, 2,08; 95 %-KI, 1,40-3,11) ermittelt. Die Gesamtprävalenz der Hypertonie bei Patienten mit Vitiligo betrug 19,0 % (95 %-KI, 2,0 %-36,0 %). SCHLUSSFOLGERUNGEN: Unserer Ergebnisse lassen auf einen Zusammenhang zwischen Vitiligo und Diabetes mellitus sowie Hypertonie schließen. Dermatologen wird empfohlen diese Zusammenhänge zu berücksichtigen, um potenzielle Begleiterkrankungen bei Vitiligo-Patienten zeitnah zu identifizieren. Zudem wird Vitiligo-Patienten empfohlen, Parameter wie BMI, Blutzuckerspiegel und Blutdruck zu überwachen und bei auffälligen Veränderungen dieser Parameter unverzüglich einen Spezialisten zu konsultieren.
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BACKGROUND: Working in an underground tunnel environment is unavoidable in professions such as miners and tunnel workers, and there is a concern about the health of these workers. Few studies have addressed alterations in the intestinal microbiome of workers within that environment. RESULTS: Fecal samples were collected from the workers before they entered the tunnel (baseline status, BS) and after they left the tunnel (exposed status, ES), respectively (a time period of 3 weeks between them). We analyzed 16S rRNA sequencing to show the changes in microbial composition and self-evaluation of mental health questionnaire was also performed. The results showed that Shannon and Simpson indices decreased significantly from BS to ES. A higher abundance was found in the phylum Actinobacteria, classes Actinobacteria and Deltaproteobacteria, orders Bifidobacteriales, Coriobacteriales, and Desulfovibrionales, families Bifidobacteriaceae, Peptostreptococcaceae, Coriobacteriaceae, Clostridiaceae_1, Desulfovibrionaceae, Pseudomonadaceae, and Microbacteriaceae, and genera Bifidobacterium, Romboutsia, Clostridium sensu stricto, and Leucobacter in ES, while BS showed greater levels of genera Faecalibacterium and Roseburia. The self-evaluation showed that at least one-half of the tunnel workers experienced one or more symptoms of mental distress (inattention, sleeplessness, loss of appetite, headache or dizziness, irritability) after working in the underground tunnel environment. CONCLUSIONS: Collectively, the underground tunnel environment led to alterations in the intestinal microbiome, which might be relevant to symptoms of mental distress in underground-tunnel workers.
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Bacterias/clasificación , Heces/microbiología , Estrés Laboral/microbiología , ARN Ribosómico 16S/genética , Adulto , Bacterias/genética , Bacterias/aislamiento & purificación , ADN Bacteriano/genética , ADN Ribosómico/genética , Femenino , Microbioma Gastrointestinal , Estado de Salud , Humanos , Masculino , Filogenia , Adulto JovenRESUMEN
OBJECTIVES: To describe the characteristics of major aphthous ulcers (MjOU) in children and analyze its potential risk factors. MATERIALS AND METHODS: Data were collected from the National Clinical Research Center for Oral Diseases of China between 2012 and 2017. Children younger than 15 years old, who had a giant mucosa ulcer (≥ 1 cm in diameter) and met the diagnostic criteria for MjOU were included in this study. Differences were compared between two subgroups of patients based on the location of the ulcerous lesions. A measurement of ratio (TBR) between the length of the mandibular second molar tooth germ and the height of the mandible was performed in children with MjOU lesions located in the mandibular retromolar pad region (MjOU-P) and their age- and sex-matched controls. RESULTS: A total of 1067 children were diagnosed with oral ulcers during the study period, of which 125 (11.7%, 95% CI: 9.8%-13.7%) met the diagnostic criteria for MjOU. More than half (n = 64, 51.2%) of the MjOU cases were MjOU-P, which had a male predilection (n = 52, 81.3%) with a significant majority at 7 to 9 years of age (n = 43, 67.2%). In comparison to the MjOU located in other regions, MjOU-P lasted longer in duration and had more comorbidities. Logistic regression analysis showed that MjOU-P was statistically significantly associated with TBR controlling age and gender. CONCLUSIONS: MjOU-P is a predominant form of MjOU in children and is a distinct subgroup of major ulcers that is likely associated with the development of the mandibular second molars. CLINICAL RELEVANCE: This study is the first to describe the demographic and clinical features of MjOU in children, which may facilitate the identification and treatment of these patients.
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Úlceras Bucales , Adolescente , Niño , China , Humanos , Masculino , Mandíbula , Diente Molar , Úlceras Bucales/epidemiología , Factores de RiesgoRESUMEN
BACKGROUND: Postoperative epidural haematoma and wound infection can cause devastating neurological damage in spinal surgery. Closed drainage is a common method to prevent epidural haematoma, infection and related neurological impairment after lumbar decompression; however, it is not clear whether drainage can reduce postoperative complications and improve clinical efficacy. This randomized study aims to explore the role of closed drainage in reducing postoperative complications and improving the clinical efficacy of single-level lumbar discectomy. METHODS: A total of 420 patients with single-level lumbar disc herniation were finally included in this study (169 females and 251 males, age 50.0 ± 6.4 years). A total of 214 patients were randomly assigned to the closed drainage group, and 206 patients were assigned to the non-drainage group. The incidence of postoperative fever, symptomatic epidural haematoma, wound infection and the need for revision surgery were compared between the two groups by the chi-square test or Fisher's exact test. The visual analogue scale (VAS) and oswestry disability index (ODI) were used to evaluate the improvement of pain relief and the recovery of lumbar function. The VAS and ODI scores were compared between the two groups using t tests. RESULTS: The complications of the two groups were compared and analysed. There was only a statistically significant difference in the postoperative fever rate (p = 0.022), as the non-drainage group had a higher fever rate, but there were no significant differences in the rates of symptomatic epidural haematoma, wound infection or revision operation (p > 0.05). After concrete analysis, for the rate of fever less than 38.5 degrees, there was a statistically significant difference (p = 0.027), but there was no significant difference when the fever was greater than 38.5 degrees (p > 0.05). When comparing the VAS scores of the operation area on the first day after the operation, the pain relief in the closed drainage group was significantly better than that in the non-drainage group, with scores of 5.1 ± 0.8 and 6.0 ± 0.7, respectively (p < 0.001). However, there was no significant difference between the two groups in the other VAS scores of operation areas, the VAS scores of the lower extremity, or the ODI scores (p > 0.05). CONCLUSIONS: For single-level lumbar discectomy, closed drainage is beneficial for reducing postoperative low-grade fever and relieving pain in the operation area in the very early postoperative stage. However, drainage does not have a significant impact on reducing the incidence of postoperative complications or improving clinical efficacy. TRIAL REGISTRATION: Current Controlled Trials ChiCTR1800016005 , May/06/2018, retrospectively registered.
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Desplazamiento del Disco Intervertebral , Vértebras Lumbares , Adulto , Discectomía/efectos adversos , Drenaje , Femenino , Humanos , Desplazamiento del Disco Intervertebral/diagnóstico por imagen , Desplazamiento del Disco Intervertebral/cirugía , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugía , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
Evidence for blood pressure-lowering effects of vitamin C (VC) supplementation in clinical trials is inconsistent and limited studies have examined the effect of VC supplementation on hypertension (HTN) control. In this study, eligible patients were cluster assigned to receive 300 mg VC per day or nothing for 6 months. During the 6-month follow-up period, a questionnaire survey was obtained and standardized blood pressure measurements were performed on all subjects. Oral administration of VC significantly decreased the diastolic blood pressure and pulse pressure with a significant increase in HTN control. After adjusting for confounding variables, treatment with VC was associated with ~ 0.5 risk reduction of uncontrolled HTN in subjects received anti-hypertensive medications, whereas lower indoor and outdoor and ground temperature were significantly associated with an increased risk of uncontrolled HTN in all patients. Our results warrant further studies investigating the mechanisms underlying the association between VC and HTN control.
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Antioxidantes/uso terapéutico , Ácido Ascórbico/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Hipertensión Esencial/tratamiento farmacológico , Hipertensión Esencial/fisiopatología , Temperatura , Anciano , Antihipertensivos/uso terapéutico , Suplementos Dietéticos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de RiesgoRESUMEN
Summary: Phylogeny reconstruction is fundamentally crucial for molecular evolutionary studies but remains computationally challenging. Here we present CloudPhylo, a tool built on Spark that is capable of processing large-scale datasets for phylogeny reconstruction. As testified on empirical data, CloudPhylo is well suited for big data analysis, achieving high efficiency and good scalability on phylogenetic tree inference. Availability and Implementation: https://github.com/XingjianXu/cloudphylo Contact: zhangzhang@big.ac.cn Supplementary Information: Supplementary data are available at Bioinformatics online.
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Evolución Molecular , Filogenia , Análisis de Secuencia de ADN/métodos , Programas Informáticos , Bacterias/genética , Genómica/métodosRESUMEN
The characteristics of life-long persistent infection of hepatitis B virus (HBV) and the prevalence of different genotypes of HBV in China may cause new recombinants. In north-west China, HBV inter-genotype recombinants have been reported frequently over the last decade. Here, we report a B/C inter-genotype recombinant HBV with a novel genome mosaic structure from Lanzhou, a city in north-west China.
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Virus de la Hepatitis B/genética , Virus de la Hepatitis B/aislamiento & purificación , Hepatitis B/virología , Recombinación Genética , China , Genotipo , Virus de la Hepatitis B/clasificación , Humanos , Datos de Secuencia Molecular , Filogenia , Proteínas Virales/genéticaRESUMEN
BACKGROUND: Hepatitis B (HB) is an important disease worldwide. Almost 350 million people are positive for Hepatitis B virus surface antigen (HBsAg), and one-third of them live in China. According to a nation-wide serosurvey in China in 2006, the prevalence of HBsAg was higher in Northwest China than in other areas. However, the epidemic HBV strains in this area are poorly studied. RESULTS: In this study, 242 complete hepatitis B virus (HBV) genome sequences were obtained from HBV asymptomatic carriers in major cities of Northwest China. The 242 HBV sequences clustered into genotypes B, C and D. Through comparison of the genotype consensus sequences, 158 genotype-dependent positions were observed in P, S and X ORFs. Clinically relevant mutation screening in this study revealed that no HBV antiviral drug resistance mutations were observed and the vaccination failure mutations were heavily underrepresented. CONCLUSIONS: The role of genotype D strains in HBV prevalence should not be ignored in Northwest China. Due to low prevalence of vaccination failure mutations, it can be inferred that the genotype B, C and D strains in Northwest China may have less likelihood of vaccine escape.
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ADN Viral/genética , Variación Genética , Virus de la Hepatitis B/clasificación , Virus de la Hepatitis B/genética , Hepatitis B/epidemiología , Hepatitis B/virología , Adolescente , Adulto , Portador Sano/epidemiología , Portador Sano/virología , China/epidemiología , ADN Viral/química , Femenino , Genoma Viral , Genotipo , Virus de la Hepatitis B/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Epidemiología Molecular , Datos de Secuencia Molecular , Prevalencia , Análisis de Secuencia de ADN , Adulto JovenRESUMEN
Car networking systems based on 5G-V2X (vehicle-to-everything) have high requirements for reliability and low-latency communication to further improve communication performance. In the V2X scenario, this article establishes an extended model (basic expansion model) suitable for high-speed mobile scenarios based on the sparsity of the channel impulse response. And propose a channel estimation algorithm based on deep learning, the method designed a multilayer convolutional neural network to complete frequency domain interpolation. A two-way control cycle gating unit (bidirectional gated recurrent unit) is designed to predict the state in the time domain. And introduce speed parameters and multipath parameters to accurately train channel data under different moving speed environments. System simulation shows that the proposed algorithm can accurately train the number of channels. Compared with the traditional car networking channel estimation algorithm, the proposed algorithm improves the accuracy of channel estimation and effectively reduces the bit error rate.
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Algoritmos , Redes Neurales de la Computación , Reproducibilidad de los Resultados , Comunicación , Simulación por ComputadorRESUMEN
BACKGROUND: Patients with myasthenia gravis (MG) lose part of their working or living ability due to illness, and bring burden to caregivers. The purpose of this study was to explore the factors related to caregivers' disease family burden for MG patients in Northwest China. METHODS: The study utilized our Myasthenia Gravis database and distributed online questionnaires to both MG patients and their caregivers. The questionnaires included a general data collection form, the Patient Health Questionnaire-9 (PHQ-9) scale, and the Caregivers' Family Burden Scale of Disease (FBSD). Univariate analysis and multivariate linear regression analysis were run, with FBSD as the outcome variable for separate analyses. RESULTS: 178 MG patients were eligible for inclusion in the analysis, of whom 80 patients' caregivers had a positive family burden of MG. The daily activity burden of the family and the economic burden of the family were the heaviest among the six dimensions of the caregivers' family disease burdens. The factors independently associated with FBSD were depression symptom level, MG severity classification and family's monthly per capita income (p < 0.05). CONCLUSIONS: Depression symptom level, MG severity classification and family's monthly per capita income are independent factors related to the caregivers' disease family burden for MG patients.
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Miastenia Gravis , Calidad de Vida , Humanos , Estudios Transversales , Cuidadores , Costo de Enfermedad , China/epidemiología , Miastenia Gravis/epidemiología , Encuestas y CuestionariosRESUMEN
Background: To identify the epidemiology and mortality predictors of severe childhood community-acquired pneumonia (CAP) and evaluate the influence of medications on clinical outcomes in the real world. Methods: We conducted a multicenter retrospective observational study among children aged ≤5 years with severe CAP, separately comparing the detailed information between those who experienced in-hospital death and those who survived in three different age groups. A multivariate logistic regression model was used to determine mortality predictors. Results: A total of 945 children were recruited: 341 young children aged 2-59 months, 47 infants aged 29 days to 2 months, and 557 neonates aged less than 28 days. A total of 88 deaths occurred (9.3%). There was low adherence to antimicrobial guidelines in the group aged 2-59 months, and carbapenems widely served as initial empirical regimens. However, analysis of all three age groups showed that the efficacy of antibacterial drugs with initial empirical selection grades higher than those recommended by the guidelines was not better than that of antibacterial drugs with grades recommended by the guidelines. In multivariate analyses, very severe pneumonia (odds ratio (OR): 3.48; 95% confidence interval (CI): 1.36-8.93), lower birth weight (OR: 4.64; 95% CI: 1.78-12.20), severe underweight (OR: 6.06; 95% CI: 2.34-15.63), mechanical ventilation (OR: 2.58; 95% CI: 1.00-6.62; OR: 15.63; 95% CI 3.25-76.92), a higher number of comorbidities (OR: 8.40; 95% CI: 1.89-37.04), comorbidities including anemia (OR: 5.24; 95% CI: 2.33-11.76) and gastrointestinal hemorrhage (OR: 3.79; 95% CI: 1.36-10.53), and the use of sedative-hypnotics (OR: 2.60; 95% CI: 1.14-5.95) were independent risk factors for death; infants treated with probiotics had a lower mortality rate (OR: 0.14; 95% CI: 0.06-0.33). Conclusions: Severe CAP remains a primary cause of death in children under 5 years of age. Clinical characteristics, comorbidities and medications are evidently associated with death. Importantly, we should pay particular attention to the identification of mortality predictors and establish prophylactic measures to reduce mortality.
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With increasing consumption of energy and increasing environmental pollution, research on capturing the vibration energy lost during transportation and vehicle driving is growing rapidly. There is a large amount of vibration energy in the automobile exhaust system that can be recycled. This paper proposes a self-powered intelligent device (SPID) using a piezoelectric energy generator. The SPID includes a piezoelectric generator and sensor unit, and the generator is installed at the end of the automobile exhaust system. The generator adopts a parallel structure of four piezoelectric power generation units, and the sensing unit comprises light-emitting diode warning lights or low-power sensors. A simulated excitation experiment verifies the working state and peak power of the piezoelectric generator unit, which can achieve 23.4 µW peak power. The self-power supply and signal monitoring functions of the intelligent device are verified in experiments conducted for driving light-emitting diode lights and low-power sensors. The device is expected to play a crucial role in the field of intelligent driving and automobile intelligence.
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Objective: This meta-analysis of randomized controlled trials (RCTs) aims to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) for postoperative delirium (POD) in surgical patients. Methods: Based on database searches of the Wanfang, China National Knowledge Infrastructure (CNKI), VIP, Chinese Biology Medicine (CBM), PubMed, Cochrane Library, and Web of Science, relevant RCTs published before December 30, 2022, were extracted. Outcome indicators included the incidence of POD, changes in Confusion Assessment Method (CAM) scores, Visual Analogue Scale (VAS) scores, and the intraoperative consumption of anesthetics. Data were pooled and analyzed by Review Manager 5.3, and publication bias detection was conducted using Stata 17.0. Results: A meta-analysis containing 715 experimental and 717 control participants from 12 RCTs was performed. The overall results showed that TEAS had obvious superiority with a lower incidence of POD on any day during the postoperative 1 week. In subgroup analyses, the CAM scores on the third postoperative day were significantly lower in the TEAS group than in the control group (MD = -0.52, 95% CI: -1.02 to -0.03, P = 0.04), the VAS scores on the first postoperative day were significantly lower in the TEAS group than in the control group (MD = -0.19, 95% CI: -0.36 to -0.02, P = 0.03), the consumption of propofol and remifentanil were both significantly lower in the TEAS group compared with the control group (MD = -23.1, 95% CI: -37.27 to -8.94, P = 0.001; MD = -105.69, 95% CI: -174.20 to -37.19, P = 0.002). No serious adverse events of TEAS were reported in any of the referenced studies. Conclusion: TEAS has an obvious curative effect in preventing POD and pain in the earlier stage of surgical patients. It could be a promising assisted anesthesia technique in the future.
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Background: Liver cancer is one of the most frequently diagnosed malignant tumors, with an extremely high incidence rate. Diagnosis of liver cancer is difficult with the existing methods and improved biomarkers are urgently needed. A number of studies have established a link between abnormal miR-375 expression and liver cancer. Therefore, we conducted a systematic analysis to appraise whether miR-375 can be used as a screening tool for liver cancer detection. Methods: Through a systematic database search, studies investigating miR-375 expression in serum by the quantitative real-time reverse transcription-PCR (qRT-PCR) method were included in the study. A total of 1,100 participants (576 with liver cancer and 534 without liver cancer) were recruited. The efficacy of microRNA-375 in the detection of liver cancer was assessed by sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under curve (AUC). Results: The pooled sensitivity and specificity of miR-375 in the detection of liver cancer were 0.91 (95% confidence interval [CI]: 0.74-0.98) and 0.83 (95% CI: 0.67-0.92), respectively. Furthermore, the pooled PLR was 5.40 (95% CI: 2.58-11.31), NLR was 0.10 (95% CI: 0.03-0.36), DOR was 52.52 (95% CI: 10.02-275.42), and AUC was 0.93 (95% CI: 0.90-0.95), indicating that miR-375 is effective at detecting liver cancer. Conclusions: According to our meta-analysis, measuring serum miR-375 has high sensitivity and specificity, which will facilitate its clinical application in liver cancer monitoring.
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MicroARN Circulante , Neoplasias Hepáticas , MicroARNs , Humanos , MicroARNs/genética , MicroARN Circulante/genética , Biomarcadores de Tumor/genética , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/genética , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: The present study aimed to investigate the prevalence of peri-implant disease and identify potential disease risk factors in western China. METHODS: The present retrospective study was conducted in 131 consecutive patients receiving 248 dental implants treated with implant-supported prostheses with a mean follow-up of 2.52 years. Several patient-related, implant-related, and oral hygiene maintenance factors were analyzed. RESULTS: Peri-implant disease developed in 68 (51.91%) patients and 110 (44.35%) implants. The prevalence of peri-implant mucositis and peri-implantitis were 45.80% and 7.63%, respectively, at the subject level, and 36.69% and 7.66%, respectively, at the implant level. Multivariate analysis exhibited that male [odds ratio (OR) = 1.91; 95% confidence interval (CI): 1.02-3.57; p = 0.04], implant length < 10mm (OR = 7.87; 95% CI:1.62-38.46; p = 0.01), poor proximal contact of the prosthesis (OR = 1.90; 95% CI: 1.06-3.42; p = 0.03), tooth brushing once a day (OR = 3.11; 95% CI: 1.26-7.68; p = 0.04) and moderate periodontitis (OR = 13.00; 95% CI: 4.38-38.60; p < 0.01) were independent risk factors for peri-implant disease.