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Objective:To investigate the effect of T-lymphocyte and subpopulation counts on the prognosis of severe acute pancreatitis (SAP) patients.Methods:The clinical data of 90 patients with SAP diagnosed at the Shanghai General Hospital between January 2019 and June 2022 were retrospectively analyzed, and the patients were divided into good prognosis and poor prognosis group according to whether they were diagnosed for 28 d. The general information of the patients was recorded, including blood-related immunological indicators within 24 h of diagnosis, including leukocytes, neutrophils, lymphocytes, monocytes, CD 3+ , CD 4+ , CD 8+ T-lymphocyte count and CD 4+ /CD 8+ T-lymphocyte ratio, IgG4 level; blood inflammation index procalcitonin, albumin level and APACHEⅡ score at admission; survival and complication status of patients at 28 d of diagnosis. Non-parametric Mann-Whitney U test was used to analyze the correlation between each index and the prognosis of the patients. The subject operating characteristic curve (ROC) of patients was plotted, and area under curve (AUC) was calculated to assess the value of CD 3+ and CD 4+ T-lymphocytes in predicting the prognosis of SAP. Results:The majority of SAP patients were male (65.6%). The main cause of SAP was gallstone (56.7%), followed by hyperlipidemia (35.6%). At 28 days after diagnosis, 85(94.4%) patients survived, and 39 of them were cured and included in the good prognosis group. Forty-six cases were complicated with infection, multiple organ dysfunction syndrome (MODS) and local pancreatic complications, and 5 cases (5.56%) died; and a total of 51 cases were included in the poor prognosis group. Compared with the good prognosis group, the number of CD 3+ T-lymphocytes [366(268, 498) cells /μl vs 709(578, 999) cells /μl], CD 4+ T-lymphocytes [209(120, 298) cells /μl vs 486(303, 548) cells /μl] and albumin level (33.9 g/L vs 35.9 g/L) within 24 hours in the poor prognosis group were significantly lower, while the level of procalcitonin (1.02 ng/ml vs 0.43 ng/ml) and APACHEⅡ score [7(4, 10) vs 5(3, 8)] were significantly increased, and all the differences were statistically significant (all P value <0.05). ROC curve analysis showed that the AUC values for CD 3+ and CD 4+ T-lymphocyte counts within 24 hours for predicting poor prognosis of SAP were 0.857 (95% CI 0.696-1.000) and 0.867 (95% CI 0.708-1.000), respectively. The cut-off values were 524 cells /μl and 301 cells /μl, the sensitivity were both 85.7%, and the specificity were 78.6% and 85.7%, respectively. Conclusions:The significant decrease of peripheral blood CD 3+ and CD 4+ T-lymphocyte count within 24 h of SAP diagnosis has a certain predictive value for the prognosis of patients with SAP.
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Objective:To construct a risk prediction model for infection with Klebsiella pneumonia (KP) for patients with severe acute pancreatitis (SAP).Methods:Retrospective analysis was done on the clinical data of 109 SAP patients who were admitted to Shanghai General Hospital, between March 2016 and December 2021. Patients were classified into infection group ( n=25) and non-infection group ( n=84) based on the presence or absence of KP infection, and the clinical characteristics of the two groups were compared. The least absolute shrinkage and selection operator (LASSO) algorithm was used to reduce the dimension of the variables with statistical significance in univariate analysis. A nomogram prediction model was created by incorporating the optimized features from the LASSO regression model into the multivariate logistic regression analysis. Receiver operating characteristic curve (ROC) was drawn and the area under curve (AUC) was calculated; and consistency index (C-index) were used to assess the prediction model's diagnostic ability. Results:A total of 25 strains of KP were isolated from 109 patients with SAP, of which 21(84.0%) had multi-drug resistance. 20 risk factors (SOFA score, APACHEⅡ score, Ranson score, MCTSI score, mechanical ventilation time, fasting time, duration of indwelling of the peritoneal drainage tube, duration of deep vein indwelling, number of invasive procedures, without or with surgical intervention, without or with endoscopic retrograde cholangiopancreatography (ERCP), types of high-level antibiotics used, digestion disorders, abnormalities in blood coagulation, metabolic acidosis, pancreatic necrosis, intra-abdominal hemorrhage, intra-abdominal hypertension, length of ICU stay and total length of hospital stay) were found to be associated with KP infection in SAP patients by univariate analysis. The four variables (APACHEⅡ score, duration of indwelling of the peritoneal drainage tube, types of high-level antibiotics used, and total length of hospital stay) were extracted after reduced by LASSO regression. These four variables were found to be risk factors for KP infection in SAP patients by multiple logistic regression analysis (all P value <0.05). Nomogram prediction model for KP infection in SAP was established based on the four variables above. The verification results of the model showed that the C-index of the model was 0.939, and the AUC was 0.939 (95% CI 0.888-0.991), indicating that the nomogram model had relatively accurate prediction ability. Conclusions:This prediction model establishes integrated the basic clinical data of patients, which could facilitate the risk prediction for KP infection in patients with SAP and thus help to formulate better therapeutic plans for patients.
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Objective:To analyse the clinical efficacy and outcome of early abdominal paracentesis drainage (APD) in the treatment of severe acute pancreatitis (SAP).Methods:The clinical data of 107 SAP patients with massive abdominal fluid in Shanghai General People Hospital from May 2017 to December 2021 were collected and analyzed. Patients were divided into APD group ( n=56) and NO-APD group ( n=51) according to whether they underwent APD or not within 3 days after admission. The APD group was then divided into abdominal compartment syndrome (ACS) subgroup ( n=29) and NO-ACS subgroup ( n=27) according to whether ACS had occurred or not at the time of puncture. Patients' general data, the duration of systemic inflammatory response (SIRS), length of ICU stay, the trends of intra-abdominal pressure and inflammatory indicators (white blood cell count and the content of C-reactive protein) within 1-3 days after admission, incidence of infection complication, step-up therapy, discharge or death were recorded. Results:The intra-abdominal pressure were 18.6±5.6mmHg , 13.7±4.2mmHg (1 mmHg=0.133 kpa) in APD group and NO-APD group, respectively. The intra-abdominal pressure of APD group was significantly higher than that of NO-APD group, and the difference was statistically significant ( P=0.000). Compared with NO-APD group, the duration of SIRS was significantly shortened in APD group [3(2, 4) days vs 4(3, 6) days, P=0.029]. On day 1, 2 and 3 after admission, the intra-abdominal pressure was 18.6±5.6 mmHg, 16.4±4.7 mmHg and 13.5±3.9 mmHg in APD group, and was 13.7±4.2 mmHg, 12.3±3.6 mmHg and 11.0±2.6 mmHg in NO-APD group, respectively. The intra-abdominal pressure of the APD group dropped faster than the NO-APD group ( P=0.004). The white blood cell count was (14.8±4.8), (10.5±4.5) and (9.0±3.8)×10 9/L in APD group, and was (14.2±5.4), (12.3±7.3), (11.7±5.3)×10 9/L in NO-APD group, respectively. Compared with the NO-APD group, the decrease rate of white blood cell count was faster in APD group ( P=0.006). The C-reactive protein content was (153.6±47.1), (150.4±10.5) and (108.8±49.4)mg/L in APD group, and were (174.8±31.1), (191.6±29.4) and (186.8±45.5)mg/L in NO-APD group . The content of C-reactive protein in APD group decreased significantly, while that in NO-APD group did not decrease. There was a significant difference between the two groups ( P=0.009). In the subgroup comparisons, the duration of SIRS in the ACS subgroup was significant longer than that in the NO-ACS subgroup [4(3, 5) days vs 2(1, 3)days, P=0.000]. Compared between the two groups and two subgroups respectively, there were no statistically significant differences on length of ICU stay, infection complication rate, advanced treatment rate and mortality. Conclusions:For SAP patients with abdominal fluid, APD in the early stage could shorten the duration of SIRS, decrease intra-abdominal pressure rapidly, improve inflammatory indicators, but could not improve the clinical outcome.
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Objective:To evaluate the clinical efficacy of continuous renal replacement therapy (CRRT) with adsorptive filter oXiris in the treatment of severe acute pancreatitis (SAP).Methods:The clinical data of 5 SAP patients who received the treatment of absorptive filter oXiris in Department of Critical Care Medicine of Shanghai General Hospital from February 2021 to February 2022 were collected. The changes of inflammatory indicators, hemodynamics, acid-base balance indicators and organ function indicators were compared before and 24 h after treatment.Results:Before the treatment of oXiris, 3 patients had pancreatic necrotic infection, and all the five patients had systemic inflammatory response syndrome(SIRS), acute respiratory and circulatory failure and acute renal injury. At 24 h after the treatment with oXiris, the levels of inflammatory indicators such as white blood cell count [(13.4±5.0)×10 9/L vs (25.8±10.0)×10 9/L), CRP [(149.6±68.3)mg/L] vs (289.0±129.4)mg/L] and procalcitonin [3.7(1.4, 17.7)ng/ml vs 12.2(3.2, 62.9)ng/ml] in the blood samples from the patients were greatly decreased. Hemodynamics were obviously improved; heart rate [(107.4±9.5)bpm/min vs (143.4±9.7)bpm/min] was decreased, and the mean artery pressure [(87±5)mmHg vs (73±13)mmHg], 1 mmHg=0.133 kPa] tended to be stabilized. Metabolic acidosis was significantly improved; pH value (7.4±0.0 vs 7.2±0.1) and base excess (-2.1±2.5 vs -14.5±6.1) were increased, while lactic acid [(2.6±1.2)mmol/L vs (10.62±6.55)mmol/L] was decreased. Organ dysfunctions were improved; PaO 2/FiO 2 value (241.7±58.5 vs 115.9±53.6) was increased, while serum creatinine [(148.0±42.5)μmol/L vs (232.8±77.4)μmol/L], intra-abdominal pressure [(18.6±4.5)mmHg vs (24.2±4.0)]mmHg, modified Marshall score [3(3.0, 4.0) vs 6(5.5, 9.0)] and APACHEⅡ score (17.6±2.9 vs 26.0±5.2) were decreased. All the differences above were statistically significant (all P value <0.05). Conclusions:It is safe and feasible to treat SAP patients with CRRT by using oXiris in clinical practice, which may have the functions of clearing inflammatory mediators, stabilizing hemodynamics and acid-base balance and improving organ function.
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Objective:To evaluate the effect of quick response (QR) code health education in clinical nursing of vascular surgery.Methods:A total of 538 patients hospitalized in the vascular Surgery department of Beijing Friendship Hospital affiliated to Capital Medical University from April 2020 to December 2020 were selected as the research subjects. The subjects were divided into control group ( n = 272) and experimental group ( n = 266) by random number table method. Patients in the control group received health education by conventional oral methods, while patients in the experimental group received health education by means of QR code health education. After health education, the compliance, duration of health education, disease knowledge awareness rate and patient satisfaction rate were compared between the two groups of patients. Results:The compliance rate in medication compliance, outpatient follow-up visit, living habits in the experimental group were higher than those in the control group ( χ2 values were 2.96-4.82, P<0.05). The average length of health education by nurses in the experimental group was (4.53 ± 3.21) min, which was lower than (10.15 ± 1.03) min in the control group. The difference was statistically significant ( t = 3.41, P<0.05). The average score of health knowledge in the experimental group was 91.46 ± 4.77, which was higher than 85.37 ± 3.25 in the control group. The difference was statistically significant ( t = 8.59, P<0.05). The satisfaction rate of patients in the experimental group was 96.62% (257/266), which was higher than 75.37% (205/272) in the control group. The difference was statistically significant ( χ2= 63.04, P<0.05). Conclusions:The application of QR code health education in clinical nursing of vascular surgery can improve patient satisfaction rate, save health education time and increase the awareness rate of patients to disease knowledge. This kind of education is worthy of vigorous promotion in clinical practice.
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Objective:To establish a prediction model of acute upper gastrointestinal rebleeding (AUGIRB) for elderly patients by combining and applying multiple indicators.Methods:A retrospective observational study was conducted. The clinical data of 161 elderly patients (age ≥ 65 years old) who suffered from acute upper gastrointestinal bleeding (AUGIB) and who were hospitalized in Shanghai General Hospital from July 2018 to December 2020 were recorded. The patients were divided into the rebleeding group (31 cases) and the non-rebleeding group (130 cases) according to whether gastrointestinal rebleeding occurred. Univariate analysis was adopted to screen AUGIRB-related risk factors and Logistic regression analysis was used to screen independent predictors of AUGIRB so that a predictive model was constructed. Based on the area under the curve (AUC) of the receiver operator characteristic curve (ROC curve), the predictive ability of the prediction model for AUGIRB was evaluated, the optimal cut-off value was determined, and the odds ratio ( OR) and its 95% confidence interval (95% CI) were calculated. Bootstrap resampling technology was used to validate the predictive ability of the model. Results:Univariate Logistic analysis showed that oral anticoagulant drugs, oral antiplatelet drugs, albumin (ALB), platelet count (PLT), Glasgow-Blatchford bleeding score (GBS), D-dimer, fibrinogen (FIB), and international normalized ratio (INR) all had a significant effect on the occurrence of AUGIRB among elderly patients. Multivariate Logistic regression analysis showed that the oral antiplatelet drugs ( OR = 11.150, 95% CI was 1.888-65.852, P < 0.05) and GBS score ( OR = 2.503, 95% CI was 1.523-4.114, P < 0.05) were the independent risk factors of AUGIRB among elderly patients, while the ALB ( OR = 0.764, 95% CI was 0.626-0.932, P < 0.05) and FIB ( OR = 0.065, 95% CI was 0.011-0.370, P < 0.05) were the protective factors of AUGIRB among elderly patients. The AUC of the above four indexes joint prediction model was 0.979. The verification results of the model showed that the consistency index (C-index) of the model was 0.986. Conclusion:The prediction model fitted in this research has a high prediction accuracy and it also has a certain reference value for the judgment of elderly patients who suffer from AUGIRB.
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Objective:To investigate the influencing factors of the scientific research performance and analyze the differences between subjective and objective ones among the different characteristics of staffs in work and then propose tailored management strategies based on the research findings.Methods:A total number of 963 young researchers under the age of 45 (including doctors, medical technicians, scientific researchers) were surveyed and the impact on the scientific research performance of four subjective and objective factors including demographic characteristics and research motivation, self-efficacy, team support and the external environment were analyzed through self-developed questionnaire.Results:The academic degree, age, time spent overseas, administrative position, postgraduate mentor, professional title and levels, category of departments on the scores of scientific research performance had reached statistical significance ( P <0.05) by using Single factor analysis. The results showed that the impact on the scientific research performance followed a descending order of the category of postgraduate mentors, academic degree, professional title levels, the category of departments, self-efficacy, time spent overseas, and professional title series. Conclusions:According to the survey, this research focuses on the predictive factors which affecting scientific research performance as the important methods of scientific research promotion and talent training, and puts forward to the ideas of talent training, scheme of optimizing talent selection, carrying out accurate policy implementation and scientific assessment.
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Objective:To investigate the contents of paranasal sinus CT reports about clinically pertinent lesions and anatomic variations in patients with chronic rhinosinusitis and analyze the lesions and the anatomic variations less described in CT reports to improve the quality of paranasal sinus CT reports.Methods:A national questionnaire survey on radiologists interpreting paranasal sinus CT was conducted online in March, 2020. Questions were focused on the frequency of the lesions or anatomic variations of the paranasal sinuses described in paranasal sinus CT reports, and the results were analyzed and compared among radiologists by different levels of the hospital, professional titles, years of CT reading experience, subspecialties, and education backgrounds.Results:A total of 6 525 valid questionnaires were obtained, in which 97.7%, 97.7%, and 92.8% of radiologists described mucosal thickening, hypertrophy of turbinate or deviation of the nasal septum, and space occupying lesions within paranasal sinuses in CT reports, respectively. Only 35.0%, 26.9%, and 22.5% of radiologists described frontal recess lesions, dehiscence of foramen rotundum or pterygoid canal, and anterior/posterior ethmoid artery anatomy in CT reports, respectively. The anatomic variations that predisposed patients to major surgical complications or recurrent rhinosinusitis were more frequently documented in CT reports by radiologists with experience of head and neck radiology, senior titles or more than 30 years of radiological experience in tertiary hospitals than other radiologists.Conclusions:Lesions within the paranasal sinus were almost documented in all paranasal sinus CT reports. However, the anatomic variations that predisposed patients to major surgical complications or recurrent rhinosinusitis were infrequently described, which needs to be optimized by improving the quality of paranasal sinus CT reports.
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With the concepts of minimal invasive surgery and precision medicine embedding deeply in modern medicine, traditional clinical treatment strategies are constantly updated due to the rapid progression of medical research. Systematic dissection of the regional lymph nodes is a key component in the surgical therapy of gynecologic malignancies, however it may result in a series of complications, such as lower extremity lymphedema, deep venous thrombosis, immune disorders and so on, which seriously impact the patients' quality of life. The necessity of systematic lymphadenectomy and the extent of lymph nodes resection have always been one of the most controversial issues in gynecologic oncology. In recent years, the extensive application of sentinel lymph node (SLN) technology has been increasingly used in the treatment of gynecologic malignancies, which may provide important guidance on this issue. This article reviews the clinical application status, detection methods, detection efficiency, and current controversies regarding SLN mapping and biopsy in cervical cancer, endometrial cancer, ovarian cancer and vulvar cancer, discussing the application value of SLN technology in gynecologic oncology.
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Macrophages play an important role in material-related immune responses and bone formation, but the functionality of macrophage-derived extracellular vesicles (EVs) in material-mediated bone regeneration is still unclear. Here, we evaluated intracellular communication through small extracellular vesicles (sEVs) and its effects on endogenous bone regeneration mediated by biomimetic intrafibrillarly mineralized collagen (IMC). After implantation in the bone defect area, IMC generated more neobone and recruited more mesenchymal stem cells (MSCs) than did extrafibrillarly mineralized collagen (EMC). More CD63
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Biomimetics , Bone Regeneration , Cell Differentiation , Collagen , Extracellular Vesicles , Macrophages , OsteogenesisABSTRACT
Objective@#To understand the AIDS awareness and related factors as well as the demands for AIDS-related health education programs, among first-grade students from three senior high schools in Tianjin.@*Methods@#A cross-sectional study using both stratified cluster and convenient sampling methods was conducted. Anonymous questionnaires including social demographic characteristics, AIDS-related knowledge and needs for AIDS health education were distributed to the first-grade students from two general middle schools and one vocational senior middle school in Tianjin.@*Results@#A total of 1 082 students were responding to the questionnaires. Among them, the overall awareness rates of AIDS-related knowledge were 34.3%(371/1 082), 71.9%(778/1 082) of the students had received knowledge about AIDS and 59.4% (643/1 082) of the students had received knowledge about sexual health in the past, from the three schools. There appeared statistical differences among the two types of schools. 7.0% (76/1 082) of the students reported having had sexual behaviors. Results from the multivariate logistic regression analysis showed that, in vocational senior middle school, the awareness rate of AIDS knowledge was lower (compared with general middle school, OR=0.41, 95%CI: 0.29-0.59) and in the following items, including no need in receiving safe sex health knowledge (compared with needs of safe sex health knowledge, OR=0.62, 95%CI: 0.43-0.91), no interests in reading AIDS-related health education materials (compared with attention to AIDS health education materials, OR=0.41, 95%CI: 0.30-0.56), not aware of safe sex behavior (compared with aware of safe sex behavior, OR=0.55, 95%CI: 0.39-0.77), not aware of correct condom use, compared with aware of correct condom use (OR=0.33, 95%CI: 0.24-0.46).@*Conclusions@#The overall awareness rate of AIDS knowledge was low among the first-grade students in Tianjin. Some students reported of already having had insertive sex, sexual health knowledge has a significant impact on AIDS knowledge, suggesting that sexual health education and AIDS health education among high school students be strengthened in Tianjin.
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OBJECTIVE： To prepare Paclitaxel（PTX）nanostructured lipid carriers （NLC） modified by small peptide alanine-glutamic acid-tyrosine-leucine-arginine （AEYLR）， and to evaluate its anti-tumor effect in vitro and in vivo. METHODS： NLC， PTX-NLC （P-NLC） and AEYLR modified P-NLC （A-P-NLC） were prepared by emulsion evaporation-low temperature solidification curing method. Its appearance， particle size， multi-dispersion index（PDI） and Zeta potential were characterized，encapsulation rate，drug loading and in vitro drug release were detected respectively. Using NCI-H1299 and S180 cells as objects， CCK-8 method was adopted to investigate inhibitory effects of free PTX， P-NLC and A-P-NLC （0.44-44.00 μg/mL， by PTX） to those cells. The half inhibition concentration （IC50） was calculated. Using S180 tumor-bearing mice as model animal， anti-tumor effects of free PTX， P-NLC and A-P-NLC （5 mg/kg， by PTX） were evaluated. RESULTS： P-NLC and A-P-NLC were round-like and dispersed evenly. The particle size， PDI and Zeta potential of A-P-NLC were （43.92±0.76） nm， 0.203±0.034 and （－19.77±1.16） mV， which were all increased to certain extent， compared with P-NLC. The encapsulation efficiency and drug loading of A-P-NLC were （95.71±0.68）％ and（1.97±0.25）％， which were both decreased to certain extent， compared with P-NLC. The cumulative release rate of A-P-NLC was（35.17±2.08）％ within 48 h， showing significant sustained-release effect compared with free PTX； the release of A-P-NLC was slower than P-NLC. Compared with free PTX and P-NLC， inhibitory rates of same concentration of A-P-NLC to NCI-H1299 cells and S180 cells were almost increased significantly， while IC50 values were all decreased significantly. There was no death in S180 tumor-bearing mice treated with A-P-NLC and the general condition was good； the volume of tumors was significantly reduced， the mass of tumors was significantly reduced， and the inhibition rate of tumors was significantly increased （P＜0.05 or P＜0.01）. CONCLUSIONS： A-P-NLC has significantly sustained-release effects； its inhibitory rate to NCI-H1299 cells and S180 cells in vitro， and its inhibitory effects on S180 solid tumor in mice are all better than free PTX and P-NLC， while the toxicity is decreased to certain extent.
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OBJECTIVE: To prepare Salinomycin nanostructured lipid carriers (Sal-NLCs) and optimize its formulation. METHODS: Sal-NLCs was prepared by emulsion evaporation-low temperature solidification method. Using particle size, Zeta potential, encapsulation efficiency and drug loading as evaluation indexes, central composite design-response surface methodology was used to optimize the amount of Sal, the ratio of solid lipid glyceryl bisstearate to liquid lipid glyceryl octanoate in oil phase, ratio of surface active agent polyoxyethylene 35 castor oil (EL) to polyethylene glycol-15-hydroxy stearate (HS 15), the amount of polyoxyethylene (40) stearate (P40). The morphology, particle size, polydispersity index (PDI), Zeta potential, encapsulation efficiency, drug loading and in vitro release mechanism of Sal-NLCs were investigated. RESULTS: The optimal prescription was as follows as Sal 0. 86 mg, glyceryl bisstearate 40.70 mg, glyceryl octanoate 11.30 mg, EL 44.05 mg, HS15 7.95 mg, P40 3.8 mg. Prepared Sal-NLCs was round-like and dispersed evenly. The particle size, PDI, Zeta potential, encapsulation efficiency and drug loading of prepared Sal-NLCs were(81.81 ± 2.60) nm, 0.183 ± 0.042, (-24.9 ± 3.4) mV,(94.35 ± 1.50)％ and (1.47 ±0.04)％ (n=5), respectively.24 h accumulative release rate was (99.81 ± 3.90)％ (n=3).Drug release behavior was in line with Higuchi model, and relative error of particle size, Zeta-potential, encapsulation efficiency and drug loading to predicted value of model were all lower than 4％. CONCLUSIONS: Sal-NLCs with sustained-release effect is prepared successfully according to optimized formulation, and its quality meets the expected standard.
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Objective To study the relations between famine exposure and the risk of chronic diseases as diabetes mellitus,obesity,hypertension,coronary heart disease and stroke in the population of Harbin.Methods Our data was collected from the baseline survey-the China Kadoorie Biobank project (CKB) in Harbin.Retrospective cohort study design was used.Related risks on chronic diseases including diabetes mellitus,obesity,hypertension,coronary heart disease and stroke,were compared among the famine exposed or non-exposed people,respectively by logistic analysis method.Results After adjusted for factors as age,sex,physical activity,smoking,alcohol intake,diet,family history of diseases,it appeared that the factor ‘ famine exposure'had increased the risks of diseases as obesity (OR=1.204,95％CI:1.104-1.313,P＜0.01),hypertension (OR=1.315,95％CI:1.210-1.429,P＜0.01) and coronary heart disease (OR=1.495,95％CI:1.369-1.632,P＜0.01).The lower the age of population being exposed to famine,the greater the risk of the development of all kinds of chronic diseases.Conclusions Famine exposure appeared a risk factor for obesity,hypertension,and coronary heart disease.It is of great significance to ensure the life-long nutrition of the people,especially in the early and adolescent stages,to prevent obesity,hypertension,and coronary heart disease in their later lives.
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Objective To study the relations between famine exposure and the risk of chronic diseases as diabetes mellitus,obesity,hypertension,coronary heart disease and stroke in the population of Harbin.Methods Our data was collected from the baseline survey-the China Kadoorie Biobank project (CKB) in Harbin.Retrospective cohort study design was used.Related risks on chronic diseases including diabetes mellitus,obesity,hypertension,coronary heart disease and stroke,were compared among the famine exposed or non-exposed people,respectively by logistic analysis method.Results After adjusted for factors as age,sex,physical activity,smoking,alcohol intake,diet,family history of diseases,it appeared that the factor ‘ famine exposure'had increased the risks of diseases as obesity (OR=1.204,95％CI:1.104-1.313,P＜0.01),hypertension (OR=1.315,95％CI:1.210-1.429,P＜0.01) and coronary heart disease (OR=1.495,95％CI:1.369-1.632,P＜0.01).The lower the age of population being exposed to famine,the greater the risk of the development of all kinds of chronic diseases.Conclusions Famine exposure appeared a risk factor for obesity,hypertension,and coronary heart disease.It is of great significance to ensure the life-long nutrition of the people,especially in the early and adolescent stages,to prevent obesity,hypertension,and coronary heart disease in their later lives.
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The interplay between mechanoresponses and a broad range of fundamental biological processes, such as cell cycle progression, growth and differentiation, has been extensively investigated. However, metabolic regulation in mechanobiology remains largely unexplored. Here, we identified glucose transporter 1 (GLUT1)-the primary glucose transporter in various cells-as a novel mechanosensitive gene in orthodontic tooth movement (OTM). Using an in vivo rat OTM model, we demonstrated the specific induction of Glut1 proteins on the compressive side of a physically strained periodontal ligament. This transcriptional activation could be recapitulated in in vitro cultured human periodontal ligament cells (PDLCs), showing a time- and dose-dependent mechanoresponse. Importantly, application of GLUT1 specific inhibitor WZB117 greatly suppressed the efficiency of orthodontic tooth movement in a mouse OTM model, and this reduction was associated with a decline in osteoclastic activities. A mechanistic study suggested that GLUT1 inhibition affected the receptor activator for nuclear factor-κ B Ligand (RANKL)/osteoprotegerin (OPG) system by impairing compressive force-mediated RANKL upregulation. Consistently, pretreatment of PDLCs with WZB117 severely impeded the osteoclastic differentiation of co-cultured RAW264.7 cells. Further biochemical analysis indicated mutual regulation between GLUT1 and the MEK/ERK cascade to relay potential communication between glucose uptake and mechanical stress response. Together, these cross-species experiments revealed the transcriptional activation of GLUT1 as a novel and conserved linkage between metabolism and bone remodelling.
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Animals , Humans , Mice , Rats , Biomechanical Phenomena , Blotting, Western , Bone Remodeling , Cells, Cultured , Glucose Transporter Type 1 , Genetics , Hydroxybenzoates , Pharmacology , Immunohistochemistry , MAP Kinase Signaling System , Mice, Inbred C57BL , Osteoprotegerin , Metabolism , Periodontal Ligament , Cell Biology , RANK Ligand , Metabolism , Rats, Sprague-Dawley , Reverse Transcriptase Polymerase Chain Reaction , Tooth Movement Techniques , Transcriptional ActivationABSTRACT
Objective To explore the effect of personalized intervention on drug compliance in patients with multidrug-resistant pulmonary tuberculosis. Methods A total of 80 patients with multidrug-resistant pulmonary tuberculosis were selected from March 22, 2016 to March 22, 2017, and randomized groups were randomly divided into the observation group and the control group,40 cases in each groups . The observation group and the control group Intervention and routine care. Results Observation group of patients satisfaction score (97.92±1.24), compliance score (95.42±3.14), the incidence of adverse events (5.00%), reasonable nutrition rate (100.00%), prescribed medication rate (100.00%), don't do STH without authorization (100.00%), rate of quitting cigarettes, alcohol and drug withdrawal rate (95.00%), and regularly review rate (95.00%), the psychological function (97.53±1.22) and body function (96.18 ± 1.42) points (95.31±2.41), material life, social function (94.82± 3.42mm) were better than control group (P<0.05).Conclusion Individualized intervention in multidrug-resistant tuberculosis patients can improve drug compliance.
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Objective To investigate the intensity of HBsAg and HBcAg expression in liver tissue of patients with chronic hepatitis B virus (HBV) infection and its clinical significance.Methods A total of 994 HBV infected patients underwent liver biopsy and histopathological examination.The expression of HBsAg and HBcAg in liver tissue was detected by histoimmunochemistry.Patients were divided into HBeAg (+)/HBVDNA(+), HBeAg(-)/HBV DNA(+) and HBeAg(-)/HBV DNA(-) groups according to HBeAg and HBV DNA levels;patients were divided into ＜2 × normal (ULN) group, 2-＜5 × ULN groupand ≥5 × ULN group according to the alanine aminotransferase (ALT) levels.The histologic activity (A), fibrosis (F), the expression of HBsAg and HBcAg in liver tissue and their correlations with clinical features were analyzed.Logistic regression analysis was used to study the factors affecting the expression of HBsAg and HBcAg in liver tissue.Results Among 994 HBV infected patients, 941 cases (94.67％) were intrahepatic HBsAg positive and 553 cases (55.63％) were intrahepatic HBcAg positive;403 cases (40.85％) were ≥A2 in histologic activity and 371 cases (36.09％) were ≥F2 in fibrosis.The degree of A and F was the highest in HBeAg (-) / HBV DNA (+) group, followed by HBeAg (-) / HBV DNA (-) group, and was the lowest in HBeAg (+) / HBV DNA (+) group.The intensity of intrahepatic HBsAg expression was significantly different among three groups (x2 =6.299, r =-0.760, P ＜ 0.05), however, the difference was not showed in pairwise comparisons.The difference of intrahepatic HBcAg intensity among three groups was statistically significant (x2 =282.995, r =-0.645, P ＜ 0.01), the intensity was the highest in HBeAg (+) / HBV DNA (+) group and the lowest in HBeAg (-) / HBV DNA (-) group.The constituent ratio of HBeAg positive and HBV DNA level were higher and the average age was lower in intrahepatic HBsAg positive group than those in HBsAg negative group.The constituent ratio of positive HBeAg, the levels of ALT, AST, PLT and HBV DNA were higher and the average age, the average FIB-4 level were lower in intrahepatic HBcAg positive group than those in HBcAg negative group.The HBV DNA level was an independent risk factor for intrahepatic HBsAg intensity, and the HBeAg positive and HBV DNA level were independent risk factors for intrahepatic HBcAg intensity.There were no significant differences in A and F among different groups of intrahepatic HBsAg intensity (x2 =1.943 and 2.630, both P ＞ 0.05).There was significant difference in F among different groups of intrahepatic HBcAg intensity (x2 =12.352, P ＜ 0.01), but not in A.The degree of F was the highest in intrahepatic HBcAg negative group.There was significant difference in intrahepatic HBcAg intensity among different groups of ALT level (x2 =16.349, P ＜ 0.01), but not in intrahepatic HBsAg intensity.The intrahepatic HBcAg intensity in ALT ＜ 2 × ULN group was lower than that in other two groups.Conclusions Most of patients with chronic HBV infection are intrahepatic HBsAg positive and more than half of them are intrahepatic HBcAg positive.The intrahepatic HBsAg intensity is not associated with A and F, but correlates with HBV DNA level.The intrahepatic HBcAg intensity is not associated with A, but it is negatively correlated with F and positively correlated with positive HBeAg expression, HBV DNA level and ALT level.
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Objective To analyze the mortality rate in index partners of HIV discordant couples in the context of antiretroviral therapy and related factors in Zhumadian,Henan province.Methods An open and prospective cohort survey was conducted annually during 2008-2014.Information about the index partners'demographic characteristics,CD4+T (CD4) cell counts,viral load,AIDS-related syndromes,date of therapy initiation,level of treatment institution,and outcome of death were collected.Life table was used to calculate survival rate,and Cox proportional hazards model was used to analyze the mortality related factors.Results Among 4 196 index partners receiving antiretroviral therapy between 2008 and 2014,350 were fatal,with the mortality rate of 1.88 per 100 person years (95％CI:1.86-1.90).The survival rates of these patients with the duration of follow-up from 1 to 7 years were 99.64％,97.70％,95.62％,93.54％,91.25％,86.86％ and 82.36％ respectively.Factors related to the survival of the index partners of HIV discordant couples were age ≥50 years (HR=3.48,95％CI:2.67-4.55),junior high school or above education level (HR=0.75,95％CI:0.56-1.00),baseline CD4 cell counts ＞350 cells per μl (HR=0.55,95％CI:0.42-0.72),baseline viral load ＞400 copies/ml (HR=1.71,95％CI:1.32-2.22) and initiating treatment prior to cohort entry (HR=0.65,95％ CI:0.41-1.05).Conclusions The mortality rate of index partners receiving antiretroviral therapy was relatively low,indicating a better effect of long-term treatment on patients' survival.It is necessary to further identify and control the key factors influencing the survival of patients receiving therapy,improve the timeliness and adherence of the treatment,keeping patients' immunity level.Meanwhile,much attention should be paid to the drug resistance due to long term treatment and treatment failure.
ABSTRACT
Objective To analyze the mortality rate in index partners of HIV discordant couples in the context of antiretroviral therapy and related factors in Zhumadian,Henan province.Methods An open and prospective cohort survey was conducted annually during 2008-2014.Information about the index partners'demographic characteristics,CD4+T (CD4) cell counts,viral load,AIDS-related syndromes,date of therapy initiation,level of treatment institution,and outcome of death were collected.Life table was used to calculate survival rate,and Cox proportional hazards model was used to analyze the mortality related factors.Results Among 4 196 index partners receiving antiretroviral therapy between 2008 and 2014,350 were fatal,with the mortality rate of 1.88 per 100 person years (95％CI:1.86-1.90).The survival rates of these patients with the duration of follow-up from 1 to 7 years were 99.64％,97.70％,95.62％,93.54％,91.25％,86.86％ and 82.36％ respectively.Factors related to the survival of the index partners of HIV discordant couples were age ≥50 years (HR=3.48,95％CI:2.67-4.55),junior high school or above education level (HR=0.75,95％CI:0.56-1.00),baseline CD4 cell counts ＞350 cells per μl (HR=0.55,95％CI:0.42-0.72),baseline viral load ＞400 copies/ml (HR=1.71,95％CI:1.32-2.22) and initiating treatment prior to cohort entry (HR=0.65,95％ CI:0.41-1.05).Conclusions The mortality rate of index partners receiving antiretroviral therapy was relatively low,indicating a better effect of long-term treatment on patients' survival.It is necessary to further identify and control the key factors influencing the survival of patients receiving therapy,improve the timeliness and adherence of the treatment,keeping patients' immunity level.Meanwhile,much attention should be paid to the drug resistance due to long term treatment and treatment failure.