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AIM: To analyse the prevalence and risk factors of dry eye among children aged 7-14 years in myopia prevention and control clinic.METHODS:A total of 222 children aged 7-14 years in myopia prevention and control clinic from December 2021 to February 2022 were included. General data of included children were collected, assessing the prevalence of dry eye by the ocular surface disease index(OSDI)scale and Keratograph 5M, and analyzing risk factors for dry eye occurrence by Logistic regression model.RESULTS:The prevalence of dry eye in children in myopia prevention and control clinic was 27.9%. Logistic Regression analysis showed that, allergic conjunctivitis(OR=2.31, 95%CI=1.12-4.78, P=0.02), refractive error(OR=5.57, 95%CI=2.40-12.94, P<0.01), use time of electronic >2h per day(OR=2.74, 95%CI=1.11-6.78, P=0.03), time of playing games >2h per day(OR=2.33, 95%CI=1.12-4.84, P=0.02), outdoor activity time ≤2h per day(OR=4.28, 95%CI=2.02-9.07, P<0.01)and sleep duration <8h per day(OR=3.23, 95%CI=1.44-7.27, P=0.01)were risk factors for dry eye among the children.CONCLUSIONS:The prevalence of dry eye among children in myopia prevention and control clinic should be paid high attention. Therefore, improving behavior habits and controlling the use time of visual display terminal products to prevent and slow down the occurrence of dry eye in children.
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Objective To study the changes in serum homocysteine (Hcy) and matrix metalloproteinase-9 (MMP-9) levels and risk factors in patients with coronary heart disease (CHD) complicated with Helicobacter pylori (HP) infection in Chengdu area, and to provide a theoretical basis for the prevention of HP infection in patients with coronary heart disease. Methods A total of 348 CHD patients admitted to our hospital in Chengdu from 2019 to 2021 were selected. Hp infection status was detected by C14 urea breath test. Patients were classified into control group (n=197) and HP infection group (n=151) according to the detection results. Data including gender, age, body mass index and peptic ulcer history were collected, and univariate analysis and logistic regression were used to screen the risk factors affecting the occurrence of HP infection in patients with CHD. Results The prevalence rate of HP infection was 43.39% (151/348) among the selected CHD patients. Serum levels of Hcy and MMP-9 were notably elevated in HP infection group compared with control group (P<0.05). The proportion of patients with age ≥60 years old, hyperlipidemia, proton pump inhibitor use history, and frequent consumption of out-of-home food and spicy food in HP infection group was obviously larger than that in control group (P<0.05). Hyperlipidemia (OR=3.719), history of proton pump inhibitor use (OR=3.254) and frequent consumption of out-of-home food (OR=2.721) were independent risk factors for HP infection in CHD patients (P<0.05). Conclusion CHD patients in Chengdu suffer a prevalence rate of HP infection, and have elevated levels of serum Hcy and MMP-9. Furthermore, the intervention measures for patients with hyperlipidemia, proton pump inhibitor drug use history and frequent consumption of out-of-home food are of vital importance for decreasing the risk of HP infection.
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Objective:To investigate the relationship between blood pressure variability (BPV) and incidence of post-traumatic stress disorder (PTSD) in trauma patients.Methods:Patients admitted to the department of emergency medicine of the Affiliated Hospital of Xuzhou Medical University for acute trauma from January 2018 to December 2021 were enrolled. The clinical data and blood pressure at admission (T1), 10 minutes before anesthesia (T2), 60 minutes after surgery (T3), and 24 hours after surgery (T4) were collected. Coefficient of variation of blood pressure variation [CV-BP, including coefficient of variation of systolic blood pressure (CV-SBP), coefficient of variation of diastolic blood pressure (CV-DBP), coefficient of variation of mean arterial pressure (CV-MAP)] and its quartile were calculated. Patients were divided into Q1 group (CV-MAP ≤ 7.27), Q2 group (7.27 < CV-MAP ≤ 9.50), Q3 group (9.50 < CV-MAP ≤ 14.05) and Q4 group (CV-MAP > 14.05) according to CV-MAP quartile. The PTSD symptoms of the patients were evaluated using the PTSD scale (PCL-5) one month later, and the patients were divided into the PTSD group and the non-PTSD group according to whether PCL-5 score higher than 38. Then the differences of the above indicators were compared and analyzed. Spearman correlation analysis was used to analyze the relationship between each index and PCL-5 score; the risk factors of PTSD were analyzed by univariate binary Logistic regression. Variables with P < 0.05 were included in the multivariate binary Logistic regression model. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of CV-MAP on the incidence of PTSD. Results:A total of 112 patients were enrolled, including 24 in PTSD group and 88 in non-PTSD group. Compared with non-PTSD group, the proportion of women, T1 shock index, proportion of intraoperative and postoperative blood transfusion in PTSD group was higher. Besides, PTSD group also had longer PT, more intraoperative and postoperative blood transfusion, and lower postoperative hemoglobin (Hb) level (all P < 0.05). The T1 SBP, DBP, MAP and T4 MAP of patients in PTSD group were significantly lower than those in non-PTSD group [T1 SBP (mmHg, 1 mmHg≈0.133 kPa): 105.0 (86.3, 121.3) vs. 122.0 (112.0, 132.8), T1 DBP (mmHg): 62.5 (50.0, 77.3) vs. 76.0 (68.5, 82.8), T1 MAP (mmHg): 77.8 (60.4, 91.3) vs. 93.3 (82.5, 99.0), T4 MAP (mmHg): 83.8±9.1 vs. 88.7±10.4, all P < 0.05], CV-SBP, CV-DBP and CV-MAP were higher than those in the non-PTSD group [CV-SBP: 12.80 (10.12, 19.16) vs. 9.30 (6.07, 12.95), CV-DBP: 16.62±6.47 vs. 12.40±5.61, CV-MAP: 14.10 (9.25, 18.85) vs. 8.90 (6.93, 13.29), all P < 0.05]. Spearman correlation analysis showed that there was a positive correlation between CV-MAP and PCL-5 scores in patients with acute trauma ( r = 0.429, P < 0.001); multivariate binary Logistic regression analysis showed that only CV-MAP [odds ratio ( OR) = 1.128, 95% confidence interval (95% CI) was 1.015-1.254, P = 0.025] and CV-DBP ( OR = 1.114, 95% confidence interval (95% CI) was 1.016-1.221, P = 0.022) was the risk factor for PTSD in acute trauma patients. Compared with Q1 group, Q4 group was significantly more likely to develop PTSD ( OR = 18.6, 95% CI was 1.9-179.1, P = 0.012). CV-SBP, CV-DBP and CV-MAP had certain predictive value on PTSD diagnosis in patients with acute trauma according to ROC curve analysis results [area under the ROC curve (AUC) was 0.713, 0.682 and 0.726, respectively], among which CV-MAP has the highest predictive value. When the cut-off value of CV-MAP was 12.158, the sensitivity was 75.0% and the specificity was 69.3%. Conclusion:Higher BPV after trauma is a risk factor for PTSD. Maintaining stable blood pressure in trauma patients is of great significance for prevention and treatment of PTSD.
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Objective:To analyze the risk factors that affect the occurrence of hypothermia during laparoscopic colorectal cancer surgery, and establish a nomogram warning model, and verify the model.Methods:The clinical data of 275 patients undergoing laparoscopic colorectal cancer surgery in Hainan Branch of Chinese People′s Liberation Army General Hospital from January 2019 to December 2020 were retrospectively selected as the modeling group. The patients were divided into hypothermia group and normal group according to whether hypothermia occurred during the operation, and multivariate Logistic regression analysis was used to screen the risk factors that affect the occurrence of hypothermia during the operation. To use R software to establish a nomogram early warning model, and use Hosmer-Lemeshow (HL), calibration curve, area under the ROC curve and clinical decision curve (DCA) to evaluate the prediction effect of the model. In addition, 60 patients undergoing laparoscopic colorectal cancer surgery in the hospital from January to April 2021 were selected as the verification group for external verification of the model.Results:The incidence of intraoperative hypothermia in 275 patients undergoing laparoscopic colorectal cancer surgery was 42.91% (118/275). In this study, 4 risk factors including anesthesia time >150 min ( OR = 3.939, 95% CI 1.762-8.804), intraoperative blood loss ≥150 ml ( OR = 2.053, 95% CI 1.187-3.550), intraoperative fluid supplement ≥1 500 ml ( OR = 2.084, 95% CI 1.199-3.624), and total CO 2 dosage≥200 L ( OR = 2.707, 95% CI 1.571-4.663) were included to construct an intraoperative hypothermia warning model. Internal verification: the area under the ROC curve was 0.797 (95% CI 0.744-0.851), the HL goodness of fit test of the Logistic regression model with χ2 = 6.27, P = 0.617, the predicted occurrence risk value of the calibration curve was basically the same as the actual occurrence risk value. External validation: the area under the ROC curve of the external validation group of the prediction model was 0.745 (95% CI 0.662-0.628). The 95% CI area of the GiViTI calibration curve did not cross the 45°diagonal bisector ( P = 0.735), and when the DCA threshold range was 0.01-0.97, the nomogram model was reasonable to predict intraoperative hypothermia and the patient could get high net benefit. Conclusions:The nomogram warning model established based on the risk factors of hypothermia during laparoscopic colorectal cancer surgery has good discrimination, consistency and clinical practicability, and can provide a certain reference value for intraoperative medical staff to predict the occurrence of hypothermia.
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Objective:To investigate the clinical manifestations, pathological characteristics, treatment and prognosis of pediatric rheumatic carditis with the initial symptom of acute heart failure, and to improve the clinical understanding of the disease.Methods:The clinical data, laboratory examination results, imaging findings, treatment and prognosis data of 10 cases with acute rheumatic carditis were collected and analyzed retrospectively.The patients pre-sented with acute heart failure as the first symptom and were treated in Shenzhen Children′s Hospital from January 2015 to February 2022.Results:There were 4 males and 6 females in this study.The mean age was 9.1 years (3 years and 1 month to 11 years and 3 months), and the average onset age was (9.3 ± 3.2) days (4-14 days). All the 10 cases had circulation symptoms.Besides, 4 cases were also complicated with joint symptoms, 3 cases with neurological symptoms and 2 cases with skin symptoms.Echocardiography revealed mitral valve diseases in all cases.More specifically, combined valve diseases were found in 5 cases, pure mitral regurgitation in 3 cases, and mixed mitral valve diseases (mitral regurgitation complicated with mitral stenosis) in 2 cases.After receiving antibiotic therapy, anti-infection treatment and anti-heart failure therapy, symptoms improved in all patients and valve lesions were alleviated.All patients were followed up for 6 months to 6 years.Six cases had persistent rheumatic heart disease during the follow up.Conclusions:Pediatric rheumatic carditis with the initial symptom of acute heart failure is characterized by early onset and the typical manifestation of rheumatic fever.Mitral valve disease is the commonest lesion.Echocardiography is of great value for the early diagnosis of the disease.Medical treatment is effective, but the incidence of chronic rheumatic heart disease is still high.
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Objective@#To analyze the influence of reproductive health education in middle school on self efficacy and intention of condom use among college freshmen, so as to provide evidence for fertility protection related intervention and policy making.@*Methods@#A questionnaire survey was conducted among college freshmen in Beijing by hierarchical cluster sampling method. A total of 3 001 students were surveyed. The difference was compared by using χ 2 test and ANOVA. Multivariate linear and Logistic regression model was used to analyze the influencing factors associated with condom use self efficacy and condom use intention.@* Results@#The overall rate that reproductive health education received before college among freshmen in Beijing was 65.11%. The college freshmen from urban areas reported more adequate reproductive health education (71.11%) than those from non urban areas before college (59.36%)( P <0.05). The total scores of UNGASS (4.22±0.90 vs 4.05±0.98), condom use self efficacy (24.64±5.34 vs 23.09±4.93) and the intention of condom use (82.44% vs 70.88%) of college freshmen received reproductive health education in middle school were higher than those of college students without pre college reproductive health education( P <0.01). Multiple linear regression analysis showed that the score of condom use self efficacy of college students received pre college reproductive health education was higher than those without pre college reproductive health education( β =1.21, 95% CI =0.79-1.63, P <0.01). Multivariate Logistic regression analysis showed that reproductive health, the intention of condom use of college freshmen who received pre college reproductive health education was higher than that of college freshmen without reproductive health education( OR =1.63, 95% CI =1.33-2.01, P <0.01).@*Conclusion@#Reproductive health education in middle school can improve college freshmen s self efficacy and intention of condom use, contribute to the implementation of safe sex, and is of great significance to the protection of college students fertility.
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Objective:To investigate the efficacy and safety of dual wavelength pulsed dye laser combined with 30% supramolecular salicylic acid in the treatment of moderate and severe facial acne.Methods:Sixty patients with moderate and severe acne that visited the Dermatology Department of the First Affiliated Hospital of Chongqing Medical University from May 2020 to January 2021, were selected and randomly divided into observation group and control group, with 30 patients in each group. The observation group was given dual-wavelength pulsed dye laser combined with 30% supramolecular salicylic acid. 30% supramolecular salicylic acid was used once every two weeks, for a total of six times. Dual-wavelength pulsed dye laser was given once a month, for a total of three times. The control group was only given dual-wavelength pulsed dye laser, once a month, a total of three times.Results:Twenty-two cases (73.33%) in the observation group were effective, while 14 cases (46.67%) in the control group were effective. The efficacy of the observation group was better than that of the control group, and the difference was statistically significant (χ 2=4.44, P<0.05). There were no obvious adverse reactions in both groups. Conclusions:Dual-wavelength pulsed dye laser combined with 30% supramolecular salicylic acid is effective and safe in the treatment of moderate and severe facial acne, which is worth popularizing.
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Objective:To analyze clinical manifestations, pathological features and prognosis of patients with stage Ⅰ cutaneous melanoma.Methods:Clinical data were collected from 163 patients with stage Ⅰ cutaneous melanoma in Department of Dermatology, Xijing Hospital from January 2010 to January 2020, and clinical manifestations, pathological features, treatment methods and prognosis were retrospectively analyzed.Results:Among the 163 patients with stage Ⅰ cutaneous melanoma, 56 (34.36%) were males, and 107 (65.64%) were females, with a median age of 53 years at the clinic visit. Primary skin lesions were most frequently located on the extremities in 104 cases (63.80%) , of which 39 presented with lesions on the finger or toe nails and 65 with lesions on the other parts of the extremities; skin lesions were located at sun-exposed sites such as the head and face in 29 (17.79%) cases, and at non-sun-exposed sites such as the trunk and extremities except the hands and feet in 30 (18.40%) . Of the 163 patients, 56 (34.36%) were pathologically diagnosed with stage ⅠA cutaneous melanoma, and 107 (65.64%) with stage ⅠB cutaneous melanoma. According to a pathological staging system, 104 (63.80%) patients suffered from acral lentiginous melanoma, 23 (14.11%) superficial spreading melanoma, 15 (9.20%) nodular melanoma, 14 (8.59%) malignant lentigo-maligna melanoma, and 7 (4.29%) other rare or difficult-to-determine types. All the 163 patients received surgical treatment at least once, of whom 15 underwent finger or toe amputation, 94 extended resections, and 54 unextended resections; 35 received secondary surgeries, of whom 33 underwent extended resections and 2 finger amputation. Seven patients developed postoperative lymph node and/or distant organ metastases, 2 of whom died after distant organ metastases. The 5-year survival rate of the 163 patients was 98.00%.Conclusion:Stage Ⅰ cutaneous melanoma commonly has favorable prognosis, and 7 patients developed postoperative lymph node and/or distant organ metastases in this study, suggesting that long-term follow-up of patients with acral melanoma and early intervention of those with metastatic melanoma should be strengthened.
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ObjectiveTo explore the effect of Banxia Xiexintang （BXT） on the NOD-like receptor protein 3 （NLRP3）/cysteinyl aspartate-specific protease-1 （Caspase-1） pyroptosis pathway and its downstream factors in rats with ulcerative colitis （UC）， and to explain the mechanism of BXT in the treatment of UC. MethodSD rats were randomly divided into normal control group， model group， low- and high-dose BXT groups （6.3， 12.6 g·kg-1·d-1）， and salazosulfapyridine （SASP） group （0.42 g·kg-1·d-1）， with 7 rats in each group. The UC model was induced by intragastric administration of 2.5% dextran sodium sulfate （DSS） solution for 10 days， followed by drug intervention for 7 days. The general state of rats was observed during the experiment， and the disease activity index （DAI） score was calculated during the administration period. At the end of the experiment， colonic tissues were collected for hematoxylin-eosin （HE） staining to observe the pathological changes and the curative effect of BXT. Real-time fluorescence-based quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA transcriptional levels of NLRP3， Caspase-1， gasdermin D （GSDMD）， and interleukin （IL）-1β in colonic tissues. Western blot was used to detect the protein expression of NLRP3， Caspase-1， GSDMD， and IL-1β in colonic tissues to explore the therapeutic mechanism of BXT. ResultCompared with the normal control group， the model group showed increased DAI score， pathological changes in colonic tissues， and up-regulated mRNA and protein expression of NLRP3， Caspase-1， GSDMD， and IL-1β （P<0.05， P<0.01）. Compared with the model group， the groups with drug intervention showed reduced DAI scores and improved pathological changes in colonic tissues. The mRNA and protein expression levels of NLRP3， Caspase-1， GSDMD， and IL-1β in colonic tissues of the BXT groups were significantly down-regulated or tended to be down-regulated， especially in the low-dose BXT group （P<0.05， P<0.01）. ConclusionBXT can inhibit pyroptosis and alleviate inflammation in rats with UC by regulating the NLRP3/Caspase-1 pathway.
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ObjectiveTo improve the current standard of Belladonnae Herba in the 2020 edition of Chinese Pharmacopoeia. MethodTaking hyoscyamine sulfate， atropine sulfate and scopoletin as reference substances， and ethyl acetate-methanol-concentrated ammonia（17∶4∶2）as developing solvent， thin layer chromatography （TLC） was applied in the qualitative identification of Belladonnae Herba. The moisture， total ash and ethanol-soluble extract of Belladonnae Herba were determined based on the general principles in the 2020 edition of Chinese Pharmacopoeia （volume Ⅳ）. The contents of hyoscyamine sulfate and scopolamine hydrobromide were analyzed by high performance liquid chromatography （HPLC） with mobile phase of acetonitrile-54 mmol·L-1 phosphate buffer solution （14∶86）， flow rate of 1.0 mL·min-1 and detection wavelength at 210 nm. ResultThe spots in the TLC were clear with good separation and specificity. Hyoscyamine sulfate and scopolamine hydrobromide showed a good linearity with peak area in the range of 0.024 7-0.789 6 g·L-1 （r=0.999 9） and 0.003 9-0.124 0 g·L-1 （r=0.999 9）， the average recoveries of these two ingredients were 100.29% （RSD 1.6%） and 99.04% （RSD 1.4%）， respectively. The limits for moisture， total ash in Belladonnae Herba should be less than 13.0% and the limit for the ethanol-soluble extract should be more than 10.0%. Due to the low content and wide variation of scopolamine hydrobromide， the content of hyoscyamine sulfate should not be less than 0.098%. ConclusionThe established method is simple， specific and reproducible， which can be used to improve the quality control standard of Belladonnae Herba.
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OBJECTIVE@#To investigate the accuracy and safety of pedicle screw placement assisted by orthopedic robot and C-arm fluoroscopy.@*METHODS@#The clinical data of 36 patients with spinal diseases underwent surgical treatment from January 2019 to August 2020 was retrospectively analyzed. Among them, 18 cases were implanted pedicle screws assisted by orthopaedic robot(observation group), including 12 males and 6 females, aged from 16 to 61 years with an average of (38.44±3.60) years;there were 1 case of adolescent scoliosis, 1 case of spinal tuberculosis, 7 cases of lumbar spondylolisthesis, 4 cases of thoracic fracture and 5 cases of lumbar fracture. Another 18 cases were implanted pedicle screws assisted by C-arm fluoroscopy(control group), including 10 males and 8 females, aged from 18 to 58 years with an average of (43.22±2.53) years;there were 1 case of adolescent scoliosis, 6 cases of lumbar spondylolisthesis, 6 cases of thoracic fracture and 5 cases of lumbar fracture. The intraoperative fluoroscopy times, nail placement time and postoperative complications were recorded in two groups. CT scan was performed after operation. The Gertzbein-Robbins standard was used to evaluate the accuracy of pedicle screw placement which was calculated.@*RESULTS@#The number of intraoperative fluoroscopy in observation group was(6.89±0.20) times, which was significantly higher than that in control group(14.00±0.18)times(P<0.05). The placement time of each screw in observation group was(2.56±0.12) min, which was significantly different from that in control group(4.22±0.17) min (P<0.05). One case of incision infection occurred in control group after operation, and recovered after active dressing change. During the follow-up period, no serious complications such as screw loosening and fracture occurred in two groups, and there was no significant difference in complications between two groups(P>0.05). A total of 107 screws were placed in observation group, including 101 screws in class A, 4 in class B, 2 in class C, 0 in class D and 0 in class E, the accuracy rate of pedicle screw placement=[(number of screws in class A+B) / the number of all screws placed in the group] ×100%=98.1%(105/107); and a total of 104 screws were placed in control group, including 90 screws in class A, 4 in class B, 5 in class C, 5 in class D and 0 in class E, the accuracy rate of pedicle screw implantation=[(number of screws in class A+B/the number of all screws placed in the group]×100%=90.3% (94/104); there was significant difference between two groups (P<0.05).@*CONCLUSION@#Orthopaedic robot assisted pedicle screw placement has the advantages of less fluoroscopy times, shorter screw placement time and higher accuracy, which can further improve the surgical safety and has a broad application prospect in the orthopaedic.
Subject(s)
Adolescent , Adult , Female , Fluoroscopy/methods , Humans , Lumbar Vertebrae/surgery , Male , Middle Aged , Pedicle Screws , Retrospective Studies , Robotic Surgical Procedures/methods , Robotics , Scoliosis , Spinal Fusion/methods , Surgery, Computer-Assisted , Young AdultABSTRACT
Objective:To estimate the radiation dose (RD) to the public from patients undergoing 177Lu-prostate specific membrane antigen (PSMA)-617 therapy, and provide reference for the formulation of radiation protection measures. Methods:From July 2020 to January 2021, 10 patients with prostate cancer (age (71.1±5.9) years) who received 177Lu-PSMA-617 therapy in the Affiliated Hospital of Southwest Medical University were retrospectively analyzed. According to the different doses of 177Lu-PSMA-617, the patients were divided into the low-dose (5.55-6.29 GBq) group and high-dose (6.70-8.94 GBq) group. Respectively at 5, 30 min and 1, 2, 4, 24, 48, 72, 96, 144 h after intravenous injection of 177Lu-PSMA-617, whole-body initial dose-equivalent rate (DR) was measured with a radiation-survey meter at 0.3, 1.0 and 2.0 m from the patients. The statistics of ROI were analyzed by HERMES, and the corresponding equations were obtained by fitting the curve regression with double exponential function model. On the basis of human social contact model proposed by the National Council on Radiation Protection and Measurements (NCRP), the RD to the public from the patient discharged from the hospital at different times after completing the 177Lu-PSMA-617 injection was estimated. Results:All patients were discharged from the hospital at 72 h after treatment. The initial DR at 0.3, 1.0 and 2.0 m were (12.6±3.3), (4.7±1.2) and (1.6±0.4) μSv/h, respectively, and the RD to the co-sleeping partner, family members and colleagues who were in contact during the day were (999±253), (121±29) and (160±39) μSv, respectively. If the patients were discharged at 48 h after treatment, the RD to the adult family members could be controlled ≤5 mSv, and the RD to colleagues and children could be controlled ≤1 mSv. Starting from the injection of 177Lu-PSMA-617, the restriction duration for co-sleeping partner and colleagues were both 2 d and the restriction duration for children were 2 d (high-dose group) or 1 d (low-dose group). The patients needed to limit the time for public transportation from the 1st to 4th day after treatment, and there was no restriction from the 5th day. Conclusion:According to the current RD restrictions on the public, 177Lu-PSMA-617 is a relatively safe treatment modality for prostate cancer if good safety precautions are taken.
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Objective:To evaluate the left atrial structure and function in patients with type 2 diabetes mellitus (T2DM) at different stages by four-dimensional automatic left atrial quantitation (4D-LAQ) and to explore the independent correlative factors affecting left atrial function of patients.Methods:Ninety-six patients who were diagnosed with T2DM in Fuwai Central China Cardiovascular Hospital endocrinology from December 2020 to October 2021 were selected as the case group, all cases were divided into two groups according to whether or not they have the microvascular complication: 48 patients with simple diabetes in DM1 group, 48 patients with microvascular complications in DM2 group. Forty-eight healthy volunteers during the same period were randomly recruited as the control group. Left atrial diameter (LAD), inter-ventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDd), left ventricular ejection fraction (LVEF), peak value of early diastolic velocity of mitral inflow (E), peak value of late diastolic velocity of mitral inflow (A), peak value of early diastolic tissue Doppler velocity of septal and lateral walls of mitral annulus (septal e′, lateral e′) were routinely measured, E/A, mean e′ and mean E/e′ were calculated.4D-LAQ technique was used to obtain left atrial minimum volume (LAVmin), left atrial maximum volume (LAVmax), left atrial pre-systolic volume (LAVpreA), left atrial maximum volume index (LAVImax), left atrial total emptying fraction (LAEF), left atrial reservoir longitudinal strain (LASr), left atrial conduit longitudinal strain (LAScd) and left atrial contraction longitudinal strain (LASct). The differences of left atrial parameters among three groups were compared. The independent correlation factors affecting left atrial function were investigated by univariate and multivariate linear regression analyses.Results:Compared with the control group, LAEF, LASr and LAScd were decreased in the DM1 group (all P<0.05), there were no significant differences in LAVImax, LAVIpreA and LAVImin between the two groups (all P>0.05). Compared with the control group and DM1 group, LAEF, LASr and LAScd were decreased, LAVImax, LAVIpreA and LAVImin were increased in the DM2 group (all P<0.05). There was no significant difference in LASct among the three groups (all P>0.05). Multivariate linear regression analyses showed duration of diabetes was independently and negatively correlated with LASr (β=-0.405, P<0.001); Body mass index(BMI) and E were independently and negatively correlated with LAScd(β=-0.159, P=0.049; β=-0.408, P<0.001), and duration of diabetes and E/e′ were independently and positively correlated with LAScd(β=0.399, P<0.001; β=0.253, P=0.004). Conclusions:Left atrial reservoir function and conduit function are impaired in T2DM patients, and deteriotated as the disease progresses. Duration of diabetes, BMI, E and E/e′ are the independent correlative factors affecting left atrial function.
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Background@#Xylazole (Xyl) is a veterinary anesthetic that is structurally and functionally similar to xylazine. However, the effects of Xyl in vitro remain unknown. @*Objectives@#This study aimed to investigate the anesthetic mechanism of Xyl using fetal rat nerve cells treated with Xyl. @*Methods@#Fetal rat nerve cells cultured for seven days were treated with 10, 20, 30, and 40 μg/ mL Xyl for 0, 5, 10, 15, 20, 25, 30, 45, 60, 90, and 120 min. Variations of amino acid neurotransmitters (AANTs), Nitric oxide-Cyclic GMP (NO-cGMP) signaling pathway, and ATPase were evaluated. @*Results@#Xyl decreased the levels of cGMP and NO in nerve cells. Furthermore, Xyl affected the AANT content and Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase activity in nerve cells. These findings suggested that Xyl inhibited the NO-cGMP signaling pathway in nerve cells in vitro. @*Conclusions@#This study provided new evidence that the anesthetic and analgesic effects of Xyl are related to the inhibition of the NO-cGMP signaling pathway.
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Objective:To analyze the left atrial (LA) function and predict the value of diastolic dysfunction (LVDD) in patients with heart failure (HF) by four-dimensional automatic left atrial quantitation (4D Auto LAQ) technology.Methods:A total of 90 patients with HF(LVDD group) and 30 healthy volunteers (control group)were enrolled from January 2021 to July 2021 in Fuwai Central China Cardiovascular Hospital. The patients with HF were divided into 3 groups according to the degree of LVDD: grade Ⅰ( n=30), grade Ⅱ( n=30), grade Ⅲ( n=30). Four-dimensional dynamic images of LA were collected by 4D Auto LAQ technology for on-machine analysis. LA volume and strain parameters were obtained, including LA maximum volume index (LAVImax), LA reservoir longitudinal and circumferential strains (LASr, LASr-c), LA conduit longitudinal and circumferential strains (LAScd, LAScd-c) and LA contraction longitudinal and circumferential strains (LASct, LASct-c). Pearson linear correlation was used to analyze the correlation between LA strain parameters and diastolic function parameters (LAVImax, E/A, E/e′) in HF patients. ROC curves were plotted to analyze the diagnostic performance of LA strain parameters and LAVImax for grade Ⅲ LVDD, the area under the curve (AUC) was calculated and pairwise comparisons were made. Results:①Compared with the control group, LAVmin, LAVpreA, LAScd, LASct, LAScd-c, and LASct-c were increased, and LASr, and LASr-c were decreased in the grade Ⅰ, Ⅱ, and Ⅲ LVDD groups (all P<0.05). LAVmin, LAVpreA, LAVmax, LAVImax, LAScd, LASct, LAScd-c and LASct-c were increased, and LASr and LASr-c were decreased in grade Ⅲ LVDD group compared with grade Ⅰ and Ⅱ LVDD groups (all P<0.05). ②Pearson correlation analysis showed that LASr, LASct, LASr-c and LASct-c were strongly correlated with diastolic function parameters (LAVImax, E/A, E/e′) (all P<0.01). ③ROC curve analysis showed that LASr-c had significantly better performance (AUC 0.868, sensitivity 96.7%, specificity 66.7%) than other parameters in the diagnosis of grade Ⅲ LVDD. Conclusions:4D Auto LAQ can effectively evaluate the LA volume and function in patients with HF. LASr-c is optimal in predicting grade Ⅲ LVDD, 4D Auto LAQ provides a new reference for evaluating diastolic function in patients with HF.
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In order to build a standardized training base for dental nurses in Chongqing, explore and improve the dental nursing talent training system, the standardized training and management leading group of dental nurses has established a training program centered on job competence and a clinical competency training center based on simulated dental clinics, which has improved the comprehensive capabilities of dental nursing teachers, implemented the assessment of "equal emphasis on process and results" system, and taken measures to provide comprehensive protection to gradually build the base. After 6 years of construction, the base has completed the training of 139 dental nursing training students, with an average passing rate of 91.21%. Among them, 92.81%(129/139) are engaged in professional dental nursing work, and 14.73%(19/129) have grown into nursing backbones. In the future, it is necessary to further strengthen the standardized training and publicity of dental nurses and expand the scope of radiation.
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Objective:To evaluate the medium-term clinical and hemodynamic outcomes of percutaneous pulmonary valve implantation (PPVI) using a domestic Venus-P self-expanding valve in the treatment of severe pulmonary regurgitation after Tetralogy of Fallot (TOF).Methods:Retrospective study.From December 2017 to December 2020, 13 TOF patients with (17.8±4.7) years old and (50.2±12.3) kg underwent PPVI using the Venus-P self-expanding valve in the Department of Children′s Heart Center, Zhengzhou University People′s Hospital were recruited.The mean valve size was (31.9±3.1) mm.All patients received the transannular patch surgery and developed severe pulmonary regurgitation.After PPVI, 13 patients were followed up for at least 12 months.The operation-related complications, improvement of valve and heart function and the durability and reintervention of the Venus-P self-expanding valve were analyzed.The right ventricular end-diastolic volume index (RVEDVi) before and after operation was compared by the paired t-test, and the New York Heart Association (NYHA) class was compared by the paired Wilcoxon signed rank sum test. Results:PPVI was successfully performed in all 13 patients without death.At 6 months post-PPVI, cardiac magnetic resonance imaging findings showed that RVEDVi was significantly reduced[(145.7±9.6) mL/m 2vs.(100.2±12.2) mL/m 2, P<0.05], and the NYHA class was significantly improved ( P<0.05). One patient presented moderate pulmonary valve regurgitation at 12 months postoperatively.No vegetation was found on echocardiography, and blood culture was negative in this case.Six patients did not have postoperative pulmonary valve regurgitation, and the remaining presented mild or less pulmonary regurgitation.One patient had sudden ventricular tachycardia on the 6 th day postoperatively, which was converted to sinus rhythm after synchronous electrocardiography.Only one case underwent appendectomy 7 months after operation due to acute appendicitis, and the remaining did not require valve-related reintervention after implantation.During the follow-up for (22.8±8.0) months, no patients had perivalve leakage, stent migration and rupture.Complications like embolization and coronary artery compression were not reported. Conclusions:PPVI using the Venus-P self-expanding valve is safe and effective in patients with severe pulmonary valve regurgitation after TOF surgery, showing an acceptable medium-term follow-up outcome.Studies with a large sample size and long follow-up period are still needed to validate our findings.
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Objective:To study the diagnostic value of the artificial intelligence (AI) diagnostic system, ACR TI-RADS classification and AI+ ACR TI-RADS combined diagnostic performance in benign and malignant thyroid nodules and its guiding significance for surgical treatment.Methods:From Nov. 1, 2021, to Feb. 26, 2022, 349 patients with 605 thyroid nodules who received surgical treatment in Department of Thyroid (Hernia) Surgery, Department of General Surgery, the First Medical Center of the PLA General Hospital, were selected. There were 95 males and 254 females, male: female=1:2.67, aged 16-78 years, and the nodule diameter was 0.2-5.6 cm. SPSS 26.0 and R studio software were used for data processing. AI diagnostic system, ACR TI-RADS grading and AI+ ACR TI-RADS combined diagnostic efficacy were statistically analyzed, respectively. ROC curve analysis was performed in parallel.Results:The AUC value of AI+ ACR TI-RADS combined diagnosis was 0.900, greater than 0.857 of AI diagnostic system and 0.788 of ACR TI-RADS, and the difference was statistically significant ( Z= 7.631, both P<0.001) . The sensitivity of the combined diagnosis was 95.32%, the specificity was 84.61%, the accuracy was 92.56%, the positive predictive value was 94.69%, the negative predictive value was 86.27%, the missed diagnosis rate was 4.68%, and the misdiagnosis rate was 15.38%, which were better than the other two diagnostic methods. With an excellent coincidence rate with postoperative pathological results ( Kappa=0.804, P<0.001) . The accuracy of combined diagnosis in identifying the maximum diameter of different tumors was 89.58% for d≤0.5 cm, 96.09% for 0.5<d≤1.0 cm, 95.45% for 1.0<d≤2.0 cm, 87.88% for 2.0<d≤4.0 cm, and 85.71% for d>4.0 cm, better than the other two diagnostic methods. Conclusions:The combined application of AI+ACR TI-RADS has a certain primary screening value in evaluating thyroid nodule properties. The combined diagnosis of the two can more effectively determine the benign and malignant thyroid nodules.
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Objective:To investigate the efficacy and safety of ixazomib combined with lenalidomide and dexamethasone (IRd) regimen in treatment of multiple myeloma (MM) patients in the real world practice.Methods:The clinical data of 24 MM patients treated with IRd regimen from January 2019 to January 2021 in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed, and their efficacy and adverse reactions were analyzed. Among the 24 patients, 5 patients were relapsed and refractory (relapsed/refractory group), and 19 newly treated patients (conversion group) who responded to bortezomib induction therapy but converted to IRd regimen due to adverse reactions or other reasons.Results:The 24 patients were treated for a median of 4 cycles (2-7 cycles), with 8 cases of complete remission (CR), 6 cases of very good partial remission (VGPR), 8 cases of partial remission (PR), 1 case of disease progression (PD), 1 case of minimal response (MR), and the overall response rate (ORR) was 91.7% (22/24); the median progression-free survival (PFS) time was 15 months (95% CI 6.6-23.4 months); 6 CR patients were negative for minimal residual disease (MRD). The common adverse reactions were hematological adverse reactions, peripheral neuropathy, fatigue, gastrointestinal reactions, and infections. The incidence rate of grade 3-4 adverse reactions was 25.0% (6/24). In the relapsed/refractory group, the best efficacy was VGPR in 1 case, PR in 3 cases, and MR in 1 case, all patients withdrew from the IRd regimen therapy due to PD after transient remission or poor effect; in the conversion group, the best efficacy was CR in 8 cases, VGPR in 5 cases, PR in 5 cases, and PD in 1 case, 57.9% (11/19) patients maintained their original best response, and 36.8% (7/19) patients improved their best response to CR; the difference in median PFS time between the two groups was statistically significant (7 months vs. not reached, P = 0.018). Conclusions:The IRd regimen is safe and effective for MM patients, especially for the conversion patients after effective bortezomib induction therapy. Although patients with relapsed/refractory MM who have previously used multi-line therapy respond to IRd regimen, the duration of remission is limited.
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Cancer is a complex disease associated with multiple gene mutations and malignant phenotypes, and multi-target drugs provide a promising therapy idea for the treatment of cancer. Natural products with abundant chemical structure types and rich pharmacological characteristics could be ideal sources for screening multi-target antineoplastic drugs. In this paper, 50 tumor-related targets were collected by searching the Therapeutic Target Database and Thomson Reuters Integrity database, and a multi-target anti-cancer prediction system based on mt-QSAR models was constructed by using naïve Bayesian and recursive partitioning algorithm for the first time. Through the multi-target anti-cancer prediction system, some dominant fragments that act on multiple tumor-related targets were analyzed, which could be helpful in designing multi-target anti-cancer drugs. Anti-cancer traditional Chinese medicine (TCM) and its natural products were collected to form a TCM formula-based natural products library, and the potential targets of the natural products in the library were predicted by multi-target anti-cancer prediction system. As a result, alkaloids, flavonoids and terpenoids were predicted to act on multiple tumor-related targets. The predicted targets of some representative compounds were verified according to literature review and most of the selected natural compounds were found to exert certain anti-cancer activity in vitro biological experiments. In conclusion, the multi-target anti-cancer prediction system is very effective and reliable, and it could be further used for elucidating the functional mechanism of anti-cancer TCM formula and screening for multi-target anti-cancer drugs. The anti-cancer natural compounds found in this paper will lay important information for further study.