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Objective: To investigate the value of implantable cardiac monitor (ICM) in the diagnosis and treatment of patients over 60 years old with unexplained syncope. Methods: This was a multi-center, prospective cohort study. Between June 2018 and April 2021, patients over the age of 60 with unexplained syncope at Beijing Hospital, Fuwai Hospital, Beijing Anzhen Hospital and Puren Hospital were enrolled. Patients were divided into 2 groups based on their decision to receive ICM implantation (implantation group and conventional follow-up group). The endpoint was the recurrence of syncope and cardiogenic syncope as determined by positive cardiac arrhythmia events recorded at the ICM or diagnosed during routine follow-up. Kaplan-Meier survival analysis was used to compare the differences of cumulative diagnostic rate between the 2 groups. A multivariate Cox regression analysis was performed to determine independent predictors of diagnosis of cardiogenic syncope in patients with unexplained syncope. Results: A total of 198 patients with unexplained syncope, aged (72.9±8.25) years, were followed for 558.0 (296.0,877.0) d, including 98 males (49.5%). There were 100 (50.5%) patients in the implantation group and 98 (49.5%) in the conventional follow-up group. Compared with conventional follow-up group, patients in the implantation group were older, more likely to have comorbidities, had a higher proportion of first degree atrioventricular block indicated by baseline electrocardiogram, and had a lower body mass index (all P<0.05). During the follow-up period, positive cardiac arrhythmia events were recorded in 58 (58.0%) patients in the ICM group. The diagnosis rate (42.0% (42/100) vs. 4.1% (4/98), P<0.001) and the intervention rate (37.0% (37/100) vs. 2.0% (2/98), P<0.001) of cardiogenic syncope in the implantation group were higher than those in the conventional follow-up group (all P<0.001). Kaplan-Meier survival analysis showed that the cumulative diagnostic rate of cardiogenic syncope was significantly higher in the implantation group than in the traditional follow-up group (HR=11.66, 95%CI 6.49-20.98, log-rank P<0.001). Multivariate analysis indicated that ICM implantation, previous atrial fibrillation, diabetes mellitus or first degree atrioventricular block in baseline electrocardiogram were independent predictors for cardiogenic syncope (all P<0.05). Conclusions: ICM implantation improves the diagnosis and intervention rates in patients with unexplained syncope, and increases diagnostic efficiency in patients with unexplained syncope.
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Síncope , Humanos , Idoso , Síncope/diagnóstico , Síncope/etiologia , Estudos Prospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Eletrocardiografia Ambulatorial/métodos , Eletrocardiografia Ambulatorial/instrumentação , Eletrocardiografia/métodos , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/complicaçõesRESUMO
Water has been recognized in promoting material removal, traditionally ascribed to friction reduction and thermal dissipation. However, the physicochemical interactions between water and the workpiece have often been overlooked. This work sheds light on how the physicochemical interactions that occur between water (H2O) and copper (Cu) workpiece influence material deformations during the cutting process. ReaxFF molecular dynamics simulations were employed as the primary method to study the atomistic physical and chemical interactions between the applied medium and the workpiece. Upon contact with the Cu surface, H2O dissociated into OH- ions, H+ ions, and traces of O2- ions. The OH- and O2- ions chemically reacted with Cu to form bonds that weakened the Cu-Cu bonds by elongation, while the H+ ions gained electrons and diffused into the Cu lattice as H- ions. The weakening of surface Cu bonds promoted plastic deformation and reduced the difficulty of material removal. Meanwhile, further addition of H2O molecules saw a plateau in hydrolysis and more dominance of H2O physical adsorption on Cu, which weakens the elongation of Cu-Cu bonds. While the ideal case for atomic-scale material removal was found with an optimal number of 240 H2O molecules, the presented Cu material state with more H2O molecules could account for the observations in microcutting. The constricted nature of physical adsorption and hydrogen ion diffusion in the surface layer prevented the propagation of dislocations through the surface, which subsequently caused pinning points to be closer together during chip formation as observed by smaller chip fold widths on the microscale. Theoretical and experimental analysis identified the importance of accounting for physicochemical interactions between surface media and the workpiece when considering material deformations at micronanoscale.
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Objective: The phenotype and genotype of a pedigree with Glanzmann thrombasthenia caused by compound heterozygous mutation in the ITGA2B gene and its molecular pathogenesis were explored. Methods: The platelet aggregation rate of the proband and his family was detected by using a platelet aggregation test with adenosine diphosphate, collagen, epinephrine, arachidonic acid, and ristocetin. The expression levels of CD41 (αâ ¡b), CD61 (ß3), and CD42b (GPâ b) on the platelet surface was detected by flow cytometry. Gene sequencing technology was used for the genetic identification of the family. RT-PCR was used in the detection of mRNA splicing, and qRT-PCR was used in detecting the relative mRNA level of the ITGA2B gene. Bioinformatics analysis was used to evaluate the pathogenicity of mutation sites and their effects on protein structure and function. The expressions of total αâ ¡b and ß3 in platelets were analyzed by Western blot. Results: Except ristocetin, the other four inducers could not induce platelet aggregation in the proband. Flow cytometry showed that the expression levels of αâ ¡b and ß3 were only 0.25% and 9.76%, respectively, on the platelet surface of the proband, whereas GPâ b expression was relatively normal. The expression levels of glycoproteins in the other family members were almost normal. c.480C>G and c.2929C>T mutations were detected in the proband through gene sequencing. The c.480C>G mutation was inherited from his mother, and the c.2929C>T mutation was inherited from his father. The RT-PCR and sequencing results showed that the c.480C>G mutation caused mRNA splicing in the proband and his mother, resulting in the deletion of 99 bases in c.476G-574A (p.S160-S192). qRT-PCR showed that the c.2929C>T variant reduced the mRNA level of the ITGA2B gene in the proband and his father. Bioinformatics analysis suggested that the c.480C>G mutation might form a binding sequence with hnRNP A1 protein and generate the 5'SS splice site. The three-dimensional structural model of the αâ ¡b subunit showed that the ß-propeller domain of the p.S160-S192 deletion lost two ß-strands and one α-helix in blade 2. The c.2929C>T nonsense mutation caused premature translation termination and produced a truncated protein with the deletion of p.R977-E1039, including the cytoplasmic domain, transmembrane domain, and a ß chain of the extracellular Calf-2 domain. The total αâ ¡b expression of the proband was absent, and the relative expression of ß3 was 11.36% of the normal level. Conclusion: The compound heterozygous mutation c.480C>G in exon 4 and c.2929C>T in exon 28 of the ITGA2B gene probably underlies Glanzmann thrombasthenia in this pedigree.
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Heterozigoto , Integrina alfa2 , Mutação , Linhagem , Trombastenia , Humanos , Integrina alfa2/genética , Trombastenia/genética , Masculino , Feminino , Agregação Plaquetária , Genótipo , AdultoRESUMO
Detection of low viral load samples has long been a challenge for African swine fever (ASF) prevention and control. This study aimed to compare the detection efficacy of droplet digital PCR(ddPCR) and quantitative PCR(qPCR) for African swine fever virus (ASFV) at different viral loads, with a focus on assessing the accuracy of ddPCR in detecting low viral load samples. The results revealed that ddPCR had a detection limit of 1.97 (95% CI 1.48 - 4.12) copies/reaction and was 18.99 times more sensitive than qPCR (detection limit: 37.42, 95% CI 29.56 - 69.87 copies/reaction). In the quantification of high, medium, and low viral load samples, ddPCR showed superior stability with lower intra- (2.06% - 7.58%) and inter-assay (3.83% - 7.50%) coefficients of variation than those of qPCR (intra-assay: 8.08%-29.86%; inter-assay: 9.27%-34.58%). Bland-Altman analysis indicated acceptable consistency between ddPCR and qPCR for high and medium viral load samples; however, discrepancies were observed for low viral load samples, where two samples (2/24, 8.33%) exhibited deviations beyond the acceptable range (-46.18 copies/reaction). Moreover, ddPCR demonstrated better performance in detecting ASFV in clinical samples from asymptomatic pigs and environmental samples, with qPCR showing false negative rates of 7.69% (2/26) and 27.27% (12/44), respectively. McNemar analysis revealed significant differences between the two methods (P = 0.000) for samples with a viral load <100 copies/reaction. The results of this study demonstrate that ddPCR has better detection limits and adaptability than qPCR, allowing for a more accurate detection of ASFV in early-stage infections and low-concentration environmental samples. These findings highlight the potential of ddPCR in the prevention and control of ASF.
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Objective: To investigate the clinical effect of intraarticular vancomycin on early periprosthetic joint infection (PJI) in knee arthroplasty and the incidence of postoperative complications. Methods: This is a retrospective cohort study. The clinical data of 1 867 patients who underwent primary knee arthroplasty at Department of Joint Surgery, the Affiliated Hospital of Qingdao University from April 2022 to June 2023 were retrospectively analysed, including total knee arthroplasty (TKA), robotic-assisted total knee arthroplasty (RA-TKA) and unicondylar knee arthroplasty (UKA). There were 687 males and 1 180 females, aged (68.0±11.2)years(range:45 to 87 years). Patients were divided into the vancomycin group and the control group according to whether or not intra-articular injection of 1 g of vancomycin powder dissolved in 30 ml of saline was performed after intraoperative joint capsule closure. In the vancomycin group, 925 patients were included, including 782 TKA, 27 RA-TKA and 116 UKA.In the control group, 942 patients were included, including 767 TKA, 99 RA-TKA and 76 UKA. Early PJI, wound complications, and vancomycin-related toxicity including acute renal collapse, ototoxicity, and allergic reactions were assessed within 3 months postoperatively. The data were compared using the independent sample t test, χ² test, and Fisher's exact probability method, as appropriate. Major Extremity Trauma Research Consortium (METRC). Results: No PJI was found in all patients in the vancomycin group.Five cases (0.7%,5/767) of early PJI were found in TKA patients in the control group, with a statistically significant difference (P=0.030); 1 case of early PJI was found in each RA-TKA and UKA patients, with non-significant difference compared with vancomycin group (all P>0.05). Two cases (0.3%,2/782) of incisional complications were found in TKA patients in the vancomycin group, and 4 cases (0.5%, 4/767) of incisional complications were found in TKA patients in the control group, with non-significant difference(P=0.449); no incisional complication was found in RA-TKA patients in the vancomycin group, and 1 case (1.0%,1/99) of incisional complications were found in RA-TKA patients in the control group, the difference was not statistically significant (P>0.05); no incisional complication was found in both groups of UKA patients.No vancomycin-related acute kidney injury, ototoxicity, or allergic reactions was observed in all patients. Conclusion: Intra-articular injection of 1 g of vancomycin suspension after arthrotomy closure during TKA maybe lower the risk of early PJI without increasing the risk of wound complication and vancomycin-associated systemic toxicity.
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Artroplastia do Joelho , Infecções Relacionadas à Prótese , Vancomicina , Humanos , Vancomicina/administração & dosagem , Masculino , Artroplastia do Joelho/efeitos adversos , Feminino , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Infecções Relacionadas à Prótese/prevenção & controle , Infecções Relacionadas à Prótese/etiologia , Idoso de 80 Anos ou mais , Injeções Intra-Articulares , Antibacterianos/administração & dosagem , Resultado do TratamentoRESUMO
Immediate implant placement can reduce the number of treatments and the time without teeth, but it carries a higher aesthetic risk. Soft tissue augmentation can reduce the risk of gingival recession to a certain extent, improve the predictability and long-term stability of immediate implant aesthetics, and is currently a hot research topic. A comprehensive understanding of the evidence-based medicine and surgical techniques using soft tissue augmentation in immediate implant surgery can assist in clinical diagnosis, treatment decisions and improve treatment outcomes. This article elucidates the changes in soft and hard tissues after immediate implant placement, aesthetic risks, and risk factors. It also discusses the advantages, timing, material selection, and commonly used clinical techniques of soft tissue transplantation in immediate implantation, aiming to provide reference for clinical doctors to improve the effectiveness of immediate implantation.
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Estética Dentária , Retração Gengival , Humanos , Retração Gengival/cirurgia , Implantes Dentários , Gengiva/transplante , Implantação Dentária Endóssea/métodos , Fatores de Risco , Implantação Dentária/métodosRESUMO
BACKGROUND: Kimura's disease (KD) is a rare chronic inflammatory condition characterized by nodules and lymphadenopathy in the head and neck region, exhibiting type II inflammation. Dupilumab is commonly used against type II inflammation. AIM: To evaluate the efficacy and safety of dupilumab in KD patients. DESIGN: The real-world study was conducted in a hospital in China. METHODS: Six male patients with a mean age of 24.50 ± 15.47 years were treated with dupilumab following the same protocol as that for atopic dermatitis (AD). Clinical and laboratory indicators, such as maximum nodule diameter, blood eosinophil count, eosinophil percentage, and total serum IgE levels were assessed at baseline, week 12, and week 24. Adverse events were documented. Paired t-tests and one-way ANOVA were used for statistical analysis. RESULTS: The results showed significant reductions in the longest nodule diameter at week 12 (P = 0.008) and week 24 (P = 0.001) compared to baseline. Blood eosinophil count decreased by 57.95% (P = 0.024) at week 12 and 90.59% (P = 0.030) at week 24. Eosinophil percentage decreased by 58.44% (P = 0.026) at week 12 and 89.37% (P = 0.013) at week 24. Total serum IgE levels decreased by 78.02% (P = 0.040) at week 12 and 89.55% (P = 0.031) at week 24. The presence of AD did not affect the results. One patient experienced temporary facial erythema after 32 weeks of treatment, which resolved with topical treatment. No other adverse events were reported. CONCLUSION: Dupilumab demonstrated effectiveness in treating KD without severe adverse events.
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Periodontitis is a complex disease characterized by distinct inflammatory stages, with a peak of inflammation in the early phase and less prominent inflammation in the advanced phase. The insulin-like growth factor 2-binding proteins 2 (IGF2BP2) has recently been identified as a new m6A reader that protects m6A-modified messenger RNAs (mRNAs) from decay, thus participating in multiple biological processes. However, its role in periodontitis remains unexplored. Here, we investigated the role of IGF2BP2 in inflammation and osteoclast differentiation using a ligature-induced periodontitis model. Our findings revealed that IGF2BP2 responded to bacterial-induced inflammatory stimuli and exhibited differential expression patterns in early and advanced periodontitis stages, suggesting its dual role in regulating this disease. Depletion of Igf2bp2 contributed to increased release of inflammatory cytokines, thereby exacerbating periodontitis after 3 d of ligature while suppressing osteoclast differentiation and ameliorating periodontitis after 14 d of ligature. Mechanistically, we demonstrated that IGF2BP2 directly interacted with Cd5l and Cd36 mRNA via RNA immunoprecipitation assay. Overexpression of CD36 or recombinant CD5L rescued the osteoclast differentiation ability of Igf2bp2-null cells upon lipopolysaccharide stimulus, and thus the downregulation of Cd36 and Cd5l effectively reversed periodontitis in the advanced stage. Altogether, this study deepens our understanding of the potential mechanistic link among the dysregulated m6A reader IGF2BP2, immunomodulation, and osteoclastogenesis during different stages of periodontitis.
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Perda do Osso Alveolar , Periodontite , Humanos , Osteoclastos/metabolismo , Perda do Osso Alveolar/metabolismo , Periodontite/metabolismo , Inflamação/metabolismo , Osteogênese , Proteínas de Ligação a RNA/farmacologiaRESUMO
Malocclusion is an oral disease with a high prevalence. The goal of orthodontic treatment is health, aesthetics, function and stability. The transmission straight wire appliance and technique is an innovative orthodontic system with independent intellectual property rights invented by Professor Jiuxiang Lin's team based on decades of clinical experience, which provides a new solution for the non-surgical correction of skeletal malocclusions, especially class â ¢ malocclusion, and it is also a good carrier for the implementation of the concept of healthy orthodontics. Due to the lack of guidelines, how to implement standardized application of transmission straight wire technique remains a problem to be solved. This technical specification was formed by combining the guidance from Professor Jiuxiang Lin and joint revision by a number of authoritative experts from the Orthodontic Special Committee, Chinese Stomatological Association, with reference to relevant literatures, and combined with abundant clinical experience of many experts. This specification aims to provide reference to standardize the clinical application of transmission straight wire technique, so as to reduce the risk and complications, and finally to improve the clinical application level of this technique.
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Má Oclusão Classe III de Angle , Má Oclusão , Humanos , Estética Dentária , Má Oclusão/terapia , Fios Ortodônticos , Prevalência , Ortodontia Corretiva/métodosRESUMO
Objective: To investigate the cytotoxic effects of induced pluripotent stem (iPS) cells of anti-mesothelin (MSLN)-chimeric antigen receptor natural killer (CAR-NK) cells (anti-MSLN-iCAR-NK cells) on ovarian epithelial cancer cells. Methods: Twenty cases of ovarian cancer patients who underwent surgical treatment at Henan Provincial People's Hospital from September 2020 to September 2021 were collected, and 20 cases of normal ovarian tissues resected during the same period due to other benign diseases were also collected. (1) Immunohistochemistry and immunofluorescence were used to verify the expression of MSLN protein in ovarian cancer tissues. (2) Fresh ovarian cancer tissues were extracted and cultured to obtain primary ovarian cancer cells. Recombinant lentiviral vectors targeting anti-MSLN-CAR-CD244 were constructed and co-cultured with iPS cells to obtain anti-MSLN-iCAR cells. These cells were differentiated into anti-MSLN-iCAR-NK cells using cytokine-induced differentiation method. The cell experiments were divided into three groups: anti-MSLN-iCAR-NK cell group, natural killer (NK) cell group, and control group. (3) Flow cytometry and live cell staining experiment were used to detect the apoptosis of ovarian cancer cells in the three groups. (4) Enzyme-linked immunosorbent assay (ELISA) was used to measure the expression levels of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), granzyme B (GZMB), perforin 1 (PRF1), interleukin (IL)-6, and IL-10 in the three groups of ovarian cancer cells. Results: (1) Immunohistochemistry analysis showed that a positive expression rate of MSLN protein in ovarian cancer tissues of 65% (13/20), while normal ovarian tissues had a positive rate of 30% (6/20). The comparison between the two groups was statistically significant (χ2=4.912, P=0.027). Immunofluorescence analysis revealed that the positive expression rate of MSLN protein in ovarian cancer tissues was 70% (14/20), while normal ovarian tissues had a positive rate of 30% (6/20). The comparison between the two groups was statistically significant (χ2=6.400, P=0.011). (2) Flow cytometry analysis showed that the apoptotic rate of ovarian cancer cells in the anti-MSLN-iCAR-NK cell group was (29.27±0.85)%, while in the NK cell group and control group were (8.44±0.34)% and (6.83±0.26)% respectively. There were statistically significant differences in the comparisons between the three groups (all P<0.01). Live cell staining experiment showed that the ratio of dead cells to live cells in the anti-MSLN-iCAR-NK cell group was (36.3±8.3)%, while in the NK cell group and control group were (5.4±1.4)% and (2.0±1.3)% respectively. There were statistically significant differences in the comparisons between the three groups (all P<0.001). (3) ELISA analysis revealed that the expression levels of IFN-γ, TNF-α, GZMB, PRF1, IL-6, and IL-10 in ovarian cancer cells of the anti-MSLN-iCAR-NK cell group were significantly higher than those in the NK cell group and the control group (all P<0.05). Conclusion: The anti-MSLN-iCAR-NK cells exhibit a strong killing ability against ovarian cancer cells, indicating their potential as a novel immunotherapy approach for ovarian cancer.
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Células-Tronco Pluripotentes Induzidas , Neoplasias Ovarianas , Humanos , Feminino , Carcinoma Epitelial do Ovário/metabolismo , Neoplasias Ovarianas/metabolismo , Interleucina-10/metabolismo , Interleucina-10/farmacologia , Células-Tronco Pluripotentes Induzidas/metabolismo , Complexo Ferro-Dextran/metabolismo , Complexo Ferro-Dextran/farmacologia , Fator de Necrose Tumoral alfa/metabolismo , Linhagem Celular Tumoral , Células Matadoras Naturais , Interleucina-6RESUMO
Periodontitis is a chronic inflammatory disease that compromises the integrity of the supporting tissues of the teeth and leads to the loss of the alveolar bone. The Mir338 cluster has been proven to be a potential target for the treatment of osteoporosis and is also enriched in gingival tissues with periodontitis; however, its role in periodontitis remains unknown. Here, we aimed to use periodontitis as a model to expand our understanding of the Mir338 cluster in osteoimmunology and propose a new target to protect against bone loss during periodontitis progression. Significant enrichment of the Mir338 cluster was validated in gingival tissues from patients with chronic periodontitis and a ligature-induced periodontitis mouse model. In vivo, attenuation of alveolar bone loss after 7 d of ligature was observed in the Mir338 cluster knockout (KO) mice. Interestingly, immunofluorescence and RNA sequencing showed that ablation of the Mir338 cluster reduced osteoclast formation and elevated the inflammatory response, with enrichment of IFN-γ and JAK-STAT signaling pathways. Ablation of the Mir338 cluster also skewed macrophages toward the M1 phenotype and inhibited osteoclastogenesis via Stat1 in vitro and in vivo. Furthermore, the local administration of miR-338-3p antagomir prevented alveolar bone loss from periodontitis. In conclusion, the Mir338 cluster balanced M1 macrophage polarization and osteoclastogenesis and could serve as a novel therapeutic target against periodontitis-related alveolar bone loss.
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Perda do Osso Alveolar , Periodontite Crônica , MicroRNAs , Camundongos , Animais , Humanos , Perda do Osso Alveolar/tratamento farmacológico , Osteoclastos/metabolismo , Osteogênese/genética , Macrófagos , Periodontite Crônica/genética , MicroRNAs/metabolismoRESUMO
BACKGROUND: The underlying mechanism of epidural-related maternal fever (ERMF) is not fully understood. This systematic review aimed to identify factors associated with ERMF in low-risk, full-term women using neuraxial analgesia. METHODS: PubMed, Embase, Web of Science, CENTRAL, and Wanfang Data were searched from inception to September 10, 2022 with no language restriction. Studies reported descriptive data regarding the factors associated with ERMF. A random effects model meta-analysis was used to pool the raw data of univariate analyses for each identified factor. Sensitivity and subgroup analyses were performed to explore possible sources of heterogeneity. RESULTS: Eighteen observational studies involving 33â¯427 women were included, with 18 factors eligible for meta-analyses. Higher body mass index, baseline temperature, admission maternal interleukin-6 levels and white blood cell counts, nulliparity, increasing gestational age, longer duration of labor and rupture of membranes, increasing number of vaginal examinations, oxytocin use, higher birth weight, lower cervical dilation at initiation of analgesia, and longer analgesia duration were associated with increased risk of ERMF, while intermittent compared with continuous epidural dosing was associated with a decreased risk of ERMF (odds ratio 0.25, 95% CI 0.16 to 0.48, Pâ¯<â¯0.001). However, heterogeneity among studies was high and the quality of evidence was low for these meta-analyses, except for intermittent epidural dosing. CONCLUSIONS: Many factors are associated with ERMF but may not be independent or causal. Further study is needed to clarify the interactions of these factors in ERMF development and whether modification of these factors might influence risk of ERMF.
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Analgesia Epidural , Analgesia Obstétrica , Trabalho de Parto , Gravidez , Feminino , Humanos , Analgesia Epidural/efeitos adversos , Risco , Manejo da Dor , Ocitocina , Analgesia Obstétrica/efeitos adversosRESUMO
The shrinkage and ecological degradation of the Aral Sea resulting from the uncontrolled use of water resources and the unregulated expansion of agriculture activities call for sustainable management of water-agriculture-ecology (WAE) nexus from a basin perspective. However, managers face thorny challenges brought by multiple uncertainties in the management and planning processes. In this study, an interval stochastic fuzzy programming (ISF) method is developed for tackling multiple uncertainties presented as probability distributions, flexible variables and interval parameters. Then, an ISF-WAE model is formulated for Aral Sea Basin, which considers 108 planning scenarios that reflect different food-security and ecology-restoration requirements, as well as risk-response attitudes of decision maker over a long-term planning horizon (2021-2050). Results reveal that for Aral Sea Basin: (i) managers should set strict acreage benchmarks for cereal crops, in which wheat would account for a range of [29.1, 31.2] % of the total agricultural area; (ii) for promoting ecological restoration, the proportion of agricultural water allocation should decrease by a range of [12.7, 16.1] % during the planning horizon; (iii) due to low water requirement and high ecological value of grassland, it is recommended to expand grassland area to improve the sustainability of the Aral Sea Basin in the case of limited water resources.
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Modelos Teóricos , Água , Incerteza , Agricultura , Probabilidade , Recursos HídricosRESUMO
Objective: To conduct a meta-analysis on the influencing factors of mild cognitive impairment (MCI) in the Chinese elderly. Methods: The literature related to the influencing factors of MCI in Chinese elderly population was retrieved through CNKI, Wanfang, VIP, PubMed, Embase and Web of Science databases up to March 13, 2022. Stata17.0 software was used to calculate the combined risk ratio (RR) with the 95% confidence interval (CI), test the heterogeneity, and assess the publication bias. Results: A total of 2 450 articles were retrieved, and 49 articles met the inclusion criteria, including 5 cohort studies and 44 case-control studies. Meta-analysis results showed that male (RR=0.778, 95%CI: 0.696-0.870, I2=73.1), education>6years (RR=0.428, 95%CI: 0.374-0.490, I2=86.9) and regular exercise (RR=0.496, 95%CI: 0.421-0.585, I2=81.5) were protective factors for MCI, while age≥70 years (RR=2.431, 95%CI: 2.086-2.833, I2=79.3), family history of dementia (RR=3.228, 95%CI: 2.140-4.867, I2=0.0), smoking (RR=1.214, 95%CI: 1.098-1.342, I2=78.8), alcohol consumption (RR=1.165, 95%CI: 1.047-1.297, I2=68.2), solitary living (RR=2.816, 95%CI: 2.123-3.736, I2=42.0), insomnia (RR=1.402, 95%CI: 1.093-1.799, I2=41.3), overweight/obesity (RR=1.431, 95%CI: 1.207-1.696, I2=75.9), hypertension (RR=1.731, 95%CI: 1.589-1.886, I2=67.1), hyperlipidemia (RR=1.722, 95%CI: 1.541-1.924, I2=63.9), diabetes mellitus (RR=1.495, 95%CI: 1.341-1.666, I2=71.6), cardiovascular diseases (RR=1.671, 95%CI: 1.446-1.932, I2=74.6) and cerebrovascular diseases (RR=2.309, 95%CI: 2.040-2.613, I2=76.3) were risk factors of MCI. Conclusion: The present study indicates that male, junior high school education or above and regular exercise are protective factors of MCI, while age≥70 years, family history of dementia, smoking, alcohol consumption, living alone, insomnia, overweight/obesity, hypertension, hyperlipidemia, diabetes, cardiovascular diseases and cerebrovascular diseases are risk factors of MCI.
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Doenças Cardiovasculares , Disfunção Cognitiva , Demência , Diabetes Mellitus , Hipertensão , Distúrbios do Início e da Manutenção do Sono , Humanos , Masculino , Idoso , Sobrepeso , População do Leste Asiático , Disfunção Cognitiva/epidemiologia , Fatores de Risco , Obesidade , Demência/psicologiaRESUMO
Alveolar ridge augmentation is a common method to solve the problem of insufficient bone mass during implant treatment, while shaping bone substitutes during surgery, maintaining space and stability remain challenging. Digital bone block refers to a digital method for making bone grafts suitable for personalized defect shape. With the advancement of digital technology and the development of materials science, the means of realizing digital bone blocks have also undergone a series of updates. This paper summarizes the relevant researches in the past, systematically introduces the workflow, implementation methods, development history and future prospects of digital bone blocks, and provides suggestions and references for clinicians to use digital methods to improve the predictability of bone augmentation outcome.
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A total of 10 lactobacillus strains were isolated from broiler chickens and their probiotic properties including tolerance to gastrointestinal fluids and heat treatment, antimicrobial activity, adhesion capacity to intestinal cells, surface hydrophobicity, autoaggregation, antioxidative activity, and immunomodulatory effects on chicken macrophages were evaluated. The Limosilactobacillus reuteri (LR) was the most frequently isolated species, followed by Lactobacillus johnsonii (LJ) and Ligilactobacillus salivarius (LS). All isolates showed good resistance to simulated gastrointestinal conditions and antimicrobial activity against 4 indicator strains including Escherichia coli, Salmonella typhimurium, Klebsiella pneumoniae, and Proteus mirabilis LR 21 exhibited excellent performances on autoaggregation, hydrophobicity and adhesion capacity to Caco-2 intestinal cells. In the meantime, this strain also possessed considerable tolerance to heat treatment, which indicated great potential to be used in the feed industry. However, LJ 20 strain had the highest free radical scavenging activity compared with the other strains. Furthermore, qRT-PCR results revealed that all isolated strains significantly increased the transcriptional levels of proinflammatory genes and tended to induce the M1-type polarization on HD11 macrophages. Particularly, the technique for order preference by similarity to ideal solution (TOPSIS) was adopted in our study to compare and select the most promising probiotic candidate based on in vitro evaluation tests.
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Anti-Infecciosos , Probióticos , Animais , Humanos , Lactobacillus , Galinhas , Células CACO-2 , Escherichia coli , Probióticos/farmacologiaRESUMO
Objective: To analyze the epidemiological characteristics of typhus in China from 1950 to 2021, and discuss the challenges in typhus prevention and control in China and suggest future prevention and control strategies. Methods: Based on the reported data of typhus from 1950 to 2021 in China from the Infectious Disease History Database of China Public Health Science Data Center and the National Notifiable Infectious Disease Reporting Information System of Chinese Center for Disease Control and Prevention, we conducted a descriptive statistical analysis. Mann-Kendall test and circular distribution method were used to analyze the incidence, mortality and case fatality of typhus to reveal the temporal, spatial and population distributions and diagnosis of typhus in China. Results: From 1950 to 2021, a total of 452 965 typhus cases and 7 339 typhus deaths were reported in China, with the cases numbers exceeding 10 000 in 14 years of the 1950s, 1960s and 1980s, respectively. Since 1990s, the reported cases and incidence rate of typhus have decreased dramatically and the most cases were sporadic. However, the reported typhus cases in Anhui, Hubei, Hunan Provinces showed significant uptrends. Although typhus could occur all the year round, but the seasonality was observed with the incidence mainly in summer and autumn. For different provinces from the north to the south, the peaks of typhus' monthly incidence tended to shift to earlier dates. The male to female ratio of the cases was 1.01â¶1 (18 529â¶18 366). However, more cases occurred in women in recent years. The cases aged ≤9 years accounted for the highest proportion (18.9%), but the number of cases aged ≥50 years showed an upward trend. Most cases were farmers with the proportion increasing year by year. Moreover, the cases in students and scattered-living children also accounted for relatively higher proportions. The median of the interval between onset and diagnosis of typhus was 6 days. Most cases were clinically diagnosed, while the proportion of laboratory-confirmed cases was low and most laboratory cases were confirmed by Well-Felix reaction. Conclusions: Although the incidence and mortality of typhus in China has decreased significantly, the risk for local typhus outbreaks still exists. The prevention and control of typhus still face many challenges. It is indispensable to strengthen the pathogen detection and surveillance for typhus in China.
Assuntos
Tifo por Ácaros , Tifo Epidêmico Transmitido por Piolhos , Criança , Humanos , Masculino , Feminino , Tifo por Ácaros/epidemiologia , Tifo Epidêmico Transmitido por Piolhos/epidemiologia , China/epidemiologia , Incidência , Notificação de DoençasRESUMO
Chlorocresol nanoemulsion disinfectant (CND) is an environmental disinfectant prepared with nanoemulsion as its drug carrier. This study aimed to investigate the bactericidal effect of CND on Staphylococcus aureus ( S. aureus) and its effect on bacterial ultrastructure. The neutralizing effect of CND against S. aureus was first screened by suspension quantitative evaluation experiment procedure of neutralizer. Disinfection performance was evaluated by the determination of Minimal Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC), quantitative bactericidal experiment, and comparative experiment of disinfection performance between 0.1% CND and 0.1% chlorocresol aqueous solution. Meanwhile, the effect of CND on the ultrastructure of S. aureus was investigated with scanning electron microscope (SEM) and transmission electron microscope (TEM) to preliminarily explore the bactericidal mechanism. The results showed that 3% Tween-80 in PBS could be screened as the neutralizer of CND against S. aureus. MIC and MBC were 100 µg/mL and 200 µg/mL, respectively. The bactericidal rates were all 100% when 0.06% and 0.08% disinfectant acted for 15 and 5 min, respectively. Furthermore, compared with 0.1% chlorocresol aqueous solution, the bactericidal effect of 0.1% CND was significantly enhanced (p⟨0.01). After treatment with CND for 10 min, SEM observation showed that the morphology of S. aureus cells were changed and the integrity destroyed. TEM observation showed that the cell shape changed, and the structures of the cell wall, cell membrane and cytoplasm were damaged in varying degrees. CND showed the strong bactericidal effect on S. aureus and could cause ultrastructure alterations of S. aureus.
Assuntos
Desinfetantes , Infecções Estafilocócicas , Animais , Desinfetantes/farmacologia , Staphylococcus aureus , Antibacterianos/farmacologia , Cresóis/farmacologia , Infecções Estafilocócicas/veterinária , Testes de Sensibilidade Microbiana/veterináriaRESUMO
Objective: To compare the treatment effect of distraction osteogenesis (DO) and maxillomandibular advancement (MMA) for severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients and to guide clinical decisions about treatment of OSAHS. Methods: Thirty-seven OSAHS patients which accepted maxillomandibular advancement (MMA) or distraction osteogenesis (DO) in Stomatological Hospital of the Department of Maxillofacial Trauma and Orthognathic Surgery, School of Stomatology, The Forth Military Medical University from June 2017 to June 2019 were collected. Their preoperative and postoperative data of cephalometry, polysomnography (PSG), Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS) scores were collected and analyzed. With propensity score matching method, the treatment effect of MMA and DO was analyzed and compared. Results: According to the statistics of MMA group, only AHI was correlated with operative successful rate and cure rate. With the increase of AHI, the treatment effect of MMA on OSAHS patients gradually decreased. The cut-off point of AHI as a predictor of MMA treatment failure was 78.2 n/h. All the matched cases were severe OSAHS patients. Statistical analysis showed that the mandibular elongation of DO patients[(24.00±4.39) mm] was significantly more than that of MMA group [(11.20±1.37) mm] (t=-6.11, P<0.001), the improvement of PSG index [including lowest oxygen saturation (LSpO2), longest apnea (LA) and longest hypopnea (LH)] in DO group [LSpO2=(93.40±1.82)%; LA=(18.28±8.32) s; LH=(61.84±32.94) s] was significantly higher than that in the MMA group [LSpO2=(86.00±4.06)%, LA=(64.08±21.78) s, LH=(172.40±30.70) s](t=-3.72, P=0.005; t=4.39, P=0.003; t=5.49, P=0.004). The PSQI and the ESS scores of DO group (PSQI=4.20±0.83; ESS=3.40±1.52) were also significantly better than that of MMA group (PSQI=8.80±2.39, ESS=9.40±2.88)(t=4.07, P=0.001; t=4.12, P=0.002). Conclusions: For severe OSAHS patients, the objective and subjective indicators of DO treatment group showed a better therapeutic effect than that of MMA.