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Objective:To analyze the trend of maternal mortality ratio (MMR) and death causes in Tianjin from 2011 to 2020 and to guide the management of maternal health.Methods:All the reviews data of 89 maternal death cases in Tianjin from 2011 to 2020 were retrospectively collected to analyze the trend of MMR, rank order of death causes, and death review results using Chi-square test. Results:(1) The average MMR in Tianjin was 7.97/100 000 during the study period, showing an overall fluctuating decline. The highest MMR was 12.61/100 000 in 2014 and the lowest was 3.85/100 000 in 2019. (2) Among the dead pregnant women and parturients, non-registered residents had higher proportion of women with advanced age, no steady occupation/unemployment, below junior college education, multipara, or without maternal health manual compared with the registered residents [33.33% (8/24) vs 20.00% (13/65), χ2=46.18; 100.00%(24/24) vs 69.23%(45/65), χ2=9.53; 87.50% (21/24) vs 64.62% (42/65), χ2=4.44; 79.17% (19/24) vs 44.62% (29/65), χ2=8.42; 75.00%(18/24) vs 13.85% (9/65), χ2=31.02; all P<0.05]. (3) Direct obstetric factors and indirect factors that caused death were accounted for 57.30% (51/89) and 42.70% (38/89). The top five death causes were postpartum hemorrhage, hypertensive disease during pregnancy, sudden death, venous thrombosis and pulmonary embolism, and amniotic fluid embolism. (4) In terms of the maternal death review results, 39.33% (35/89) of maternal deaths were avoidable, among which 94.29% (33/35) were caused by direct obstetric factors and 5.71% (2/35) were indirect. (5) The main influencing factors of avoidable death causes were knowledge and skills inadequacy in the health care system (62.86%, 22/35), of which 86.36% (19/22) happened in health facilities at and below the district/county level. Conclusion:It is suggested to strengthen the medical care of health facilities at and below the district/county level and the maternal health management of the non-permanent residents to ensure maternal and infant safety and to further reduce the MMR.
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Objective@#To understand sensory characteristics and its correlation with behavioral problems among children with autism spectrum disorder (ASD), so as to provide reference basis for early diagnosis and comprehensive intervention of ASD children.@*Methods@#Using cross sectional survey, 193 ASD children trained by Nantong rehabilitation institutions were recruited from September 2021 to February 2022. All children were investigated with the Short Sensory Profile (SSP) and Parent Symptom Questionnaire (PSQ).@*Results@#Among the 193 ASD children, 106 (54.9%) children had abnormal sensory characteristics, including 45 (23.3%) with possible abnormalities and 61 (31.6%) with obvious abnormalities. The abnormal rate of auditory filtering was the highest in the seven dimensions, reaching 85.0%, followed by low strength/weakness, motor sensitivity, taste/smell sensitivity, low response/seeking sensation, vision/hearing sensitivity and tactile sensitivity. The total incidence of sensory abnormalities was 93.3%. There were significant differences in six dimensions of PSQ scale scores of ASD children with different degrees of sensory abnormalities, including conduct problems, learning problems, psychosomatic disorders, impulsive hyperactivity, anxiety and hyperactivity index ( H =38.89, 38.90, 19.53, 46.34, 34.54, 54.90, P <0.01). With the aggravation of sensory abnormalities in children with ASD, the scores of all dimensions of the PSQ scale increased significantly. The total score of SSP was negatively correlated with the six dimensions of conduct problems, learning problems, psychosomatic disorders, impulsive hyperactivity, anxiety and hyperactivity index in PSQ ( r =-0.53, -0.50, -0.32, -0.55, -0.43, -0.61, P <0.01).@*Conclusion@#ASD children generally have sensory abnormalities, which coincide with severity of behavioral problems. There is a positive correlation between sensory abnormalities and behavioral problems in ASD children. More attention should be paid to the abnormal sensory characteristics of children with ASD in the future diagnosis and treatment process.
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Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.
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Child , Child, Preschool , Consensus , Dental Caries/prevention & control , Dental Caries Susceptibility , Humans , Oral HealthABSTRACT
Since 2010, the incidence of severe fever with thrombocytopenia syndrome (SFTS) has been increased. Owing the progress in diagnosis and treatment, the overall mortality of SFTS in China has decreased, while the mortality in critical SFTS patients is still high. In order to provide guidance and working procedures for clinicians to diagnose and treat critical SFTS, the National Medical Center for Major Public Health Events invited experts to discuss and formulate this consensus based on their experience and up-to-date knowledge on SFTS.
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@#To reveal the pharmacological mechanism of 3-arylcoumarin derivative 3-(4′-hydroxyphenyl)-6-hydroxycoumarin (SJ-6) against vascular calcification, advanced glycation end products (AGEs) were used to induce the calcification of human aortic vascular smooth muscle cells (HCASMCs), and calcification was identified by alizarin red staining and quantification.The effects of SJ-6 on alkaline phosphatase (ALP) activity, cell proliferation rate, calcium content, and total reactive oxygen species (ROS), superoxide dismutase (SOD), AGEs, and tetra methylethlene diamine proteinase factor-α (TNF-α), interleukin-6 (1L-6), interleukin-β (1L-β), runt-related transcription factor 2 mRNA (Runx2 mRNA), the receptor of advanced glycation endproducts (RAGE), nuclear factor kappa-B (NF-κB), napdh oxidase-1 (NoX-1), protein kinase C(PKC), protein kinase b(AKT), p38 mitogen-activated protein kinase (p38 MAPK), and smooth muscle actin-α (SMA-α) protein expression were determined.According to our results, SJ-6 significantly decreased AGEs content, ALP activity, intracellular calcium content, ROS content, Runx2 mRNA and inflammatory factors TNF-α, 1L-6 and 1L-β (P < 0.05) and increased SOD content (P < 0.01), with similar to those of the positive control drug aminoguanidine hydrochloride (AGH).Therefore, we investigated the pharmacological mechanism of compound SJ-6, which was found to significantly inhibit the expression of RAGE, NF-κB, NoX-1, PKC, Akt, p-p38 and other essential signaling proteins in the calcified cell model (P < 0.01) and increas the expression of smooth actin SMA-α (P < 0.01).SJ-6 inhibits vascular calcification by inhibiting oxidative stress and the expression of AGEs/RAGE, Akt/PKC and NF-κB signaling pathways, suggesting that it may be a novel drug for the treatment of vascular calcification.
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Objective:To explore whether sleep quality suffers in patients with mild Alzheimer's disease(AD)and mild cognitive impairment(MCI), and to further investigate the correlation between sleep disorders and cognitive function in these patients.Methods:In this study, 30 mild AD patients, 39 MCI patients and 43 demographically matched healthy controls were enrolled.Sleep quality was assessed by the Pittsburgh sleep quality index(PSQI), and cognitive function was assessed by the mini-mental state examination(MMSE), the Montreal cognitive assessment(MoCA)and a set of neuropsychological scales.The correlation of sleep quality with cognitive function was analyzed for the three groups.Results:Differences were significant in sleep time score[0.0(1.0), 1.0(2.0) vs.1.0(1.0), F=8.18, P=0.02]and daytime function score[1.0(1.0), 1.0(1.0) vs.0.0(1.0), F=8.73, P=0.01]between mild AD, MCI and health control groups.Spearman correlation analysis suggested that scores of sleep disorders were negatively correlated with DSB( r=-0.43, P=0.02)and scores of daytime function were positively correlated with ADL( r=0.39, P=0.03)in patients with mild AD.In addition, scores of sleep quality were negatively correlated with the DSB score( r=-0.40, P=0.01), scores of sleep disorders were positively correlated with ADL( r=0.45, P<0.01), scores of daytime function were negatively correlated with DSF( r=-0.42, P=0.01), DSB( r=-0.62, P<0.01)and VFT-S( r=-0.33, P=0.04), and the total PSQI score was negatively correlated with DSF( r=-0.45, P=0.01)and DSB( r=-0.44, P=0.01)in the MCI group. Conclusions:Patients with mild AD and MCI have longer sleep time and impaired daytime function than healthy people, and sleep quality is correlated with memory, attention and daily living ability in patients with mild AD and MCI.
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Objective:To investigate the application value of contrast-enhanced ultrasound (CEUS) combined with thyroid imaging reporting and data system (TI-RADS) classification in the differential diagnosis of benign and malignant thyroid nodules.Methods:The clinical data of 157 thyroid nodules from 122 participants who underwent conventional ultrasound and CEUS examination from January 2016 to January 2017 in the First Hospital of Shanxi Medical University, China were collected. The image features were analyzed for conventional ultrasound and TI-RADS classification. According to CEUS results, the thyroid nodules were classified by TI-RADS. Based on pathological results, the efficacy of CEUS combined with TI-RADS classification versus conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was investigated. Results:The area under the curve of CEUS combined with TI-RADS classification (AUC = 0.900) was greater than that of conventional ultrasound combined with TI-RADS classification (AUC = 0.808). The sensitivity, specificity, accuracy, positive and negative predictive values of conventional ultrasound combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules were 81.6% (80/98), 67.8% (40/59), 76.4% (120/157), 80.8% (80/99), 68.9% (40/58), respectively. They were 98.0% (96/98), 78.0% (34/59), 90.4% (142/157), 88.1% (96/109), 95.8% (46/48), respectively for CEUS combined with TI-RADS classification. The sensitivity of CEUS combined with TI-RADS classification in the differential diagnosis of benign and malignant thyroid nodules was significantly higher than that of conventional ultrasound combined with TI-RADS classification ( χ2 = 12.50, P < 0.001). Conclusion:CEUS combined with TI-RADS classification is more effective in the differential diagnosis of benign and malignant thyroid nodules than conventional ultrasound combined with TI-RADS classification.
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Tocilizumab has been reported to attenuate the "cytokine storm" in COVID-19 patients. We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment. We conducted a randomized, controlled, open-label multicenter trial among COVID-19 patients. The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone. The cure rate, changes of oxygen saturation and interference, and inflammation biomarkers were observed. Thirty-three patients were randomized to the tocilizumab group, and 32 patients to the control group. The cure rate in the tocilizumab group was higher than that in the control group, but the difference was not statistically significant (94.12% vs. 87.10%, rate difference 95% CI-7.19%-21.23%, P = 0.4133). The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12 (P = 0.0359). In moderate disease patients with bilateral pulmonary lesions, the hypoxia ameliorated earlier after tocilizumab treatment, and less patients (1/12, 8.33%) needed an increase of inhaled oxygen concentration compared with the controls (4/6, 66.67%; rate difference 95% CI-99.17% to-17.50%, P = 0.0217). No severe adverse events occurred. More mild temporary adverse events were recorded in tocilizumab recipients (20/34, 58.82%) than the controls (4/31, 12.90%). Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative. For patients with bilateral pulmonary lesions and elevated IL-6 levels, tocilizumab could be recommended to improve outcome.
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Antibodies, Monoclonal, Humanized , COVID-19/drug therapy , Humans , SARS-CoV-2 , Treatment OutcomeABSTRACT
Objective@#To evaluate the cognitive impairment in elderly patients with minor ischemic stroke and to analyze risk factors for stroke recurrence.@*Methods@#This was a retrospective case-control study.Ninety-five elderly patients with acute ischemic stroke hospitalized in the neurology department of Second People's Hospital of Liaocheng were enrolled from January 2016 to January 2017.Based on the National Institutes of Health Stroke Scale(NIHSS), all cases were divided into the minor stroke group(NIHSS score≤3, n=62)and the medium-severe stroke group(NIHSS score>3, n=33). After 12-month follow-up, the NIHSS, modified Rankin scale(mRS)and Montreal cognitive assessment(MoCA)were used to evaluate the study subjects.@*Results@#Of the 95 patients, there were 62 males(65.3%)and 33 females(34.7%), with age of(68.3±6.7)years.No significant differences were found in baseline characteristics of age, male ratio, subtypes and history between two groups(all P>0.05). But, the treatment rate of intravenous thrombolysis was lower in minor stroke group than in medium-severe stroke group[6.5%(4 cases)vs.42.4%(14 cases)(P<0.01)]. The scores of NIHSS[(1.0±0.5)vs.(3.2±1.1), P<0.01], mRS[(1.6±0.7)vs.(2.4±1.1), P<0.01]were lower in the minor stroke group than in the medium-severe group.After a mean follow-up of(12.6±1.9)months, the rate of cognitive impairment was comparable between the two groups(P>0.05), while the rate of post stroke depression had a significant difference between two groups(P<0.05). Furthermore, there was lower rate of mortality and stroke recurrence in the minor stroke group than in the medium-severe group(0.0% or 0/62 vs.30.3% or 10/33, and 21.0% or 13/62 vs.42.4% or 14/33, P<0.05). Cox proportional hazard model showed that baseline NIHSS score, diabetes and stroke history were the risk factors for stroke recurrence in patients with minor stroke(P<0.05).@*Conclusions@#The treatment rate of intravenous thrombolysis with rt-PA, mortality rate and stroke recurrence rate are lower in patients with minor stroke than in patients with medium-severe stroke, while the incidence of post stroke cognitive impairment is high.High score of baseline NIHSS, diabetes and stroke history are risk factors for stroke recurrence in elderly patients with minor stroke.
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Objective To evaluate the cognitive impairment in elderly patients with minor ischemic stroke and to analyze risk factors for stroke recurrence.Methods This was a retrospective case-control study.Ninety-five elderly patients with acute ischemic stroke hospitalized in the neurology department of Second People's Hospital of Liaocheng were enrolled from January 2016 to January 2017.Based on the National Institutes of Health Stroke Scale(NIHSS),all cases were divided into the minor stroke group(NIHSS score≤3,n=62)and the medium-severe stroke group(NI HSS score＞ 3,n =33).After 12-month follow-up,the NIHSS,modified Rankin scale(mRS)and Montreal cognitive assessment (MoCA)were used to evaluate the study subjects.Results Of the 95 patients,there were 62 males(65.3％)and 33 females(34.7％),with age of(68.3 ± 6.7) years.No significant differences were found in baseline characteristics of age,male ratio,subtypes and history between two groups(all P＞0.05).But,the treatment rate of intravenous thrombolysis was lower in minor stroke group than in medium-severe stroke group [6.5 ％ (4 cases) vs.42.4 ％ (14 cases) (P ＜ 0.01)].The scores of NIHSS[(1.0±0.5)vs.(3.2± 1.1),P＜0.01],mRS[(1.6±0.7)vs.(2.4± 1.1),P＜0.01] were lower in the minor stroke group than in the medium-severe group.After a mean follow-up of(12.6± 1.9)months,the rate of cognitive impairment was comparable between the two groups(P ＞0.05),while the rate of post stroke depression had a significant difference between two groups(P＜0.05).Furthermore,there was lower rate of mortality and stroke recurrence in the minor stroke group than in the medium-severe group(0.0％ or 0/62 vs.30.3％ or 10/33,and 21.0％ or 13/62 vs.42.4％ or 14/33,P＜0.05).Cox proportional hazard model showed that baseline NIHSS score,diabetes and stroke history were the risk factors for stroke recurrence in patients with minor stroke(P＜0.05).Conclusions The treatment rate of intravenous thrombolysis with rt-PA,mortality rate and stroke recurrence rate are lower in patients with minor stroke than in patients with medium-severe stroke,while the incidence of post stroke cognitive impairment is high.High score of baseline NIHSS,diabetes and stroke history are risk factors for stroke recurrence in elderly patients with minor stroke.
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Objective:To investigate the correlation between acoustic radiation force impulse imaging(ARFI) and reserve function of liver and the feasibility of liver reserve function assessment by ARFI.Methods:According to the inclusion criteria, 74 patients were screened and 71 patients were finally enrolled from Henan Province People′s Hospital during June 2017 and June 2019. The portal vein diameter (D PV), spleen length (L SP) were measured by two-dimensional ultrasound. The liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) were measured by ARFI. Serological markers were checked, and the indocyanine green (ICG)15-minute retention rate (ICG R15) was measured by excretion test. The patients were divided into ICG R15<10% group and ICG R15≥10% group, the difference of the measurements between two groups were calculated, the correlations of the measurements and ICG R15 were analyzed. LSWV diagnostic performance for liver reserve function was evaluated by the ROC curve. Results:There were significant differences in LSWV, D PV, SSWV, L SP, aspartate transaminase(AST), alkaline phosphatase(ALP), y-glutamyl transpeptidase(γ-GGT) and albumin (ALB) between ICG R15<10% group and ICG≥10% group( P<0.05), but no significant differences in other measurements( P>0.05). The correlations between ICG R15 and LSWV( r=0.673, P<0.001), D PV( r=0.355, P<0.05), SSWV( r=0.384, P<0.05), L SP( r=0.403, P<0.001), ALP( r s=0.245, P<0.05) and ALB( r s=-0.390, P<0.05) were statistically significant. The ROC curve showed high diagnostic performance for liver reserve function assessment by LSWV. The area under the ROC curve was 0.903 (95% CI=0.810-0.961, P<0.01), and the cut-off value was 2.15 m/s (sensitivity 84.6%, specificity 86.7%). Conclusions:The LSWV can evaluate the reserve function and it is a useful supplement to the ICG excretion experiment.
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Objective:To explore the empathy of patients with cerebral small vessel disease (CSVD) and its relationship with cognitive functions.Methods:A total of 35 patients with CSVD and 26 normal controls with matching gender, age and education were enrolled.The Chinese version of the interpersonal reactivity index (IRI-C) and the multifaceted empathy test(MET) were used to assess the empathy of the participants.The montreal cognitive assessment scale (MoCA), the Hamilton anxiety scale(HAMA), and the Hamilton depression scale (HAMD) were applied to assess participants' overall cognitive function and emotional state.SPSS 19.0 software was used to analyze the differences between the CSVD group and the control group, while the influencing factors of empathy were studied by Pearson correlation analysis.Results:The total scores of IRI, perspective taking(PT), fantasy(FS) and empathy concern(EC) of CSVD patients ((37.25±11.71), (6.94±4.35), (9.45±4.68) and (16.40±4.34)) were lower than those of the control group ((50.61±11.07), (11.84±3.90), (13.23±5.01), (19.69±3.03)), and the differences were statistically significant (IRI score: t=4.506, P<0.05.PT: t=4.539, P<0.05.FS: t=3.021, P<0.05.EC: t=3.308, P<0.05). The personal distress(PD) scores of CSVD group were (4.68±4.16), while(6.00±4.69) in control group, and the difference was not significant ( t=1.154, P>0.05). The MET-C results showed that there was a difference in the correct number of empathic emotion recognition between the two groups(CVSD group: (25.08±6.77), control group: (32.30±3.42), t=4.978, P<0.05), however, there was no significant difference between the two groups in emotional empathy scores ( t=1.390, P>0.05). Pearson correlation analysis showed that the total score of IRI and PT in the CSVD group were positively correlated with education level ( r=0.374, 0.471, both P<0.05). PT was positively correlated with MoCA score ( r=0.458, P=0.006). PD was positively correlated with HAMA score and HAMD score ( r=0.521, 0.541, both P<0.05). The correct number of emotion recognition was positively correlated with education level ( r=0.600, P<0.001) and MoCA score ( r=0.665, P<0.001), and negatively correlated with HAMA score( r=-0.445, P<0.05) and HAMD score ( r=-0.421, P<0.05). Conclusion:The empathy of patients with CSVD is lower than that of the normal group, and it is manifested as a decline in cognitive empathy, which is positively related to the overall cognitive function.
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Objective:To investigate the prevalence of nutritional risk among hospitalized patients with gynecologic tumor and provide a reference for nutritional intervention.Methods:Hospitalized patients with gynecologic tumor in a grade A class 3 hospital in Beijing were consecutively enrolled from December 2016 to December 2017. Nutritional risk was measured by nutritional risk screening 2002(NRS 2002)within the first 24 h after admission. The relevant influencing factors were analyzed.Results:A total of 1 500 hospitalized patients who met entry criteria and obtained informed consent were consecutively enrolled. The prevalence of nutritional risk was 23.1%, and 53.1 % patients had at least one nutrition-related problem. The analysis of relevant influencing factors showed that patients of age under 30 years and over 50 years( χ2=108.014, P<0.01), malignancy( χ2=112.197, P<0.01), low differentiation pathological type( χ2=251.392, P<0.01), chemotherapy( χ2=339.999, P<0.01)accompanied with vomiting( χ2=121.402, P<0.01), diarrhea( χ2=49.920, P<0.01)had the relatively high prevalence rate of nutritional risk. Pathological stage and operation had no significant effect( P>0.05). Conclusions:The prevalence of nutritional risk among hospitalized patients with gynecologic tumor is relatively high. The main relevant influencing factors include age, kinds of diseases, pathological type, chemotherapy, vomiting and diarrhea.
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OBJECTIVE@#To explore the correlation of plasma N-acetyl-neuraminic acid level with Thrombolysis In Myocardial Infarction (TIMI) risk score and clinical outcomes of patients with acute coronary syndrome (ACS).@*METHODS@#We consecutively enrolled 708 consecutive patients (401 male and 307 female, mean age 63.6±10.6 years) undergoing coronary angiography in our hospital between October, 2018 and July, 2019, including 597 patients with ACS and 111 without ACS (control group). The patients with ACS group were divided into high (=104), moderate (=425) and low (=68) risk groups according to their TIMI risk scores. All the participants were examined for plasma Neu5Ac level using liquid chromatography-tandem mass spectrometry and underwent coronary angiography with their Gensini scores calculated. The patients with ACS were followed up after discharge for a mean of 15 months for the occurrence of major adverse cardiac events (Mace). Binary logistic regression analysis was performed to identify the risk factors of Mace in these patients.@*RESULTS@#Plasma Neu5Ac levels were significantly higher in ACS group than in the control group ( < 0.05). ROC curve analysis showed that plasma Neu5Ac level could assist in the diagnosis of ACS (0.648 [0.597-0.699]) with a sensitivity of 39.2% and a specificity of 86.5% at the cutoff value of 288.50 ng/mL. In the ACS patients, plasma Neu5Ac level was significantly higher in the high-risk group than in the moderate-risk and low-risk groups ( < 0.05) and could assist in the diagnosis of a high risk (0.645 [0.588-0.703]) with a sensitivity of 42.3% and a specificity of 80.1% at the cutoff value of 327.50 ng/ mL. Plasma Neu5Ac was positively correlated with age, serum uric acid, creatinine, lipoprotein a, Ddimer, C-reactive protein, MB isoform of creatine kinase and Gensini score and negatively correlated with high-density lipoprotein level. During the followup, 80 ACS patients experienced Mace, who had significantly higher plasma Neu5Ac level than those without Mace (=517). Logistic regression analysis showed that plasma Neu5Ac level and a history of previous stroke were independent risk factors for the occurrence of Mace.@*CONCLUSIONS@#Plasma Neu5Ac level can provide assistance in the diagnosis and risk stratification of ACS and is an independent risk factor for prognosis of ACS patients.
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Primary biliary cholangitis (PBC) is an immune-mediated chronic and progressive intrahepatic cholestasis disease. Treatment with ursodeoxycholic acid (UDCA) can significantly improve the prognosis of patients with PBC, but some patients still have poor response to UDCA, which is the main risk factor for disease progression. Several evaluation models and scoring systems based on biochemical response have been applied to screen out patients with poor response in clinical practice. Integrated traditional Chinese and Western medicine therapy for PBC has certain advantages in improving the symptoms, liver biochemistry, fibrosis indices, and biochemical response rate of PBC patients and thus holds promise for clinical application; however, further improvement is needed for experimental design and efficacy evaluation.
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Objective:To evaluate the rapid diagnostic value of serum novel coronavirus (2019-nCoV) IgM/IgG detection in COVID-19, aiming to further improve the diagnostic and screening system of COVID-19.Methods:Blood samples were collected from 32 patients with COVID-19 (tested positive for 2019-nCoV nucleic acid by RT-PCR and presented with clinical symptoms) and 34 non-COVID-19 patients (tested negative for 2019-nCoV nucleic acid by RT-PCR and clinically confirmed as non-COVID-19 patients). Colloidal gold-based immunochromatography was used for rapid detection of 2019-nCoV IgM/IgG in these samples. The sensitivity and specificity of the test, and the correlation of serum 2019-nCoV IgM/IgG with disease course were analyzed.Results:Among the 32 COVID-19 patients, nine tested positive for 2019-nCoV IgM with a positive rate of 28.1% (9/32) and 25 positive for 2019-nCoV IgG with a positive rate of 78.1% (25/32). The total positive rate was 84.4% (27/32). Two of the 34 non-COVID-19 patients tested positive for 2019-nCoV IgG with a positive rate of 5.9% (2/34), while none of them was positive for 2019-nCoV IgM. The positive rates of serum IgM were 42.9% (3/7), 30.8% (4/13) and 16.7% (2/12) at 10-20 d, 21-30 d and 31-40 d after the patients developed the symptoms of COVID-19, respectively, which showed a decreasing tread with prolonged disease course. The positive rates of serum IgG in COVID-19 patients were 57.1% (4/7), 84.6% (11/13) and 83.3% (10/12) at 10-20 d, 21-30 d and 30-40 d after symptom onset. The rate showed an increasing trend with prolonged disease course and reached the peak in about 21-30 d.Conclusions:Serum 2019-nCoV IgM/IgG detection (using colloidal gold method) had high sensitivity (84.4%) and strong specificity (94.1%) in the diagnosis of 2019-nCoV infection. It had a great value in the diagnosis and screening of COVID-19 and could be used as a valuable complementary method to the COVID-19 diagnostic system due to its advantages of flexibility, rapidity and simplicity.
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OBJECTIVE@#To investigate the inhibitory effect of matrine on the proliferation of human non-small cell lung cancer (NSCLC) and explore the possible molecular mechanism.@*METHODS@#Cultured human NSCLC A549 cells were treated with 0.4, 0.8, 1.2, 1.6, and 2.0 g/L matrine for 24, 48 or 72 h. CCK-8 assay was used for measuring the changes in A549 cell viability. The morphological changes of the cells were observed under a fluorescence microscope, and flow cytometry was employed for analyzing the cell apoptosis. The effects of matrine and the PI3K specific inhibitor LY294002 (10 nmol/L) on AKT pathway and autophagy-related proteins in A549 cells were investigated using Western blotting.@*RESULTS@#Matrine significantly inhibited the proliferation of A549 cells in a time- and dose-dependent manner ( < 0.05). At the concentration of 1.6 g/L or higher, matrine caused obvious cell shrinkage and fragmentation and significantly increased floating cells; autophagy vacuoles could be observed in the cells after acridine orange staining. Within the concentrations range of 0.8-1.6 g/L, matrine time- and dosedependently increased the cell apoptosis. Treatment of the cells with 1.6 g/L matrine and 10 nmol/L LY294002 resulted in significantly lowered expressions of p-AKT and p-mTOR proteins and increased the expression of light chain 3B (LC 3B), an autophagy-related protein, as compared with those in the control cells ( < 0.05).@*CONCLUSIONS@#We demonstrate that matrine inhibits the proliferation and induces autophagy and apoptosis of A549 cells by deactivating AKT pathway, suggesting the potential of matrine as an anti-cancer agent for lung cancer.
Subject(s)
Alkaloids , Apoptosis , Autophagy , Carcinoma, Non-Small-Cell Lung , Cell Proliferation , Humans , Lung Neoplasms , Phosphatidylinositol 3-Kinases , Proto-Oncogene Proteins c-akt , Quinolizines , Signal Transduction , TOR Serine-Threonine KinasesABSTRACT
Objective@#To explore the risk factors for prognosis in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF), and to establish a prognostic model.@*Methods@#A total of 193 patients diagnosed with HBV-ACLF who were admitted to the Department of Infectious Diseases of the Third Hospital of Hebei Medical University were collected from 1st January 2013 to 1st November 2018 as a derivation cohort. Thirty-five patients diagnosed with HBV-ACLF who were admitted to the Fifth Hospital of Shijiazhuang during the period from 1st July 2017 to 1st November 2018 were collected as a validation cohort. The survival condition of all patients at week 12 of admission was observed. The risk factors associated with short-term prognosis were analyzed by using multivariate logistic regression analysis, and a logistic regression equation prediction model was established and verified. The diagnostic performance of the prognostic model was evaluated using the receiver operating characteristic (ROC) curve, and was compared with model for end-stage liver disease (MELD) scoring system, Child-Turcotte-Pugh (CTP) scoring system, sequential organ failure assessment (SOFA) scoring system and chronic liver failure (CLIF)-SOFA scoring system.@*Results@#Multivariate logistic regression analysis showed that age (odds ratio(OR)=2.133, 95% confidence interval(CI)1.033-4.405), total bilirubin (OR=3.371, 95%CI 1.610-7.060), serum creatinine (OR=4.448, 95%CI 1.697-11.661), hepatic encephalopathy (OR=5.313, 95%CI 2.463-11.461), and ascites (OR=2.959, 95%CI 1.410-6.210) were independent risk factors for predicting the short-term prognosis of patients with HBV-ACLF. The newly established logistic regression model (LRM)=-1.726+ 0.757×age+ 1.215×total bilirubin+ 1.049 2×serum creatinine+ 1.670×hepatic encephalopathy (with=1, without=0) + 1.085×ascites (with=1, without=0). The area under the ROC curve of the LRM for predicting the short-term prognosis of patients with HBV-ACLF was 0.82 (95%CI 0.76-0.88). Furthermore, the areas under the ROC curve of the models of MELD, CTP, SOFA, CLIF-SOFA were 0.67 (95%CI 0.60-0.75), 0.73 (95%CI 0.66-0.80), 0.77 (95%CI 0.70-0.83) and 0.72 (95%CI 0.65-0.80), respectively. The ROC-area under curve of the validation cohort was 0.81 (95%CI 0.65-0.97).@*Conclusions@#Age, total bilirubin, serum creatinine, hepatic encephalopathy, and ascites are independent risk factors for the prognosis of HBV-ACLF. The prognostic model established based on these factors can accurately predict the patients′ short-term prognosis, which is superior to MELD, CTP, SOFA and CLIF-SOFA.
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@#Firstly, three 3-arylcoumarins 4a- 4c were synthesized from p-aminophenylacetic acid and salicylaldehyde by Perkin condensation reaction and hydrochloric acid acidification; subsequent-amidation reaction of 4a- 4c with substituted benzoyl chlorides 6a- 6h furnished; ten 3-(4′-benzoyl amino-phenyl)coumarins 7a- 7j. The structures of all target compounds were fully characterised by NMR and ESI-MS. Those target compounds were screened for-glucosidase inhibitory and advanced glycation end products(AGEs)formation inhibitory activity. The results showed that compound 7f had good inhibitory activity against α-glucosidase(IC50=10. 84±0. 36 μmol/L); compound 7g possessed much more potent inhibitory activity against AGEs formation(IC50=5. 01±0. 55 μmol/L)than the positive control aminoguanidine hydrochloride(IC50=290. 31±7. 32 μmol/L). These results provided a theoretical basis for further research on antidiabetic drugs.
ABSTRACT
Objective@#To explore the effect of shared care model on diabetes management among patients with type 2 diabetes mellitus (T2DM), therefore, to establish a more efficient education and management model for patients with T2DM.@*Methods@#Through convenient sampling, a total of 210 patients with T2DM were recruited from the outpatient clinic of the endocrinology center at Luhe Hospital, Capital Medical University, Beijing, from August to October, 2017. Patients were equally divided into two groups (n=105/group): intervention group and control group.The intervention group completed 103 cases and the control group 100 cases.The intervention group adopted the shared care education model, while the control group followed the conventional education management model. The follow up time of the intervention group was 12 months. The levels of glycosylated hemoglobin (HbA1c), Body Mass Index (BMI) and diabetes self-management behaviors were collected at baseline and at 12-months and compared between two groups. Measurement data were examined by t-test and rank-sum test; Count data were examined by chi square test, P<0.05 was thought to be statistically significant.@*Results@#At 12-month following the implementation of the management models, the HbAlc and BMI of the intervention group were (6.47 ± 0.66)%, (22.28 ± 2.41) kg/m2, and those of the control group were (6.90 ± 0.61)%, (23.49 ± 1.59) kg/m2, respectively. There were significant differences between the two groups (t=-4.63, 0.00, P< 0.01). The intervention group had healthy diet, exercise, self-blood sugar monitoring, blood sugar monitoring in compliance with doctor's advice, self-foot examination and medication scores of (6.08 ± 1.34), (6.06 ± 1.59), (5.18 ± 2.00), (5.28 ± 1.99), (4.64 ± 2.54), (6.80 ± 0.55) respectively, while the control group had (5.43 ± 1.71), (5.46 ± 1.89), (4.27 ± 1.64), (4.23 ± 1.64), (3.57 ± 2.74), (5.30 ± 2.68) respectively. There were significant differences between the two groups (t=-4.03--2.73, P<0.05).@*Conclusion@#Compared with the traditional education and management model, the shared care model with a multi-disciplinary approach is more patient-centered, and could provide systematic, standardized and personalized management for patients with T2DM and showed greater improvement in diabetes management.