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Objective:To investigate the risk factors for concomitant cardiac autonomic neuropathy in diabetic patients and to develop a Nomogram prediction model.Methods:One hundred and fifty-eight diabetic patients admitted to in Southern Hospital Zengcheng Branch from March 2019 to March 2021 were selected. Patients with normal heart rate variability were the diabetic group, and patients with abnormal heart rate variability were the group with diabetes mellitus complicated by cardiac autonomic neuropathy. Logistic regression analysis was used to analyze the risk factors of cardiac autonomic neuropathy. Nomogram models were developed and model performance was evaluated. Decision curve analysis (DCA) was used to assess the net clinical benefit of the Nomogram model.Results:Comparison of general data showed that fasting blood glucose, tumour necrosis factor-α (TNF-α), glomerular filtration rate (eGER), uric acid, C-reactive protein (CRP), interleukin-6 (IL-6), free fatty acids (FFA), standard deviation of sinus heart beat RR interval (SDNN), and duration of diabetes compared to the diabetic group had statistically significant ( P<0.05); the results of the subject work characteristics (ROC) curve analysis showed that the best cut-off values for fasting glucose, TNF-α, eGFR, uric acid, CRP, IL-6, FFA, SDNN and duration of diabetes were >7.53 mmol/L, >98.45 ng/L, ≤94.79 ml/(min·1.73 m 2), > 87.3 μmol/L, >6.22 μmol/L, >37.84 ng/L, >839.19 μmol/L, ≤ 95.88 ms, >9 years; multi-factorial Logistic regression analysis showed that fasting glucose (>7.53 mmol/L), TNF-α (>98.45 ng/L), CRP (>6.22 μmol/L), IL-6 (>37.84 ng/L), FFA (>839.19 μmol/L), SDNN (≤95.88 ms), and duration of diabetes (>9 years) were risk factors for the development of cardiac autonomic neuropathy in diabetic patients; internal validation showed that the Nomogram model predicted a C-index of 0.706 (95% CI 0.668 - 0.751) for the risk of cardiac autonomic neuropathy. The DCA results showed that the Nomogram model predicted a risk threshold of >0.25 for the development of cardiac autonomic neuropathy and that the Nomogram model provided a net clinical benefit. Conclusions:There are many risk factors for cardiac autonomic neuropathy, and the nomogram model based on risk factors in this study has good predictive power and may provide a reference for clinical screening of high-risk patients and further improvement of treatment planning.
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Objectives:To investigate the epidemiological features and associated factors of chronic renal insufficiency (CRI) in Binhai county from Jiangsu province.Methods:This is a cross-sectional study including individuals aged≥18 years old and participating in health examinations of Binhai county from January to December 2018. Medical records were collected to analyze the epidemiology of CRI [estimated glomerular filtration rate <60 ml·min -1·(1.73 m 2) -1]. Multivariate logistic regression was used to analyze the associated influencing factors of CRI. Results:A total of 395 541 individuals residing in Binhai county were enrolled, with 190 258 males (48.1%) and age of (55.34±15.12) years old. The overall crude prevalence of CRI was 2.04% (8 065/395 541, 95% CI 2.00%-2.08%) in this adult population. Furthermore, the age- and gender-standardized overall prevalence of CRI was 1.22% (95% CI 1.18%-1.25%), with a rate of 1.47% (4 676/205 283, 95% CI 1.42%-1.52%) in women and a rate 0.95% (3 389/190 258, 95% CI 0.91%-1.00%) in men. There was a strong positive correlation between the risk of CRI and age (per 10-year increase, OR=2.449, 95% CI 2.402-2.497). Compared with individuals <30 years old, the OR of CRI in individuals aged 60-69, 70-79 and ≥80 years old were 3.827 (95% CI 3.010-4.864), 12.004 (95% CI 9.457-15.239) and 44.636 (95% CI 35.187-56.622) respectively. Females ( OR=1.142, 95% CI 1.083-1.203), increasing systolic blood pressure (per 10 mmHg increase, OR=1.062, 95% CI 1.048-1.076), increasing heart rate (per 10-beat/min increase, OR=1.071, 95% CI 1.044-1.098), elevating triglyceride (per 1.33 mmol/L increase, OR=1.140, 95% CI 1.119-1.162), elevating fasting blood glucose (5.6-6.9 mmol/L/<5.6 mmol/L, OR=1.158, 95% CI 1.086-1.233; ≥7 mmol/L/<5.6 mmol/L, OR=1.387, 95% CI 1.296-1.484) and central obesity ( OR=1.126, 95% CI 1.068-1.187) were independent risk factors for CRI. Conclusions:The age- and gender-adjusted prevalence of CRI in adults in Binhai county is 1.22%. Older age, females, central obesity, and high levels of triglyceride, systolic blood pressure, heart rate and fasting glucose are independent associated factors of CRI.
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【Objective】 To evaluate the efficacy of Nd: YAG laser therapy adjunct to subgingival scaling and root planning (SRP) for treating severe chronic periodontitis. 【Methods】 We selected patients with severe chronic periodontitis whose teeth were distributed in 4 quadrants of the mouth, with probing depth (PD) of 5-8 mm, attachment loss (AL)≥5 mm and bleeding on probing (BOP). These teeth were randomly divided into three groups: SRP group, SRP+L group (Nd: YAG laser after SRP treatment), and L+SRP group (SRP after Nd: YAG laser treatment). We recorded parameters including BOP, PD and AL of the three groups at baseline and 8 weeks after treatment and made statistical analysis. 【Results】 At 8 weeks after treatment, BOP, PD and AL of the three groups were improved than those in the baseline (P<0.05). BOP positive percentage of SRP+L group and L+SRP group significantly reduced compared with SRP group (P<0.05). PD of SRP+L group significantly decreased compared with SRP group and L+SRP group (P<0.05), for sites with PD=7 mm, SRP+L group was significantly decreased compared with SRP and L+SRP groups (P<0.05). AL of SRP group significantly decreased compared with SRP+L group and L+SRP group (P<0.05). 【Conclusion】 Severe periodontal treatment with Nd:YAG laser adjunct to SRP is more effective in reducing BOP and PD, and for deeper pockets PD is significantly decreased in SRP+L group, but there is no advantage in the improvement of AL.
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Objective To analyze the changes and characteristics of respiratory tract bacteria in Hebei 3A Hospital, and to provide new rationale for clinical diagnosis and treatment.Methods A single-center retrospective analysis was conducted. 7497 patients with respiratory tract infection admitted to Hebei Chest Hospital from January 2013 to December 2016 were enrolled. Deep sputum was collected, and the bacterial cultures and susceptibility analysis was conducted in sputum and upper respiratory secretions were collected by fiberoptic bronchoscopy.Results A total of 7497 patients with respiratory tract infection were enrolled in the study, and 11909 strains of 13 kinds of dominant pathogens were isolated. The dominant pathogens for respiratory tract infection wereMonilia albican (23.7%),Klebsiella pneumoniae (12.9%),Pseudomonas aeruginosa (11.6%),Escherichia coli (9.5%),Candida glabrata (9.1%),Acinetobacter baumanii (7.9%),Aspergillus (6.7%),Stenotrophomonas maltophilia (4.5%), coagulase negativeStaphylococcus(3.7%) and some species ofPseudomonas (3.7%),Staphylococcus aureus (3.0%),Aerobacter cloacae (1.9%), andCandida tropicalis (1.8%). A total of 6198 strains of 7 kinds of Gram negative (G-) bacilli infection dominant pathogens accounts for 52.0% of all infections,Klebsiella pneumonia (24.8%),Pseudomonas aeruginosa (22.3%),Escherichia coli (18.2%) andAcinetobacter baumanii (15.3%) were the main pathogens, and increased year by year. Susceptibility analysis showed that the preferred antibiotics for G- bacteria were carbapenems, followed by risperidone, sulbactam, cefepime, amikacin, and the third generation of cephalosporins. A total of 798 strains of 2 kinds of Gram positive (G+) bacilli infection dominant pathogens accounted for 6.7% of all infections, were coagulase negativeStaphylococcus(54.8%) and Staphylococcus aureus (45.2%), each had changed little by year. Susceptibility analysis showed that G+ bacteria were sensitive to glycopeptides, followed by cefoxitin, cotrimoxazole, the tetracyclines, quinolones, azithromycin, erythromycin and so on. The advantages of 4 species of fungi were 4913 strains, accounted for all of the 41.3% strains, with 57.5% of Candida albicans, and the trend was increasing year by year. Susceptibility analysis results showed that the antifungal susceptibility of dominant fungi were higher.Conclusions G- bacilli is still the main source of infection, and showed an upward trend year by year. Fungal infection rate cannot be ignored, and we must pay attention to fungal infection incentives. We should strengthen the rational use of antibiotics.
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ABSTRACT:Objective To investigate the effects of berberine on matrix metalloproteinases/tissue inhibitors of matrix metalloproteinases (MMPs/TIMPs) in rat periodontitis .Methods Adult male Sprague‐Dawley rats were subjected to thread ligation and porphyromonas gingivalis ( P . gingivalis ) inoculation resulting in periodontitis . Berberine [150 mg/(kg · d)] or vehicle was administered by oral gavage for 4 weeks .Alveolar bone loss and soft‐tissue destruction were determined by micro‐computed tomography (μ‐CT) and HE staining .The contents of tumor necrosis factor‐α(TNF‐α) and interleukin‐1β(IL‐1β) of gingival tissue were examined by ELISA .The expressions of MMP‐2 ,MMP‐9 and TIMP‐2 as well as the phosphorylation of P38 MAPK and NF‐κB were determined by Western blot .Results Significant increases were observed in alveolar bone loss and periodontal soft‐tissue destruction with higher levels of TNF‐α, IL‐1β and MMP‐2/9 expressions and the activities of P38 MAPK and NF‐κB in the experiment periodontitis group .Berberine of [150 mg/(kg · d)] not only improved the periodontal tissue and decreased alveolar bone loss ,but also reduced the contents of TNF‐α,IL‐1βand MMP‐2/9 and increased TIMP‐2 .In addition ,berberine inhibited the phosphorylation of P38 MAPK/NF‐κB .Conclusion Berberine protects against periodontal tissue damage via decreasing MMP‐2 and MMP‐9 expressions but increasing TIMP‐2 expression , which may be induced by inhibition of P38 MAPK/NF‐κB and the anti‐inflammatory effect on rat periodontitis .
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ObjectiveTo summarize the intraoperative nursing of patients undergoing aparoscopic adjustable gastric banding placation to reduce weight and improve the efficiency of operative cooperation.Method The clinical data on the intraoperative nursing of 9 patients undergoing laparoscopic adjustable gastric banding placation were retrospectively reviewed and analyzed.Result All patients lived through the successful operations and the postoperative rehabilitation were in good condition without postoperative complications and sequelae.Conclusion Full preoperative operation,familiarity with the operative procedures,close cooperation with surgeons are key to smooth performance of the operation and assurance of patient’s safety.
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ScanningElectronMicroscopy/EnergyDispersionSpectrum(SEM/EDS),ElectronProbe Microanalysis ( EPMA ) and Optical Microscopy ( OM ) are the traditional methods for inclusion type identifying at present. The disadvantages such as inconvenient sample preprocessing, low sensitivity and time consuming limited their application. Laser-Induced Breakdown Spectroscopy ( LIBS) is not only performing in bulk analysis field but also in elemental distribution and depth profile information field, so it causes great concern in material science. In this paper, 34CrNiMo6 steel and heavy railway steel samples were analyzed by LIBS in scanning mode to characterize the inclusion type. For 34CrNiMo6 steel, 2D intensity distribution and channel combination revealed the spectra line intensity of Mn and S were abnormal high simultaneously at some region, which indicated there were some MnS inclusion existed in these samples. And for heavy railway steel, 2D distribution and channel combination revealed the spectra line intensity of Si, Ca, Mg and Al were abnormal high simultaneously at some region, showed the existence of Si-Al-Ca-Mg inclusion in these samples. The SEM/EDS analysis result of above-mentioned samples showed agreed well with LIBS.
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<p><b>OBJECTIVE</b>To investigate the changes of cholinergic nerves in doxorubicin (DOX)-induced rat failing heart and tumor necrosis factor-α (TNF-α) in the heart tissue and serum.</p><p><b>METHODS</b>Adult Sprague-Dawley rats were randomized into control (n=10) and DOX-induced chronic heart failure (CHF) groups (n=15), and in the latter group, the rats were given intraperitoneal injections of 2.5 mg/kg DOX once a week for 6 weeks, with a total cumulative dose of 15 mg/kg. The control rats were injected with normal saline (1 ml/week). Karnovsky-Roots histochemical staining combined with point counting was used to demonstrate the distribution of cholinergic nerves in the heart. The expression levels of TNF-α in the heart tissue and serum were determined with ELISA.</p><p><b>RESULTS</b>Positively stained cholinergic nerves were found in all the rat hearts in the two groups, but in CHF group, the point counts of cholinergic nerves were significantly lower than that of the control group (P<0.01). Compared with the control rats, those with DOX-induced CHF showed elevated levels of TNF-α both in the heart tissue and in the serum (P<0.01).</p><p><b>CONCLUSION</b>In rats with DOX-induced CHF, the parasympathetic nervous system is down-regulated in the failing heart, and the diminished cholinergic anti-inflammatory pathway may play an important role in the progression of CHF.</p>