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1.
Chinese Journal of Preventive Medicine ; (12): 1047-1058, 2023.
Article in Chinese | WPRIM | ID: wpr-985515

ABSTRACT

Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R2 of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.


Subject(s)
Pregnancy , Child , Humans , Female , Glycated Hemoglobin , Cohort Studies , Diabetes Mellitus/diagnosis , Sensitivity and Specificity , ROC Curve
2.
Chinese Journal of Internal Medicine ; (12): 1102-1113, 2023.
Article in Chinese | WPRIM | ID: wpr-994427

ABSTRACT

Objective:To investigate the clinical characteristics of patients with rheumatic diseases and abnormal liver function, as well as determine the proportion and severity of liver function abnormalities.Methods:Cross-sectional study. Data were collected from patients registered in the Chinese Rheumatism Date Center from 2011 to 2021. The rheumatic diseases analyzed in this study were rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren syndrome (SS), ankylosing spondylitis (AS), and gout. Patient data, including demographic characteristics [ such as age, sex, body mass index,(BMI), and smoking history], liver function test results [including alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase(ALP), and total bilirubin], and use of anti-rheumatic immune drugs and liver-protective drugs, were collected and compared between groups with normal and abnormal liver functions. In addition, the proportions of abnormal liver function were compared between sex and age groups.Results:A total of 116 308 patients were included in this study, including 49 659 with RA, 17 597 with SLE, 9 039 with SS, 11 321 with AS, and 28 692 with gout. The lowest proportion of liver function abnormalities was observed in patients with RA[11.02% (5 470/49 659)], followed by those with SS[17.97% (1 624/9 039)] and AS [18.22% (2 063/11 321) ], whereas patients with SLE [21.14% (3 720/17 597) ] and gout [28.73% (8 242/28 692)] exhibited the highest proportion of these abnormalities. Elevated ALT, mostly classified as grade 1, was the most commonly noted liver function abnormality, whereas elevated ALP was the least common. Some patients who took liver-protective drugs had normal liver function, with the lowest percentage observed in patients with gout [7.45% (36/483) ] and ranging from 21.7% to 30.34% in patients with RA, SLE, SS, and AS. The proportion of liver function abnormalities was higher in males than in females for all disease types [RA: 13.8%(1 368/9 906) vs. 10.3%(4 102/39 753); SLE: 33.6% (479/1 424) vs. 20.0% (3 241/16 173); SS: 25.4%(111/437) vs. 17.6%(1 513/8 602); AS: 20.1%(1 629/8 119) vs. 13.6% (434/3 202); and gout: 29.3% (8 033/27 394) vs. 16.1% (209/1 298)]. In RA, SLE, and AS, the proportions of liver function abnormalities were similar across all age groups. In SS, the proportion of liver function abnormalities increased with age [<40 years: 14.9%(294/1 979); 40-59 years: 18.1%(858/4 741); ≥60 years: 20.4%(472/2 319)], whereas a reversal of this trend was observed in gout [<40 years: 34.9%(4 294/12 320); 40-59 years: 25.5%(2 905/11 398);≥60 years: 21.0%(1 042/4 971)].Conclusions:The proportions of combined liver function abnormalities in patients with rheumatologic diseases were high, and the utilization rates of liver-protective drugs were low. It is necessary to pay more attention to monitoring patients′ liver function, timely administer liver-protective drugs, and optimize liver-protective regimens during the treatment of rheumatic diseases.

3.
Chinese Journal of Internal Medicine ; (12): 1068-1076, 2023.
Article in Chinese | WPRIM | ID: wpr-994423

ABSTRACT

Gout is a metabolic disease resulting from the accumulation of monosodium urate (MSU) in joints, leading to crystal-induced arthritis. In China, gout is common, but there is insufficient knowledge regarding standardized criteria for the diagnosis and treatment of this condition. Based on evidence and guidelines from China and other countries, the Chinese Rheumatology Association developed standardized criteria for the diagnosis and treatment of gout in China. The purpose was to standardize gout diagnosis methods as well as treatment opportunities and strategies in order to reduce misdiagnosis, missed diagnosis, and irreversible damage.

4.
Chinese Journal of Ultrasonography ; (12): 692-698, 2023.
Article in Chinese | WPRIM | ID: wpr-992873

ABSTRACT

Objective:To investigate whether radiomics based on ultrasound images can predict lym-phatic metastasis of rectal cancer before surgery.Methods:A total of 80 patients with rectal cancer who underwent endorectal ultrasound (TRUS) and endorectal elastography were confirmed by postoperative pathology in Zhejiang Cancer Hospital from January 2016 to December 2019 were retrospectively analyzed. The general characteristics (gender, age, tumor size, depth of tumor infiltration, tumor location, carcinoembryonic antigen, glycoantigen 199) of the lymph node metastasis group ( n=27) and the non-metastasis group ( n=53) were compared, and the clinical risk factors with statistically significant differences were screened out. The tumor maximum sagittal 2D TRUS images and endorectal elastography were manually outlined, and the radiomics features were extracted using the open source software pyradiomics 3.0.1, and the filtering and embedding methods were used to reduce the dimensionality of the data to select the important features and obtain the best parameters of the model. Then all samples were randomly divided into training and validation sets in the ratio of 8∶2, the models were trained using the best model parameters, which were tested and validated in the validation set, and the predictive efficacy of different models was evaluated according to the ROC curve. Results:The depth of tumor infiltration was statistically significant in predicting whether the lymph nodes metastasized or not (χ 2=11.555, P<0.05), and its area under ROC curve(AUC) value was 0.699. A total of 1 710 features were extracted from sagittal 2D TRUS images and endorectal elastography. After pre-processing and screening, 10 features were strongly correlated with lymph node metastasis status. The 10 features were used to construct the prediction models with AUC values of 0.703, 0.726 and 0.742 for the Logistic Regression Model, Random Forest Model and Support Vector Machine Model, respectively. And the AUC value of the ensemble averaging model in the validation set was 0.734. The imaging-omics prediction model outperformed the prediction model based on statistical analysis of clinical data (AUC: 0.734 vs 0.699, Z=1.984), with a statistically significant difference ( P<0.05). Conclusions:The endorectal ultrasound and endorectal elastography-based radiomics model constructed in this study is better than the model constructed based on statistical analysis of clinical data only, and it is valuable for preoperative lymph node metastasis prediction in rectal cancer.

5.
Chinese Medical Journal ; (24): 1430-1438, 2023.
Article in English | WPRIM | ID: wpr-980942

ABSTRACT

BACKGROUND@#This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability.@*METHODS@#This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability.@*RESULTS@#STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min.@*CONCLUSION@#The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.


Subject(s)
Humans , Reproducibility of Results , Surveys and Questionnaires , Practice Guidelines as Topic
6.
Chinese Medical Journal ; (24): 951-958, 2023.
Article in English | WPRIM | ID: wpr-980882

ABSTRACT

BACKGROUND@#The clinical features of enthesitis in patients with psoriatic arthritis (PsA) have been reported in some Western countries, but data in China are very limited. This study aimed to describe the characteristics of enthesitis in Chinese patients with PsA and compared them with those in other cohorts.@*METHODS@#Patients with PsA enrolled in the Chinese Registry of Psoriatic Arthritis (CREPAR) (December 2018 to June 2021) were included. Data including demographics, clinical characteristics, disease activity measures, and treatment were collected at enrollment. Enthesitis was assessed by the Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht ankylosing spondylitis enthesitis score (MASES), and Leeds enthesitis index (LEI) indices. A multivariable logistic model was used to identify factors related to enthesitis. We also compared our results with those of other cohorts.@*RESULTS@#In total, 1074 PsA patients were included, 308 (28.7%) of whom had enthesitis. The average number of enthesitis was 3.3 ± 2.8 (range: 1.0-18.0). More than half of the patients (165, 53.6%) had one or two tender entheseal sites. Patients with enthesitis had an earlier age of onset for both psoriasis and arthritis, reported a higher proportion of PsA duration over 5 years, and had a higher percentage of axial involvement and greater disease activity. Multivariable logistic regression showed that axial involvement (odds ratio [OR] 2.21, 95% confidence interval [CI], 1.59-3.08; P <0.001), psoriasis area and severity index (PASI) (OR: 1.03, 95% CI: 1.01-1.04; P = 0.002), and disease activity score 28-C reactive protein (DAS28-CRP) (OR: 1.25, 95% CI: 1.01-1.55; P = 0.037) were associated with enthesitis. Compared with the results of other studies, Chinese patients with enthesitis had a younger age, lower body mass index (BMI), a higher rate of positive human leukocyte antigen (HLA)-B27, more frequent dactylitis, and a higher proportion of conventional synthetic disease-modifying antirheumatic drugs' (csDMARDs) use.@*CONCLUSIONS@#Enthesitis is a common condition among Chinese patients with PsA. It is important to evaluate entheses in both peripheral and axial sites.


Subject(s)
Humans , Arthritis, Psoriatic/drug therapy , East Asian People , Enthesopathy/complications , Registries , Severity of Illness Index , Spondylarthritis/epidemiology
7.
Shanghai Journal of Preventive Medicine ; (12): 573-579, 2023.
Article in Chinese | WPRIM | ID: wpr-979917

ABSTRACT

ObjectiveTo compare the incidence of respiratory and allergic diseases in children in Xuhui District, Shanghai in 2013 and 2020, and to determine the influencing factors. MethodsAnnual average levels of air pollutants including PM2.5, PM10, O3, SO2, and NO2 were collected and described in Shanghai from 2013 to 2020. A cross-sectional survey was conducted by using a questionnaire among grade 3 to 5 students in a school in Xuhui District, Shanghai, in September 2013 and 2020, respectively. The questionnaire collected variables including living environment, daily habits, family history of respiratory and allergic diseases, and incidence of these diseases in children. Chi-square test was used to determine the difference across respiratory and allergic diseases. Logistic regression was conducted to determine the influencing factors. ResultsA total of 1 398 valid questionnaires were collected (705 in 2013 and 693 in 2020). Compared with 2013, annual average concentrations of PM2.5, PM10, O3, SO2, and NO2 in 2020 significantly decreased. The prevalence of bronchial asthma, bronchitis, persistent cough and persistent expectoration in 2013 were significantly higher than those in 2020 (P<0.05) in Xuhui District. Multivariate analysis showed that severe air pollution, boys, parents with asthma or allergy, parents with higher educational levels, and more allergens in household were the risk factors associated with the incidence of bronchial asthma, bronchitis, allergic rhinitis and atopic eczema (P<0.05). Parents with allergy history, high smoking frequency of family member, and more allergens in household were the risk factors associated with the incidence of persistent cough and persistent expectoration (P<0.05). ConclusionTo 2013,2020 air pollution in Shanghai has been mitigated and prevalence of bronchial asthma and bronchitis of children has decreased. Childhood respiratory and allergic diseases are associated with indoor and outdoor environment, family medical history, and family daily habits.

8.
Journal of Sun Yat-sen University(Medical Sciences) ; (6): 642-650, 2023.
Article in Chinese | WPRIM | ID: wpr-979218

ABSTRACT

ObjectiveTo investigate the effect of myosin heavy chain 7 gene-derived miRNA-208b-3p on the fibrotic phenotype of cardiac fibroblasts. MethodsmiRNA chip array was performed to detect the dysregulated miRNAs in the myocardium of diabetic db/db mice and db/m control mice. Neonatal mouse ventricular cardiomyocytes (NMVCs) and cardiac fibroblasts (CFs) were isolated from C57BL/6 mice and cultured. Real-time quantitative PCR (RT-qPCR) was conducted to determine the expression of miR-208b-3p in mouse CFs and NMVCs subjected to angiotensinⅡ(AngⅡ) and high glucose plus glucose oxidase (G/Go) treatment, respectively. Cell counting kit 8(CCk8) assay, flow cytometry and determination of fibrosis-related protein, including COL1A1, COL3A1and α-SMA, were performed in mCFs transfected with miR-208b-3p. Dual luciferase reporter assay was performed to confirm the interaction between miR-208b-3p and the 3'-UTR of metal response element binding transcription factor 2 (Mtf2) and progesterone receptor membrane component 1(Pgrmc1), respectively. The expressions of Mtf2 and Pgrmc1 at the mRNA and protein levels in mCFs after miR-208b-3p mimic transfection were determined using RT-qPCR and Western blot assay, respectively. The small interfering RNA (siRNA) was used to inhibit Mtf2 and Pgrmc1 expression in mCFs, and the effects of Mtf2 siRNA, Pgrmc1 siRNA and miR-208b-3p on fibrosis-related protein expression in mCFs were investigated. ResultsResults of miRNA chip array and RT-qPCR assay showed that miR-208b-3p was up-regulated in the myocardium of the diabetic db/db mice. miR-208b precursor and the host gene of Myh7 were consistently increased in db/db mice. miR-208b-3p and Myh7 mRNA were expressed in mCFs and NMVCs, but the levels of miR-208b-3p and Myh7 mRNA in NMVCs were much higher than those in mCFs. miR-208b-3p was up-regulated in mCFs and NMVCs subjected to Ang Ⅱ and G/Go treatment, respectively. miR-208b-3p could significantly enhance fibrosis-related protein, including COL1A1, COL3A1 and α-SMA, in mCFs, without affecting the proliferation activity and cell cycle distribution of mCFs. Dual luciferase reporter assay revealed the interactions of miR-208b-3p with the 3'-UTR of Mtf2 and Pgrmc1. The results of RT-qPCR and Western blotting confirmed that miR-208b-3p inhibited Mtf2 and Pgrmc1 expression at the post- transcriptional level. Transfection with miR-208b-3p mimic, Mtf2 siRNA and Pgrmc1 siRNA could consistently enhance the fibrosis-related protein expression in the cardiac fibroblasts. ConclusionsmiR-208b-3p enhances fibrosis-related gene expression by targeting Mtf2 and Pgrmc1in mCFs.

9.
Journal of Environmental and Occupational Medicine ; (12): 796-804, 2023.
Article in Chinese | WPRIM | ID: wpr-979195

ABSTRACT

Background Perfluorinated compounds (PFCs) are persistent organic pollutants. Dietary exposure to PFCs among pregnant women may lead to elevated risks of adverse events during pregnancy and postpartum depression. Objective To estimate potential risk of dietary exposure to PFCs among pregnant women in Xuhui District, Shanghai, and the relationship between dietary PFCs exposure and risks of adverse events during pregnancy and postpartum depression. Methods This study was a small cohort study which recruited women residing in Xuhui District from July 2017 to September 2018. All information was collected through questionnaires by trained investigators. Basic information and dietary information were collected at the time of inclusion, where the dietary information was obtained through the Food Frequency Questionnaire (FFQ). A follow-up visit was conducted within 42 d after delivery to collect the occurrence of adverse events during pregnancy and postpartum depression. According to the results of dietary survey, sampling and PFCs level testing were conducted on commercially available staple foods, poultry and livestock meat, aquatic products, vegetables, milk and dairy products, eggs, etc. The food sampling points covered all subdistricts in Xuhui District, including farmers' markets, supermarkets, convenience stores, and shops. Daily exposure level and hazard ratio (HR) of PFCs per capita were calculated according to the dietary survey and laboratory testing. Logistic regression was used to estimate the relationship between PFCs exposure and the risks of adverse events during pregnancy and postpartum depression. The levels of PFCs exposure were further divided into 4 groups according to interquartile range, and OR and Ptrend value were calculated respectively. Results A total of 345 pregnant women were recruited in this study, whose average age was (29.61±4.92) years. Among them, 26.37% subjects reported at least one adverse event during pregnancy, and 30.14% subjects reported an Edinburgh Postnatal Depression Scale (EPDS) score ≥12. A total of 132 food samples were collected and tested, and PFCs were positive mainly in milk and dairy products, poultry meat, livestock meat, eggs, fresh water products, and sea water products. The PFCs positive rate in fresh water products was the highest, reaching 100%. The average concentration of PFCs in the positive samples was 0.018-2.10 μg·kg−1. The HR of PFCs was 4.44. A higher risk of postpartum depression was found along with a higher perfluorooctane sulfonate (PFOS) exposure level (Ptrend=0.02). Conclusion Dietary PFCs exposure may pose a health risk to pregnant women. The study findings suggest that decreasing the intake of freshwater products might help reduce the risk of PFCs exposure among pregnant women in Xuhui district, Shanghai.

10.
Neuroscience Bulletin ; (6): 1069-1086, 2023.
Article in English | WPRIM | ID: wpr-982423

ABSTRACT

Cortical interneurons can be categorized into distinct populations based on multiple modalities, including molecular signatures and morpho-electrical (M/E) properties. Recently, many transcriptomic signatures based on single-cell RNA-seq have been identified in cortical interneurons. However, whether different interneuron populations defined by transcriptomic signature expressions correspond to distinct M/E subtypes is still unknown. Here, we applied the Patch-PCR approach to simultaneously obtain the M/E properties and messenger RNA (mRNA) expression of >600 interneurons in layer V of the mouse somatosensory cortex (S1). Subsequently, we identified 11 M/E subtypes, 9 neurochemical cell populations (NCs), and 20 transcriptomic cell populations (TCs) in this cortical lamina. Further analysis revealed that cells in many NCs and TCs comprised several M/E types and were difficult to clearly distinguish morpho-electrically. A similar analysis of layer V interneurons of mouse primary visual cortex (V1) and motor cortex (M1) gave results largely comparable to S1. Comparison between S1, V1, and M1 suggested that, compared to V1, S1 interneurons were morpho-electrically more similar to M1. Our study reveals the presence of substantial M/E variations in cortical interneuron populations defined by molecular expression.


Subject(s)
Mice , Animals , Neocortex/physiology , Mice, Transgenic , Interneurons/physiology
11.
Chinese Journal of Contemporary Pediatrics ; (12): 339-343, 2023.
Article in Chinese | WPRIM | ID: wpr-981960

ABSTRACT

OBJECTIVES@#To investigate the positive rate of enterovirus (EV) nucleic acid in throat swabs of term late neonates hospitalized during the coronavirus disease 2019 (COVID-19) epidemic and the clinical characteristics of the neonates.@*METHODS@#A single-center cross-sectional study was performed on 611 term late infants who were hospitalized in the neonatal center from October 2020 to September 2021. Throat swabs were collected on admission for coxsackie A16 virus/EV71/EV universal nucleic acid testing. According to the results of EV nucleic acid test, the infants were divided into a positive EV nucleic acid group (8 infants) and a negative EV nucleic acid group (603 infants). Clinical features were compared between the two groups.@*RESULTS@#Among the 611 neonates, 8 tested positive for EV nucleic acid, with a positive rate of 13.1‰, among whom 7 were admitted from May to October. There was a significant difference in the proportion of infants contacting family members with respiratory infection symptoms before disease onset between the positive and negative EV nucleic acid groups (75.0% vs 10.9%, P<0.001). There were no significant differences between the two groups in demographic data, clinical symptoms, and laboratory test results (P>0.05).@*CONCLUSIONS@#There is a certain proportion of term late infants testing positive for EV nucleic acid in throat swabs during the COVID-19 epidemic, but the proportion is low. The clinical manifestations and laboratory test results of these infants are non-specific. Transmission among family members might be an important cause of neonatal EV infection.


Subject(s)
Infant , Infant, Newborn , Humans , Enterovirus , COVID-19/diagnosis , Cross-Sectional Studies , Pharynx , Nucleic Acids , Enterovirus Infections
12.
China Journal of Orthopaedics and Traumatology ; (12): 507-513, 2023.
Article in Chinese | WPRIM | ID: wpr-981724

ABSTRACT

OBJECTIVE@#To evaluate outcomes of mixed unicompartmental knee arthroplasty(UKA) and total knee arthroplasty(TKA) in the treatment of medial osteoarthritis(OA) of the knee.@*METHODS@#Retrospective analysis of 156 patients, 44 males and 112 females, aged from 50 to 75 years old with an average of(58.76±4.97) years old, who underwent knee arthroplasty from October 2017 to October 2019. The patients were divided into two groups:81 cases(81 knees) underwent TKA, including 23 males and 58 females, aged from 51 to 75 years old with an average of (58.60±5.01) years old, and 75 case (75 knees) underwent UKA with mixed phase 3 Oxford, including 21 males and 54 females, aged from 50 to 72 years old with an average of (58.92±4.95) years old. The two groups were compared regarding to the clinical outcomes, assessed using surgical information and complications, American Knee Society score(AKSS) clinical score and functional score. Radiographs were assessed using hip-knee-ankle angle(HKA), tibial component valgus/varus angle(TCVA), tibial component posterior slope angle(TCPSA), femoral component valgus/varus angle(FCVA), femoral component posterior slope angle(FCPSA), looking for bearing dislocation, prosthesis loosening, progression of OA in lateral compartment.@*RESULTS@#Intraoperative bleeding, operative time and hospital days were significantly better in the UKA group than in the TKA group (P<0.05), and there were no postoperative complications in either group. Patients in both groups were enrolled with an average follow-up time of (38.01±8.90) months, ranged from 24 to 54 months. AKSS functional, AKSS clinical, HKA in both groups significantly improved at the final follow-up compared with those before operation. At the final follow-up, the UKA group was significantly better than the TKA group in AKSS functional and AKSS clinical, whereas HKA in the TKA group was better. At the final follow-up. TCVA and FCVA between the two groups were not significantly different, while TCPSA and FCPSA in the UKA group were significantly greater than the TKA group. No signs of progression of OA to the lateral compartment were observed.@*CONCLUSION@#Mixed phase 3 Oxford UKA in medial unicompartmental knee osteoarthritis was considerably better than TKA for less blood loss, shorter operation time, shorter hospital stay, rapid postoperative recovery, helping achieve satisfactory function, provided satisfactory outcome.


Subject(s)
Male , Female , Humans , Middle Aged , Aged , Arthroplasty, Replacement, Knee , Osteoarthritis, Knee/surgery , Retrospective Studies , Treatment Outcome , Knee Joint/surgery , Knee Prosthesis
13.
Chinese Journal of Hospital Administration ; (12): 433-438, 2022.
Article in Chinese | WPRIM | ID: wpr-958805

ABSTRACT

The salary reform of public hospitals has a positive incentive effect on enhancing the public welfare of public hospitals, stimulating the enthusiasm of medical staff, and promoting high-quality development. The authors introduced the practice and exploration of the sequential salary system reform in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology since 2018. It included the reform of physician performance based on medical groups, the reform of nursing performance based on vertical nursing management, the reform of medical technology performance based on resource marginal utilization, and the reform of management performance based on job responsibilities and 360°evaluation. The practice has showed that the salary reform could promote the improvement of medical service ability, improve nurses′ satisfaction, shorten the waiting time for medical technical examination, and steadily improve the performance of " National Examination" and the comprehensive ranking of hospitals. When studying and implementing the policy requirements of salary system reform, hospitals in different regions should take measures in accordance with local conditions, with accurate and safe information systems as the support, and focus on the distribution mode, compensation structure and funding sources.

14.
Chinese Journal of Ultrasonography ; (12): 620-625, 2022.
Article in Chinese | WPRIM | ID: wpr-956635

ABSTRACT

Objective:To explore the application value of dual contrast-enhanced ultrasound in the differential diagnosis of renal cystic lesions.Methods:Eighty-four cases with renal cysts who were diagnosed by routine ultrasound in Zhejiang Cancer Hospital and Zhejiang Xiaoshan Hospital from January 2019 to October 2020 were included in the study. Intravenous contrast-enhanced ultrasound and enhanced MRI were performed to differentiate benign and malignant cysts. Patients with benign cysts underuent intravenous pyelography and intracapsular contrast-enhanced ultrasound. Before sclerotheraphy to exclude renal pelvic cysts. The diagnostic results of dual radiography were compared with MRI and intravenous pyelography.Results:Among 84 patients with suspected renal cysts, the diagnostic accuracy of enhanced MRI for cystic renal cancer was 97.62%, and the sensitivity was 97.62%. The diagnostic accuracy of intravenous contrast-enhanced ultrasound was 98.81, the sensitivity was 100%, and the specificity was 98.73%. There was no statistically significant difference between the two groups (all P>0.05). 77 cases were diagnosed as benign renal cysts, the detection rate of intravenous pyelography was 9.1% (7/77), the detection rate of renal pelvic cysts by intracystic ultrasonography was 6.5% (5/77). With intravenous pyelography as the gold standard, the diagnostic accuracy of intracapsular contrast-enhanced ultrasound was 97.4% (75/77), the sensitivity was 71.4% (5/7), and the specificity was 100% (70/70). Conclusions:Compared with enhanced magnetic resonance and intravenous pyelography before renal cyst sclerosing therapy, there is no difference in diagnostic efficiency of double contrast ultrasound for benign and malignant cysts. The diagnostic efficiency of renal pelvic cysts is high, and the operation is convenient. It can identify cystic renal cancer and cysts from the renal pelvis and improve the safety of sclerotherapy.

15.
Journal of Forensic Medicine ; (6): 739-746, 2022.
Article in English | WPRIM | ID: wpr-984166

ABSTRACT

OBJECTIVES@#To investigate the genetic information of 57 autosomal InDel loci (A-InDels) included in AGCU InDel 60 fluorescence detection kit in the Beichuan Qiang population of Sichuan Province and evaluate its application value in forensic medicine.@*METHODS@#A total of 200 unrelated healthy individuals from Beichuan Qiang population of Sichuan Province were typing detected by AGCU InDel 60 fluorescence detection kit. Allele frequencies and population genetic parameters of the 57 A-InDels were statistically analyzed and compared with the available data of 26 populations.@*RESULTS@#After Bonferroni correction, there was no linkage disequilibrium between the 57 A-InDels, and all loci were in Hardy-Weinberg equilibrium. Except for rs66595817 and rs72085595, the minor allele frequencies of 55 A-InDels were above 0.3. PIC ranged from 0.298 3 to 0.375 0, CDP was 1-2.974 8×10-24, CPEduo was 0.999 062 660, and CPEtrio was 0.999 999 999. The calculation of the genetic distance showed that Beichuan Qiang population had the closest genetic distances with Beijing Han and South China Han populations, but far away from African populations.@*CONCLUSIONS@#The 57 A-InDels in AGCU InDel 60 fluorescence detection kit have a good genetic polymorphism in Beichuan Qiang population of Sichuan Province, which can be used as effective supplemental for individual identification and paternity identification in forensic medicine.


Subject(s)
Humans , Genetics, Population , Asian People/genetics , Polymorphism, Genetic , Gene Frequency , INDEL Mutation , China , Microsatellite Repeats , Genetic Loci
16.
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery ; (12): 330-334, 2022.
Article in Chinese | WPRIM | ID: wpr-923382

ABSTRACT

@#Objective    To investigate the short-term efficacy and safety of thoracoscopy-assisted epicardial radiofrequency ablation for atrial fibrillation (AF) and/or left atrial appendage exclusion (LAAE). Methods    The clinical data of 12 patients with solitary AF admitted to Beijing Tiantan Hospital from November 2018 to August 2020 were retrospectively analyzed, including 7 males and 5 females, with an average age of 65.2±5.3 years. Of them, 2 had paroxysmal AF, 1 had persistent AF and 9 had permanent AF. Results    No patient died during hospitalization, 5 patients underwent radiofrequency ablation for AF and LAAE, and 6 received LAAE alone. The operation time was 293±70 min in radiofrequency ablation for AF+LAAE patients and 71±14 min in LAAE patients. Two patients restored sinus rhythm, two restored after electric cardioversion, and one remained AF in AF+LAAE patients. Postoperatively, 1 patient had pleural effusion and 1 had subcutaneous emphysema. No stroke was observed. Conclusion    Thoracoscopy-assisted radiofrequency ablation for AF and/or LAAE reduce the risk of procedure, and provide alternative approach to treat AF-associated diseases. However, large sample size studies using prospective cohort designs are required to corroborate the present findings.

17.
Journal of Experimental Hematology ; (6): 466-475, 2022.
Article in Chinese | WPRIM | ID: wpr-928738

ABSTRACT

OBJECTIVE@#To investigate the toxicity management and efficacy evaluation of BCMA-chimeric antigen receptor T cells(CART) in the treatment of relapsed and refractory multiple myeloma (MM).@*METHODS@#The efficacy and adverse reactions of 21 patients with MM who received BCMA-CART treatment at the First Affiliated Hospital of Wenzhou Medical University from December 2017 to September 2020 were evaluated, and the efficacy assessment and survival analysis for high-risk patients and non-high-risk patients were evaluated.@*RESULTS@#After infusion of BCMA-CART cells in 21 MM patients, the number of effective cases was 17, of which the complete remission (sCR/CR) was 10, and the partial remission (VGPR/PR) was 7. The median OS time for all patients was 19.4 months, and the median PFS time was 7.9 months. The number of patients with extramedullary disease(EMD), high-risk genetics, and ISS stage Ⅲ were 5, 15 and 8, and the effective number was 3, 11 and 6, respectively. The treatment of 3 patients without high-risk factors was effective. The median OS and median PFS of patients with EMD were 14.2 and 2.5 months, respectively, which were shorter than those of patients without EMD (19.4 months and 8.9 months, respectively). The median OS and median PFS of patients with high-risk cytogenetic factors and ISS Ⅲ were not significantly different from those of non-high-risk patients. Cytokine release syndrane (CRS) occurred in 20 patients, of which 14 cases were Grade 1 CRS, while 6 were Grade 2, no CRS of Grade 3 or above occurred. IL-6 receptor inhibitors were used in 9 patients. All CRS were controlled effectively, and no patients had neurological toxicity.@*CONCLUSION@#BCMA-CART is a certain curative effect in the treatment of relapsed and refractory multiple myeloma, and the adverse reactions can be well controlled through close monitoring and timely treatment.


Subject(s)
Humans , B-Cell Maturation Antigen , Immunotherapy, Adoptive/adverse effects , Multiple Myeloma/therapy , Receptors, Chimeric Antigen , Remission Induction
18.
Chinese Journal of Hospital Administration ; (12): 690-694, 2022.
Article in Chinese | WPRIM | ID: wpr-995974

ABSTRACT

In recent years, China has issued many laws and regulations on enhancing hospital security order management, and the related system has been gradually improved. However, the management requirements of hospitals are hard to implement. In this way, hospitals have burdened intensive internal pressure to implement the policies, with the dilemma of insufficient external support. Based on the perspective of social co-governance, this study discussed the development of policies related to hospital security order management in China. Also, it summarized the best practices about how to ensure hospitals security order from the aspects of the government, hospitals as well as social organizations. Additionally, it analysed current existing problems, such as the lack of sufficient cooperation of the police-doctor linkage mechanism, the inadequate implementation of technical prevention measures, the delayed mediation and disposal of doctor-patient contradiction, the imperfect of supporting policies and etc.Finally, this paper provided relevant suggestions on long-term mechanism to ensure the security order of hospitals.

19.
Chinese Journal of Hospital Administration ; (12): 561-565, 2022.
Article in Chinese | WPRIM | ID: wpr-995948

ABSTRACT

The development characteristics of tertiary public hospitals in China presented differently under the macro environment in different periods. Based on the theory of supply and demand chain of medical services, the authors discussed the key factors affecting the high-quality development of tertiary public hospitals under the new situation from the four elements of production, distribution, circulation and consumption, and put forward countermeasures and suggestions as follows: optimizing the supply of medical talents and system construction in the production process; speeding up the layout of high-quality resources and the construction of an integrated medical service system in the distribution process; strengthening imformation construction and the scientific and technological innovation in the circulation process; expanding healthcare/prevention integration and refining supporting policies in the consumption process, so as to provide reference for accelerating the high-quality development of public hospitals in China.

20.
Journal of Environmental and Occupational Medicine ; (12): 730-736, 2022.
Article in Chinese | WPRIM | ID: wpr-960472

ABSTRACT

Background Air quality health index (AQHI) has been widely used to quantify the health effects of multiple pollutants observed in population-based epidemiological studies, and can better reflect the widespread linear non-threshold between air pollution and health effects. Objective To explore an AQHI for pediatric respiratory diseases (AQHIr) in Shanghai and evaluate its feasibility. Methods The daily numbers of hospital outpatient visits for pediatric respiratory diseases from 2015 to 2019 were obtained from five general hospitals in Xuhui, Baoshan, Hongkou, Jinshan, and Chongming Districts of Shanghai. Monitoring data on air pollutants (PM2.5, PM10, SO2, NO2, and O3), air quality index (AQI), and meteorological variables (temperature, relative humidity, air pressure, and wind speed) were collected from five air quality monitoring sites nearest to selected hospitals. Time-series analysis using generalized additive model (GAM) was conducted to estimate the associations between respiratory-related pediatric outpatient visits and the concentrations of air pollutants. The sum of excess risk (ER) of hospital outpatient visits was used to construct AQHIr. To assess the predictive power of AQHIr, the associations of AQHIr and AQI with the number of pediatric respiratory outpatient visits in three hospitals in Xuhui, Hongkou, and Chongming districts were compared. Results Air pollutants had various effects on respiratory diseases outpatient visits. PM2.5, NO2, and O3 had most significant impacts on lag0 day and the associated ERs of hospital outpatient visits for each 10 μg·m−3 increase in pollutant concentration were 1.27% (95%CI: 0.88%-1.66%), 0.75% (95%CI: 0.40%-1.11%), and 0.36% (95%CI: 0.10%-0.62%), respectively. PM10 and SO2 had most significant impacts on lag3 day and the associated ERs of hospital outpatient visits for each 10 μg·m−3 increase in pollutant concentration were 0.81% (95%CI: 0.51%-1.12%) and 5.64% (95%CI: 3.37%-7.96%), respectively. There were significant effects of combinations of two pollutants among PM2.5, PM10, NO2, SO2, and O3 except for PM10+NO2, SO2+PM2.5, and SO2+NO2 (P<0.05). According to the results of single-pollutant and two-pollutant models, PM2.5, NO2, SO2, and O3 were selected to construct AQHIr. The comparison showed that for every interquartile range increase in AQHIr, the ER for pediatric outpatient visits was higher than that for the value corresponding to AQI. Conclusion Air pollutants in Shanghai have an impact on the number of pediatric respiratory outpatient visits. The AQHIr based on and outpatient visits for pediatric respiratory diseases can be a sensitive index to predict the effects of air pollution on children's respiratory health.

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