Risk and Prevention of Thromboembolism in Inflammatory Bowel Disease / 胃肠病学

The incidence rate of inflammatory bowel disease(IBD)in China is in a rapid rise period in recent years,and the course of the disease is repeated and prolonged.The risk of IBD combined with thromboembolism is significantly increased,and it is one of the important reasons for poor prognosis in IBD patients.However,the pathological and physiological mechanisms of thromboembolism have not been fully understood and have not received sufficient attention from clinical physicians.This article aims to provide a systematic review of the risks and mechanisms of thromboembolism in IBD,and to summarize the progress in its prevention and treatment strategies,in order to be helpful for the prevention and treatment of thromboembolism in IBD patients.

Construction of a mortality prediction model for severe fever with thrombocytopenia syndrome / 中华临床感染病杂志

Objective:To construct a mortality prediction model for severe fever with thrombocytopenia syndrome (SFTS) and to evaluate its prediction ability.Methods:Clinical data of 120 hospitalized patients with SFTS at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2017 to June 2023 were retrospective analyzed. Based on clinical prognosis, patients were divided into survival group ( n=89) and fatal group ( n=31). The risk factors of SFTS mortality were analyzed with multivariate Logistic regression, based on which a mortality risk prediction model was constructed. The predictive value of the model was examined with receiver operator characteristic (ROC) curve. SPSS 23.0 software was used to process and analyze the data. Results:Logistic regression analysis indicated that skin petechiae ( OR=5.171, 95% CI 1.617-16.530, P=0.006), mental disturbance ( OR=5.481, 95% CI 1.540-19.512, P=0.009), increased serum lactate dehydrogenase level ( OR=1.002, 95% CI 1.001-1.004, P<0.001), and increased serum creatinine level ( OR=1.018, 95% CI: 1.007-1.029, P=0.002) were independent risk factors for SFTS mortality. A mortality risk prediction model was established based on the regression coefficient of risk factors: Logit( P)=-6.623+ skin petechiae×1.643+ mental disturbance × 1.701+ lactate dehydrogenase level (U/L)×0.002+ creatinine level (μmol/L)×0.018. The area under ROC curve (AUC) of the prediction model was 0.91 (95% CI 0.86-0.96, P<0.001), and its predictive ability was higher than that of skin petechiae ( Z=3.788, P<0.001), mind change ( Z=5.728, P<0.001), lactate dehydrogenase ( Z=2.309, P=0.021), and creatinine ( Z=2.064, P=0.039). Conclusion:The mortality prediction model constructed based on skin petechiae, mental disturbance, lactate dehydrogenase, and creatinine has good predictive value for the prognosis of SFTS patients.

Association between miR-1, miR-133b and liver fibrosis in patients with hepatic alveolar echinococcosis / 中华地方病学杂志

Objective:To investigate the relationship between microRNA (miR)-1, miR-133b and hepatic fibrosis in patients with hepatic alveolar echinococcosis.Methods:From October 2020 to April 2021, patients who were definitely diagnosed as hepatic alveolar echinococcosis (9 cases), cirrhosis (9 cases) and hepatocellular carcinoma (5 cases) in the First Affiliated Hospital of Xinjiang Medical University were selected as the research subjects, and healthy volunteers in the same period were taken as the control (10 cases). Peripheral blood samples of all subjects were collected to prepare plasma, and the expression levels of miR-1 and miR-133b in peripheral blood were detected by quantitative real-time PCR. At the same time, tissue samples around the liver lesion (proximal), and the corresponding tissues about 5 cm from the lesion (distal) were collected from 5 patients with hepatic alveolar echinococcosis, and immunohistochemical staining was used to detect the cell activation related indicators [cyclinD1, cyclin dependent kinase 1 (CDK1), α-smooth muscle actin (α-SMA)], fibrosis indicators (Collagen Ⅰ, Collagen Ⅲ), transforming growth factor-β1 (TGF-β1) signal pathway related genes [TGF-β1, TGF-β1 receptor type Ⅰ/Ⅱ (TGF-β1RⅠ, TGF-β1RⅡ)] and its downstream related proteins (SMAD2, SMAD3).Results:The quantitative real-time PCR results showed that there were significant differences in the expression levels of miR-1 and miR-133b in the peripheral blood of patients with hepatic alveolar echinococcosis, cirrhosis, hepatocellular carcinoma and the control group ( H = 16.54, 28.40, P < 0.001); the expression levels of miR-1 and miR-133b in hepatic alveolar echinococcosis group were higher than those in control group, cirrhosis group ( P < 0.05). The expression levels of CDK1 (0.46 ± 0.02, 0.42 ± 0.01), α-SMA (0.54 ± 0.09, 0.51 ± 0.07), TGF-β1 (0.55 ± 0.15, 0.51 ± 0.13), TGF-β1RⅠ (0.58 ± 0.09, 0.57 ± 0.08), and TGF-β1RⅡ(0.40 ± 0.05, 0.39 ± 0.05) between the proximal and distal tissue of liver lesion in hepatic alveolar echinococcosis patients were statistically significantly different ( t = 5.56, 3.17, 3.18, 4.27, 5.65, P = 0.005, 0.034, 0.034, 0.024, 0.011). There was no statistically significant difference in the expression levels of CyclinD1, Collagen Ⅰ, Collagen Ⅲ, SMAD2 and SMAD3 between the proximal and distal tissue of liver lesion in hepatic alveolar echinococcosis patients ( t = 3.06, 3.06, 2.86, 1.43, 1.50, P = 0.055, 0.055, 0.064, 0.247, 0.230). Pearson correlation analysis showed that miR-1 in the patients' peripheral blood was positively correlated with TGF-β1RⅠ in the proximal tissue of the liver lesion ( P = 0.001); there was no correlation between miR-1, miR-133b and CDK1, α-SMA, TGF-β1, TGF-β1RⅡ( P > 0.05). Conclusions:The expression of TGF-β1 signaling pathway related factors in the proximal tissue of liver lesion in patients with hepatic alveolar echinococcosis is up-regulated. The expression of miR-1 and miR-133b in peripheral blood is upregulated, and miR-1 is positively correlated with TGF-β1RⅠ level in proximal tissue of liver lesion, suggesting that miR-1 may promote the occurrence of liver fibrosis in hepatic alveolar echinococcosis.

Prevalence of anemia among primary school students from Kazakh ethnic groups in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region / 预防医学

Objective@#To investigate the prevalence of anemia and its influencing factors among primary school students from Kazakh ethnic groups in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region, so as to provide insights into improvements of nutrition and prevention of anemia among students.@*Methods@#Grade 1 to 3 Kazakh ethnic students were sampled using a cluster sampling method from 7 primary schools in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region from April to June, 2022. Demographics and dietary behaviors were collected using questionnaire surveys, and the height and body weight were measured, while peripheral blood hemoglobin was detected. Factors affecting anemia were identified using a multivariable logistic regression model.@*Results@#A total of 2 378 questionnaires were allocated, and 2 214 valid questionnaires were recovered, with an effective rate of 93.10%. The respondents included 1 123 men (50.72%) and 1 091 women (49.28%), and had a mean age of (8.12±1.41) years. The prevalence of anemia was 22.49%, and the detection rates of mild and moderate anemia were 15.31% and 7.18%, with no severe anemia detected. Multivariable logistic regression analysis identified frequency of eating eggs (0, OR=2.532, 95%CI: 2.114-3.015; 1 to 3 times/week, OR=1.926, 95%CI: 1.648-2.216), frequency of eating meat (1 to 3 times/week, OR=1.468, 95%CI: 1.256-1.689; 4 to 7 times/week, OR=2.212, 95%CI: 1.823-2.641), frequency of healthy check-up (0, OR=2.872, 95%CI: 2.523-3.231; 1 time/year, OR=1.826, 95%CI: 1.546-2.108), monthly mean household income (1 500 Yuan and lower per month, OR=1.324, 95%CI: 1.071-1.582; 1 501 to 3 000 Yuan per month, OR=1.124, 95%CI: 1.029-1.221) and caregiver (grandparents, OR=1.175, 95%CI: 1.038-1.324; others, OR=1.241, 95%CI: 1.032-1.466) as factors affecting anemia.@*Conclusions@#The prevalence of anemia is 22.49% among primary school students from Kazakh ethnic groups in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region, with mild anemia as the predominant type. Dietary behaviors, frequency of healthy check-up, economic status and caregiver may affect the development of anemia.

Analysis of the poor prognostic factors affecting 48 cases of cervical stump carcinoma / 中华放射肿瘤学杂志

Objective@#To explore the poor prognostic factors of patients with cervical stump carcinoma, aiming to provide certain reference for the clinical diagnosis and treatment.@*Methods@#Clinical data of 48 patients with cervical stump carcinoma admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 1, 2005 to December 1, 2016 were retrospectively analyzed. A total of 19 patients (40%) withⅠA-ⅡA stage cervical stump carcinoma were treated with surgery+ adjuvant therapy and 29 patients (60%) in ⅡB-Ⅳ stage received radiotherapy combined with chemotherapy. The median age of onset was 51 years old. Uterine fibroids were the main cause of subtotal hysterectomy. The average time interval from subtotal hysterectomy to definite diagnosis was 10.76 years.@*Results@#The 1-, 3-, 5-year survival rate was 98%, 83% and 74%, respectively. Univariate analysis demonstrated the time interval from subtotal hysterectomy (P=0.016), tumor diameter (P=0.016), clinical stage (P=0.036), histological grade (P=0.009), lymph node metastasis (P=0.044), parametrial invasion (P=0.046), myelosuppression (P=0.013) and radical surgery (P=0.019) were the poor prognostic factors of cervical stump carcinoma.@*Conclusions@#Poor prognosis of patients with cervical stump carcinoma is correlated with tumor diameter, clinical stage, histological grade, lymph node metastasis, parametrial invasion and myelosuppression. Histological grade is an independent risk factor.

IL-6, IL-8 and TNF-α expression levels in serum and aqueous humor in patients with neovascular glaucoma and their significance / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To detect IL-6, IL-8 and TNF-α expression levels in serum and aqueous humor of patients with neovascular glaucoma(NVG)and explore the significance. <p>METHODS:A prospective case analysis method was applied to include patients with neovascular glaucoma in 38 cases(38 eyes), and according to grading criteria of iris neovascularization, they were divided into grade Ⅱ with 8 eyes, grade Ⅲ with 19 eyes, grade Ⅳ with 11 eyes. Thirty-one patients(31 eyes)with primary open angle glaucoma(POAG)and 33 patients(33 eyes)with age related cataract were selected as the control. IOP level was detected preoperatively, and venous blood and aqueous humor samples of patients were selected, and IL-6, IL-8 and TNF-α contents in serum and humor were detected by using enzyme linked immunosorbent assay(ELISA). <p>RESULTS:IL-6, IL-8 and TNF-α levels in serum and aqueous humor of NVG group were significantly higher than those in POAG group and cataract group(<i>P</i><0.05). IL-6, IL-8 and TNF-α levels in serum and aqueous humor of POAG group were significantly higher than those in cataract group(<i>P</i><0.05). IL-6, IL-8 and TNF-α levels in serum and aqueous humor of grade ⅣNVG group were significantly higher than those of patients with grade Ⅲ(<i>P</i><0.05). IL-6, IL-8 and TNF-α levels in serum and aqueous humor of patients with grade Ⅲ were significantly higher than those of grade Ⅱ(<i>P</i><0.05). IL-6, IL-8 and TNF-α levels in serum and aqueous humor of NVG patients were positively correlated with IOP(<i>P</i><0.05). <p>CONCLUSION: IL-6, IL-8 and TNF-α are highly-expressed in serum and aqueous humor of NVG patients. It may be involved in iris neovascularization and intraocular pressure elevation.

Correlation between neutrophils lymphocytes ratio and disease activity in patients with ulcerative colitis / 中国医师杂志

Objective To investigate the conrelation between neutrophils lymphocytes ratio (NLR) and disease activity of ulcerative colitis (UC).Methods Case-control study was used to compare NLR differences of 82 active UC patients,45 inactive UC patients,and 254 healthy controls.The multivariate analysis was applied to analyze the correlation between the NLR,erythrocyte sedimentation rate (ESR),Creactive protein (CRP),white blood cells (WBCs),and UC activity.The sensitivity and specificity of NLR to identify UC activity was evaluated.Results NLR of active UC group was 2.45 ± 1.22,which was significantly higher than that of inactive UC group and healthy control group,their NLR were 1.92 ± 0.68 and 1.83 ±0.75,respectively (H =9.991,P =0.007).The multivariate analysis showed that only CRP was correlated with UC activity (OR =1.396,95％ CI:1.086 ～ 1.795,P =0.009).Receiver operating characteristic (ROC) curve analysis showed that the optimum NLR cut-off point for UC activity was 2.23,the sensitivity and specificity were 55.82％ and 62.75％,respectively.Conclusions NLR has a certain reference value for the evaluation of UC activity,but it cannot be independent as a clinical index to evaluate the UC activity.

Incidence and influencing factors for post-operative healthcare-associated infec-tion in Uyghur patients undergoing cardiothoracic surgery in a hospital / 中国感染控制杂志

Objective To evaluate the incidence and influencing factors for post-operative healthcare-associated in-fection(HAI)in Uyghur patients undergoing cardiothoracic surgery in a hospital.Methods Clinical data of Uyghur patients hospitalized in the department of cardiothoracic surgery in a hospital of Kashgar region between June 2010 and June 2014 were collected,incidence of post-operative HAI was surveyed.Influencing factors for post-operative HAI were analyzed by univariate and multivariate logistic regression models.Results A total of 779 patients’clini-cal data were collected,53 patients (6.80%)developed post-operative HAI.The major infection sites were lower respiratory tract (2.44%),digestive tract(1 .28%),urinary tract(1 .16%),upper respiratory tract(1 .03%),and surgical sites(0.51 %).Multivariate logistic regression analysis showed that history of diabetes,body mass index (BMI)≥30 kg/m2 ,duration of operation ≥ 160 minutes,and invasive procedure were risk factors for post-opera-tive HAI in Uyghur patients undergoing cardiothoracic surgery.Conclusion Incidence of post-operative HAI in Uy-ghur patients undergoing cardiothoracic surgery in this hospital is high,risk factors for HAI are history of diabetes, high BMI,long duration of operation,and invasive procedure.

The application of comparative imageology in oral and maxillofacial medical imaging diagnostics teaching / 中华医学教育探索杂志

The development of medical imaging diagnosis technology has brought forward higher requirements for the teaching of oral and maxillofacial medical imaging diagnostics, In this study, we intro-duce the methods and concepts of comparative imaging to guide students to analyze and compare oral and maxillofacial diseases from different perspectives, and to promote the students' understanding of the disease image and mastery of disease diagnosis, improve the students' ability to choose the appropriate imaging method in the future clinical work. Comparative imaging is one of the important teaching methods in the diagnosis of oral and maxillofacial medical imaging, and it is also the direction of its future development.

Clinical characteristics of 67 cases of new-onset diffuse type ulcerative colitis / 中华消化杂志

Objective To analyze the clinical characteristics of new onset diffuse type ulcerative colitis.Methods From May 2007 to March 2012,clinical data of hospitalized patients diagnosed in the People's Hospital of Xinjiang Autonomous Region as new onset ulcerative colitis were retrospectively analyzed,and constituent ratios of nationality,gender,age at diagnosis,residential environment,severity of disease,clinical symptoms,results of laboratory examination,results of colonoscopic examination and results of histopathological examination were compared among the diffuse type,the type of proctosigmoiditis and the type of left-sided colitis.Normal distribution data were analyzed by one-way analysis of variance,skew distribution data and ordinal data were analyzed by Kruskal-Wallis H test,and count data were analyzed by chi-square test in the comparison among the three groups.Results A total of 67 patients with new-onset diffuse type ulcerative colitis were enrolled.The constituent ratios of Han nationality,Uygur nationality and Kazak nationality were 32.8％(22/67),58.2％(39/67),and 9.0％(6/67),respectively.The ratio of male to female was 1.48∶ 1.The age at diagnosis was (43.27 ± 16.91) years old.The ratio of city to countryside was 3.19∶ 1.To the severity of the disease,mild was more common,the proportion of mild,moderate and severe were 56.7％(38/67),20.9％(14/67) and 22.4％ (15/67),respectively.Abdominal pain,diarrhea and purulent stools were the predominant symptoms.Some patients might have fever and tenesmus,a few patients accompanied with abdominal distension,nausea,vomiting and peripheral arthritis.The percentage of increasesed erythrocyte sedimentation rate,hypersensitive Creation protein and plasmatic fibrinogen was 37.3％(25/67),44.8％(30/67) and 31.3％ (21/67),respectively.To compare with patients with proctosigmoiditis and left-sided colitis,the patients with new-onset diffuse type colitis had higher Mayo score and were more prone to develop abdominal pain,diarrhea,severe colitis,and were more common in Uygur nationality.There were statistical differences in abdominal pain,diarrhea,severity,ratio of Uygur nationality and Mayo score in pairwise comparison among the three groups (all P＜0.017).Conclusion Abdominal pain,diarrhea and Uygur nationality are more common in new onset diffuse ulcerative colitis in Xinjiang Region,with relatively high Mayo score and mild to moderate degree,while severity significantly increased compared to the type of proctosigmoiditis and the type of left-sided colitis.

Analysis of prolactin level of 205 aggressive-phase vitiligo patients and its clinical significance / 中国基层医药

Objective To explore the relation between the serum prolactin level and the development of aggressive-phase vitiligo.Methods The peripheral blood serum of 205 aggressive-phase vitiligo patients ( trial group) and 98 healthy volunteer(control group) were assayed by chemiluminescence analysis.Results ( 1 ) The data of the prolactin levels and the overall distribution of sample mean had statistically significant differences between the control group and trial group( P ＜ 0.05 ).The PRL level of the trial group [ ( 275.96 ± 178.51 ) μIU/ml ] was significantly lower than that of the control group [ (282.98 ± 115.39)μIU/ml ] ( P ＜ 0.05 ).(2) The PRL level of the female trial group[ (288.68 ± 198.45) μ IU/ml]was significantly different from the female control group[ (303.82 ± 121.62)μIU/ml] ( P ＜ 0.05),and the PRL level between the male trial group [ (256.54 ± 141.72) μIU/ml] and the male control group [ (236.43 ± 84.67 ) μIU/ml ] had no significant differences ( P ＞ 0.05 ).Conclusion PRL should not directly result in or participate in development of vitiligo.So it could not be a diagnostic tests to measure the stage of vitiligo and the diagnosis basis for vitiligo's syndrome differentiation of chinese-medicine or Uygur-medicine.