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OBJECTIVE@#To investigate a new noninvasive diagnostic model for nonalcoholic fatty liver disease (NAFLD) based on features of tongue images.@*METHODS@#Healthy controls and volunteers confirmed to have NAFLD by liver ultrasound were recruited from China-Japan Friendship Hospital between September 2018 and May 2019, then the anthropometric indexes and sampled tongue images were measured. The tongue images were labeled by features, based on a brief protocol, without knowing any other clinical data, after a series of corrections and data cleaning. The algorithm was trained on images using labels and several anthropometric indexes for inputs, utilizing machine learning technology. Finally, a logistic regression algorithm and a decision tree model were constructed as 2 diagnostic models for NAFLD.@*RESULTS@#A total of 720 subjects were enrolled in this study, including 432 patients with NAFLD and 288 healthy volunteers. Of them, 482 were randomly allocated into the training set and 238 into the validation set. The diagnostic model based on logistic regression exhibited excellent performance: in validation set, it achieved an accuracy of 86.98%, sensitivity of 91.43%, and specificity of 80.61%; with an area under the curve (AUC) of 0.93 [95% confidence interval (CI) 0.68-0.98]. The decision tree model achieved an accuracy of 81.09%, sensitivity of 91.43%, and specificity of 66.33%; with an AUC of 0.89 (95% CI 0.66-0.92) in validation set.@*CONCLUSIONS@#The features of tongue images were associated with NAFLD. Both the 2 diagnostic models, which would be convenient, noninvasive, lightweight, rapid, and inexpensive technical references for early screening, can accurately distinguish NAFLD and are worth further study.
Subject(s)
Humans , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Ultrasonography , Anthropometry , Algorithms , ChinaABSTRACT
Objective To analyze the genetic subtypes of human immunodeficiency virus (HIV) and the prevalence of pretreatment drug resistance in the newly reported HIV-infected men in Guangxi. Methods The stratified random sampling method was employed to select the newly reported HIV-infected men aged≥50 years old in 14 cities of Guangxi from January to June in 2020.The pol gene of HIV-1 was amplified by nested reverse transcription polymerase chain reaction and then sequenced.The mutation sites associated with drug resistance and the degree of drug resistance were then analyzed. Results A total of 615 HIV-infected men were included in the study.The genetic subtypes of CRF01_AE,CRF07_BC,and CRF08_BC accounted for 57.4% (353/615),17.1% (105/615),and 22.4% (138/615),respectively.The mutations associated with the resistance to nucleoside reverse transcriptase inhibitors (NRTI),non-nucleoside reverse transcriptase inhibitors (NNRTI),and protease inhibitors occurred in 8 (1.3%),18 (2.9%),and 0 patients,respectively.M184V (0.7%) and K103N (1.8%) were the mutations with the highest occurrence rates for the resistance to NRTIs and NNRTIs,respectively.Twenty-two (3.6%) patients were resistant to at least one type of inhibitors.Specifically,4 (0.7%),14 (2.3%),4 (0.7%),and 0 patients were resistant to NRTIs,NNRTIs,both NRTIs and NNRTIs,and protease inhibitors,respectively.The pretreatment resistance to NNRTIs had much higher frequency than that to NRTIs (2.9% vs.1.3%;χ2=3.929,P=0.047).The prevalence of pretreatment resistance to lamivudine,zidovudine,tenofovir,abacavir,rilpivirine,efavirenz,nevirapine,and lopinavir/ritonavir was 0.8%, 0.3%, 0.7%, 1.0%, 1.3%, 2.8%, 2.9%, and 0, respectively. Conclusions CRF01_AE,CRF07_BC,and CRF08_BC are the three major strains of HIV-infected men≥50 years old newly reported in Guangxi,2020,and the pretreatment drug resistance demonstrates low prevalence.
Subject(s)
Male , Humans , Middle Aged , Reverse Transcriptase Inhibitors/therapeutic use , HIV Infections/drug therapy , Drug Resistance, Viral/genetics , China/epidemiology , Mutation , HIV-1/genetics , Protease Inhibitors/therapeutic use , GenotypeABSTRACT
Objective@#To examine the exposure to television advertising of unhealthy food among children and adolescents in Beijing, in order to provide a basis for the formulation of marketing management policies with unhealthy food.@*Methods@#Four weekdays and four weekend days were randomly selected during October 19, 2020 to January 17, 2021, excluding holidays and school holidays. The top five popular channels of children and adolescents aged 3 to 18 years old were selected. A total of 720 hours was included for coding and analysis. World Health Organization Nutrient Profile Model for the Western Pacific Region was used to classify food and assess the health level.@*Results@#A total of 13 864 advertisings (ads) was monitored, 38.8% (5 376) of which were food ads. Furthermore, 49.9% (2 680) of food ads were unhealthy food ads, with a frequency of 2.00 per hour per channel. The top five most frequent food ads were infant formula for 12-36 months (26.7%), cheese (16.7%), savory snacks (12.2%), milk drinks (10.5%) and chocolate and candy (6.0%). The most frequently used marketing strategies for unhealthy food ads were brand benefit claims (96.8%) and promotional characters (67.9%).@*Conclusion@#Children and adolescents in Beijing are highly exposed to TV marketing of unhealthy foods. Marketing strategies such as brand benefit claims and promotional characters are employed to boost the impact of unhealthy food ads. There is an urgent need to introduce relevant policies to regulate TV marketing of unhealthy foods.
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ObjectiveTo investigate the risk factors and construct a predictive model for severe myelosuppression due to chemotherapy in triple negative breast cancer (TNBC). MethodsPatients with TNBC who received anthracycline combined with cyclophosphamide sequential paclitaxel chemotherapy regimen at the Second Affiliated Hospital of Nanchang University from September 2, 2016 to September 2, 2021 were selected and assigned to severe myelosuppression group and no/mild myelosuppression group. The χ2 test and binary logistic regression were used to analyze the risk factors for severe myelosuppression due to chemotherapy and to develop a prediction model. Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve were used to evaluate the predictive efficiency of the regression model. Kappa consistency test was used to verify the regression model externally. ResultsA total of 207 patients who met the inclusion were enrolled and 106 patients (51%) had severe myelosuppression. Binary logistic regression multivariate analysis showed that age 40 to 60 years (OR = 3.463, 95% CI: 1.144 to 10.486, P = 0.028), age >60 years (OR = 3.474, 95% CI: 1.004 to 12.020, P = 0.049), body mass index (BMI) 18.5 to 24.0 (OR = 1.445, 95% CI: 0.686 to 3.087, P = 0.328), BMI <18.5 (OR = 3.582, 95% CI: 1.260 to 10.182, P = 0.017), tumor TNM stage Ⅱ (OR = 1.698, 95% CI: 0.831 to 3.468, P = 0.146), tumor TNM stage Ⅲ (OR = 2.943, 95% CI: 1.199 to 7.227, P = 0.019), previous diabetes (OR = 2.441, 95% CI: 1.076 to 5.539, P = 0.033), low pre-treatment albumin level (OR = 2.759, 95% CI: 1.141 to 6.669, P = 0.024) and low pre-treatment lymphocytes (OR = 3.428, 95% CI: 1.689 to 6.958, P = 0.001) were independent risk factors for severe myelosuppression due to chemotherapy. The χ2 value for the logistic regression model Hosmer-Lemeshow test was 11.507, P= 0.175, the area under the ROC curve was 0.763, standard error 0.033, 95% CI: 0.698-0.828, P=0.000. External validation showed that the prediction model had a specificity of 88% and a sensitivity of 80%; the kappa value was 0.679, standard error 0.081, P=0.000. conclusionThis logistic regression model had high predictive efficacy and is useful for clinicians to predict whether patients with TNBC develop severe myelosuppression.
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Objective:To study the effect of blood volume feedback control system on improving intradialytic-hypotension (IDH) in maintenance hemodialysis (MHD) patients.Methods:It was a prospective cohort study. Thirty MHD patients with recurrent IDH in the Dialysis Center of the First Affiliated Hospital of Zhejiang University School of Medicine from March 2021 to March 2022 were selected. A self-control study was conducted in MHD patients. The patients were treated with routine hemodialysis in both baseline phase (A1) and reversal phase (A2), while with hemodialysis under the blood volume feedback control system in intervention phase (B). Each phase lasted for 4 weeks (12 hemodialysis sessions). The average occurrences of IDH and IDH-related adverse events (IDH-RAE, stopping dehydration for more than 10 minutes or getting off the hemodialysis machine 10 minutes earlier due to IDH) of each patient between phase A1, B, and A2 were calculated and compared. In a total of 1 080 dialysis records, a logistic regression analysis model was established with age, sex and intervention as independent variables and with the occurrence of IDH-RAE as the outcome.Results:A total of 30 eligible patients were included in the study, including 14 males (46.7%) and 16 females (53.3%), aged 63.0 (56.5, 72.5) years old, with a median dialysis age of 84.0 (37.2, 120.0) months. The average times of IDH in 30 MHD patients decreased from 1.17 (0.83, 1.67) in stage A1 (before intervention) to 0.33 (0.25, 0.58) in stage B (after intervention) ( P<0.05). The frequency of IDH-RAE decreased significantly from 0.29 (0.19, 0.47) in stage A1 to 0.17 (0,0.25) in stage B ( P<0.05). Logistic regression analysis results indicated that the use of blood volume feedback control system reduced the risk of IDH-RAE by 53% ( OR=0.47, 95% CI 0.34-0.64, P<0.001). Conclusions:The application of blood volume feedback control system can effectively reduce the occurrences of IDH and the risk of IDH-RAE in MHD patients.
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Hydroxychloroquine is widely used in a variety of autoimmune diseases. However, long-term use of hydroxychloroquine can cause severe retinopathy, which has a complex pathogenic mechanism and diverse clinical manifestations, mainly manifested as photoreceptor and retinal pigment epithelial damage and irreversible vision loss. Identifying damage before retinitis pigment epithelium lesions preserve central vision, so early detection is crucial to slow disease progression and reduce vision loss. The development of multimodal imaging technology and the issuance of the latest treatment guidelines provide a powerful tool for the early screening and treatment of hydroxychloroquine retinopathy. Proficient in the latest guidelines for the treatment of hydroxychloroquine can better guide clinicians to do a good job in disease screening and management, recommend risks, safe dosages and appropriate screening procedures to patients and strengthen the prevention of hydroxychloroquine retinopathy, which will help save the vision of more patients and reduce the waste of medical resources.
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Objective To explore the optimal administration route of tranexamic acid (TXA) in shoulder arthroscopic surgery. Methods Patients undergoing arthroscopic rotator cuff repair were randomly divided into four groups: control group (without TXA treatment), intravenous group (TXA was intravenously administered 10 minutes before surgery), irrigation group (TXA was added to the irrigation fluid during subacromial decompression and acromioplasty), and intravenous plus irrigation group (TXA was applied both intravenously and via intra-articular irrigation). The primary outcome was visual clarity assessed with visual analog scale (VAS) score, and the secondary outcomes included irrigation fluid consumption and time to subacromial decompression and acromioplasty procedure. Results There were 134 patients enrolled in the study, including 33 in the control group, 35 in the intravenous group, 32 in the irrigation group, and 34 in the intravenous plus irrigation group. The median and interquartile range of VAS scores for the intravenous, irrigation, and intravenous plus irrigation groups were 2.70 (2.50, 2.86) (Z = -3.677, P = 0.002), 2.67 (2.50, 2.77) (Z = -3.058, P < 0.001), and 2.91 (2.75, 3.00) (Z = -6.634, P < 0.001), respectively, significantly higher than that of the control group [2.44 (2.37, 2.53)]. Moreover, the control group consumed more irrigation fluid than the intravenous group, irrigation group, and intravenous plus irrigation group (all P < 0.05). The intravenous plus irrigation group consumed less irrigation fluid than either the intravenous group or the irrigation group (both P < 0.001). There was no difference in subacromial decompression and acromioplasty operative time among the four groups. Conclusion TXA applied both topically and systematically can improve intraoperative visual clarity, and the combined application is more effective.
Subject(s)
Humans , Tranexamic Acid/therapeutic use , Shoulder , Arthroscopy/methods , Decompression, Surgical/methods , Treatment OutcomeABSTRACT
ABSTRACT Introduction: Muscle fatigue bothers athletes, affecting training level and competitive performance, it also has a great impact on the physical health of athletes, predisposing them to accidents and an early termination of their career. Relieving sports fatigue is the focus of research in the field of sports health nowadays. Objective: Study the effect of acupuncture and moxibustion rehabilitation combined with physical training on sports fatigue. Methods: A controlled experiment was used. The experimental group used acupuncture and moxibustion combined with exercise training, while the control group used acupuncture and moxibustion. The same group of doctors performed the acupuncture and moxibustion treatment according to the actual situation of the patients, and they tested the changes in VAS pain score and PRI pain score. Results: The VAS pain score in the experimental group was 7.88 points before the procedure and 2.96 points after the sixth week of the procedure. The control group score was 7.67 before the start and 5.03 after training. The total PRI pain score in the experimental group was 6.52 points before training and 2.05 points in the sixth week of training. The control group scored 6.66 before the procedure and 3.89 in the sixth week. Conclusion: The combination of training and exercises can achieve a better rehabilitation effect compared to the isolated treatment of acupuncture and moxibustion. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: A fadiga muscular incomoda os atletas, afetando o nível de treinamento e o desempenho competitivo, também tem um grande impacto sobre a saúde física dos atletas, predispondo a acidentes e a um término precoce da carreira. Aliviar a fadiga esportiva é o foco da pesquisa no campo da saúde esportiva nos dias de hoje. Objetivo: Estudar o efeito de reabilitação pela acupuntura e moxabustão combinada com o treinamento físico sobre a fadiga esportiva. Métodos: Foi utilizado um experimento controlado. O grupo experimental usou acupuntura e moxabustão combinadas com treinamento com exercícios, enquanto o grupo de controle usou acupuntura e moxabustão. O mesmo grupo de médicos realizou o tratamento de acupuntura e moxabustão de acordo com a situação real dos pacientes, e testaram as alterações do escore de dor VAS e do escore de dor PRI. Resultados: A pontuação de dor VAS no grupo experimental foi de 7,88 pontos antes do procedimento e 2,96 pontos após a sexta semana de procedimento. A pontuação do grupo de controle foi 7,67 antes do início e 5,03 após o treinamento. A pontuação total de dor PRI no grupo experimental foi 6,52 pontos antes do treinamento e 2,05 pontos na sexta semana de treinamento. A pontuação do grupo de controle foi de 6,66 antes do procedimento e 3,89 na sexta semana. Conclusão: A combinação do treinamento com exercícios pode alcançar um melhor efeito de reabilitação em comparação com o tratamento isolado de acupuntura e moxabustão. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: La fatiga muscular molesta a los deportistas, ya que afecta al nivel de entrenamiento y al rendimiento competitivo, además de tener un gran impacto en la salud física de los atletas, predisponiendo a accidentes y al cese prematuro de la carrera. En la actualidad, el alivio de la fatiga deportiva es objeto de investigación en el campo de la salud deportiva. Objetivo: Estudiar el efecto de la rehabilitación mediante acupuntura y moxibustión combinada con entrenamiento físico sobre la fatiga deportiva. Métodos: Se utilizó un experimento controlado. El grupo experimental utilizó acupuntura y moxibustión combinadas con entrenamiento físico, mientras que el grupo de control utilizó acupuntura y moxibustión. El mismo grupo de médicos realizó el tratamiento de acupuntura y moxibustión de acuerdo con la situación real de los pacientes, y comprobó los cambios en la puntuación del dolor según VAS y la puntuación del dolor según PRI. Resultados: La puntuación VAS del dolor en el grupo experimental fue de 7,88 puntos antes del procedimiento y de 2,96 puntos después de la sexta semana del procedimiento. La puntuación del grupo de control fue de 7,67 antes del inicio y de 5,03 después del entrenamiento. La puntuación total del dolor PRI en el grupo experimental fue de 6,52 puntos antes del entrenamiento y de 2,05 puntos en la sexta semana de entrenamiento. La puntuación del grupo de control era de 6,66 antes del procedimiento y de 3,89 a la sexta semana. Conclusión: La combinación de entrenamiento con ejercicios puede lograr un mejor efecto rehabilitador en comparación con el tratamiento aislado de acupuntura y moxibustión. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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ABSTRACT Introduction: Following the development of ice and snow sports tourism projects, the hidden dangers of early extensive construction have gradually emerged. It mainly manifests itself in the sports safety of ice and snow sports tourism projects. Objective: Explore the management strategy of sports safety under the snow and ice sports tourism landscape. Methods: Literature research, interviews, and questionnaires were used to analyze the development in the study area of ice and snow tourism, the tourists themselves, and regional site construction. Finally, the paper analyzes strategies to improve sports safety management in related areas from the landscape manager's point of view. Results: The development of snow and ice sports tourism projects in the study area is satisfactory; however, due to the epidemic's impact, the current situation is relatively low, showing a trend of slow improvement. In terms of sports injury risk, after optimal training and safety management, the proportion of climatic characteristics of the site was 24.81%; the proportion of the population on the ski slopes was 40.92%; the proportion of equipment cleaning and maintenance was 59.23%; the degree of congestion on the ski slopes was 41.30%; the proportion of public safety was 34.42%; the proportion of basic emergency medical treatment was 32.30%; epidemics and other infectious diseases accounted for 83.13% of the total. Follow-up is done before the start, in the process, and after the occurrence of multiple managements. Conclusion: The safety management strategy of snow and ice sports tourism combines the factors of tourists and managers, and has great practical significance, so it is worthy of promotion. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: Com o desenvolvimento de projetos de turismo esportivo no gelo e na neve, os perigos ocultos da construção extensiva precoce têm surgido gradualmente. Ele se manifesta principalmente na segurança esportiva de projetos de turismo de esportes de gelo e neve. Objetivo: Explorar a estratégia de gestão da segurança esportiva sob o panorama do turismo esportivo de neve e gelo. Métodos: Pesquisa bibliográfica, entrevistas e questionários foram usados para analisar o desenvolvimento na área de estudo do turismo de gelo e neve, e dos próprios turistas bem como a construção de locais regionais. Finalmente, do ponto de vista do gerente de paisagens, o trabalho analisa as estratégias para melhorar a gestão da segurança esportiva em áreas relacionadas. Resultados: O desenvolvimento de projetos de turismo esportivo de neve e gelo na área de estudo é satisfatório, porém, devido ao impacto da epidemia, a situação atual é relativamente reduzida, mostrando uma tendência de lenta melhoria. Em termos de risco de lesões esportivas, após treinamento otimizado e gerenciamento da segurança, a proporção de características climáticas do local foi de 24,81%; a proporção de população nas pistas de esqui foi de 40,92%; a proporção de limpeza e manutenção dos equipamentos foi de 59,23%; o grau de congestionamento das pistas de esqui foi de 41,30%; a proporção de segurança pública foi de 34,42%; a proporção de tratamento médico básico de emergência foi de 32,30%; epidemias e outras doenças infecciosas representaram 83,13% do total. O acompanhamento é feito antes do início, no processo, e após a ocorrência de múltiplas gestões. Conclusão: A estratégia de gerenciamento de segurança do turismo esportivo de neve e gelo combina os fatores de turistas e gerentes, e tem grande significado prático, por isso é digna de promoção. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: Con el desarrollo de los proyectos turísticos de deportes de hielo y nieve, han ido apareciendo gradualmente los peligros ocultos de la construcción extensiva temprana. Se manifiesta principalmente en la seguridad deportiva de los proyectos turísticos de deportes de hielo y nieve. Objetivo: Explorar la estrategia de gestión de la seguridad deportiva en el marco del paisaje turístico de los deportes de nieve y hielo. Métodos: Se utilizó la investigación bibliográfica, entrevistas y cuestionarios para analizar el desarrollo en la zona de estudio del turismo de hielo y nieve, y a los propios turistas, así como la construcción de emplazamientos regionales. Por último, desde el punto de vista del gestor del paisaje, se analizan estrategias para mejorar la gestión de la seguridad deportiva en ámbitos afines. Resultados: El desarrollo de proyectos de turismo deportivo de nieve y hielo en la zona de estudio es satisfactorio, sin embargo, debido al impacto de la epidemia, la situación actual es relativamente baja, mostrando una tendencia de lenta mejora. En cuanto al riesgo de lesiones deportivas, tras optimizar la formación y la gestión de la seguridad, la proporción de características climáticas del lugar fue del 24,81%; la proporción de población en las pistas de esquí fue del 40,92%; la proporción de limpieza y mantenimiento del equipo fue del 59,23%; el grado de congestión de las pistas de esquí fue del 41,30%; la proporción de seguridad pública fue del 34,42%; la proporción de tratamiento médico básico de urgencia fue del 32,30%; las epidemias y otras enfermedades infecciosas representaron el 83,13% del total. El seguimiento se realiza antes del inicio, en el proceso y después de que se produzcan múltiples gestiones. Conclusión: La estrategia de gestión de la seguridad del turismo deportivo de nieve y hielo combina los factores de los turistas y los gestores, y tiene una gran importancia práctica, por lo que merece ser promovida. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
ABSTRACT
Aortoiliac occlusive disease (AIOD) refers to the stenosis and occlusion of the distal abdominal aorta and(or) bifurcation of the aortoiliac artery,which is mainly caused by atherosclerosis,leading to pelvic and lower limb ischemia.Open surgery has always been the main treatment for complex AIOD.However,in recent years,with the development of endovascular surgery technologies and medical instruments,its treatment concept has been greatly changed.More and more clinical evidence has proved that the long-term efficacy of endovascular therapy is not inferior to that of traditional open surgery,so minimally invasive endovascular therapy has become the preferred treatment for AIOD.
Subject(s)
Humans , Aortic Diseases/surgery , Arterial Occlusive Diseases/surgery , Atherosclerosis , Endovascular Procedures , Iliac Artery/surgery , Treatment Outcome , Vascular PatencyABSTRACT
The high performance liquid chromatography(HPLC) characteristic chromatogram of Xiaoer Ganmaoning Oral Liquid(oral liquid for short) was established. The medicinal materials corresponding to characteristic peaks, their index components and ranges of similarity with the reference chromatograms were clarified. The similarity between the characteristic chromatograms of 10 batches of the oral liquid and the reference chromatogram was higher than 0.994. Eighteen characteristic peaks were identified, which were derived from different medicinal materials including Scutellariae Radix, Arctii Fructus, Lonicerae Japonicae Flos, Gardeniae Fructus and Forsythiae Fructus. Further, 11 characteristic peaks were assigned by the comparison with reference substances as chlorogenic acid, neochlorogenic acid, cryptochlorogenic acid, isochlorogenic acid A, isochlorogenic acid C, baicalin, baicalein, wogonin, scutellarin, forsythiaside A and arctiin. Also, the characteristic chromatogram of precipitate in the oral liquid was established, and the similarity between characteristic chromatograms of 10 batches of the precipitate and the reference chromatogram was higher than 0.940. The 14 characteristic peaks originating from the precipitate and those from the oral liquid were consistent in retention time, and the content of all index components in the precipitate was lower than 5% of that in the oral liquid. Moreover, the stability of precipitate during the accelerated stability test was explored with filtration and Matlab-based image sensory evaluation. The precipitate mass and precipitation degree both increased over the stability test duration significantly. The stability of the oral liquid was used as a model system in this study to establish the integrated quality control system which related to medicinal materials, preparations and precipitate with HPLC characteristic chromatograms and image sensory evaluation, which lays a foundation for the exploration of the quantity value transfer of the oral liquid.
Subject(s)
Chromatography, High Pressure Liquid/methods , Drugs, Chinese Herbal/chemistry , Quality Control , Scutellaria baicalensis/chemistryABSTRACT
Objective: To evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) with the novel Prizvalve® system in treating severe aortic stenosis. Methods: This is a single-center, prospective, single-arm, observational study. A total of 11 patients with severe aortic stenosis with high risk or inappropriate for conventional surgical aortic valve replacement (SAVR) were included, and TAVI was achieved with the Prizvalve® system between March 2021 and May 2021 in West China Hospital. Transthoracic echocardiography (TTE) was performed immediately after prosthesis implantation to evaluate mean transaortic gradient and maximal transaortic velocity. The device success rate was calculated, which was defined as (1) the device being delivered via the access, deployed, implanted and withdrawn, (2) mean transaortic gradient<20 mmHg (1 mmHg=0.133 kPa) or a maximal transaortic velocity<3 m/s post TAVI, and without severe aortic regurgitation or paravalvular leak post TAVI. TTE was performed at 30 days after the surgery, and all-cause mortality as well as the major cardiovascular adverse events (including acute myocardial infarction, disabling hemorrhagic or ischemic stroke) up to 30 days post TAVI were analyzed. Results: The age of 11 included patients were (78.1±6.3) years, with 8 males. A total of 10 patients were with NYHA functional class Ⅲ or Ⅳ. Devices were delivered via the access, deployed, implanted and withdrawn successfully in all patients. Post-implant mean transaortic gradient was (7.55±4.08) mmHg and maximal transaortic velocity was (1.78±0.44) m/s, and both decreased significantly as compared to baseline levels (both P<0.05). No severe aortic regurgitation or paravalvular leak was observed post TAVI. Device success was achieved in all the 11 patients. No patient died or experienced major cardiovascular adverse events up to 30 days post TAVI. Mean transaortic gradient was (9.45±5.07) mmHg and maximal transaortic velocity was (2.05±0.42) m/s at 30 days post TAVI, which were similar as the values measured immediately post TAVI (both P>0.05). Conclusions: TAVI with the Prizvalve® system is a feasible and relatively safe procedure for patients with severe aortic stenosis and at high risk or inappropriate for SAVR. Further clinical studies could be launched to obtain more clinical experience with Prizvalve® system.
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Aortic Valve , Aortic Valve Stenosis/surgery , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation , Prospective Studies , Transcatheter Aortic Valve Replacement/methods , Treatment OutcomeABSTRACT
Objective: To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies. Methods: To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease. Results: In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95%CI:3.86-5.13) days, 5.12 (95%CI:4.63-5.62) days, 0.87 (95%CI:0.67-1.07) days, 11.89 (95%CI:9.81-13.98) days and 22.00 (95%CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95%CI:6.89-10.86) days and 6.18 (95%CI:1.89-10.47) days, respectively. Conclusion: The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.
Subject(s)
Humans , COVID-19 , Cohort Studies , Contact Tracing , Incidence , Prospective StudiesABSTRACT
High myopia is a disease with a high incidence rate and an increasing trend, which could lead to irreversible visual impairment worldwide. Myopia traction maculopathy (MTM), belonging to one of the pathological changes of high myopia, could cause vision damage and even blindness in patients. Recently, a new classification of MTM based on optical coherence tomography can effectively evaluate the condition of patients and is helpful for the diagnosis and treatment of MTM. Moreover, the improvement of internal limiting membrane peeling method and the innovation of macular buckle material provide new ideas for the treatment of MTM based on traditional surgery. New treatment such as vitreal traction release laser surgery, enzymatic vitreolysis and posterior scleral crosslinking have gained increasing attention. By combining these new treatments with artificial intelligence, 3D printing technology and advanced vitrectomy equipment, it is hoped that a safer and more effective treatment for MTM will be found in the future.
ABSTRACT
High myopia is a disease with a high incidence rate and an increasing trend, which could lead to irreversible visual impairment worldwide. Myopia traction maculopathy (MTM), belonging to one of the pathological changes of high myopia, could cause vision damage and even blindness in patients. Recently, a new classification of MTM based on optical coherence tomography can effectively evaluate the condition of patients and is helpful for the diagnosis and treatment of MTM. Moreover, the improvement of internal limiting membrane peeling method and the innovation of macular buckle material provide new ideas for the treatment of MTM based on traditional surgery. New treatment such as vitreal traction release laser surgery, enzymatic vitreolysis and posterior scleral crosslinking have gained increasing attention. By combining these new treatments with artificial intelligence, 3D printing technology and advanced vitrectomy equipment, it is hoped that a safer and more effective treatment for MTM will be found in the future.
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With the extensive use of plastic products and the sharp increase of plastic waste, microplastics produced by degradation in the natural environment and artificially added by industry have been detected in food, air, ocean, and even extreme geographical environment. The environmental pollution and the biological health hazards caused by this new type of pollutant has become a global scientific problem to be solved urgently. Zebrafish (Danio rerio), as a typical model organism, has been widely used to evaluate the environmental pollution and health hazards caused by microplastics. This review on the research progress of model animal zebrafish in toxicity evaluation of microplastics mainly emphasized the toxic effects of microplastics on selected organs of zebrafish, briefly introduced the influencing factors of toxicity induced by microplastics, discussed the standardization of experiments for the evaluation of microplastic toxicity using zebrafish, and finally explored the future research directions.
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OBJECTIVE@#To compare and analyze the difference between the injuries of recreational skiers in public ski resorts and those of skiing athletes in official competitions, and to explore the suggestions of medical insurance for these two types of skiers.@*METHODS@#The injury data of recreational skiers in Chongli District, Zhangjiakou City, Hebei Province during 2018-2019 and 2019-2020 snow seasons, and the injury data of skiers in two official international skiing competitions during 2019-2020 snow season and domestic test events in Chongli District of 2021 Winter Olympic Games were analyzed retrospectively, and the similarities and differences were compared.@*RESULTS@#A total of 1 187 injuries occurred to recreational skiers in the two public ski resorts during the 2018-2019 snow season, with an injury rate of 0.3%.There were 1 277 injury sites in total, and the most frequent injury sites were head and neck (230 cases, 18.0%), followed by knee joint (204 cases, 16.0%) and lower extremity (131 cases, 10.3%). Thirty-one skiers were injured in the two official international skiing competitions in the 2019-2020 and 2020-2021 snow season, and in the domestic test competitions in the 2021 Winter Olympic Games, and the injury rates were 11.5%, 17.2% and 12.0%, respectively. There were 37 injury sites in total, among which 11 (29.7%) were in the head and neck, followed by 6 (16.2%) in the knee joint and 5 (13.6%) in the chest, rib and abdomen.@*CONCLUSION@#In order to better guarantee the safety of skiers and timely provide corresponding medical help, safety facilities and technical guidance should be added to the snow resort for leisure skiing, and medical stations should be set up in the snow resort. As the formal ski racing for skiing athletes during the game has 30 to 80 times higher injury ratesthan recreational skiers, and compared with the recreational skiing, head and neck injury rate is higher, and the damage is much heavier, more complete first aid facilities and experienced medical workers are, needed so the field should be equipped with the circuit inside the quantities, track fixed outside the clinic, surrounding referral hospitals set up trauma centers to provide athletes with more timely medical care.
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Humans , Athletic Injuries/epidemiology , Lower Extremity , Retrospective Studies , Skiing , Trauma CentersABSTRACT
To improve the efficacy of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT), a fluorocarbon microemulsion-based gel (FMBG) loaded with both 5-ALA and carbon dioxide (CO2) was prepared in this study. Its physical and chemical properties such as particle size, zeta potential, morphology, pH value and viscosity were characterized. Acid-base titration experiment was used to determine the CO2 loading, a fluorescence derivatization method was established to determine the content of 5-ALA, and the confocal laser scanning microscope and Franz diffusion cell method were carried out to investigate its transdermal ability. Through the laser speckle contrast imaging, the CO2-affected blood flow perfusion of skin was measured. Finally, the skin irritation test was tested by hematoxylin-eosin staining (H&E) method. These results showed that the prepared FMBG was a milky white gel, with an average particle size of 202.4 nm, a zeta potential of -25.3 mV, a pH of 6.0, and a viscosity of 1 062.0 mPa·s. It can be stored stably for seven days at room temperature. The 5-ALA content of FMBG was measured to be approximately equal to 20% (w/w). At room temperature and normal pressure, the CO2 loading content of FMBG was 5.016 mg·L-1, which was 1.5 times as much as that of water. The transdermal absorption experiment and blood perfusion results showed that the FMBG can effectively enable the transdermal delivery of 5-ALA and CO2, and significantly increased the blood perfusion of skin. H&E staining results indicated that FMBG had negligible skin irritation (all animal tests were approved by the Ethics Committee of 900 Hospital of the Joint Logistics Team). In this study, a safe and stable FMBG loaded with both 5-ALA and CO2 was successfully prepared. It was suitable for transdermal application, having the potential of enhancing the efficacy of 5-ALA-mediated PDT.
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The therapeutic effect of tumor photodynamic therapy is severely limited by the hypoxic tumor microenvironment. Inhibiting tumor celloxygen consumption is a more effective way than increasing its oxygen supply to overcome the tumor hypoxia and enhance photodynamic therapy. To carry out this strategy, the supramolecular nanoparticles VER-ATO-SMN loaded with photosensitizer verteporfin (VER), oxygen-consuming inhibitor atovaquone (ATO), and stabilizer polyvinylpyrrolidone (PVP)-K30 were prepared by the nanoprecipitation method, and the optimal prescription was screened and optimized by single factor experiments. The results showed that the optimal prescription for VER-ATO-SMN was ATO∶VER (w/w) = 1∶1, PVP-K30 = 100 mg, N,N-dimethylformamide∶water (v/v) = 1∶10. The morphology, particle size, particle dispersion index and encapsulation efficiency of supramolecular nanoparticles were characterized. The VER-ATO-SMN showed a spherical morphology and was well dispersed. The hydrodynamic size of VER-ATO-SMN was 101.21 ± 4.30 nm as determined by dynamic light scattering (DLS). The encapsulation efficiencies of VER and ATO in VER-ATO-SMN prepared with the optimal prescription were 70.86% and 77.52%, respectively. The VER-ATO-SMN exhibited good laser stability and also showed high stability in conditions which simulated the physiological solution. Compared with free VER and VER liposome, VER-ATO-SMN performed enhanced therapeutic effect at the cell level. The mechanism was that VER-ATO-SMN could effectively incorporate into cells and improving the intracellular oxygen concentration by reducing the oxygen consumption of tumor cells could increase the amount of reactive oxygen species generated by VER mediated photodynamic therapy. The in vivo anticancer efficacy results of tumor-bearing mice suggested that VER-ATO-SMN could effectively inhibit the tumor growth or even completely eliminate the tumor. All animal experiments were performed in line with national regulations and approved by the Animal Experiments Ethical Committee of 900 Hospital of the Joint Logistics Team.
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@#AIM: To study the clinical efficacy, complications and visual related quality of life(VRQoL)of Ozurdex in the treatment of macular edema secondary to retinal vein occlusion(RVO-ME). <p>METHODS: Totally 30 patients with ME, which had developed secondary to either CRVO(13 eyes)or BRVO(17 eyes), were monitored for 6mo after treatment with Ozurdex in the Department of Ophthalmology of our Hospital. We measured the best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular thickness(CMT)at different time after treatment(1wk, 1mo, 2mo, 3mo, 4mo, 5mo, and 6mo after treatment), and we also measured the Chinese version vision related quality of life questionnaire-25(CVRQoL-25)at 3mo after treatment and compared them separately with the ones measured before treatment to evaluate the efficacy, adverse reactions and the visual related quality of life. <p>RESULTS: Generalized estimation equation results showed that BCVA, CMT and IOP all had differences at different time points(<i>P</i><0.001). A BCVA increase was achieved and CMT decreased in all patients at any time point after the onset of treatment(<i>P</i><0.001). The changes of BCVA and CMT were the largest in the 2mo compared to the baseline(<i>P</i><0.001). The score of CVRQol-25 at 3mo after treatment was significantly higher than that before treatment and then the central retinal thickness decreased and a BCVA increased compared to the baseline level(<i>P</i><0.01). The score of CVRQoL-25 at 3mo was negatively correlated both with the LogMAR BCVA evaluated before treatment and at 3mo after treatment(<i>r</i>s= -0.717, -0.746, all <i>P</i><0.001); Meanwhile, the score of CVRQoL-25 was also negatively correlated with CMT at 3mo after treatment(<i>r</i>s= -0.862,<i> P</i>=0.001). In 19 eyes(63%)of the patients with RVO-ME,a relapse was observed after a follow-up time of 1-3mo and the average recurrence time was(2.8±0.5)mo. In follow-up of 6mo, about(2.3±0.4)intravitreal Ozurdex injections per eye was observed. The increase in IOP was observed at 1wk, 1, 2, 3mo after pretherapy(<i>P</i><0.05). The mean IOP values reached a peak at 2mo after injection, which rose(7.85±0.32)mmHg above the baseline level(<i>P</i><0.05)and decreased to normal at 4mo after treatment. 10% of patients had an elevation in IOP above 25mmHg, which could be medically controlled and 4 eyes(13%)of patients had cataract formation, two of which needed to surgery. <p>CONCLUSION: Ozurdex proved to be efficacious with increase in visual acuity and reduction of central retinal thickness and improve the visual function-related quality of life of RVO-ME patients. After single injection of Ozurdex, visual acuity benefited for 2-3mo. 63% of the patients relapsed at about 3mo after treatment. Adverse reactions associated to the use of Ozurdex include the formation of cataracts and an increase in IOP.