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Objective To construct a human health literacy indicator system for prevention of parasitic diseases based on Delphi method. Methods Based on literature reviews and expert interviews, a questionnaire was designed and a two-round Delphi consultation was performed. A human health literacy indicator system for prevention of parasitic diseases was constructed according to the deletion criteria and experts’ advice. Results A total of 14 experts completed the two-round consultation. The second-round authority coefficients were 0.91 to 0.96 for the first-level indicators, 0.87 to 0.97 for the second-level indicators and 0.86 to 0.97 for the third-level indicators. A human health literacy indicator system for prevention of parasitic diseases was constructed with the main framework of basic knowledge and awareness, healthy behaviors, and healthy skills, which contained 3 first-level indicators, 12 second-level indicators and 48 third-level indicators. Among the three first-level indicators, basic knowledge and awareness had the highest weighting coefficient (0.336 5), followed by healthy behaviors (0.334 9), and healthy skills had the lowest weighting coefficient (0.328 6). The three secondary-level indicators with the highest combined weights included awareness of the epidemic status (0.088 2), awareness of the resource of infection (0.085 8) and basic awareness of parasitic diseases (0.085 5). Conclusion A human health literacy indicator system for prevention of parasitic diseases is preliminarily constructed, which provides insights into the development of health literacy evaluation tools for prevention of parasitic diseases in the new era.
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Objective@#The objective of this study was to analyze the different brain oxygen metabolism statuses in preeclampsia using magnetic resonance imaging and investigate the factors that affect cerebral oxygen metabolism in preeclampsia. @*Materials and Methods@#Forty-nine women with preeclampsia (mean age 32.4 years; range, 18–44 years), 22 pregnant healthy controls (PHCs) (mean age 30.7 years; range, 23–40 years), and 40 non-pregnant healthy controls (NPHCs) (mean age 32.5 years; range, 20–42 years) were included in this study. Brain oxygen extraction fraction (OEF) values were computed using quantitative susceptibility mapping (QSM) plus quantitative blood oxygen level-dependent magnitude-based OEF mapping (QSM + quantitative blood oxygen level-dependent imaging or QQ) obtained with a 1.5-T scanner. Voxel-based morphometry (VBM) was used to investigate the differences in OEF values in the brain regions among the groups. @*Results@#Among the three groups, the average OEF values were significantly different in multiple brain areas, including the parahippocampus, multiple gyri of the frontal lobe, calcarine, cuneus, and precuneus (all P-values were less than 0.05, after correcting for multiple comparisons). The average OEF values of the preeclampsia group were higher than those of the PHC and NPHC groups. The bilateral superior frontal gyrus/bilateral medial superior frontal gyrus had the largest size of the aforementioned brain regions, and the OEF values in this area were 24.2 ± 4.6, 21.3 ± 2.4, and 20.6 ± 2.8 in the preeclampsia, PHC, and NPHC groups, respectively. In addition, the OEF values showed no significant differences between NPHC and PHC. Correlation analysis revealed that the OEF values of some brain regions (mainly involving the frontal, occipital, and temporal gyrus) were positively correlated with age, gestational week, body mass index, and mean blood pressure in the preeclampsia group (r = 0.361–0.812). @*Conclusion@#Using whole-brain VBM analysis, we found that patients with preeclampsia had higher OEF values than controls.
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This study investigated the intervention effect of Guanxinning Tablet on human umbilical vein endothelial cells (HUVECs) injury induced by oxidized low density lipoprotein (ox-LDL), providing experimental basis for Guanxinning Tablet in the treatment of atherosclerosis-related diseases. Under the damage of HUVECs by ox-LDL, the cell viability was detected by CCK-8 (cell counting kit-8) assay; lactate dehydrogenase (LDH) in the cell culture supernatant was detected by the corresponding kit; the cell morphology of different groups was observed by common phase contrast microscope; reactive oxygen species (ROS) and NO levels in the cells were detected by DCFH-DA and DAF-FM DA probes, respectively; monocyte adhesion assay was used to detect the recruitment of THP-1 in HUVECs, and TMRM dye was used to detect the level of mitochondrial membrane potential; interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and monocyte chemoattractant protein-1 (MCP-1) secretion in the cells was detected by ELISA assay. The results showed that Guanxinning Tablet had a concentration-dependent proliferative effect on HUVECs. Under the stimulation of 100 μg·mL-1 ox-LDL, the morphology of endothelial cells was significantly changed. At this time, NO level was significantly decreased, ROS level was significantly increased and accompanied by a decrease in mitochondrial membrane potential. The recruitment of THP-1 cells by endothelial cells and IL-6, ICAM-1 and MCP-1 were also significantly increased, resulting in oxidative stress and inflammatory injury. Guanxinning Tablet and its composed extracts could significantly improve cell morphology, increase NO level, decrease ROS production, and also reduce the secretion of inflammation-related proteins IL-6 and MCP-1. Salvia miltiorrhiza and Ligusticum striatum DC. have significant synergistic effects on NO. Among them, salvianolic acid B and salvianic acid A exerted the main effects, and the combined efficacy of salvianic acid A and ferulic acid was superior to that of single administration. The above results showed that Guanxinning Tablet and their active substances had the effects of improving endothelial basal function, resisting oxidative stress, and alleviating inflammatory injury, and Salvia miltiorrhiza and Ligusticum striatum DC. synergized, which may be related to their regulation of oxidative stress and inflammation and have application prospects in the treatment of atherosclerosis-related diseases.
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ObjectiveTo investigate the deafness genetic mutation spectrum in nonsyndromic hearing impairment (NSHI) associated with enlarged vestibular aqueducts (EVA). MethodsFrom October, 2015 to August, 2016, 85 patients with NSHI from Hubei Yichang Special Education School were examined with temporal bone CT, and 20 deafness-related gene mutations in GJB2, GJB3, SLC26A4 and mtDNA 12S rRNA were detected with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. ResultsA total of 31 patients were found EVA with temporal bone CT. Compared with non-EVA patients, the proportion of deafness-related gene mutations was more in patients with EVA (χ2 = 11.160, P = 0.001), especially for c.919-2A>G mutation of SLC26A4 (χ2 = 23.870, P < 0.001). ConclusionThe deafness gene mutation spectrum is different in NSHI patients with or without EVA. It is needed to optimize genetic testing scheme for deafness for early diagnosis and intervention of NSHI associated with EVA.
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Objective To investigate the HPV vaccination status of children aged 9-14 years, parents’ vaccine-related cognition, willingness to vaccinate children and their influencing factors. Methods From January to April 2021, the convenience sampling method was used to collect data based on the online platform and the Department of Pediatrics and Adolescent Gynecology of the Children's Hospital of Zhejiang University School of Medicine. The data were analyzed by descriptive analysis, Chi-square test, and logistic regression. Results A total of 864 questionnaires were collected, and 846 valid questionnaires were obtained after screening, with an effective rate of 97.9%. 13.57% of mothers and 3.09% of girls were vaccinated, and the vaccine awareness rate was 68.43%. 87.22% of parents were willing to bring their children for vaccination. Risk perception (OR=4.79, 95% CI: 2.22-10.35), willingness to vaccinate themselves (OR =29.01, 95% CI: 12.62-66.69), awareness of sex education (OR =3.73, 95% CI: 1.08-12.83) and whether the vaccines were free (P<0.001) were related to whether parents were willing to vaccinate their children. Conclusion Parents of children aged 9-14 have high awareness of HPV and HPV vaccine and are willing to vaccinate their children with HPV vaccine , but the vaccination rate in children is low. Disease perception, willingness to vaccinate, awareness of sex education, and whether vaccines are free are all the factors influencing parents' willingness to vaccinate children.
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Sepsis is a life-threatening organ dysfunction caused by dysregulation of the body's response to infection. It is one of the common and serious complications in clinically critical patients with trauma, burn, shock, infection, etc., with high morbidity and mortality. Although the treatment of sepsis has made great achievements in clinical practice, the mortality of patients with sepsis is still increasing due to its secondary complications. Septic cardiomyopathy (SCM) is one of the major complications that threaten septic patient's life. SCM refers to myocardial dysfunction with the aggravation of the primary disease, which is manifested by biventricular dilatation accompanied by a decrease in left ventricular ejection fraction (LVEF). It is one of the major complications that threaten the life of patients with sepsis. The existing research shows that the mechanism of SCM includes myocardial mitochondrial dysfunction, myocardial cell apoptosis, calcium circulation disorder and its treatment including conventional treatment, β 1 receptor blocker treatment and traditional Chinese medicine treatment, etc. This paper reviewed the pathogenesis of SCM and its related, in order to provide references for the rational diagnosis and treatment of SCM.
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Sepsis is a disease caused by pathogenic microorganisms such as bacteria, which is characterized by host response disorder, organ dysfunction and high mortality. In early stage, it is mainly inflammatory reaction, howeverin late stage, it is mainly immunosuppression. It is a little pale to explain the poorprognosis caused by sepsis only by severe infection and immunosuppression. From the perspective of the absolute mortality of sepsis over the world, the battle against sepsis has not won a comprehensive victory. It has been 10 years since "ferroptosis" was formally proposed by Dixionet al. in 2012. The research areahas never decreased from the initial tumor related diseases to nervous system diseases and cardiovascular system diseases, and has made some progress. At present, in the context of sepsis, it is found that ferroptosis plays an increasingly important role in organ dysfunction, and also has an important impact on the treatment and prognosis of the disease. This article summarizes the related pathways and interventions of several major ferroptosis at present, in order to have a more comprehensive understanding of the pathogenesis of sepsis, seek new treatment targets, optimize diagnosis and treatment strategies, and improve survival rate, quality of life and clinical prognosis.
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Objective:To explore the basic characteristics of various types of intensive care unit (ICU) patients and the predictive value of six common disease severity scores in critically ill patients on the first day on the 28-day death risk.Methods:The general information, disease severity scores [acute physiology score Ⅲ (APSⅢ), Oxford acute disease severity (OASIS) score, Logistic organ dysfunction score (LODS), simplified acute physiology score Ⅱ (SAPSⅡ), systemic inflammatory response syndrome (SIRS) score and sequential organ failure assessment (SOFA) score], prognosis and other indicators of critically ill patients admitted from 2008 to 2019 were extracted from Medical Information Mart for Intensive Care-Ⅳ 2.0 (MIMIC-Ⅳ 2.0). The receiver operator characteristic curve (ROC curve) of six critical illness scores for 28-day death risk of patients in various ICU, and the area under the ROC curve (AUC) was calculated, the optimal Youden index was used to determine the cut-off value, and the AUC of various ICU was verified by Delong method.Results:A total of 53 150 critically ill patients were enrolled, with medical ICU (MICU) accounted for the most (19.25%, n = 10 233), followed by cardiac vascular ICU (CVICU) with 17.78% ( n = 9 450), and neurological ICU (NICU) accounted for the least (6.25%, n = 3 320). The patients in coronary care unit (CCU) were the oldest [years old: 71.79 (60.27, 82.33)]. The length of ICU stay in NICU was the longest [days: 2.84 (1.51, 5.49)] and accounted for the highest proportion of total length of hospital stay [63.51% (34.61%, 97.07%)]. The patients in comprehensive ICU had the shortest length of ICU stay [days: 1.75 (0.99, 3.05)]. The patients in CVICU had the lowest proportion of length of ICU stay to total length of hospital stay [27.69% (18.68%, 45.18%)]. The six scores within the first day of ICU admission in NICU patients were lower than those in the other ICU, while APSⅢ, LODS, OASIS, and SOFA scores in MICU patients were higher than those in the other ICU. SAPⅡ and SIRS scores were both the highest in CVICU, respectively. In terms of prognosis, MICU patients had the highest 28-day mortality (14.14%, 1 447/10 233), while CVICU patients had the lowest (2.88%, 272/9 450). ROC curve analysis of the predictive value of each score on the 28-day death risk of various ICU patients showed that, the predictive value of APSⅢ, LODS, and SAPSⅡ in comprehensive ICU were higher [AUC and 95% confidence interval (95% CI) were 0.84 (0.83-0.85), 0.82 (0.81-0.84), and 0.83 (0.82-0.84), respectively]. The predictive value of OASIS, LODS, and SAPSⅡ in surgical ICU (SICU) were higher [AUC and 95% CI were 0.80 (0.79-0.82), 0.79 (0.78-0.81), and 0.79 (0.77-0.80), respectively]. The predictive value of APSⅢ and SAPSⅡ in MICU were higher [AUC and 95% CI were 0.84 (0.82-0.85) and 0.82 (0.81-0.83), respectively]. The predictive value of APSⅢ and SAPSⅡ in CCU were higher [AUC and 95% CI were 0.86 (0.85-0.88) and 0.85 (0.83-0.86), respectively]. The predictive value of LODS and SAPSⅡ in trauma ICU (TICU) were higher [AUC and 95% CI were 0.83 (0.82-0.83) and 0.83 (0.82-0.84), respectively]. The predictive value of OASIS and SAPSⅡ in NICU were higher [AUC and 95% CI were 0.83 (0.80-0.85) and 0.81 (0.78-0.83), respectively]. The predictive value of APSⅢ, LODS, and SAPSⅡ in CVICU were higher [AUC and 95% CI were 0.84 (0.83-0.85), 0.81 (0.80-0.82), and 0.78 (0.77-0.78), respectively]. Conclusions:For the patients in comprehensive ICU, MICU, CCU, and CVICU, APSⅢ or SAPSⅡ can be applied for predicting 28-day death risk. For the patients in SICU and NICU, OASIS or SAPSⅡ can be applied to predict 28-day death risk. For the patients in TICU, SAPSⅡ or LODS can be applied for predicting 28-day death risk. For CVICU patients, APSⅢ or LODS can be applied to predict 28-day death risk.
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Objective:To identify the proteins differentially expressed in extraocular muscles between restrictive strabismus patients with thyroid-associated ophthalmopathy (TAO) and concomitant esotropia patients by proteomic analysis using tandem mass tag (TMT).Methods:Extraocular muscles samples from 5 restrictive strabismus patients with TAO and 5 concomitant esotropia patients were collected at Peking University People's Hospital from August 2019 to December 2020.All the patients received strabismus surgery.Differentially expressed proteins (DEPs) in extraocular muscles samples were identified by quantitative proteomic analysis and bioinformatic analysis based on TMT.Fold change≥1.2 or≤0.83 and P value<0.05 was regarded as the threshold to screen DEPs.GO annotation, KEGG pathways enrichment analysis and protein-protein interaction (PPI) network of DEPs were conducted through UniProtGOA and STRING.This study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.2021PHB058-001). Results:A total of 53 DEPs were identified, 34 of which were up-regulated and 19 were down-regulated.The biological processes DEPs mainly participated included response to stimulation, multicellular organismal process, metabolism, developmental process, intracellular signal transduction, and positive regulation of biological process.DEPs were involved in pathways including focal adhesion, tight junction, regulation of action cytoskeleton, and apoptosis.Six key proteins identified using PPI network were myosin heavy chain 2, myosin heavy chain 7, myosin regulatory light chain, α-actinin-2, fibrinogen alpha chain and fibrinogen beta chain.Conclusions:There are DEPs in extraocular muscles between restrictive strabismus patients with TAO and concomitant esotropia patients.Myosin, actinin and filamin may be involved in the pathogenesis of TAO through regulation of actin cytoskeleton and focal adhesion.
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Objective:To establish a nomograph prediction model of early critical changes in children with febrile convulsion, and to provide guidance for the prevention and nursing of children with febrile convulsion.Methods:Convenient sampling method was adopted to select 384 children with febrile convulsion in Anhui Children ′s Hospital from January 2018 to April 2021 as the research objects. Based on pews, the children with febrile convulsion were divided into 334 cases of non risk group and 50 cases of risk group. Binary Logistic regression analysis were used to determine the independent risk factors affecting the early critical changes of children with febrile convulsion. A nomogram was drawn based on the independent risk factors. The discrimination and consistency of the model were verified by model ROC curve and Hosmer Lemeshow goodness of fit.The external validation of model prediction efficiency were verified by validation data. Results:Binary Logistic regression analysis showed that age, respiratory rhythm disorder, unconsciousness, breath rate, heart rate, neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), duration of first convulsion and mean body temperature after first convulsion were influence factors for early critical changes in children with febrile convulsion ( P<0.05). The C-index of the model was 0.974 (95% CI 0.954-0.993), and the C-index of the external validation of the model was 0.922 (95% CI 0.880-0.966). The results of H-L fitting test showed that the difference was not statistically significant( χ2=0.29, P>0.05). Conclusions:The early critical changes of children with febrile convulsion may be affected by respiratory rhythm disorder, confusion of consciousness, breath rate, heart rate, NLR, RDW, duration of the first convulsion, mean temperature after the first convulsion and other factors. Pediatric emergency department should collect corresponding intervention measures for children with febrile convulsion according to the establishment of prediction model to prevent their early deterioration.
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Objective:To investigate the lymphocyte subsets and clinical characteristics of children with abnormal reaction to Bacillus Calmette-Guérin(BCG)vaccination.Methods:A total of 35 children with BCG disease diagnosed in the Children′s Hospital Affiliated to Xi′an Jiaotong University from January 2013 to December 2019 were enrolled retrospectively.Patients with strong local reaction and lymphadenitis after vaccine injection were selected as the localized group, and with lymphadenitis complicated with distant organ involvement were classified as the disseminated group.The differences in clinical infection indicators, demographic data, lymphocyte subsets and prognosis between the two groups were compared.Results:There are 25 cases in the localized group and 10 cases in the disseminated group, male 20 cases and female 15 cases.Compared with the localized group, the incidence of cough, fever and growth retardation all increased in the disseminated group, with statistical significance(all P<0.05). Lymphocyte ratio[(61.14±18.61)% vs.(39.64±31.45)%], T lymphocytes [CD3 + (×10 6/L): (1 821±487)vs.(1 065±539)], helper/inducible T lymphocytes[CD3 + CD4 + (×10 6/L): (1 058±357)vs.(445±140)], double positive T lymphocytes[CD3 + CD4 + CD8 + (×10 6/L): (24.07±7.17)vs.(14.10±8.89)], CD4 + /CD8 + ratio[CD4 + /CD8 + (%): (1.65±0.73)vs.(1.00±0.25)], natural killer cells[CD16 + CD56 + (×10 6/L): (19.70±2.34)vs.(12.76±7.01)]were lower in the disseminated group than those in the localized group and the differences were significant(all P<0.05). In the disseminated group, 6 cases were diagnosed with immunodeficiency disease and 7 cases died during the follow-up period.All the children in the localized group were cured. Conclusion:Most BCG reaction have a good prognosis, while disseminated children combined with primary immune deficiency have worst prognosis.Early lymphocyte subsets analysis is effective for BCG disease screening.
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Neonatal hyperammonemia has great damage to the central nervous system, which can lead to severe disability and even death.Early reduction of blood ammonia and shortening the duration of hyperammonemia coma can improve the poor prognosis of the central nervous system.Renal replacement therapy can reduce blood ammonia quickly and effectively which is an important treatment for neonatal hyperammonemia.Common kidney replacement therapies include peritoneal dialysis, intermittent hemodialysis, continuous renal replacement therapy and hybrid therapy.This review aims to elaborate the indications of renal replacement therapy, the advantages and disadvantages of various renal replacement therapy modes in the treatment of neonatal hyperammonemia and hybrid therapy.
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Objective To investigate the bacterial community diversity in Dermatophagoides farinae. Methods Laboratory-cultured D. farinae was collected, and the composition of microbial communities was determined by sequence analyses of the V4 region in the bacterial 16S ribosomal RNA (16S rRNA) gene on an Illumina PE250 high-throughput sequencing platform. Following quality control and filtering of the raw sequence files, valid reads were obtained and subjected to operational taxonomic units (OTU) clustering and analysis of the composition of microbial communities and alpha diversity index using the Usearch software, Silva database, and Mothur software. Results A total of 187 616 valid reads were obtained, and 469 OTUs were clustered based on a sequence similarity of more than 97%. OTU annotation showed that the bacteria in D. farinae belonged to 26 phyla, 43 classes, 100 orders, 167 families and 284 genera. The bacteria in D. farinae were mainly annotated to five phyla of Proteobacteria, Firmicutes, Bacteroidota, Actinobacteriota, and Acidobacteriota, with Proteobacteria as the dominant phylum, and mainly annotated to five dominant genera of Ralstonia, norank-f-Mitochondria, Staphylococcus and Sphingomonas, with Wolbachia identified in the non-dominant genus. Conclusions A high diversity is identified in the composition of the bacterial community in D. farinae, and there are differences in bacterial community diversity and abundance among D. farinae.
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The rare edible and medicinal fungus Antrodia cinnamomea has a substantial potential for development. In this study, Illumina HiSeq 2000 was used to sequence its transcriptome.The results were assembled de novo, and 66,589 unigenes with an N50 of 4413 bp were obtained. Compared with public databases, 6,061, 3,257, and 2,807 unigenes were annotated to the Non-Redundant, Gene Ontology, and Kyoto Encyclopedia of Genes and Genomes databases, respectively. The genes related to terpene biosynthesis in the mycelia of A. cinnamomea were analyzed, and acetyl CoA synthase (ACS2 and ACS4), hydroxymethylglutaryl CoA reductase (HMGR), farnesyl transferase (FTase), and squalene synthase (SQS) were found to be upregulated in XZJ (twig of C. camphora) and NZJ (twig of C. kanehirae). Moreover, ACS5 and 2,3-oxidized squalene cyclase ( OCS) were highly expressed in NZJ, while heme IX farnesyl transferase (IX-FIT) and ACS3 were significantly expressed in XZJ. The differential expression of ACS1, ACS2, HMGR, IX-FIT, SQS, and OCS was confirmed by real-time quantitative reverse transcription PCR. This study provides a new concept for the additional exploration of the molecular regulatory mechanism of terpenoid biosynthesis and data for the biotechnology of terpenoid production.
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Objective:To compare the efficacy of pars plana vitrectomy (PPV) and nonvitrectomizing vitreous surgery (NVS) in the treatment of idiopathic epimacular membrane (IMEM).Methods:A prospective , randomized and comparative clinical study. From April 2019 to May 2020, 21 eyes of 21 patients with IMEM diagnosed in Chongqing Aier Eye Hospital were included in the study. Among them, 11 males had 11 eyes, and 10 females had 10 eyes. Best-corrected visual acuity (BCVA), optical coherence tomography angiography (OCTA), and corneal, intraocular, and global aberration measurements were performed in all eyes. The international standard logarithmic visual acuity chart was used for BCVA examination, and the visual acuity was converted into logarithm of minimum angle of resolution (logMAR) during statistics. The iTrace visual function analyzer was used to measure the corneal, intraocular and whole ocular aberrations, and the dysfunction lens index (DLI) was calculated. Lens density in Scheimpflug images was calculated using Pentacam three-dimensional anterior segment analysis and diagnosis system. The 6 mm×6 mm area of the macular area was scanned by OCTA, which was divided by the software automatically into three concentric circles with the fovea as the center, namely the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, The outer ring area of 3-6 mm was used to measure the superficial vessel density (SVD) and superficial perfusion density (SPD) of the entire macular area, the central area, the inner ring area, and the outer ring area. The patients were divided into PPV combined with epimacular membrane (MEM) peeling group (PPV group) and NVS direct peeling MEM group (NVS group) by random number table method, 10 cases with 10 eyes and 11 cases with 11 eyes, respectively. The age of the two groups ( t=-0.72), logMAR BCVA ( t=-0.98), lens density ( t=-1.10), DLI ( t=1.15), SVD ( t=0.82) and SPD ( t=1.19) of entire macular area, corneal aberration ( t=0.45), intraocular aberration ( t=-0.22), and whole eye aberration ( t=0.83), there was no significant difference ( P>0.05). All eyes were operated on with a 27G vitrectomy system. The MEM was removed from the eyes of the NVS group under NVS condition, and the MEM was removed from the eyes of the PPV group under the condition of PPV, and the operation time was recorded at the same time. The follow-up period after surgery was 12 months. Relevant examinations were performed using the same equipment and methods before surgery. Taking the last follow-up as the time point for efficacy judgment, the BCVA, lens opacity, DLI, visual quality, SVD, SPD and MEM recurrence in the macula were compared between the two groups. The two groups were compared by paired t test. Results:The operation time of eyes in PPV group and NVS group was 20.81±3.52 and 5.70±1.30 min, respectively, and the difference was statistically significant ( t=7.23, P<0.001). At the last follow-up, the logMAR BCVA of PPV group and NVS group were 0.65±0.25 and 0.44±0.20, respectively, and the difference was statistically significant ( t=-2.16, P=0.04); compared with before operation, the BCVA of eyes of the two groups was significantly improved, and the difference was statistically significant. ( t=2.52, 4.41; P=0.033, P<0.001). The lens density and DLI of the affected eyes in the PPV group and NVS group were 10.64±1.58, 6.24±3.99 and 5.77±1.63, 7.74±1.55, respectively, and the differences were statistically significant ( t=-3.90, 2.85; P<0.05). The macular area SVD ( t=1.03), SPD ( t=1.77), corneal aberration ( t=-0.42), intraocular aberration ( t=-1.10), and whole-eye aberration ( t=-1.17) of eyes of the two groups, the difference was not statistically significant ( P>0.05). During the follow-up period, there were 2 eyes with MEM recurrence, 1 eye in the PPV group and 1 eye in the NVS group; there was no significant difference in the recurrence rate of MEM between the two groups ( χ2=0.005, P=0.94). Conclusion:Compared with PPV combined with MEM stripping, the BCVA after NVS surgery increases more, has a better protective effect on the lens, and has a shorter operation time.
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Objective:To create radiomics models based on abbreviated multimodal magnetic resonance imaging (MRI) for the diagnosis of breast cancer.Methods:All breast MR imaging data between Jun 2014 and Mar 2019 were retrospectively collected. Patients with pathological results of puncture or surgical resection were involved in this study. One thousand three hundred and six patients (416 benign and 890 breast cancer) were divided into training cohort ( n=702), internal validation cohort ( n=302), and external validation cohort ( n=302). All images were reduced to: the joint model group [including T2 weighted imaging (T2WI), DWI (diffusion-weighted imaging) and first contrast-enhanced sequences], non-enhanced group (T2WI and DWI) and single-phase enhanced group (first contrast-enhanced sequences). Analysis of variance (ANOVA) and least absolute shrinkage and selection operator (LASSO) were used to reduce the dimension of texture features. Three supervised machine learning algorithms (Bagging decision tree, Gaussian process, support vector machine) were used to predict benign and malignant breast lesions, and the best classifier was selected to construct breast cancer diagnosis model. Models were validated by internal and external validation cohorts. Results:The Gaussian process algorithm was chosen. The area under the curve (AUC) of the joint model and the non-enhanced model for predicting breast cancer were 0.903 and 0.893 for the training cohort, 0.893 and 0.863 for the internal validation cohort, and 0.878 and 0.864 for the external validation cohort.Conclusions:The radiomics model based on abbreviated multimodal MRI can accurately diagnose breast cancer. And the non-enhanced model can accurately diagnose breast cancer without contrast enhancement, which provides feasibility for simplifying the diagnosis process.
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Objective:To investigate the relationship between plasma fibrinogen(FIB) levels and early neurological deterioration(END) in elderly patients with type 2 diabetes mellitus(DM) after acute cerebral infarction(ACI).Methods:136 ACI patients admitted to the neurology department of our hospital from January 2018 to December 2019 were included as study subjects.Patients were divided into an END group and a non-END group based on whether END occurred.Univariate and multivariate analyses were conducted to assess the relationship between FIB and END.Elderly patients with concurrent ACI and DM were divided into an END group(18 cases)and a non-END group(26 cases)for propensity score matching analysis.After matching adjustment, age, sex, hypertension, TOAST classification and FIB were analyzed by multivariate Logistic regression.Results:Among 136 patients with ACI, 38(27.9%)had END and 98(72.1%)did not have END and the END group had higher values or percentages than the non-END group in age[(62.3±2.4)ys and(59.2±1.8)ys, t=2.035, P=0.044], history of hypertension(76.3% and 57.1%, χ2=4.295, P=0.038), history of diabetes(47.4% and 26.5%, χ2=5.433, P=0.020), NIHSS score[(8.5±5.7)and(6.1±4.6), t=2.548, P=0.012], TOAST classification(large artery atherosclerosis: 65.8% vs.40.8%, cardioembolism: 5.3% vs.10.2%, small artery occlusion: 23.7% vs.23.5%, other determined cause: 2.6% vs.20.4%, undetermined cause: 2.6% vs.5.1%, χ2=10.314, P=0.035), blood glucose[(8.89±1.28)mmol/L and(7.36±1.64)mmol/L, t=6.048, P=0.000]and FIB level[(3.57±1.33)g/L and(3.07±1.14)g/L, t=2.236, P=0.027]. Multiple regression analysis showed that higher FIB levels were not associated with END( P>0.05). Propensity score matching analysis of 44 patients with concurrent ACI and DM showed that history of hypertension, NIHSS score and FIB level before matching were significantly higher in the END group than in the non-END group( P<0.05)and FIB was higher in the END group than in the non-END group after matching.Multiple regression analysis showed that FIB was significantly associated with END. Conclusions:Increased FIB levels are positively correlated with END in patients with diabetes following acute ischemic stroke and possess good predictive value.
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Objective:To observe the changes in hippocampus (CA1) and study the effect of chronic intermittent hypobaric hypoxia (CIHH) preconditioning on the memory and cognitive function of mice exposed to the whole brain irradiation.Methods:A total of 48 C57BL/6 male mice were randomly divided into control group, CIHH group, irradiation group (IR group) and CIHH+ IR group. For IR group, the whole brain of mice were irradiated with 10 Gy of 6 MV X-rays in a single fraction. Pretreatment with CIHH was performed by placing mice in a hypobaric chamber before radiation. The mirrors water maze experiment was performed in the four groups to observe the escape latency, the number of crossing platforms and the target quadrant residence time. Nissl staining was used to observe the changes of neuronal cells in hippocampal CA1 region. Immunofluorescence was used to detect the expression of microtubule-associated protein cells (DCX) in the subgranular zone (SGZ) of hippocampal dentate gyrus (DG) to evaluate neurogenesis.Results:After 30 days of whole brain irradiation, the escape latency of mice prolonged gradually, the frequency of crossing platform decreased ( P< 0.001), and the exploration time in the target quadrant decreased ( P<0.001). X-ray irradiation caused disorder of mice neuronal cells, degeneration and necrosis of neuronal cells, and decrease of DCX expression in CA1 region of mice. Compared with IR group, the CIHH+ IR group had shortened the escape latency, increased the frequency of crossing platform [(2.08±0.26) vs. (0.83±0.24), P<0.001], and also increased the exploration time in the target quadrant [(14.12±0.82)s vs. (7.42±0.73)s, P<0.001]. Pretreatment with CIHH also alleviated the deformation and necrosis of neurons in hippocampus, and increased DCX expression in CA1 region. Conclusions:Pretreatment of mice with CIHH plays a protective role in radiation induced hippocampal injury.
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Objective:To explore CT imaging features related to disease-free survival (DFS) for gastric cancer (GC) patients with no clinical lymph node metastasis (cN0).Methods:From January 2005 to December 2018, 298 patients with GC were collected retrospectively in Peking University People′s Hospital. All the patients performed CT scanning before operation, and cT1-4N0M0 was defined by CT images. The clinical tumor stage (cT), extramural vessel invasion (EMVI), tumor morphological type, location and size were defined and recorded based on preoperative contrast-enhanced CT images. According to the pathological results, the patients were divided into pT1-2, pT3-4, pN0, and pN1-3 subgroups, with 148, 150, 135, and 163 cases, respectively. Progressive events and corresponding time were recorded during follow-up. DFS was defined as the time from radical operation to progressive events; if no progressive events occurred, DFS was defined as the time from radical operation to the last follow-up. The Kaplan-Meier curve and log-rank test were used to analyze the differences in cumulative DFS among patients with different CT imaging features, and Cox survival analysis was used to explore the independent CT imaging risk factors affecting DFS of cN0 patients. The log-rank test was used to test the effect of independent risk factors on cumulative DFS in different subgroups.Results:The follow-up time of enrolled patients was 36.0 (14.9, 59.3) months. The 3-year cumulative DFS rates of cT3-4 and cT1-2 GC patients were 61.2% and 85.6%, respectively, and the difference of DFS was statistically significant (χ 2=22.72, P<0.001). The 3-year cumulative DFS rate of EMVI-positive patients was 46.3%, which was lower than that of EMVI-negative patients (77.1%), and the difference was statistically significant (χ 2=21.34, P<0.001). There was no significant difference in 3-year cumulative DFS between different tumor locations and morphological types (χ 2=1.75, 1.73, P=0.189, 0.196). The difference in 3-year cumulative DFS between the tumor maximal diameter ≥3.4 cm and <3.4 cm groups was statistically significant (χ 2=17.58, P<0.001). On Cox survival analysis, cT (HR=5.203, P=0.001) and EMVI (HR=1.971, P=0.025) were independent risk factors for 3-year DFS in patients with cN0 GC. The results of subgroup analysis showed that the effect of EMVI on the 3-year DFS in pN0, pN1-3, pT1-2 and pT3-4 subgroups was statistically significant ( P<0.05). The effect of cT on the 3-year DFS was statistically significant in pN0, pN1-3, and pT1-2 subgroups ( P<0.05), but not in pT3-4 group (χ 2=2.58, P=0.108). Conclusion:cT and EMVI defined on preoperative CT examination are independently prognostic factors of 3-year DFS for patients with cN0 GC.
ABSTRACT
@#Proliferative vitreoretinopathy(PVR)is a common complication of perforation injury and surgery for rhegmatogenous retinal detachment. The pathogenesis of this disease is still unclear. However, studies have shown that retina pigment epithelium(RPE)cells have the ability to secrete cytokines, and many growth factors are overexpressed in vitreous or subretinal fluid in PVR patients. These growth factors and their receptors play an important role in the occurrence and development of PVR. When the blood-retinal barrier is broken, the physiological balance of growth factors disappears, and RPE cells are stimulated by growth factors to undergo epithelial-mesenchymal transformation(EMT), migration and proliferation, this leads to the formation of the preretinal membrane, which pulls on the retina and causes retinal detachment. In recent years, scholars have done a lot of researches on the signaling pathways, EMT process and cell proliferation involved in the formation of PVR with growth factors. This article will summarize the function of growth factors involved in the formation of PVR and the therapeutic effects of antagonistic growth factors in the development of PVR.