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Objective To observe the 24-week survival status of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) treated with plasma exchange (PE) and double plasma molecular adsorption system (DPMAS) alone or in combination, and to establish a predictive model for 24-week prognosis. Methods Related clinical data were collected from 133 patients with HBV-ACLF who received PE and DPMAS alone or in combination in The Affiliated Provincial Hospital of Anhui Medical University from January 2015 to December 2019, and according to the survival status at the 24-week follow-up after treatment, they were divided into survival group with 71 patients and death group with 62 patients. A total of 55 patients with HBV-ACLF who received PE and DPMAS alone or in combination in The Second Affiliated Hospital of Anhui Medical University from January 2018 to January 2020 were enrolled as validation group to validate the performance of the model. Related clinical data included mode of artificial liver support therapy, age, sex, total bilirubin (TBil), international normalized ratio (INR), creatinine (Cr), serum sodium, platelet count (PLT), albumin (Alb), and presence or absence of ascites, hepatorenal syndrome, hepatic encephalopathy, and gastrointestinal bleeding. The t -test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank-sum test was used for comparison of continuous data with skewed distribution between two groups; the chi-square test and the Fisher's exact test were used for comparison of categorical data between groups. The Cox regression model was used to analyze the influencing factors for the prognosis of HBV-ACLF patients after PE and DPMAS alone or in combination and establish a predictive model; the receiver operator characteristic (ROC) curve was plotted and the DeLong method was used to compare the area under the ROC curve (AUC) between the new predictive model and Model for End-Stage Liver Disease (MELD)/MELD combined with serum sodium concentration (MELD-Na) scores. Results At 24 weeks after treatment, 71 patients survived and 62 patients died in the modeling group. The Cox regression analysis showed age (hazard ratio [ HR ]=1.030, P =0.013), TBil ( HR =1.018, P < 0.001), INR ( HR =1.517, P < 0.001), and PLT ( HR =0.993, P =0.04) were independent influencing factors for 24-week survival. According to the results of the Cox regression analysis, a prognostic model for HBV-ACLF patients treated with PE and DPMAS alone or in combination was established as ATIP=0.029×age (years)+0.018×TBil (mg/dL)+0.417×INR-0.007×PLT (10 9 /L). Both the modeling group and the validation group showed that the ATIP model had a better predictive performance than MELD and MELD-NA scores(all P < 0.05). Conclusion Age, TBil, INR, and PLT are independent influencing factors for the 24-week survival of HBV-ACLF patients treated with PE and DPMAS alone or in combination, and the ATIP model has a good performance in predicting the 24-week prognosis of HBV-ACLF patients treated with PE and DPMAS alone or in combination.
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Objective:To investigate the effect of single-port laparoscopy and conventional laparoscopic surgery in ovarian cystectomy.Methods:The clinical data of 139 patients with laparoscopic surgery for ovarian cyst admitted to the same department of gynecology from December 2016 to December 2019 in Suzhou Hospital Affiliated of Anhui Medical University were retrospectively analyzed, and they were divided into single-port laparoscopic surgery group (62 cases) and conventional laparoscopic surgery group (77 cases) according to different surgical methods. The clinical indictors, the levels of estrogen, T lymphocyte subgroups, the complications rate and incision satisfaction rate between two groups were compared.Results:The operation in both groups was smooth and there was no conversion to open surgery. Compared with the conventional laparoscopic surgery group, the surgery time, intraoperative blood loss in single-port laparoscopic surgery group were higher, the hospital stays in single-port laparoscopic surgery group was shorter, but there were no significant differences ( P>0.05). The levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2) in two groups before operation had no significant differences ( P>0.05). At 30 d after operation, the levels of FSH, LH and E 2 in single-port laparoscopic surgery group were higher than those in conventional laparoscopic surgery group, but the differences were no statistically significant ( P>0.05). Before operation, the levels of CD 4+, CD 8+ and CD 4+/CD 8+ in two groups has no significant differences ( P>0.05). At 3 d after operation, the levels of CD 4+, CD 8+ and CD 4+/CD 8+ in single-port laparoscopic surgery group were higher than those in conventional laparoscopic surgery group: 0.51 ± 0.03 vs. 0.47 ± 0.02, 0.41 ± 0.23 vs. 0.39 ± 0.05, 1.36 ± 0.02 vs. 1.24 ± 0.02, and the differences were statistically significant ( P<0.05). The rate of complication in two groups had no significant difference ( P>0.05). At 3 d after operation, the scores of visual analogue scale (VAS) of pain in single-port laparoscopic surgery group were lower than that in conventional laparoscopic surgery group: (1.12 ± 0.21) scores vs. (3.56 ± 0.65) scores, and the difference was statistically significant ( P<0.05). The incision satisfaction rate in single-port laparoscopic surgery group was significantly higher than that in conventional laparoscopic surgery group: 90.32%(56/62) vs. 72.73%(56/77), and the difference was statistically significant ( P<0.05). Conclusions:Single-port laparoscopy can be safely and smoothly implemented in ovarian cystectomy, and can reduce postoperative pain, improve cell immunity, and have better cosmetic result.
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Objective:To explore the feasibility and safety of enhanced recovery after surgery (ERAS) combined with laparoscopic in benign gynecologic tumor.Methods:The clinical data of 160 patients with benign gynecologic tumor underwent gynecological laparoscopic surgery in Suzhou Municipal Hospital from January 2017 to May 2018 were selected and analyzed. In these patients, 80 patients who underwent ERAS combined with laparoscopic was enrolled in ERAS group, and 80 patients who underwent laparoscopic surgery in traditional model was enrolled in control group. The operation time, intraoperative blood loss, postoperative exhaust time, rate of postoperative complications, the scores of visual analogue scale (VAS) at postoperative 3, 6, 12, 24 h, average hospital stay, and average hospitalization expenses were compared between two groups.Results:The operation time, intraoperative blood loss in two groups had no significant differences ( P>0.05). The rate of postoperative complications in two groups had no significant difference ( P>0.05). The postoperative exhaust time in ERAS group was shorter than that in control group [(9.8 ± 2.7) h vs. (19.1 ± 4.0) h] ( P<0.05). The scores of VAS at postoperative 12, 24 h were lower than those in control group [(1.9 ± 0.7) scores vs. (4.2 ± 0.8) scores, (1.3 ± 0.4) scores vs. (3.5 ± 0.9) scores] ( P<0.05). Four patients in control group were injected with pethidine and no patients in ERAS group used pethidine, and the rate of using pethidine in two groups had significant difference [0 vs. 5.0%(4/80)]( P<0.05). The average hospital stay, average hospitalization expenses in ERAS group were lower than those in control group [(3.9 ± 0.7) d vs. (5.2 ± 0.9) d, (1.1 ± 0.1) ten thousand Yuan vs. (1.3 ± 0.1) ten thousand Yuan] ( P<0.01). Conclusions:The ERAS combined with laparoscopic in benign gynecologic tumor is safe and effective during perioperative period, and is worth of expanding.
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Objective@#To understand the emotional and behavioral problems among preschool children in Ezhou city, and to analyze its association with screen time,to provide a reference for making preventive measures.@*Methods@#1 720 children were selected from 9 kindergartens in Ezhou by cluster sampling method. Questionnaires were completed by the children’s parents or primary caregivers.@*Results@#High total difficulty score accounted for 9.8%(169/1 720) of all participants,the abnormal proportion of peer communication problems is the highest. The average screen time was (1.95±1.88) hours, among them 2.6% spent more than 2 hours. The average screen time on weekends was (2.84±2.58) hours, among them 19.1% spent more than 2 hours. The results of multiple linear regression analysis showed that weekday, weekend and total screen times was associated with children’s total difficulty score, emotional problems, conduct problems, peer interaction and hyperactivity(P<0.05). Furthermore, with the duration of screen time increased, the susceptibility of emotional and behavioral problems in these four dimensions increased.@*Conclusion@#Screen time is associated with emotional and behavioral problems among preschool children. Schools and parents should pay attention to interventions that target family TV viewing practices, and parent-child interaction and communication.
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At present, hepatitis B virus (HBV) infection is one of the leading causes of liver cirrhosis and liver cancer. With the development of the society, the improvement in living standards, and the change in lifestyle, nonalcoholic fatty liver disease (NAFLD) has gradually replaced hepatitis B and becomes the most important chronic liver disease in China. Due to the large number of patients with chronic HBV infection, the number of patients with chronic HBV infection and NAFLD has been increasing year by year, which has become an important feature of liver disease spectrum in China. Therefore, the interaction between NAFLD and chronic hepatitis B (CHB) has attracted more and more attention. This article reviews the interaction between CHB and NAFLD and the pathogenesis of CHB with NAFLD.
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To explore differential expression of long non-coding RNA (lncRNA) in patients with coronary artery disease plus clopidogrel resistance. Methods: Patients underwent percutaneous coronary intervention (PCI) and treated with clopidogrel were recruited, and their clinical data and blood samples were collected. Patients were divided into a clopidogrel sensitive group and a clopidogrel resistance group according to platelet aggregation rate. lncRNA microarray and real-time RT-PCR were performed in 5 and 34 patients in each group, respectively. Results: lncRNA microarray showed that 11 lncRNAs in peripheral leukocytes were up-regulated and 8 lncRNAs were down-regulated in clopidogrel resistant group. Real-time PCR indicated that two lncRNAs (NONHSAT083775.2 and NONHSAT107804.2) in leukocytes were up-regulated and one lncRNA (NONHSAT133455.2) was down-regulated in the clopidogrel resistant group compared with the clopidogrel sensitive group, consistent with the results of lncRNA microarray. Conclusion: Clopidogrel resistance is associated with the up-regulation of lncRNA NONHSAT083775.2 and NONHSAT107804.2 and the down-regulation of NONHSAT133455.2.
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Humans , Clopidogrel , Coronary Artery Disease , Genetics , Percutaneous Coronary Intervention , Platelet Aggregation , Platelet Aggregation Inhibitors , RNA, Long NoncodingABSTRACT
Objective To study the correlation between thyroid autoantibodies anti‐thyroid peroxidase antibody (TPOAb) with recurrent miscarriage to seek the objective data indicator for clinical diagnosis of recurrent miscarriage .Methods A total of 1 016 pregnant women of physical examination and normal thyroid function in the obstetric and gynecologic clinic of our hospital from March 2012 to May 2014 were selected as the research subjects .Among them ,90 cases of abortion were screened out and di‐vided into the primary abortion group(60 cases) and the recurrent abortion group(30 cases) .90 healthy childbearing age women of physical examination were selected as the control group .The positive TPOAb cases were performed statistics and compared among various groups ,the ratio was calculated;the TPOAb level was recorded in each group .At the same time the correlation between TPOAb with recurrent abortion was analyzed .Results The TPOAb positive rate in the recurrent abortion group was 46 .67% , which was significantly higher than 25 .00% in the primary abortion group and 4 .44% in the control group;at the same time the TPOAb positive rate of primary abortion group was also significantly higher than that of the control group ,the difference had sta‐tistical significance (P<0 .05) .The TPOAb concentration level in the recurrent abortion group was significantly higher than that in the primary abortion group and the control group;the TPOAb concentration level in the primary abortion group was also signifi‐cantly higher than that in the control group ,the differences were statistically significant (P< 0 .05) .In the follow‐up of adverse pregnancy occurrence with recurrent abortion as the adverse pregnancy event ,and according to the method of Spearman correlation analysis ,with the increase of TPOAb level ,the occurrence rate of recurrent miscarriage was higher ,which showed the positive cor‐relation(r=0 .764 ,P=0 .000) .Conclusion Monitoring the patient′s TPOAb level can better show the symptoms of recurrent abor‐tion .
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Aim To investigate the intraspecific variation of Carthamus tinctorius L. (safflower) and establish foundation for further breeding of safflower germplasm resource and screening the quality correlation genes. Methods Amplified fragment length polymorphism (AFLP) was carried out to analyze genetic variation of 28 safflower populations collected in China. Unweighed pair-group method of with arithmetical averages (UPGMA) cluster analysis was used to construct a dendrogram and to estimate the genetic distances among the populations. Results All populations could be uniquely distinguished using 12 selected primer combinations. Similarity coefficients ranged from 0. 48 to 0. 96 among the populations.Dendrogram revealed distinct segregation of all the cultivars into three main groups and one midst group.Conclusion Limited genetic diversity exists within the tested 28 collections at intra specific level and AFLP-based phylogeny was not absolutely consistent with that based on morphological characters may be due to the interaction effect between genotype and environment.