الملخص
Introducción : La Organización Mundial de la Salud (OMS) efectuó recomendaciones en relación con la recopilación y notificación de datos agregados semanales de COVID-19. Objetivo : Investigar el grado de cumplimiento de las recomendaciones elaboradas por la OMS para la notificación de casos y muertes de COVID-19 en la Argentina durante el año 2020 a 2022, y comparar la notificación de muertes con el número de defunciones por COVID-19 consolidadas en el registro de estadísticas vitales del país. Materiales y métodos : Estudio cuantitativo descriptivo, basado en revisión documental y en fuentes de datos secundarias. Se utilizó los reportes diarios de información epidemiológica y la base de datos Dataset, COVID-19 casos registrados en la República Argentina. Adicionalmente, para estimar la omisión en los registros epidemiológicos de fallecimientos por COVID-19 en los años 2020 y 2021, se cotejaron los resultados de las bases de datos Dataset COVID-19 con la base de las Estadísticas vitales de mortalidad por causa de defunción, proporcionadas por la Dirección de Estadísticas e Información en Salud (DEIS). Se analizaron las variables recomendadas por la OMS para la notificación de casos y muertes por COVID-19. En cuanto a las consideraciones éticas relacionadas con el uso de la información utilizada en este trabajo, las bases de datos cumplen con lo estipulado por la Ley Nacional N° 17.622 de Resguardo del Secreto Estadístico, garantizando que la información mantiene el carácter confidencial y reservado del informante. Resultados: Del análisis de los reportes diarios, durante 2020 se observó que, de los 13 indicadores recomendados, 9 presentan datos algunos meses y los 4 restantes no se relevaron; en 2021 solo 7 indicadores presentaron datos algunos meses, y en 2022 solo 3 indicadores se continuaron informando. Respecto al análisis de la base de datos Dataset COVID-19, la mayoría fueron captadas. Respecto a la comparación de los valores de las defunciones registradas por el sistema de vigilancia epidemiológica y por la DEIS para los años 2020 y 2021, las muertes registradas fueron superiores en el registro de la DEIS (9,6% y 14,2%). Conclusiones : El Estado argentino cumplió con gran parte de las recomendaciones que establece la OMS para la notificación de los casos de COVID-19. Estudios posteriores deberían analizar otros componentes de la calidad de los datos, así como la oportunidad de los registros de defunciones, característica necesaria para la toma de decisiones en salud pública.
Introduction : The World Health Organization (WHO) establishes recommendations regarding the collection and reporting of weekly aggregated data on COVID-19. Objective : To investigate the degree of compliance with the recommendations made by the WHO for the reporting of COVID-19 cases and deaths in Argentina during the years 2020 to 2022, and to compare death notifications with the number of COVID-19 deaths recorded in the country's vital statistics registry. Materials and methods : Descriptive quantitative study, based on a documentary review and secondary data sources. Daily reports of epidemiological information and the Dataset database containing registered COVID-19 cases in the Argentine Republic were used. Additionally, to estimate the omission in the epidemiological records of COVID-19 deaths in the years 2020 and 2021, the results of the Dataset COVID-19 databases were compared with the vital statistics death registry on cause of death, provided by the Directorate of Statistics and Health Information (DEIS, by its acronym in Spanish). The variables recommended by the WHO for the reporting of COVID-19 cases and deaths were analyzed. As for the ethical considerations related to the use of the information in this study, the databases comply with the provisions of National Law 17,622 on the Protection of Statistical Secrecy, ensuring that the information remains confidential and reserved for the informant. Results : From the analysis of daily reports, it was observed that in 2020, out of the 13 recommended indicators, 9 had data for some months, and the remaining 4 were not reported. In 2021 only 7 indicators had data for some months, and in 2022 only 3 indicators continued to be reported. Regarding the analysis of the Dataset COVID-19 database, most data were captured. In comparing the values of deaths recorded by the epidemiological surveillance system and by the DEIS for the years 2020 and 2021, the deaths recorded were higher in the DEIS registry (9.6% and 14.2%). Conclusions : The Argentine state largely complied with the recommendations established by the WHO for the reporting of COVID-19 cases. Subsequent studies should analyze other components of data quality, as well as the timeliness of death records, a necessary characteristic for public health decision-making.
الملخص
RESUMEN Los caninos se pueden encontrar en situación heterotópica: fosas nasales, seno maxilar, sínfisis mentoniana, o ectópicamente cerca de su asiento normal, pero en diferentes posiciones. Lo más frecuente es que presenten su eje oblicuo hacia mesial, generalmente en palatino o vestibular en el caso de los inferiores, y relativamente frecuente bilateral. La sintomatología es nula en la inclusión y el diente se diagnostica por otros hechos o existe apariencia clínica en el caso de enclavamiento. El abordaje ortoquirúrgico de caninos retenidos ha avanzado con los miniimplantes; esto ha llevado a realizar ajustes en las técnicas quirúrgicas, priorizando la tracción mediante la técnica VISTA para un posicionamiento adecuado en la arcada. Los miniimplantes mejoran la eficacia y precisión, destacando su relevancia en ortodoncia en conjunto con la cirugía oral. Anteriormente se llevaban a cabo diferentes técnicas; a nivel vestibular, se realizaban colgajos con reposición apical o técnicas poco recomendables, como la fenestración mucosa, pues esta podría producir problemas periodontales; por otra parte, a nivel palatino, se realizaba la descubierta de los caninos incluidos mediante un colgajo mucoperióstico (técnica de ventana quirúrgica), en el que se realiza una alveolotomía conductora. Por todo ello, ha de tenerse en cuenta que la apa-ratología fija ortodóntica proporciona una alternativa que evita la extracción de órganos dentales retenidos, a través de técnicas quirúrgicas mínimamente invasivas, que permiten mantener los caninos en la arcada dental y, por tanto, la armonía de las arcadas dentales.
ABSTRACT Canines can be found in heterotopic situation: nostrils, maxillary sinus, mentonian symphysis, or ectopically near their normal seat, but in different positions. Most frequently it presents its axis obliquely towards mesial, generally in palatine or vestibular in the case of the inferior ones, and relatively frequently bilateral. Symptomatology is null in the inclusion and the tooth is diagnosed by other facts or there is clinical appearance in the case of interlocking. The orthosurgical approach to retained canines has advanced with mini-implants; which has led to adjustments in surgical techniques, prioritizing traction using the VISTA technique for adequate positioning in the arch. Mini-implants improve efficiency and precision, highlighting their relevance in orthodontics in conjunction with oral surgery. Previously, different techniques were carried out: at the vestibular level, flaps with apical repositioning or techniques that were not recommended, such as mucosal fenestration, which could cause periodontal problems; on the other hand, at the palatal level, the included canines were uncovered by means of a mucoperiosteal flap (surgical window technique), in which a conductive alveolotomy was performed. Therefore, it should be taken into account that fixed orthodontic appliances provide an alternative that avoids the extraction of retained dental organs through minimally invasive surgical techniques.
الملخص
La utilización de herramientas tecnológicas en la docencia condiciona el desarrollo de nuevas destrezas intelectuales en los estudiantes, lo que les facilita la aplicación de estrategias de investigación, mejora sus capacidades de una forma integral, les ayuda a enfrentar las dificultades y exigencias del mundo y les permite adquirir un aprendizaje más significativo para poder desenvolverse en el ámbito socioeducativo. Con vistas a cumplir lo anterior, se desarrolló un repositorio institucional de recursos educativos abiertos para la Universidad Virtual de Salud, a partir del empleo de herramientas tecnológicas libres y de código abierto que permiten la estandarización e interoperabilidad entre cada uno de los repositorios establecidos en el Sistema Nacional de Salud, con lo cual se garantizará una lógica de organización académica.
The use of digital technologies in teaching determines the development of new intellectual skills in students, which facilitates the application of investigation strategies, improves their capabilities in an integral way, helps them face the difficulties and demands of the current world and allows them to acquire more significant learning to have a good performance in the socio-educational environment. With a view to fulfilling the above, an institutional repository of open educational resources was developed for the Virtual Health University, based on the use of free and open-source technology tools that allow the standardization and interoperability among each of the repositories established in the National Health System, which will guarantee logic of academic organization.
الملخص
Objective To explore the construction and visualization for knowledge graph of Ling Shu(Spiritual Pivot),with a view to providing ideas for the structured storage and display of the theoretical knowledge of the ancient Chinese medical books.Methods Using the professional idea of constructing knowledge graphs for reference,text mining technology was applied to construct the thesaurus,and then word division,entity recognition,and relationship extraction for the original text of Ling Shu were performed to get the elements of knowledge graph construction.The graph database Neo4j was used for the storage and query of the knowledge graph,and then the visual display of the knowledge graph was achieved.Results The 1 216 high-quality words consisting of the thesaurus of Ling Shu were obtained,and the construction of the knowledge graph of the theory of Ling Shu was realized.The constructed knowledge graph basically displayed the traditional Chinese medicine theories such as the correlation of visceral manifestations with essence qi,and the relationship between emotions and the five-zang organs described in Ling Shu,which made the retrieval and utilization of the related entities and relationships possible,and provided ideas for the structured storage and display of the theoretical knowledge of the ancient books of Chinese medicine.Conclusion The knowledge graph construction technology can be used to obtain the Chinese medicine theoretical knowledge graph of Ling Shu,and to display the knowledge connections of yin-yang and the five elements,and the internal organs and meridians expressed in the Ling Shu.The construction of the knowledge graph and its storage in the graph database enable the knowledge graph involved in the text of Ling Shu to be displayed in the form of visualized semantic network graph,and also make the embedding of other search systems such as the semantic search and semantic wiki possible,which will be helpful for the development of Chinese medicine intelligent medical services.
الملخص
Vascular surgery is an emerging clinical discipline with a wide range of categories and disease types.In theoretical teaching,a large amount of vivid imaging materials and vascular reconstruction photos are needed to effectively display the clinical manifestation.During internship training,there are not enough patients in the ward to cover common or frequently-occurring diseases of vascular surgery.As a result,development of a clinical case data-base is of great significance for the teaching of vascular surgery.This article mainly introduces the establishment and preliminary application of a clinical case database in vascular surgery teaching at Beijing Tiantan Hospital affiliated to Capital Medical University.
الملخص
Objective To investigate the predisposing factors carried out in patients with secondary primary esophageal cancer and the related factors affecting its prognosis.Methods Patients with pathologically definite esophageal cancer diagnosis from 2000-2019 in the Surveillance/Epidemiology and End Results(SEER)database were selected,from which the data of patients with other malignancies as the first and esophageal cancer as the second primary(Secondary Primary Esophageal cancer-SPE)were screened,and logistic regression was used to analyze the independent risk factors in patients with secondary primary esophageal cancer,and the independent risk factors affecting the prognosis of such patients were analyzed by Cox proportional hazard model.Results A total of 13520 patients with multiple primary malignancies with esophageal cancer,including a total of 8308 patients with secondary primary esophageal cancer.Multiple logistic analysis showed that age,tumor site,tumor differentiation,pathological examines,SEER neoplasm invasiveness and regional lymph node adoption were independent factors influencing the occurrence of SPE,while multiple Cox risk proportion analysis suggested that age,year of diagnosis,race,tumor differentiation,SEER neoplasm invasiveness,surgery,chemotherapy,radiotherapy,and triple therapy were independent risk factors influencing SPE.Conclusion This study identified risk factors for secondary primary esophageal cancer,and surgery may be an effective treatment for SPE,which clinicians can use as a reference for diagnosis and treatment.
الملخص
Objective:To illustrate the characteristics of the distribution of prophages among the Group A Streptococcus(GAS) by mining the existing whole genome sequencing of the GAS, performing bioinformatic analyses, extracting data about prophages, and analyzing the state of prophages in the genome and genetic composition of some prophages. Methods:It was a retrospective study.Genome assembly sequences of GAS reported in GenBank till May 2020 were collected, and the important background information of these strains was sorted out to create a local genomic database.A phylogenetic tree of the whole genome of GAS was conducted using the bioinformatics software.The core genome was analyzed, and potential prophages and their integrity in the genome were predicted to obtain the characteristics of the distribution of prophages.Genotype types, number of core genes, and number, length and carrying rate of prophages in the database for GAS were analyzed.Results:A database containing the genome sequence of 2 529 GAS strains was established, involving 140 emm genotypes.These strains were isolated from 19 countries from East Asia, Europe, America and Oceania.Stratified by the disease background, these strains were mainly divided into invasive infection, non-invasive infection and immune sequelae.Prophage analysis of 1 798 genomes showed that at least one complete prophage was detected in 1 366 (76.0%) genomes.The number of complete prophages of each strain ranged from 0 to 6, and the length ranged from 32.8 to 62.6 kb, which was mainly 30-40 kb in length.The phiHKUssa, phiHKUvir and phiHKU488 were the most common prophages present in dominant clones circulated in China in recent years, which mainly carried virulence genes like the speC, spd1 and ssa. Conclusions:Prophages are widely distributed in the genome of GAS, which are of great significance in the evolution and expansion of dominating clones and thus reshape the population structure within the emm genotype.The establishment of a local genome database provides important baseline data for molecular epidemiological surveillance.
الملخص
BACKGROUND:In the process of exploring the mechanism of Alzheimer's disease,the important role of bioinformatics for common target screening has been revealed,enabling the use of its screening results as a basis for exploring the therapeutic effects of drugs on the disease. OBJECTIVE:To predict the targets of liraglutide,a glucagon-like peptide-1 receptor agonist,in the treatment of Alzheimer's disease by bioinformatics and molecular biology. METHODS:DisGeNET database and SEA database were used to obtain the common genes of Alzheimer's disease and liraglutide.GO/KEGG enrichment analysis of common targets was conducted using DAVID online database.Protein-protein interaction networks were constructed using STRING database.The optimal dosage of liraglutide was determined using cell counting kit-8 assay.Expression of key proteins was analyzed using immunofluorescence and immunoblotting techniques.The mouse hippocampal neuron HT22 cell line was used for ex vivo experiments,and the cells were randomly divided into three groups:HT22 group,HT22+Aβ group,and HT22+Aβ+Lir group.No special treatment was done in the HT22 group,while Aβ1-42 was used to intervene in the HT22 cell line for 24 hours to construct an Aβ injury cell model in the HT22+Aβ group.In additional to modeling,liraglutide was added to the HT22+Aβ+Lir group for 12 hours. RESULTS AND CONCLUSION:A total of 3 333 genes associated with Alzheimer's disease were screened from DisGeNET database.Then 147 potential targets of liraglutide were obtained from SEA database.Finally,64 common targets of Alzheimer's disease and Liraglutide were determined using R packets.GO/KEGG analysis of common targets using DAVID online database suggested that common targets were mainly enriched in the following biological processes:neuroactive ligand-receptor interaction,renin-angiotensin system,bladder cancer,endopeptidase activity,peptide receptor activity,G protein-coupled peptide receptor activity,and transport vesicles.The obtained 64 common target proteins were imported into SRTING online database for protein-protein interaction network construction,and the top three genes,matrix metalloproteinases 2,9 and interleukin 1β,were obtained.The activity of cultured cells was detected by the cell counting kit-8 kit.Liraglutide at 100 nmol/L was the optimal concentration for antagonizing Aβ1-42.In the western blot and immunofluorescence assays,the expression of matrix metalloproteinases 2,9 and interleukin 1β was significantly increased in the HT22+Aβ group compared with the HT22 group(P<0.05)but significantly decreased in the HT22+Aβ+Lir group compared with the HT22+Aβ group(P<0.05).To conclude,the above bioinformatics data and secondary validation of differential genes in the GEO database suggest that both matrix metalloproteinases 2,9 and interleukin 1β could be potential targets of liraglutide in the treatment of Alzheimer's disease.
الملخص
BACKGROUND:Studies have found that glucagon-like peptide-1 and its analogues have a significant neuroprotective effect,and some drugs have been applied to the clinical stage Ⅲ study of Alzheimer's disease.However,the mechanism of its neuroprotective effect is still unclear,which needs to be further explored and clarified. OBJECTIVE:To screen out the genes related to the pathogenesis of Alzheimer's disease and the related targets of semaglutide for the treatment of Alzheimer's disease based on bioinformatics and network pharmacology analyses,to identify the potential target genes by comprehensive analysis of the two and to verify them at the cellular level. METHODS:Using DisGeNET database,differentially expressed genes between Alzheimer's disease patients and healthy population were screened out.The chemical structure formula and two-dimensional structure diagram of semaglutide were obtained using PubChem online database.GO/KEGG enrichment analysis was performed using DAVID online database.A protein-protein interaction network was constructed by using the STRING database.The HPA database was used to determine the distribution characteristics of the target proteins in various human tissues.Finally,western blot was used to detect relevant protein expression in HT22 cells after semaglutide intervention. RESULTS AND CONCLUSION:With the dataset in DisGeNET database,3 374 differentially expressed genes between Alzheimer's disease patients and healthy people were obtained,and meanwhile,101 target genes of semaglutide potential drugs were obtained.There were 23 intersection genes between them.Ten key genes were identified based on the protein-protein interaction network,which were silent information regulator 1(SIRT1),CASP9,CCND1,CASP1,KEAP1,DLG4,CASP4,GRB2,GRIA1,and EDNRA.The results of GO gene functional annotation analysis of key genes showed that the positive regulatory activity of cysteine endopeptidase,the positive regulation of proteolysis,and the positive regulation of cysteine endopeptidase involved the cytoplasmic part of the apoptotic activity process;AMPA glutamate receptor complex,inflammatory complex,CARD domain binding,cysteine endopeptidase activity,and cysteine endopeptidase activity were involved in the apoptotic process.The results of KEGG signaling pathway analysis indicated that colorectal cancer,non-small cell carcinoma,and endometrial carcinoma were related to immune infiltration,inflammation and autophagic apoptosis.In addition,according to the association ranking of key genes and their distribution in different tissues of HPA online database,SIRT1 was identified as the most significant differential gene.The expression level of SIRT1 protein was significantly down-regulated in HT22 cells after β-amyloid protein 1-42 treatment,but it could be significantly increased after being treated with semaglutide.To conclude,SIRT1 may be a target gene for semaglutide in the treatment of Alzheimer's disease.
الملخص
BACKGROUND:At present,the biological functions and molecular changes of bone marrow mesenchymal stem cells in the tumor microenvironment of acute myeloid leukemia are still unclear. OBJECTIVE:To explore the changes in the biological function of bone marrow mesenchymal stem cells in acute myeloid leukemia and the role of acute myeloid leukemia conditioned medium by bioinformatics and experiment. METHODS:Differential genes were screened from GEO data sets,and enrichment analysis was performed.The protein-protein interaction network was constructed and the Hub gene was obtained.Bone marrow mesenchymal stem cells from patients with acute myeloid leukemia and healthy donors were cultured.Bone marrow mesenchymal stem cells from healthy donors were treated with acute myeloid leukemia conditioned culture solution.Each group was subjected to the adipogenic differentiation,osteogenic differentiation,staining of β-galactosidase,detection of the cell cycle,and validation of Hub genes. RESULTS AND CONCLUSION:(1)Gene expression data of bone marrow mesenchymal stem cells from acute myeloid leukemia patients and healthy donors were obtained from GSE84881,and 184 up-regulated genes and 140 down-regulated genes were screened.(2)The biological functions of enrichment mainly include cell cycle,adipocyte differentiation,cell metabolism,and MYC pathway.According to the Degree algorithm,10 up-regulated Hub genes and 10 down-regulated Hub genes were selected.(3)The cell in vitro experiment found that:compared with the control group,the surface antigen of acute myeloid leukemia mesenchymal stem cells did not change,but it showed enhanced lipid differentiation ability,weakened osteogenic differentiation ability,increased β-galactosidase positive cell number,altered cell morphology,arrested cell cycle,increased LGALS3 expression,and decreased MYC expression.Mesenchymal stem cells from healthy donors showed similar changes after being cultured in acute myeloid leukemia conditioned medium.(4)The results show that biological function of mesenchymal stem cells is altered in the acute myeloid leukemia microenvironment,which provides new insights into the interaction between mesenchymal stem cells and tumor cells.
الملخص
BACKGROUND:Autophagy and ferroptosis play important roles in the development of chronic kidney disease,but the molecular mechanisms and gene targets related to autophagy and ferroptosis in renal tissue of chronic kidney disease are still unclear. OBJECTIVE:To screen differentially expressed genes in chronic kidney disease-related datasets based on bioinformatics,and to explore potential key biomarkers suitable for screening renal function progression in patients with chronic kidney disease. METHODS:(1)The GSE137570 dataset was obtained from GEO database to screen the differentially expressed genes by Networkanalyst database analysis.Ferroptosis and autophagy related targets were obtained by OMIM,GENECARD,FerrDb and HAMdb databases.The respective data were intersected to obtain autophagy-ferroptosis related differentially expressed genes in chronic kidney disease for parallel enrichment analysis.The STRING website was used to construct the protein-protein interaction network of differentially expressed genes,which was imported into Cytoscape software and analyzed by MCODE and Cytohubba plug-in to screen potential core targets.Enrichment analysis was performed to obtain the functions of these potential core targets.(2)In the in vitro experiment,mouse renal tubular epithelial cells were divided into two groups:the control group received no intervention,while the model group was stimulated with 5 ng/mL transforming growth factor β1 for 24 hours to induce mesenchymal transformation of renal tubular epithelial cells.Flow cytometry was used to measure the levels of reactive oxygen species and changes in mitochondrial membrane potential in the cells.RT-PCR was employed to assess ferroptosis,autophagy-related markers,and the mRNA expression of potential core targets in the cells. RESULTS AND CONCLUSION:After screening the GSE137570 dataset,a total of 480 differentially expressed genes were obtained,including 104 upregulated genes and 376 downregulated genes(log2|(FC)|>1,P<0.05).There were 562 ferroptosis-related targets and 1 266 autophagy-related targets obtained from the OMIM,GENECARD,FerrDb,and HAMdb databases.Intersection of differentially expressed genes with ferroptosis-and autophagy-related targets yielded 15 ferroptosis-related targets and 18 autophagy-related targets,respectively.The enrichment analysis results indicate that ferroptosis-related differentially expressed genes are primarily involved in biological processes such as sulfur amino acid metabolism,neutrophil degranulation,and ferroptosis signaling pathways.Autophagy-related differentially expressed genes are mainly enriched in biological processes such as platelet degranulation,extracellular matrix degradation,and receptor tyrosine kinase signaling.After screened by MCODE and CytoHubba,key genes were identified in the protein-protein interaction network,including CD44,ALB,TIMP1,PLG,CCL2,and DPP4.Immune infiltration analysis results indicate that immune cells such as B cells,CD4+ T cells,NK cells,and monocytes show significant differential expression in renal tissue after chronic kidney disease,and the core targets are also significantly correlated with these immune cells(P<0.05).The results of receiver operator characteristic curve analysis further demonstrate that the pathological progression of chronic kidney disease can be effectively diagnosed by CD44,ALB,TIMP1,PLG,CCL2,and DPP4.Single-cell sequencing results show that,except for PLG,the expression of target genes in the renal tissue of mice in each model group is generally consistent with the results of this experiment.RT-PCR results demonstrate that,for the validation of autophagy and ferroptosis phenotypes,compared with the control group,the model group shows a significant decrease in mRNA expression of LC3B,Nrf2,and SLC7A11(P<0.05),and a significant increase in P62 mRNA expression(P<0.05).Regarding the validation of potential core targets,compared with the control group,the model group exhibits a significant decrease in mRNA expression of ALB and PLG(P<0.05),and a significant increase in TIMP1 and CCL2 mRNA expression(P<0.05).Overall,these findings indicate that,through bioinformatics analysis and experimental validation,CD44,ALB,TIMP1,PLG,and CCL2 are abnormally expressed in the renal tissue of patients with chronic kidney disease,closely correlated with estimated glomerular filtration rate and tubulointerstitial fibrosis,and maybe play a predictive role in the progression of chronic kidney disease.
الملخص
Objective The rapid growth of data exchange and information volume in hospital information systems has brought significant challenges to the operation,maintenance,and service performance of the system.In order to overcome the performance bottleneck of the software and improve the response performance of the hospital information system,our hospital has tentatively introduced the Exadata database machine.Methods The machine was launched through hardware parameter selec-tion,high availability testing,and data migration.The benefits were evaluated by comparing the I/O operation time,SQL state-ment execution time,and business system module loading time before and after the launch.Results After using this machine,the overall waiting time of I/O operations decreased by 83.47% ,the execution time of the same statement decreased by over 22% ,and the average loadingtime of the business system decreased by43.74% .Conclusion The database machine can effec-tively reduce query time,accelerate the running speed of business modules,and help improve the performance of hospital infor-mation systems.
الملخص
Colorectal cancer is a major digestive disease in China, with mid-low rectal cancer as the predominant cause. Over the years, Chinese colorectal surgery has made considerable strides, attaining certain successes in clinical diagnosis and treatment, scientific research, and data platform construction. Nevertheless, there is still room for improvement in terms of the accuracy of diagnosis and standardization of treatment. Furthermore, immune checkpoint therapy represented by programmed death-1 have demonstrated initial efficacy in the treatment of mid-low rectal cancer. Further research is required to better understand the relationship and role between immune checkpoint inhibitors and traditional radiotherapy and chemotherapy, and to apply them to precise clinical practice. The authors elaborate on current status of diagnosis and treatment for mid-low rectal cancer in China, in order to provide references for its precission diagnosis and standardized treatment.
الملخص
Objective:To construct the risk prediction nomogram model of acute kidney injury (AKI) with R language and traditional statistical methods based on the large sample clinical database, and verify the accuracy of the model.Methods:It was a a retrospective case control study. The patients who met the diagnostic criteria of AKI in Tongji Hospital of Tongji University from January 1 to December 31, 2021 were screened in the clinical database, and the patients with monitored serum creatinine within 48 hours but without AKI were included as the control group. The demographic data, disease history, surgical history, medication history and laboratory test data were collected to screen the risk factors of AKI in clinic.Firstly, based on multivariate logistic regression analysis and forward stepwise logistic regression analysis, the selected risk factors were included to construct the nomogram model. At the same time, cross validation, bootstrap validation and randomly split sample validation were used for internal verification, and clinical data of patients in the sane hospital after one year (January to December, 2022) were collected for external verification. The receiver-operating characteristic curve was used to determine the discrimination of the model, and calibration curve and decision curve analysis were carried out to evaluate the accuracy and clinical net benefit, respectively.Results:A total of 5 671 patients were enrolled in the study, with 1 884 AKI patients (33.2%) and 3 787 non-AKI patients (66.7%). Compared with non-AKI group, age, and proportions of surgical history, renal replacement therapy, hypertension, diabetes, cerebrovascular accident,chronic kidney disease, drug use histories and mortality in AKI group were all higher (all P<0.05). Multivariate logistic regression analysis showed that the independent influencing factors of AKI were surgical history, hypertension, cerebrovascular accident, diabetes, chronic kidney disease, diuretics, nitroglycerin, antidiuretic hormones, body temperature, serum creatinine, C-reactive protein, red blood cells, white blood cells, D-dimer, myoglobin, hemoglobin, blood urea nitrogen, brain natriuretic peptide, aspartate aminotransferase, alanine aminotransferase, triacylglycerol, lactate dehydrogenase, total bilirubin, activated partial thromboplastin time, blood uric acid and potassium ion (all P<0.05). Finally, the predictive factors in the nomogram were determined by forward stepwise logistic regression analysis, including chronic kidney disease, hypertension, myoglobin, serum creatinine and blood urea nitrogen, and the area under the curve of the prediction nomogram model was 0.926 [95% CI 0.918-0.933, P<0.001]. The calibration curve showed that the calibration effect of nomogram was good ( P>0.05). The decision curve showed that when the risk threshold of nomogram model was more than 0.04, the model construction was useful in clinic. In addition, the area under the curve of receiver-operating characteristic curve predicted by nomograph model in external validation set was 0.876 (95% CI 0.865-0.886), which indicated that nomograph model had a high discrimination degree. Conclusion:A nomogram model for predicting the occurrence of AKI is established successfully, which is helpful for clinicians to find high-risk AKI patients early, intervene in time and improve the prognosis.
الملخص
Empowered by the rapid development of artificial intelligence technology and information security technology, basic medicine, translational medicine, and clinical medicine have entered a new era. In this process, the relevant data such as text, genetics, images, and videos have increased at an astonishing rate. Traditional specialized disease databases cannot adapt to the multimodality of data and the multicentralization of data sources in the present/future. Therefore, establishing a next-generation multimodal and multicenter collaborative specialized disease database that is suitable for secure data sharing and ethical in clinical research is essential. This paper expounds the concept and basic framework of developing a next-generation clinical research disease database with universal use, emphasizing the establishment of a multimodal data integration mechanism, a multicenter collaborative system supported by privacy-preserving computing, highly intelligent software and hardware entities, and an integrated operational management mode. It also introduces the application of this concept in the construction of a breast cancer three-dimensional life database, a project of China Breast Cancer Innovation Alliance.
الملخص
【Objective】 To examine risk factors for acute pancreatitis (AP) in individuals with chronic alcohol consumption habits. 【Methods】 The study incorporated participants from the initial survey (2006-2010) and subsequent follow-ups (2014+) taken from the UK Biobank database, with the observation period ending on November 30, 2022. During this period, 176 individuals were newly diagnosed with AP, while 59,512 remained unaffected. Vital characteristics of the target population, such as their medical histories, surgical experiences and dietary patterns, were collected during the enrolment phase (2006-2010). The Cox proportional hazard model was employed to ascertain whether these characteristics were potent risk factors for AP. Concurrently, a subgroup from the target population with documented drinking behavior was selected. The multivariate Cox proportional hazard model was utilized to analyze the relationship of the established factors, variances in alcohol consumption, and increased alcohol intake (Δ) with the onset of AP, and whether the additional alcohol intake served as a risk factor. 【Results】 Multivariate analysis revealed that consumption quantity of cooked vegetables inversely correlated with AP risk (HR=0.44, 0.39, 0.42 and 0.41 for one, two, three and four+ tablespoons per day, respectively, as compared to non-consumers). Coffee consumption (2-3 cups per day) also reduced AP risk (HR=0.45 for 2 cups/day; HR=0.39 for 3 cups/day as compared to non-coffee drinkers). However, those with biliary disease without cholecystectomy exhibited a marked increase in AP risk (HR=7.82), which reduced albeit remained elevated for those with biliary disease post-cholecystectomy (HR=2.15). Subgroup analysis showed minimal impact of alcohol intake levels on AP incidence. Yet, increased alcohol consumption (Δ of 1 bottle/week) was linked to a heightened AP risk (HR=1.05, 95% CI:1.02-1.09, P<0.05). 【Conclusion】 Among longstanding alcohol consumers, a diet rich in cooked vegetables and moderate coffee consumption offers protective effects against AP. Conversely, biliary disease (particularly without cholecystectomy) and elevated alcohol intake present considerable risk factors for the development of this condition.
الملخص
【Objective】 To investigate the relationship between the initial serum ammonia level and the risk of ICU and hospital mortalities in critically ill patients without hepatic disease. 【Methods】 A retrospective cohort study was conducted among patients admitted to the eICU Collaborative Research Database (eICU-CRD) for a single admission who had serum ammonia test records within 48 hours of the first ICU admission and had no hepatic disease. The age, sex, ethnicity, Acute Physiologic and Chronic Health Evaluation Ⅳ score (APACHE Ⅳ score), treatment methods, complications, and outcomes were extracted. Univariable and multivariable Logistic regression were used to analyze the relationship between serum ammonia level and the risk of mortality. Interactions were used to analyze whether the relationship between serum ammonia level and the risk of mortality differed in subgroups of APACHE Ⅳ scores, age, sex, and ethnicity; subgroup analyses were made. 【Results】 A total of 1 674 patients were included. The multivariable Logistic regression showed that for every 10 μg/dL increase in ammonia, the risk of ICU death increased by 6.9% (OR=1.069, 95% CI: 1.036-1.104), and the risk of hospital death increased by 4.6% (OR=1.046, 95% CI: 1.017-1.076). The risk of ICU death was 1.7 times greater in patients with initial ammonia level of 49-82 μg/dL than in those with <49 μg/dL (OR=1.700, 95% CI: 1.165-2.482), the risk of ICU death was 2.862 times greater in patients with a level of ≥82 μg/dL compared to those with <49 μg/dL (OR=2.862, 95% CI: 1.792-4.570), and the risk of hospital death was 1.844 times higher in the ≥82 μg/dL group than in the <49 μg/dL group (OR=1.844, 95% CI: 1.213-2.804). There were no significant differences between initial ammonia level and the risk of mortalities in different subgroups of APACHEⅣ scores, age, sex, or ethnicity. 【Conclusion】 In critically ill patients without hepatic disease, elevated initial serum ammonia level after ICU admission is associated with a high risk of ICU and hospital mortality.
الملخص
【Objective】 To analyze the expression of lncRNA SNHG25 in prostate cancer and its significance, so as to explore the biomarkers and potential therapeutic targets for the diagnosis and prognosis of this disease. 【Methods】 Based on the TCGA database, differential, survival, and clinical correlation analyses of SNHG25 were performed.SNHG25 expression in prostate cancer was analyzed in the UALCAN database to determine its relationship with the clinical and pathological characteristics.The lncRNA-miRNA-mRNA correlation analysis was performed.The relevant ceRNA regulatory network was constructed.Prostate cancer samples were divided into high and low SNHG25 expression groups, and differential SNHG25 related genes were filtered and then enriched. 【Results】 SNHG25 expression was significantly upregulated in prostate cancer specimens compared to normal prostate specimens (P0.05).Regulatory networks of SNHG25/miR-330-3p/DLX1 and RPL22L1 were constructed. 【Conclusion】 SNHG25 is highly expressed in prostate cancer tissues and correlated with poor prognosis.SNHG25 expression does not significantly correlate with age, T-stage, N-stage, and Gleason score.SNHG25/miR-330-3p/DLX1 and RPL22L1 regulatory networks may play an important role in the development of prostate cancer.SNHG25 may become a biomarker and potential therapeutic target for prostate cancer.
الملخص
【Objective】 To investigate the effects of radical prostatectomy (RP) or brachytherapy (BT) on the prognosis of patients with high-risk prostate cancer as initial treatment, in order to provide a reference for the selection of clinical treatment options. 【Methods】 The clinical data of 133 191 patients diagnosed with high-risk prostate cancer and treated with RP or BT during 2005 and 2014 were extracted from the SEER database.The 5-year and 10- year cancer-specific survival (CSS) and overall survival (OS) were compared with K-M analysis and univariate and multivariate Cox regression.The clinical data of another 253 patients diagnosed with high-risk prostate cancer in Subei People’s Hospital during 2015 and 2020 were collected, including 153 patients who received RP and 100 patients who received BT.The 5-year biochemical progress-free survival (bPFS) and CSS were compared with K-M analysis. 【Results】 Univariate analysis of SEER data showed that BT was associated with a higher risk of death (HR=1.319, 95%CI: 1.256-1.386, P<0.001); age, marital status and TNM stage were associated with higher risk of death (P<0.001).Multivariate analysis, adjusted for relevant variables, showed that BT did not result in a higher risk of death compared with RP (HR=0.964, 95%CI:0.924-0.996, P=0.808). The OS curve showed that the longer the observed survival time, the better OS of RP as compared to BT (P<0.001); however, the CSS survival curve showed that the longer the observed survival time, the better CSS of BT compared to RP (P<0.001).The single-center data analysis showed no significant difference between BT and RP in the 5-year bPFS (P=0.263) and CSS (P=0.946). 【Conclusion】 For patients with high-risk prostate cancer, there is a significant difference in the prognosis of the two treatments if there is no adjustment of age, marital status, TNM stage and other factors, and the efficacy of RP is better than that of BT, especially in patients with survival more than 10 years.However, there is no statistically significant difference in the prognosis after the possible confounding factors are adjusted.Therefore, the initial treatment choice for these patients should be weighed from multiple perspectives, and patients’ choices must be respected after they are fully informed.
الملخص
【Objective】 To investigate the clinical features and prognostic factors of elderly patients with localized renal cell carcinoma after operation. 【Methods】 Clinical data of all elderly patients (60-100 years old) with localized renal cell carcinoma who underwent primary tumor resection during 2004 and 2017 in United States National Cancer Institute (SEER) database were collected.The clinical features, surgical methods and prognosis were analyzed.According to the surgical methods, the patients were divided into partial nephrectomy (PN) group and radical nephrectomy (RN) group.The effects of the two surgical methods on the prognosis were compared. 【Results】 A total of 20 348 patients were included.The median survival time was 164 months, and the 3-, 5- and 10-year cumulative overall survival rates were 91.1%, 84.2% and 64.4%, respectively.Multivariate Cox analysis showed that age, sex, race, histological grade, T stage and surgical method were independent prognostic factors for overall survival (P0.05). 【Conclusion】 Old age, male, black, non-chromophobe cell carcinoma, low degree of differentiation, high T stage of tumor and RN are independent risk factors for the prognosis of elderly patients with localized renal cell carcinoma.PN is the main treatment method and has remarkable therapeutic effects.