The influence of age on the recovery of sudden sensorineural hearing loss / 中国耳鼻咽喉头颈外科

OBJECTIVE To compare the influence of age on the recovery of sudden sensorineural hearing loss.METHODS Detailed medical data of patients were reviewed.The patients were diagnosed as sudden sensorineural hearing loss from Jan 2010 to June 2018 and accepted treatments with neurotrophic drugs,steroid or hyperbaric oxygen.Age grouping was performed by every 5 years'interval.The treatment efficacy and hearing improvement were compared according to the age.RESULTS There were one hundred and sixty-three patients in this study.The majority of patients had moderate or above hearing loss,and most of the hearing curve was flat and profound type.The overall recovery rate was 56.44%,hearing gain was averaged 21.88 dB.55-60 years group had largest number of patients in the 11 age groups.Even with different treatment,the patients aged 57-66 years had the bad recovery,including the hearing gain data and total effective rate.CONCLUSION Ages has influence on the recovery of sudden sensorineural hearing loss,it maybe correlated with the etiology and patients'condition.

Clinical characteristics and drug resistance of Klebsiella pneumoniae infections at different systems / 中国基层医药

Objective:To investigate the clinical characteristics and drug resistance of Klebsiella pneumoniae infections at different systems, providing laboratory reference for the rational use of antibiotics in clinical practice.Methods:The clinical characteristics and drug resistance of patients with Klebsiella pneumoniae infections in respiratory, urinary, hematologic, and other systems who received treatment in Wuzhou Red Cross Hospital from January 2015 to December 2021 were analyzed.Results:From 2015 to 2021, there were 3 496 cases of Klebsiella pneumoniae infections in the hospital, among which the respiratory system was most affected with 2 250 strains (64.34%). The sex ratio of patients with Klebsiella pneumoniae infections at different systems was statistically significant ( χ2 = 266.77, P < 0.001). The respiratory system and hematological system were more commonly infected by Klebsiella pneumoniae in men, while the urinary system was more commonly infected in women. The sex ratio of patients with Klebsiella pneumoniae infections at other systems were similar. The age distribution of patients with Klebsiella pneumoniae infections at different systems was significantly different ( χ2 = 176.54, P < 0.001). Klebsiella pneumoniae infections of the respiratory, urinary, and hematological systems were the most common in people aged > 60-80 years, while Klebsiella pneumoniae infections in other systems were mainly found in people aged > 18-60 years. There were significant differences in the distribution of departments among different Klebsiella pneumoniae infection systems ( χ2 = 1 415.30, P < 0.001). The ICU had the highest incidence of Klebsiella pneumoniae infections in the respiratory system, while the department of internal medicine had the highest incidence of Klebsiella pneumoniae infections in the urinary and hematological systems, and the department of surgery had the highest incidence of Klebsiella pneumoniae infections in other parts of the body. The resistance rate of Klebsiella pneumoniae to common antibiotics for the hematologic system was lower than that of the other three infection systems. For infections in the respiratory system, urinary system, and other body parts, the resistance rates of Klebsiella pneumoniae to amikacin, meropenem, imipenem, and piperacillin/tazobactam were all below 10%, while the resistance rate to tobramycin was below 20%, and the resistance rate to cephalosporins was around 30%. Conclusion:The proportion of Klebsiella pneumoniae infections in different body parts varies by gender, age, and department. For Klebsiella pneumoniae infections in the hematological system, the resistance rate to commonly used antibiotics is lower than that for infections in the other three systems. In contrast, Klebsiella pneumoniae infections in the respiratory system, urinary system, and other systems have a particularly high resistance rate to third- and fourth-generation cephalosporins but are still sensitive to piperacillin/tazobactam and carbapenem antibiotics.

Factors affecting the clinical decision-making expectations of patients undergoing digestive endoscopy / 中国基层医药

Objective:To investigate the influential factors of patients' expectations for clinical decision-making during digestive endoscopy.Methods:A total of 120 patients who underwent digestive endoscopy were admitted to the Endoscopy Center of Zhejiang Provincial People's Hospital from January 2020 to January 2022. Their general information was collected, and their clinical decision-making expectations were evaluated using the Control Preference Scale (CPS). The influential factors of clinical decision-making expectations were determined using multiple linear regression analysis.Results:The total CPS score for 120 patients undergoing digestive endoscopy was (50.72 ± 5.48) points, including (14.12 ± 1.48) points for information needs, (25.17 ± 3.52) points for communication needs, and (11.43 ± 2.04) points for decision-making needs. Univariate analysis showed that the CPS score of patients undergoing digestive endoscopy was related to gender, age, marital status, educational level, number of children, and type of visit ( t = 2.68, 2.61, 2.82, 3.28, 3.61, 2.39, all P < 0.05). Multiple linear regression analysis showed that gender, age, educational level, and type of visit were the influential factors of clinical decision-making expectations for patients undergoing digestive endoscopy ( β = -0.71, 1.07, 0.53, -1.15, all P < 0.05). Conclusion:Gender, age, educational level, and type of visit are influential factors of patients' expectations for clinical decision-making during digestive endoscopy. Patients have a clear need for communication during clinical decision-making, and medical staff can strengthen communication with patients, correctly guiding them to participate in clinical decision-making expectations.

Expression of miR-210-3p in the aqueous humor of patients with age-related cataracts and its effect on human lens epithelial cell injury induced by hydrogen peroxide / Expressão de miR-210-3p no humor aquoso de pacientes com catarata relacionada à idade e seu efeito na lesão de células epiteliais do cristalino humano induzida por peróxido de hidrogênio

ABSTRACT Purpose: The regulatory effect of microRNA on diseases has been confirmed. This study aimed to evaluate the expression of microRNA-210-3p in age-related cataracts and assess the effect of abnormal miR-210-3p expressions on H2O2-induced SAR01/04 cells. Methods: Reverse-transcription quantitative polymerase chain reaction method was performed to assess the levels of miR-210-3p in aqueous humor samples. Receiver operating characteristic analysis was employed to assess the discrimination ability of miR-210-3p between patients with age-related cataracts and healthy people, and Pearson correlation analysis was used to identify the correlation between miR-210-3p and oxidative stress indices such as superoxide dismutase, glutathione peroxidase, malonaldehyde. Cell counting kit-8 assay and Transwell assay were used to estimate the biological function of H2O2-induced age-related cataract cell model. The levels of oxidative stress indices such as superoxide dismutase, glutathione peroxidase, and malonaldehyde were measured to evaluate the degree of oxidative stress damage in the age-related cataract cell model. The relationship between miR-210-3p and its target gene was verified by luciferase reporter gene analysis. Results: The miR-210-3p expression was elevated in the aqueous humor of patients with age-related cataracts. A high miR-210-3p expression showed a high diagnostic value for age-related cataracts and was significantly associated with the level of oxidative stress markers in patients with age-related cataracts. The inhibition of miR-210-3p can reverse oxidative stress stimulation and adverse effects on H2O2-induced cell function. Conclusions: The results suggested that miR-210-3p could promote cell viability, cell migration, and oxidative stress by targeting autophagy-related gene 7 in in vitro age-related cataract cell model.

RESUMO Objetivo: O efeito regulador do microRNA em doenças tem sido confirmado, e este artigo tentou avaliar a expressão do microRNA-210-3p na catarata relacionada à idade e avaliar o efeito da expressão anormal do miR-210-3p em células SAR01/04 induzidas por H2O2. Métodos: O método de transcrição reversa seguida de reação em cadeia da polimerase (RT-PCR) quantitativa foi realizado para avaliar os níveis de miR-210-3p em amostras de humor aquoso. Análise de características operacionais do receptor foi feita para avaliar a capacidade de discriminação do miR-210-3p entre pacientes com catarata relacionada à idade e pessoas saudáveis. A análise de correlação de Pearson identificou a correlação do miR-210-3p e índices de estresse oxidativo, como superóxido dismutase, glutationa peroxidase, malonaldeído. O ensaio de contagem de células kit-8 (cck-8) e o ensaio no sistema Transwell foram utilizados para estimar a função biológica do formato de células de catarata relacionada com a idade induzida por H2O2. Os níveis de índices de estresse oxidativo como superóxido dismutase, glutationa peroxidase e malonaldeído foram detectados para avaliar o grau de dano do estresse oxidativo em formato de células de catarata relacionada à idade. A relação entre miR-210-3p e seu gene alvo foi verificada por análise do gene repórter luciferase. Resultados: A expressão miR-210-3p foi elevada no humor aquoso de pacientes com catarata relacionada à idade. A expressão miR-210-3p altamente expressiva mostrou alto valor diagnóstico para catarata relacionada à idade e foi significativamente associado ao nível de marcadores de estresse oxidativo em pacientes com catarata relacionada à idade. A inibição de miR-210-3p pode reverter a estimulação do estresse oxidativo e os efeitos adversos da função celular induzida por H2O2. Conclusões: Esses dados sugeriram que a expressão miR-210-3p poderia promover a viabilidade celular, migração celular e estresse oxidativo ao direcionar genes ATG 7 relacionados à autofagia em modelo in vitro de células de catarata relacionadas à idade.

Efeito da idade-período-coorte na mortalidade por câncer do colo do útero no Centro-Oeste do Brasil, 1980-2019 / Age-period-cohort effect on cervical cancer mortality in the Center-West of Brazil, 1980-2019 / Efecto edad-período-cohorte en la mortalidad por cáncer de cuello uterino en el Centro-Oeste de Brasil, 1980-2019

Objetivos: analisar o efeito da idade-período-coorte nas taxas de mortalidade por câncer do colo do útero no Centro-Oeste do Brasil. Métodos: estudo ecológico de séries temporais, de 1980 a 2019, cujas fontes de dados foram o Sistema de Informação sobre Mortalidade e as estimativas populacionais do Instituto Brasileiro de Geografia e Estatística. Modelos de efeito idade-período-corte com distribuição de Poisson foram usados. Resultados: observaram-se 19.260 óbitos, correspondente à taxa de mortalidade padronizada média de 17,23/100 mil mulheres. O efeito da idade indicou aumento progressivo das taxas com o avançar da idade. O efeito do período evidenciou redução do risco de morte no Distrito Federal (2015-2019), Mato Grosso do Sul (2010-2014) e Mato Grosso (2010-2019), além de aumento em Goiás (2015-2019). O efeito da coorte revelou aumento do risco de morte para as nascidas antes de 1950-1954 e redução nas gerações a partir de 1955-1959. Conclusão: há evidências de efeito da idade-período-coorte na mortalidade por câncer do colo do útero no Centro-Oeste brasileiro, o que demanda fortalecimento de ações para sua prevenção e controle voltadas para mulheres de coortes e idades sob maior risco de morrer por essa causa.

Objectives: to analyze the effect of age-period-cohort on cervical cancer mortality rates in the Center-West of Brazil. Methods: ecological time series study from 1980 to 2019, utilizing data from the Mortality Information System and population estimates from the Brazilian Institute of Geography and Statistics. Age-period-cohort effect models with Poisson distribution were employed. Results: 19,260 deaths were observed, corresponding to an average standardized mortality rate of 17.23/100,000 women. The age effect indicated a progressive increase in rates as age advanced. The period effect showed a reduction in the risk of death in the Federal District (2015-2019), Mato Grosso do Sul (2010-2014), and Mato Grosso (2010-2019), as well as an increase in Goiás (2015-2019). The cohort effect showed an increase in the risk of death for those born before 1950-1954 and a reduction in the generations from 1955-1959 onwards. Conclusion: there is evidence of an age-period-cohort effect on mortality from cervical cancer in the Brazilian Center-West, which calls for the strengthening of actions for its prevention and control aimed at women of cohorts and ages at greater risk of dying from this cause.

Objetivos: análisis del efecto de la edad-período-cohorte en las tasas de mortalidad por cáncer de cuello uterino en el centro-oeste de Brasil. Métodos:estudio de series temporales ecológicas, de 1980 a 2019, cuyas fuentes de datos fueron el Sistema de Información de Mortalidad y las estimaciones de población del Instituto Brasileño de Geografía y Estadística. Se utilizaron modelos de efecto edad-período-corte con distribución de Poisson. Resultados: se registraron 19.260 fallecimientos, lo que corresponde a una tasa media de mortalidad estandarizada de 17,23/100.000 mujeres. El efecto edad indicó un aumento progresivo de las tasas con el avance de la edad. El efecto período mostró una reducción del riesgo de muerte en el Distrito Federal (2015-2019), Mato Grosso do Sul (2010-2014) y Mato Grosso (2010-2019), así como un aumento en Goiás (2015-2019). El efecto cohorte mostró un aumento del riesgo de muerte para los nacidos antes de 1950-1954 y una reducción en las generaciones a partir de 1955-1959. Conclusión: hay evidencias de un efecto edad-período-cohorte en la mortalidad por cáncer de cuello uterino en el Centro-Oeste brasileño, lo que exige el refuerzo de las acciones para su prevención y control dirigidas a las mujeres de cohortes y edades con mayor riesgo de morir por esta causa.

Fertilización asistida con óvulos propios en mujeres mayores de 40 años: indicaciones y resultados

Las mujeres posponen su maternidad por el deseo de superación personal y profesional. Se conoce que la cantidad y calidad de los óvulos por ciclo dependen de la edad de la paciente. Las tasas de éxito en tratamientos de reproducción asistida disminuyen con la edad, especialmente después de los 40 años. Se observan tasas más altas de nacidos vivos en mujeres más jóvenes y las tasas disminuyen significativamente en mujeres mayores debido a la disminución de la fertilidad y el aumento de abortos espontáneos. Por ello, la edad es crucial al evaluar la posibilidad de un embarazo exitoso mediante tratamientos de reproducción asistida (TRA). Las indicaciones para realizar fertilización in vitro (FIV) con óvulos propios en mujeres mayores de 40 años incluyen iniciar lo más pronto procedimientos de alta complejidad, buena evaluación de la reserva ovárica con análisis de la hormona antimülleriana y conteo de folículos antrales para realizar asesoramiento genético, proponer FIV-inyección intracitoplasmática de espermatozoides (ICSI) antes de los 44 años, generar expectativas realistas y realizar consentimiento informado, con estadisticas propias. En la REDLARA, de todos los procedimientos de FIV-ICSI, el 34% de las pacientes tienen más de 40 años; se prefiere transferir blastocistos con prueba genética preimplantacional de aneuploidías (PGT-A) para seleccionar embriones euploides. Las tasas de éxito son bajas, inclusive cuando son tasas de embarazo por transferencia de un embrión en el grupo de mujeres ≥ 40 años (18,2% sin PGT, 42,7% con PGT en el IMRCRP). Se recomienda acumular óvulos o embriones realizando múltiples estimulaciones ováricas. Se debe optar por transferir un solo embrión para evitar complicaciones obstétricas con embarazos múltiples en pacientes ≥ 40 años, por el alto riesgo debido a la edad.

Women postpone motherhood because of their desire for personal and professional improvement. It is known that the quantity and quality of oocytes per cycle depends on the patient's age. Success rates in assisted reproduction treatments decrease with age, especially after 40 years of age. Higher live birth rates are observed in younger women, and rates decrease significantly in older women due to decreased fertility and increased miscarriages. Therefore, age is crucial when assessing the possibility of a successful pregnancy through assisted reproductive treatments (ART). The indications to perform in vitro fertilization (IVF) with own ovules in women older than 40 years include starting as soon as possible highly complex procedures, good evaluation of ovarian reserve with antimüllerian hormone analysis (AMH) and antral follicle count (AFC) for genetic counseling, proposing IVF-intracytoplasmatic sperm injection (ICSI) before the age of 44 years, generating realistic expectations and informed consent, with own statistics. At REDLARA, of all IVF-ICSI procedures, 34% of patients are over 40 years old; preference is given to transfer blastocysts with preimplantation genetic testing for aneuploidy (PGT-A) to select euploid embryos. Success rates are low, even when they are pregnancy rates per embryo transfer in the group of women ≥ 40 years (18.2% without PGT, 42.7% with PGT in IMRCRP). It is recommended to bank ovules or embryos by performing multiple ovarian stimulations. A single embryo transfer should be chosen to avoid obstetric complications with multiple pregnancies in patients ≤ 40 years, because of the high risk due to age.

Effect of age factors on pharmacodynamics of intranasal dexmedetomidine for sedation in pediatric patients undergoing transthoracic echocardiography / 中华麻醉学杂志

Objective:To evaluate the effect of age factors on the pharmacodynamics of intranasal dexmedetomidine for sedation in the pediatric patients undergoing transthoracic echocardiography(TTE).Methods:American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ pediatric patients, aged 1-24 months, undergoing TTE from August 2019 to May 2022, were selected. This trial was performed in two parts. Part Ⅰ Pediatric patients were divided into 4 age groups: 1-6 month group, 7-12 month group, 13-18 month group and 19-24 month group. The initial dose of dexmedetomidine was 2.0 μg/kg in 0.1 μg/kg increment/decrement. The dose of dexmedetomidine was determined by using modified Dixon′s up-and-down method. The ED 50 and 95% confidence interval of intranasally administered dexmedetomidine for sedation were calculated by the Dexon-Massey method. Part Ⅱ One hundred patients were divided into 4 age groups ( n= 25 each): 1-6 month group, 7-12 month group, 13-18 month group and 19-24 month group. The 4 groups were further divided into 5 subgroups ( n=5 each) according to the dose of dexmedetomidine: 2.1 μg/kg subgroup, 2.2 μg/kg subgroup, 2.3 μg/kg subgroup, 2.4 μg/kg subgroup, and 2.5 μg/kg subgroup. Part Ⅰ and part Ⅱ trials were combined, and the ED 95 and 95% confidence interval of intranasally administered dexmedetomidine for sedation were calculated using the probit method. Results:A total of 220 pediatric patients were enrolled. There was no significant difference in ED 50 and ED 95 of dexmedetomidine intranasally administered for sedation among groups ( P>0.05). Conclusions:The pharmacodynamics of intranasal dexmedetomidine for sedation shows no significant difference in age in the pediatric patients aged 1-24 months undergoing TTE.

A survey on the prevalence and associated factors of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, China / 中华皮肤科杂志

Objective:To investigate epidemiological characteristics of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province.Methods:A cross-sectional study was conducted. From October 2016 to January 2017, all residents aged over 18 years (except pregnant women) were enrolled from 3 villages in Baiyun Town, Shimen County, Hunan Province by using a cluster-sampling method. Demographic information was collected through a face-to-face questionnaire interview. All residents received skin examination performed by professional dermatologists, and blood, urine, and hair samples were collected for the measurement of arsenic levels. Non-conditional logistic regression analysis was performed to analyze factors associated with arsenic poisoning-related skin lesions.Results:A total of 1 092 eligible residents in the arsenic tailing area were recruited in this study, and 756 (69.2%, 95% CI: 66.5%, 72.0%) presented with arsenic poisoning-related skin lesions, including hyperkeratosis, hypo- or hyper-pigmentation. The median ( Q1, Q3) arsenic levels were 0.31 (0.14, 0.74) μg/g in hair samples ( n = 1 079), 0.84 (0.67, 1.10) μg/L in blood samples ( n =1 091), and 60.31 (41.71, 91.52) μg/L in urine samples ( n =1 092). Multivariable analysis showed that the occurrence of arsenic poisoning-related skin lesions was associated with age, residential location, and occupational arsenic exposure history, but was not associated with gender, ethnicity, education levels, migration history, arsenic levels in hair, blood, or urine. Compared with the group aged 18 - 39 years, the group aged 40 - 59 years and the group aged over 60 years showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 11.34, 95% CI: 5.98, 21.50, P < 0.001; adjusted OR = 71.82, 95% CI: 35.81, 144.05, P < 0.001, respectively). Compared with the residents in the Wangyangqiao village, residents in the Heshan village and Huangchang village showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 2.89, 95% CI: 2.05, 4.08, P < 0.001; adjusted OR = 4.13, 95% CI: 1.94, 8.78, P < 0.001, respectively). The risk of arsenic poisoning-related skin lesions was significantly higher in residents with occupational exposure history than in those without (adjusted OR = 1.99, 95% CI: 1.04, 3.83, P = 0.039) . Conclusion:Nearly 70% of the residents presented with arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, and the duration and previous degree of arsenic exposure were associated with the risk of arsenic poisoning-related skin lesions.

Association between interpregnancy interval and pregnancy complications in multiparas / 中华围产医学杂志

Objective:To explore the influence of interpregnancy interval (IPI) on pregnancy complications in multiparas.Methods:This was a retrospective cohort study involving 7 669 singleton parturients who delivered at ≥28 gestational weeks in the Affiliated Hospital of Southwest Medical University between December 2015 and December 2020 and had given birth in the third trimester before. Clinical data were collected, including the baseline characteristics, pregnancy complications, gestational weeks at delivery, and neonatal birth weight. According to the IPI, these women were divided into five groups: <12 months ( n=350), 12-<24 months ( n=945), 24-<60 months ( n=2 544), 60-<120 months ( n=2 478), and ≥120 months ( n=1 352). Based on the recommendation of the World Health Organization, pregnant women with an IPI of 24-<60 months were the control group. A multivariate logistic model was used to adjust for confounders and calculate the risks of pregnancy complications, including gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP). The influences of maternal age and previous delivery mode on the associations between IPI and maternal complications were analyzed. Analysis of variance (ANOVA), Chi-square test, and Cochran-Mantel-Haenszel Chi-square test were used for statistical analysis. Results:Compared with the control group, the incidence of GDM and HDP increased in the 60-<120 months group ( OR=1.23, 95% CI: 1.01-1.48 and OR=1.47, 95% CI: 1.13-1.92) and ≥120 months group ( OR=1.37, 95% CI:1.07-1.78 and OR=1.92, 95% CI: 1.39-2.64); the risks of uterine rupture/postpartum hemorrhage and placental abruption increased in the <12 months group ( OR=1.54, 95% CI: 1.01-2.34) and 12-<24 months group ( OR=2.38 95% CI: 1.13-5.02), respectively. In the 60-<120 months group, the risk of GDM increased only in non-elderly women (adjusted OR=1.71, 95% CI: 1.36-2.14), so did the risks of GDM and HDP in the ≥120 months group (adjusted OR=3.11, 95% CI: 2.10-4.62 and adjusted OR=1.81, 95% CI: 1.12-2.91). Among women who had undergone a previous cesarean section, the risk of GDM increased in the ≥120 months group (adjusted OR=1.35, 95% CI: 1.00-1.81). In the 60-<120 months group and ≥120 months group, the risk of HDP increased in postpartum women (adjusted OR=1.79, 95% CI: 1.08-2.95 and adjusted OR=3.32, 95% CI: 1.91-5.77). Conclusion:IPI≥60 months is a risk factor for GDM and HDP, and the associations between IPI and maternal complications are influenced by maternal age.

Clinical characteristics among patients with pulmonary tuberculosis complicated by prediabetes mellitus / 中国基层医药

Objective:To analyze the clinical characteristics of pulmonary tuberculosis (PTB) in patients with prediabetes mellitus (PreDM) and improve the understanding and diagnosis of pulmonary tuberculosis complicated by prediabetes mellitus (PreDM-PTB).Methods:The clinical data of 109 inpatients with PTB who underwent glycated hemoglobin A1c (HbA1c) examination admitted to Beijing Chest Hospital, Capital Medical University from January 2015 to January 2016 were retrospectively analyzed. These patients were divided into the PreDM-PTB group ( n = 45) and the non-PreDM-PTB group (N-PreDMPTB group, n = 64) according to HbA1c test results. Patient demographic data, clinical features, imaging data, bacteriological results, and other laboratory results were collected from all patients. Results:The mean age and body mass index (BMI) were higher in the PreDM-PTB group than the N-PreDMPTB group. The proportion of patients having a smoking history was higher in the PreDM-PTB group than the N-PreDMPTB group (46.7% vs. 25.0%). The proportions of patients who had a cough (88.9%), fever (55.6%), anorexia (17.8%), chest tightness (31.1%), shortness of breath (28.9%), weight loss (40.0%), and pleural effusion (22.2%) were higher in the PreDM-PTB group than the N-PreDMPTB group. Patients with PreDM-PTB were more prone to develop anemia (55.6%), hypoproteinemia (55.6%), and increased low-density lipoprotein (26.7%) compared with patients with N-PreDMPTB. The levels of D-Dimer (93.2%), C-reactive protein (86.7%), and erythrocyte sedimentation rate (79.1%) were increased in the PreDM-PTB group compared with the N-PreDMPTB group. Sputum smear results showed that the positivity of mycobacterium tuberculosis was higher in the PreDM-PTB group (74.4%) compared with the N-PreDMPTB group. There was no significant difference in drug resistance between the two groups ( P > 0.05). The positivity of blood tuberculosis antibody and blood T-cell spot test for tuberculosis infection were 60.9% and 84.6% respectively in the PreDM-PTB group and they were 50.9% and 95.2% respectively in the N-PreDMPTB group. There were no significant differences in these two indices between the two groups ( P = 0.321, 0.066). Conclusion:Patients with Pre-DMPTB have different clinical manifestations and auxiliary examination characteristics compared with patients with N-PreDMPTB patients, which should be paid more attention to by clinicians. Early intervention should be actively adopted to prevent diabetes development from pre-DM.

Correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and D-dimer with the severity of acute cholangitis / 中国基层医药

Objective:To correlate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and D-dimer (DD) with the severity of acute cholangitis.Methods:The clinical data of 96 patients with acute cholangitis who received treatment in Panjin Central Hospital from September 2019 to March 2021 were retrospectively analyzed. These patients were divided into three groups according to the severity of acute cholangitis: 36 patients with mild acute cholangitis (group A), 35 patients with moderate acute cholangitis (group B), and 25 patients with severe acute cholangitis (group C). The correlation between age, sex, NLR, PLR, DD, and the severity of acute cholangitis was compared among the three groups.Results:In groups A and B, the area under the receiver operating characteristic curve (AUC) showing the performance of DD, NLR, and PLR levels in predicting acute cholangitis was 0.800, 0.838, and 0.721, respectively, with the optimal cut-off value of 1.985 mg/L, 9.589, and 154.410, respectively. Among them, NLR had the largest AUC, and the highest sensitivity (82.9%), and had a high diagnostic value. In groups B and C, the AUC for DD, NLR, and PLR was 0.967, 0.915, and 0.543, respectively, with the optimal cut-off value of 6.000 mg/L, 22.390, and 264.220, respectively. DD and NLR had a diagnostic significance (both P < 0.05), but PLR had no diagnostic significance ( P > 0.05). The AUC for DD was the largest, and therefore DD had a great diagnostic significance. When NLR, PLR, and DD were jointly detected, the AUC was the highest and the diagnostic value was the highest. The AUC in groups A and B was 0.866, and that in groups B and C was 0.977. Conclusion:The levels of DD, NLR, and PLR increase in patients with acute cholangitis, which are related to the severity of the disease. DD, NLR, and PRL can be used as indicators to evaluate mild and moderate acute cholangitis, and NLR has the highest diagnostic value. DD and NLR can be used as indicators to evaluate moderate to severe acute cholangitis, and the effect of DD is superior to that of NLR. The combined detection of the three indicators can increase the value to evaluate the severity of acute cholangitis, and its effect is superior to that of a single detection. The combined detection of NLR, PLR, and DD is helpful for the clinical diagnosis and treatment of acute cholangitis.

Analysis of sex differences in severe traumatic death patients of different ages / 中国基层医药

Objective:To investigate the sex differences in severe traumatic death patients of different ages.Methods:A total of 408 patients with severe trauma who received treatment in The Second Affiliated Hospital of Zhejiang University School of Medicine and Taizhou First People's Hospital from June 2017 to June 2022 were retrospectively analyzed. These patients were divided into the children group (≤ 14 years old, n = 47), the adult group (14-50 years old, n = 171), and the older adult group (> 50 years old, n = 90). Multivariate logistic regression was used to evaluate the difference in sex-based mortality among the groups. Nonlinear regression was used to evaluate the mutual interaction of increasing age and sex on the predicted survival rate. Results:Traffic accidents were the most common cause of death among men in the adult group (58.93%, χ2 = 7.95, P = 0.027). Falls were the most common cause of death among men in the older adult group (57.36%, χ2 = 8.63, P = 0.001). The Injury Severity Score of women in the adult and older adult groups was significantly higher in women than that of men in the same group [adult group: men: (24.39 ± 4.17) points, women: (26.32 ± 4.31) points, t = 2.84, P = 0.005). The incidence of post-traumatic complications in the older adult group was very higher in men than in women (respiratory failure: 28.68% in men, 14.75% in women, χ2 = 4.37, P = 0.036; circulatory failure: men: 27.13%, women: 13.11%, χ2 = 4.64, P=0.031; neuropsychiatric disorders: men: 20.93%, women: 8.20%, χ2 = 4.79, P = 0.029; respiratory infection: men: 31.78%, women: 18.03%, χ2 = 5.55, P = 0.047; other infectious diseases: men: 28.68%, women: 13.11%, χ2 = 0.69, P = 0.018). After adjusting for covariates, the mortality rate of men in the older adult group was significantly higher than that of women in the same group ( OR: 1.261, 95% CI: 1.185-1.343, P < 0.001). With the increase of age, the predicted survival rate after the trauma in patients of different sexes also decreased, in particular in men aged > 50 years (interaction P = 0.051). Among patients with blunt and severe head trauma, age-related mortality decline in patients aged > 50 years had a strong interaction with sex (interaction P = 0.002). In patients with penetrating trauma, there was a weak interaction between the predicted survival rate of different sexes (interaction P = 0.192). Conclusion:There is no significant difference in age-related change in post-traumatic mortality between different sexes. In the population aged > 50 years, men have a relatively higher risk of death than women.

Correlation of serum 25-hydroxyvitamin D and parathyroid hormone levels with hypertension in patients with type 2 diabetes mellitus / 中国基层医药

Objective:To correlate serum 25-hydroxylvitamin D and parathyroid hormone levels with hypertension in patients with type 2 diabetes mellitus.Methods:A total of 100 patients with type 2 diabetes mellitus admitted to Siming Branch, the First Affiliated Hospital of Xiamen University, China from February 2018 to August 2020 were included in this study. These patients were stratified according to hypertension, and serum 25-hydroxyvitamin D level. The correlation between serum 25-hydroxyvitamin D and parathyroid hormone and hypertension was analyzed.Results:Among the 100 patients with type 2 diabetes meliitus, 25 patients had grade 1 hypertension, 30 patients had grade 2 hypertension, 45 patients had grade 3 hypertension, 5 patients (5%) had sufficient levels of 25-hydroxyvitamin D, 10 patients (10%) had insufficient levels of 25-hydroxyvitamin D, 85 patients (85%) had inadequate levels of 25-hydroxyvitamin D. Serum levels of 25-hydroxyvitamin D in patients with grade 1, grade 2, and grade 3 hypertension were (12.18 ± 2.52) μg/L, (12.45 ± 2.39) μg/L, (10.33 ± 1.26) μg/L, respectively, and parathyroid hormone levels were (36.48 ± 0.25) ng/L, (41.15 ± 0.39) ng/L, and (47.52 ± 1.44) ng/L, respectively. As blood pressure increased, the patient's serum levels of 25-hydroxyvitamin D increased first and then decreased, while parathyroid hormone levels gradually increased. However, there were no statistically significant differences in serum levels of 25-hydroxyvitamin D and parathyroid hormone between patients of different hypertension grades ( F = 0.96, 1.93, both P > 0.05). Logistic regression analysis showed that hypertension in type 2 diabetes patients was correlated with age, body mass index, serum 25 hydroxyvitamin D level, glycated hemoglobin and parathyroid hormone level ( OR = 1.076, 1.266, 0.937, 1.257, 1.000, all P < 0.05). Conclusion:The serum levels of 25-hydroxyvitamin D and parathyroid hormone in patients with type 2 diabetes mellitus are related to hypertension.

Interactivity of obesity and central obesity on hypertension in Wuwei of Gansu province / 中国基层医药

Objective:To analyze the interaction between obesity and diabetes, obesity and central obesity, central obesity and diabetes on hypertension.Methods:A questionnaire survey on 7 622 residents of Han Chinese ethnicity, aged 35-75 years, of Liangzhou district of Wuwei city were performed using multi-stage random sampling method in September to December 2018. Relative excess risk due to interaction, attributable proportion, synergy index, and 95% CI of the three were used to evaluate the additive interaction. Logistic regression analysis was used to analyze the multiplicative interaction. Results:Among the 7 622 residents, hypertension was detected in 3 212 residents, with a crude prevalence rate of 42.14% and a standardized incidence of 33.81%. There was a significant difference in incidence of hypertension between residents of different sexes, between residents at different ages, between obese residents and normal weight residents, between residents who had central obesity and those who had no central obesity, between residents who smoked and those who did not, between residents of different family economic situations, between residents who had different occupations, and between residents who had diabetes and those who had no diabetes (all P < 0.05). Getting primary, middle, and high school education was a protective factor against hypertension, while obesity, central obesity, diabetes, male gender, age greater than 45 years were the risk factors for hypertension. Multivariate logistic regression analysis showed that there was no additive interaction between obesity and diabetes, obesity and central obesity, central obesity and diabetes on hypertension. There was a multiplicative interaction between obesity and central obesity on hypertension ( P = 0.031, 95% CI: 0.53-0.97) and the interaction was antagonistic, but there were no multiplicative interaction between obesity and diabetes, central obesity and diabetes on hypertension. Conclusion:There was a negative multiplicative interaction between obesity and central obesity on hypertension.

Temporal trend of cerebral hemorrhage mortality rate in Tengzhou, Shandong Province from 2013 to 2021 / 国际脑血管病杂志

Objective:To investigate the temporal trend of the mortality rate of intracerebral hemorrhage (ICH) among residents with different characteristics during the comprehensive prevention and control of hypertension in Tengzhou, Shandong Province from 2013 to 2021.Methods:Comprehensive prevention and control of hypertension was conducted in Tengzhou, Shandong Province from 2013 to 2021. ICH mortality rate was calculated from January 1, 2013 to December 31, 2021. ICH mortality monitoring data from Tengzhou, Shandong Province was used to analyze the temporal trend of ICH mortality among residents with different characteristics. The registered residence population came from the Public Security Bureau of Tengzhou, Shandong Province. The age and gender standardized mortality rate was calculated based on the data of China's seventh population census in 2020. The temporal and age trends of mortality were analyzed using Cochran Armitage Trend Tests.Results:From 2013 to 2021, the overall crude and standardized mortality rates of ICH in Tengzhou, Shandong Province decreased from 50.51/100 000 and 63.21/100 000 to 17.51/100 000 and 16.74/100 000, respectively ( Z=-11.013 and -15.426, P<0.001), with an average annual mortality rate decrease of 12.41% and 15.30%, respectively. The overall crude and standardized mortality rates in 2017 peaked compared to 2016, mainly due to an increase of 32.94% and 30.92% in male ICH crude and standardized mortality rates, respectively ( χ2=12.328 and 15.854, P<0.05). The mortality rate of ICH increased with age, and the decreasing trend over time became increasingly evident with age. The mortality rate of ICH in the ≥65 year old age group decreased by 77.94% over 9 years ( Z=-14.065, P<0.001). In 2017, the mortality rate of ICH in the male age group ≥65 years old and female 45-54 years old increased by 31.13% and 125.79% compared to 2016 respectively, there were statistically significant differences ( χ2=8.877 and 5.421, P<0.05). In 2021, the mortality rates of urban and rural ICH decreased by 93.22% and 46.40% compared to 2013, respectively ( Z=-13.279 and -5.393, P<0.001), with an average annual decrease of 28.56% and 7.50%, respectively. The ICH mortality rate in rural areas increased by 30.54% in 2017 compared to 2016 ( χ2=16.086, P<0.001); after 2018, the mortality rate of ICH began to be higher than that of urban areas ( χ2=33.400 and 67.305, P<0.001). Conclusions:The ICH mortality rate in Tengzhou, Shandong Province has shown a significant downward trend over time, with male mortality rate higher than female mortality rate and rural mortality rate higher than urban areas. This suggests that the key attention should be paid to both male and rural areas.

Blood lipids and apolipoprotein E gene in patients with cardiovascular and cerebrovascular diseases in Honghe Hani and Yi Autonomous Prefecture of Yunnan Province / 中国基层医药

Objective:To analyze the distribution of blood lipids and apolipoprotein E ( ApoE) gene in patients with cardiovascular and cerebrovascular diseases in Honghe Hani and Yi Autonomous Prefecture of Yunnan Province, and their relationship with ethnicity, gender, and age. Methods:A total of 102 patients with cardiovascular and cerebrovascular diseases who received treatment in Southern Central Hospital of Yunnan Province (The First People's Hospital of Honghe State) from May 2019 to June 2020 were included in this study. Their blood lipid and ApoE gene distributions were analyzed. The correlations between blood lipid and ApoE gene distribution and ethnicity, gender, and age were analyzed. Results:There was a significant difference in total cholesterol level between male and female patients with cardiovascular and cerebrovascular diseases in Honghe Hani and Yi Autonomous Prefecture of Yunnan Province [(4.10 ± 1.27) mmol/L vs. (4.70 ± 1.83) mmol/L, t = 1.87, P = 0.048]. There was no significant difference in total cholesterol level among different ethnic groups and different ages ( P = 0.343, 1.000). There were no significant differences in low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels among different ethnic groups, different sexes, and different ages ( P = 0.562, 0.125, 0.158; 0.884, 0.068, 0.681; 0.262, 0.367, 0.965). There were no significant differences in blood lipid levels among different ethnic groups, different sexes, and different ages ( P = 0.890, 0.336, 0.142). No E2/E4 gene was found in all patients. E2/E2 and E2/E3 genes of ApoE accounted for 16.67%, E3/E3 gene accounted for 70.59%, and E3/E4 and E4/E4 genes accounted for 12.74%. There was no significant difference in the distribution of ApoE gene among different ethnic groups, different sexes, and different ages ( χ2 = 0.13, 0.69, 0.44, P = 0.936, 0.429, 0.804). Conclusion:Female patients with cardiovascular and cerebrovascular diseases in Honghe Hani and Yi Autonomous Prefecture of Yunnan Province have higher total cholesterol levels than male patients. Low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels are not significantly correlated with ethnicity, sex, and age. Blood lipid abnormalities mainly manifest as low high-density lipoprotein cholesterol levels and high triglyceride levels. The E2/E4 gene has not been found in this region so far.

The influence of age on renal outcomes in patients with stage 2-4 chronic kidney disease / 中国医师杂志

Objective:To evaluate the correlation between age and renal outcomes in patients with stage 2-4 chronic kidney disease (CKD) and the impact of age on CKD outcomes in kidney diseases of different etiologies.Methods:A prospective cohort study included 470 patients with stage 2-4 CKD. The Kaplan Meier method was used to analyze the differences in CKD outcomes among different age groups. The independent risk factors for CKD progression were analyzed using a multivariate Cox regression model. We adjusted for baseline differences in risk factors for CKD outcomes between two age groups using propensity score matching (PSM).Results:Among 470 patients, 39 cases of end-stage renal disease (ESRD) events (all starting dialysis) and 51 deaths were observed. The Kaplan Meier survival curve ( P=0.039) and Cox regression univariate survival analysis ( P=0.043) both showed that <60 years old is a risk factor for CKD patients to progress to ESRD. In multivariate Cox regression, age remained an independent risk factor for the progression of CKD patients (hazard ratio 0.386, 95% CI: 0.163-0.916; P=0.031). For kidney diseases with different causes, in patients with hypertensive kidney damage ( P=0.024) and primary glomerulonephritis ( P=0.047), the cumulative incidence rate of ESRD in patients <60 years old was higher than that in patients ≥60 years old. There was no statistically significant difference in all-cause mortality rates between patients aged <60 and ≥60 years old ( P=0.646). Conclusions:Elderly patients with stage 2-4 CKD have a lower ESRD risk than younger patients. This discovery helps nephrologists and decision-makers optimize the management of elderly CKD patients.

Effects of face mask on pulse rate and blood oxygenation

ABSTRACT Objective The World Health Organization and Centers for Disease Control and Prevention recommend the use of face masks in public. This study aimed to evaluate the effects of face masks on pulse rate and partial blood oxygen saturation in patients without cardiorespiratory disorders. Methods A total of 150 volunteers of both sexes were divided into three groups (n=50) according to age (children, young adults, and older adults). The partial blood oxygen saturation and pulse rate were measured for each volunteer using a digital oximeter while wearing a facial mask and remaining at rest. The masks were removed for two minutes, and partial blood oxygen saturation and pulse rate were remeasured. The materials and types of masks used were recorded. The t -test for paired samples was used to compare the mean values obtained before and after removing the masks. Results The most frequently used mask was a two-layered cloth (64.7%). A decrease in pulse rate was observed after removing the face mask in males, particularly in children (p=0.006) and young adults (p=0.034). Partial blood oxygen saturation levels increased in young adult males after mask removal (p=0.01). Conclusion The two-layer cotton tissue face masks are associated with a higher pulse rate and reduced arterial blood oxygen saturation without associated clinical disorders, mainly in adult men with a lower tolerance to breathing and ear discomfort.

Qualidade de vida relacionada à deglutição de idosos hospitalizados: estudo transversal analítico / Calidad de vida relacionada con la deglución en adultos mayores hospitalizados: estudio transversal analítico / Swallowing-related quality of life in hospitalized elderly patients: A cross-sectional analytical study

Resumo Objetivo Avaliar a qualidade de vida relacionada à deglutição em idosos hospitalizados. Métodos Estudo transversal analítico e observacional. Participaram 52 idosos internados em clínica médica de um hospital público no Distrito Federal. Foram aplicados os instrumentos Eating Assessment Tool e o Quality of Life in Swallowing Disordens, além de coleta de dados sociodemográficos e condições de saúde. Resultados Dos idosos participantes 30,8% apresentaram risco de disfagia autorrelatada. Os idosos com risco de disfagia apresentaram menor pontuação no domínio "tempo de se alimentar" e maior pontuação no domínio de "saúde mental". O único domínio que não houve diferença estatística no padrão de resposta dos participantes que apresentaram ou não risco de disfagia foi o domínio sono. Entre as variáveis dos 11 domínios do Quality of Life in Swallowing Disordens foi possível observar correlações positivas em sua maioria com diferentes graus. Conclusão A qualidade de vida relacionada à deglutição de idosos hospitalizados está diretamente manifestada com a diminuição do convívio social, aumento do tempo para se alimentar, medo e fardo.

Resumen Objetivo Evaluar la calidad de vida relacionada con la deglución en adultos mayores hospitalizados. Métodos Estudio transversal analítico y observacional. Participaron 52 adultos mayores internados en clínica médica de un hospital público en el Distrito Federal. Se aplicaron los instrumentos Eating Assessment Tool y Quality of Life in Swallowing Disordens, además de la recopilación de datos sociodemográficos y condiciones de salud. Resultados De los adultos mayores que participaron, el 30,8 % presentó riesgo de disfagia autoinformada. Los adultos mayores con riesgo de disfagia presentaron un menor puntaje en el dominio "tiempo para alimentarse" y un puntaje más alto en el dominio "salud mental". El único dominio en el que no hubo una diferencia estadística en el tipo de respuesta de los participantes que presentaron o no riesgo de disfagia fue el del dominio sueño. Entre las variables de los 11 dominios del Quality of Life in Swallowing Disordens se observaron mayormente correlaciones positivas en diferentes niveles. Conclusión La calidad de vida relacionada con la deglución de adultos mayores hospitalizados está directamente manifestada con la reducción de la convivencia social, el aumento de tiempo para alimentarse, el miedo y la carga.

Abstract Objective To evaluate swallowing-related quality of life in hospitalized elderly patients. Methods Cross-sectional analytical and observational approach was used in our study. Fifty-two elderly patients in a medical clinic of a public hospital in Distrito Federal [Federal District] participated. In addition to collecting sociodemographic and health condition data, the Eating Assessment Tool and the swallowing-related quality of life Questionnaire were applied. Results Of the elderly participants, 30.8% had a self-reported risk of dysphagia. The elderly at risk for dysphagia had lower scores in the "eating duration" domain and higher scores in the "mental health" domain. The only domain in which there was no statistical difference in the response pattern of the participants who were, or were not at risk for dysphagia was the "sleep domain." Among the variables of the 11 domains of the Swallowing Quality of Life Questionnaire, mostly positive correlations were found, with different degrees. Conclusion The swallowing-related quality of life of hospitalized elderly patients is directly manifested as decreased social interaction, increased eating time, fear to eat, and swallowing as a burden.