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Objective To explore EEG characteristics and the therapeutic effect in children with electrical status epilepticus during slow sleep(ESES).Methods The eligible ESES cases in our center from 2014 to 2020 were included.The age at diagnosis of ESES,the duration of ESES,spike wave index(SWI)during wakefulness and the distribution of spike wave during the period of ESES,age at seizure onset,the clinical syndromes and the outcomes after treatment were analyzed.The ESES cases were divided into 4 groups according to the distribution of spike wave:focal ESES,unilateral ESES,bilateral asymmetric ESES,multiple foci ESES.The SWI during the awake stage were divided into 3 groups based on the different rates:≤20%,21%~49%,≥50%.The therapeutic outcomes were classified into three groups:satisfactory response,seizure control and ineffective.Results 50 cases were included,with 32 males and 18 females.The average onset age of ESES was 6 years and 7 months,and the average duration of ESES was 28 months.A significant correlation between the distribution of ESES and the thera-peutic effects was found,bilateral asymmetric ESES had a good therapeutic effects,while multiple foci ESES showed a poor therapeutic effects.The duration of ESES was significantly correlated with therapeutic effects,and the efficacy was worse when the duration was longer than 1 year.A significant relationship between the SWI during wakefulness of ESES and the therapeutic effects was detected,the patient with SWI≤20%during wakefulness had a good therapeutic effect.There was a negative correlation between the onset age of ESES and the duration of ESES and SWI index during wakefulness.There was a positive correlation between the duration of ESES and SWI index during wakefulness.Conclusion Our results suggest that onset age,distribution,duration and SWI during wake-fulness of ESES were correlated with therapeutic outcomes,The patient with SWI≤20%during wakefulness had a good therapeutic effect and have unfavorable outcomes with ESES last more than 1 year.The earlier onset of ESES,the longer duration of ESES and higher SWI during wakefulness will be showed..
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OBJECTIVE@#To explore the genetic basis for a child featuring global developmental disorder with epilepsy.@*METHODS@#A child who had presented at Guangzhou Women and Children's Medical Center in July 2022 was selected as the study subject. Clinical data was collected. Potential variant was detected by whole exome sequencing (WES). Candidate variant was validated by Sanger sequencing and bioinformatic analysis.@*RESULTS@#The child, a three-year-old ethnic Zhuang Chinese girl, had presented with global developmental disorder and epilepsy, for which rehabilitation therapy was ineffective. Genetic testing revealed that she has harbored a homozygous c.821T>C (p.Leu274Pro) missense variant of the PIGW gene, for which both of her parents and sister were heterozygous carriers. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as variant of uncertain significance.@*CONCLUSION@#The homozygous c.821T>C (p.Leu274Pro) variant of the PIGW gene probably underlay the onset of disease in this child. Above finding has enriched the mutational spectrum of the PIGW gene.
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Pré-Escolar , Feminino , Humanos , Biologia Computacional , Deficiências do Desenvolvimento , Epilepsia/genética , Testes Genéticos , HomozigotoRESUMO
Objective:To explore the influence factors of neurodevelopmental disorders in children with SCN8A-related early-onset epilepsy through analyzing their clinical characteristics and following up their neurodeve-lopmental status. Methods:A retrospective analysis was carried out on 21 children (13 males and 8 females, the age ranged from 4 months to 8 years, average 31.6 months)with SCN8A-related early-onset epilepsy treated in Guangzhou Women and Children′s Medical Center and Kunming Children′s Hospital between January 2017 and February 2021.All patients underwent whole-exome sequencing and Sanger sequencing.The pathogenicity was estimated according to the American College of Medical Genetics and Genomics guidelines.The clinical data of all patients were also collected, including the age of onset of the disease, forms of seizures, seizure frequency, neurological development at onset, electroencephalogram (EEG) and brain magnetic resonance imaging (MRI). Besides, the patients were followed up to acquire the effect of sodium channel blockers after the onset of seizures, the process or improvement of neurodeve-lopment, EEG evaluation and neurodevelopmental outcomes.Patients were grouped based on data analysis results.The Fisher′s exact test was conducted to measure the effect of various factors on the neurodevelopmental process and outcome, and corresponding coe-fficients were calculated. Results:The average onset age of 21 patients was 0-9 months.The follow-up duration was 4 months-8 years.Three cases died.Sixteen cases (76.2%) had early infantile epileptic encephalopathy (EIEE), 5 cases (23.8%) had epilepsy without encephalopathy, and 1 case had benign infantile epilepsy.Fourteen cases (66.7%) belonged to drug resistant epilepsy.Only one child showed normal neurodevelopment.Eleven children showed delayed neurodevelopment, but improvement was observed.Nine children were retrogressed and stagnated in terms of neurodevelopment.Small age at onset ( Fisher=9.517, P=0.020, r=0.571), high seizure frequency ( Fisher=10.512, P=0.003, r=0.572), EEG background ( Fisher=10.512, P=0.003, r=0.572), epileptic discharges ( Fisher=8.288, P=0.008, r=0.542), and EEG changes before and after treatment ( Fisher=10.437, P=0.009, r=0.586) were important factors affecting the neurodevelopmental process.Neurodevelopmental outcome was normal in only 1 case, 1 child belonged to mild mental retardation (MR), 7 children belonged to moderate MR, 3 children belonged to severe MR, and 9 children belonged to profound MR.Statistical analysis indicated that the clinical phenotype ( Fisher=10.059, P=0.004, r=0.739) and drug resistance ( Fisher=13.706, P=0.001, r=0.640) were significantly correlated with neurodevelopmental outcomes.However, the forms of seizures, EEG findings at onset and mutation sites were not related to neurodevelopmental disorders. Conclusions:Most children with SCN8A-related early-onset epilepsy are accompanied with neurodevelopmental retardation of varying degrees.Epileptic encephalopathy and poor response to drug treatment will lead to severe neurodevelopmental disorders.
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Objective:To investigate the influencing factors of hyperuricemia(HUA) and explore early intervention of metabolic diseases.Methods:A total of 70 523 participants were selected from the database of check-ups in 2016. Univariate analysis and logistic regression analysis were used to identify related factors of HUA. Correspondence analysis was performed for the aggregation of different levels of uric acid(UA) and related factors. The mediating effect of mean blood pressure(MBP) between abnormal metabolic indicators and abnormal renal function was tested.Results:The age, sex, occupation, body mass index(BMI), systolic blood pressure, diastolic blood pressure, blood urea nitrogen(BUN), creatinine(Cr), estimated glomerular filtration rate(eGFR), fasting plasma glucose(FPG), total cholesterol(TC), triacylglycerol(TG), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol, plasma viscosity were significantly related to HUA( P<0.001). Logistic regression analysis showed that youth, male, hypertension, TC, TG, and Cr were risk factors for HUA, while HDL-C was a protective factor for HUA( P<0.001). Correspondence analysis showed that during the gradual increase of UA, TC was the first to appear abnormal, followed by hypertension and TG, and the increase of Cr appeared last. Mediating effect showed that in changes of UA, the mediating effects of MBP on TC, TG, and HDL-C were 36.35%, 12.63%, and 9.41%, respectively. In changes of eGFR, the mediating effects of MBP on TC, TG and HDL-C were 30.20%, 27.70%, and 6.13%, respectively. Conclusions:UA is positively correlated with blood pressure, TC, and TG, and inversely with HDL-C. TC and TG have an impact on renal impairment, in which MBP plays a mediating role.
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Objective:To explore the clinical characteristics and treatment of a family with inherited generalized epilepsy with febrile seizures plus (GEFS + ) caused by the KCNT2 gene mutation and review the literature. Methods:Clinical data of a child with GEFS + and his family members who visited Department of Pediatric Neurology, Guangzhou Women and Children′s Medical Center in May 2019 were collected.DNA samples were collected from the peripheral blood of the proband, his parents, his elder brother, and his maternal grandparents, and genetic analysis and verification were performed using the next-generation sequencing technique.Using " KCNT2" as the key word, literature was retrieved from PubMed, China National Knowledge Infrastructure and Wanfang databases (up to August 2019). Results:The proband was a 3-year-old boy who was admitted to Guangzhou Women and Children′s Medical Center because of frequent epileptic seizures in the past 5 months.He presented with a binocular gaze and experienced 3 to 8 times of extremities myoclonic-spastic epileptic attacks every day.He had a history of 3 times of febrile seizures at the age of 2 years old.His seizures were refractory to Sodium valproate, Topiramate, Nitrazepam and Levetiracetam.His elder brother and mother had a history of childhood febrile seizures.Other members in the family had no history of convulsion.Ictal electroencephalogram showed general 1 Hz high voltage spike-slow waves.A heterozygous nonsense mutation of KCNT2 gene c. 574C>T(p.Q192X) that was never reported previously was detected in the proband, his brother, mother and maternal grandmother.Furthermore, no other family members carried the mutation at the c. 574 locus of the KCNT2 gene.No article in Chinese was found, and 2 articles in a language other than Chinese provided the complete data of 3 sporadic cases.Together with 4 cases in the family studied in this article, there were 7 cases and 4 mutation sites in KCNT2 gene.Of these mutations, there were 3 missense mutations and 1 nonsense mutation.Three sporadic patients presented with early infantile epileptic encephalopathy.The family of this study was characterized with febrile seizures and febrile seizures plus. Conclusions:A de novo mutation and phenotype of the KCNT2 gene is found in a family with GEFS + .It would expand the gene mutation spectrum and provide basis for family genetic counseling. KCNT2 mutation induced GEFS + is refractory to antiepileptic drugs.
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Objective@#To investigate the clinical value of GeneXpert in the rapid diagnosis of rifampicin resistance in tuberculosis and extrapulmonary tuberculosis.@*Methods@#From June 2018 to March 2019, a total of 122 tuberculosis patients admitted to the People's Hospital of Yueqing were selected.Among them, 109 patients with pulmonary tuberculosis and 13 patients with extrapulmonary tuberculosis.GeneXpert MTB/RIF, smear, LJ solid medium, BACTEC MGIT 960 liquid medium four detection methods were used to detect tuberculosis secretion.GeneXpert MTB/RIF, LJ solid medium, BACTEC MGIT 960 liquid medium three detection methods were used to detect extrapulmonary tuberculosis secretion.The sensitivity and specificity of GeneXpert MTB/RIF, smear, LJ solid medium, BACTEC MGIT 960 liquid medium for tuberculosis specimens were detected and compared, and the monitoring results of rifampicin resistance in extracorporeal tuberculosis specimens in culture medium detected by GeneXpert MTB/RIF, LJ solid medium, BACTEC MGIT 960 liquid were observed.@*Results@#The GeneXpert MTB/RIF, smear, LJ solid medium, BACTEC MGIT 960 liquid medium were used to detect 109 cases of tuberculosis, and the detection rates were 94.50%(103/109), 55.04%(60/109), 57.79% (63/109), 61.47%(67/109), respectively.The detection rates of extrapulmonary tuberculosis were 7.69%(1/13), 0.00%(0/13) and 15.38%(2/13), respectively.The sensitivity and specificity of the four methods for the diagnosis of tuberculosis had statistically significant differences(χ2=121.540, 127.610, all P<0.05). The diagnostic efficiency of GeneXpert MTB/RIF was significantly better than smear, LJ solid medium, BACTEC MGIT 960 liquid medium.The results of stratification analysis of rifampicin resistance using GeneXpert MTB/RIF, LJ solid medium and BACTEC MGIT 960 liquid medium showed that there were no statistically significant differences among the three methods and gold standard(χ2=0.750, 0.942, 0.947, all P>0.05).@*Conclusion@#GeneXpert technology has the advantages of simple operation, rapid detection and high detection rate.It has high clinical value for the rapid diagnosis of tuberculosis and extrapulmonary specimens and the detection of rifampicin resistance.
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Objective To explore the clinical significance of centralized surveillance of hydatidiform mole.Methods From Feb.2013 to Feb.2017 all patients with hydatidiform mole,who underwent suction curettage and were confirmed by histopathology in Dalian Maternal and Child Health Care Hospital,were registered centrally for serum hCG monitoring and treatment if necessary.Prophylactic chemotherapy was not administered regardless of risk factors for malignant transformation of hydatidiform mole.The risk factors included age of over 40 years,excessive uterine enlargement for presumed gestational age,a serum hCG level greater than 5 00 000 U/L,large theca lutein ovarian cysts (>6 cm),and a history of previous hydatidiform mole.The centralized surveillance of hydatidiform mole was based on the central pathology review,team cooperation and service improvement.Their treatments and outcomes were analyzed retrospectively.Results A total of 407 women of hydatidiform mole were registered with histopathology confirmation,including 70 high-risk hydatidiform moles.The follow-up rate was 97.5% (397/407).The incidence of post-mole neoplasia was 8.1% (32/397),which was diagnosed in 22.9% (16/70) of high-risk and in 4.9% (16/327) of low-risk hydatidiform moles,showed statistically significant difference between high-risk and low-risk groups (x2=25.108,P<0.01).Thirty-two patients with post-mole neoplasia were all at low risk of International Federation of Gynecology and Obstetrics (FIGO) score (range,0-6) and received complete remission with chemotherapy alone in 31 of them except one treated by hysterectomy.The primary cure rate of single-agent chemotherapy was 60.0% (18/30).Patients with low-risk or high-risk post-mole neoplasia were both 16.There were no significant differences between the two groups in interval that was end of antecedent pregnancy to start of treatment,the serum level of hCG before treatment,clinical stage or risk factor score (all P>0.05).Conclusions The risk of malignant transformation is increased in high-risk hydatidiform mole,however,the high risk factor itself does not affect the prognosis in patients with timely diagnosis and treatment of post-mole neoplasia.Therefore,prophylactic chemotherapy is not recommended to high-risk hydatidiform mole patients.Centralized surveillance of hydatidiform mole is practical in a local hospital of China and could greatly improve the prognosis of post-mole neoplasia.
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Objective To investigate the curative effect of pterygium excision combined with mitomycin C on scleral melting and the prevention of pterygium excision. Methods 54 patients(54 eyes)with clinical pterygium excision combined with mitomycin C who were admitted in our hospital from July 2015 to May 2017 were selected as the observation group, and they were not treated with hormones eye drops after surgery continuously. The 54 patients were given non-hormones eye drops, as well as Beifushu eye ointment until complete recovery. 36 patients admitted in our hospital from July 2013 to June 2015 were chosen as the control group and were treated with pterygium excision. The clinical treatment effect between the two groups was compared. Results All patients underwent conservative treatment with drugs after surgery. After treatment, the scleral appearance of the patients was flat and recovered completely. The effective rate of clinical treatment was 96. 30% in 54 patients of the observation group and 80. 56% in 36 patients of the control group. The scleral appearance of all patients was flat and completely repaired without any complications. No patient had recurrence in the observation group. And 2 patients had recurrence in the control group. Pterygium excision combined with mitomycin C surgery had less safety and better clinical treatment effect compared with simple pterygium excision, which would be paid more attention to in the application to ensure the safety of patients. Conclusion Pterygium excision combined with mitomycin C can effectively improve the clinical efficacy in clinical practice, but will lead to local tissue burns during the operation. Therefore, the concentration and operating time of mitomycin C in the clinical treatment should be paid attention to, to prevent the occurrence of scleral melting.
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Electroencephalogram(EEG) is necessary in diagnosis of status epilepticus (SE),particularly in non-convulsive SE with minor or atypical clinical manifestations.SE is a dynamic process,as seizures continue,in which EEG changed and appeared nonepileptic rhythm discharges.Ictal EEG patterns of SE are non-specific and different types of SE have different EEG features.In this paper,the EEG of different type SE will be summarized.
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Objective To analyze the clinical characteristics of epileptic children at early stage,and to explore the high risk factors for children′s refractory epilepsy(RE)in order to provide evidence for the early and timely treatment of RE.Methods A total of 147 epileptic patients with correct diagnosis and reasonable treatment were enrolled.Forty-nine patients were classified as drug non-responsive epilepsy(DNR-EP group).The remaining 98 patients were classified as drug-responsive epilepsy(DR-EP group).With multiple conditional Logistic regression,the clinical characte-ristics between the 2 groups were compared to identify the early predictors for RE.Results Single factor Logistic regression analysis showed that the initial age of onset <1 year,more than 20 seizures before treatment in a week,focal seizures,more than 2 kinds of epileptic seizures,changes in seizure type in the course of disease,neurological impairment,early intellectual disability,abnormal cranial magnetic resonance imaging(MRI),fixed focal abnormalities on video electroencephalogram(VEEG) after seizure-free interval,diffused anomaly of non-epileptic wave in VEEG before treatment,poor response to initial antiepileptic drugs(AEDs) therapy,compliance with the characteristics of epileptic encephalopathy at early stage significantly increased in DNR-EP group.Then multivariate conditional Logistic regression analysis demonstrated that more than 20 seizures before treatment in a week(OR=2.679,P=0.043),more than 2 kinds of epileptic seizures(OR=4.364,P=0.013),fixed focal abnormalities on VEEG after seizure-free interval(OR=3.898,P=0.008),poor response to initial AEDs therapy(OR=2.611,P=0.036),and compliance with the characteristics of epileptic encephalopathy at early stage(OR=6.022,P=0.002) were the risk factors for developing into RE.Conclusions Children are likely to develop into RE if they have more than 20 seizures before treatment in a week,with more than 2 kinds of epileptic seizures,fixed focal abnormalities on VEEG after seizure-free intervals,poor response to initial AEDs therapy,and compliance with the characteristics of epileptic encephalopathy at early stage.
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Objective:To observe the effect of emotional stimulation on the formation process of atherosclerosis ( AS) ,and explain the role of hydrogen sulfide ( H2 S) in atherosclerotic lesions. Methods:Twenty-four Sprague-Dawley rats were randomly divided into AS group, qi-stagnation and blood-stasis AS group and the control group. The AS group was fed with special diets, the qi-stagnation and blood-stasis AS group was fed with special diets and emotional stimulation, and the control group was fed with normal diets. During the experiment, the indicators including the characterization score, H2 S content, four items of the natural bleeding and blood coagula-tion, tissue blood flow and blood lipid were respectively detected in the 4 th, 8 th and 12 th week. Results:Compared with those in the AS group, since the 4 th week, the rats in qi-stagnation and blood-stasis AS group were with significantly decreased activity, slow re-sponse, lackluster fur and dark purple tongue (P<0. 01);the level of plasma lipid increased significantly, and increased further with time extension(P<0. 05 or P<0. 01);since the 8 th week, APTT and FIB changed significantly (P<0. 05),the blood flow to skin, liver and kidney decreased significantly (P<0. 05);the content of H2S was significantly higher in the 12 th week (P<0. 01). Con-clusion:Emotional stimulation promotes the formation of AS model,and the gas molecule system of H2 S plays a regulatory role in the qi-stagnation and blood-stasis AS animal model.
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Objective To observe the changes of STAT3 signaling transduction pathway and autophagy activity in human glomerular mesangial cells cultured in high glucose, as well as the effect of STAT3 on autophagy, exploring whether SAT3 further influence extracellular matrix proteins type IV collagen secretion through the regulation of autophagy. Methods Culture human renal mesangial cells under different conditions, STAT3 pathway was inhibited with specific blocking agent S3I?201 and siRNA respectively. The experiment was divided into: (1) Control group: normal glucose concentration; (2) High glucose group: divided into 12 h, 24 h, 48 h, 72 h incubation group. (3) High glucose+S3I?201 group: pretreated cells with 30 μmol/L S3I?201 (Selleck S1155) for 1 h, then incubation with high glucose for another 24 hours. (4) High glucose+STAT3?siRNA group: siRNA transfection firstly, then incubation with high glucose for 24 hours. (5) High glucose+S3I?201+3?MA group: pretreated cells with 2 mmol/L 3?MA (Selleck S2767) and 30 μmol/L S3I?201 for 1 h, then incubation with high glucose for another 24 hours. Western blot was employed to detect the protein of STAT3, p?STAT3 and autophagy related protein LC3, p62 expressions. The changes of autophagosome quantity was observed with transmission electron microscope. The extracellular matrix protein collagen IV expression was measured with ELISA. Results Compared with the control group, glomerular mesangial cells cultured with high glucose for 24h, the expressions of STAT3 and p?STAT3 increased (P<0.01), while the expression of autophagy related proteins LC3II/LC3I decreased. The expression of p62 increased and the number of autophagosome reduced under transmission electron microscope, which all indicated the decrease of autophagy activity (P<0.05). Blocking STAT3 signaling pathway with S3I?201 and STAT3?siRNA respectively, compared with high glucose group, LC3II/LC3I was up?regulated and p62 was down?regulated, and the number of autophagosome was increased significantly, which all indicated the increase of autophagy activity (P<0.05). Extracellular matrix proteins collagen IV expression of cells cultured with high glucose was higher than the control group (P<0.05), and the application of S3I?201 blocking STAT3 pathway caused type IV collagen expression to decrease (P<0.05). The application of the autophagy inhibitor 3?MA could convert the result and lead to an increase of type IV collagen expression (P<0.01). Conclusions High glucose could active STAT3 signaling pathway of human renal mesangial cell and increase STAT3, p?STAT3 expression. High glucose could inhibit autophagy activity of human renal mesangial cells. Inhibition of STAT3 pathway activation may reduce the inhibitory effect of high glucose on autophagy of human renal mesangial cells. High glucose leads to an increase of type IV collagen secretion of human glomerular mesangial cells. The activation of STAT3 pathway may increase type IV collagen secretion through negative regulation of autophagy, which eventually leads to diabetic nephropathy.
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OBJECTIVE:To evaluate the content validity and interrater reliability of the modified medication discrepancy tool (MDT). METHODS:According to the structure of MDT(English edition),the terms of MDT were modified,and 5 invited ex-perts used content validity indicator to test the content validity of MDT. The interrater reliability method was adopted to test the reli-ability of MDT. The interrater reliability was performed by 2 evaluators to same 20 research objects with modified MDT. RE-SULTS:Average item-level content validity index was over 0.800,and scale-level content validity index was 0.970. The item-level interrater reliability was between 0.667 and 1.000(P<0.01). The scale-level interrater reliability was 0.840(P<0.01). CONCLU-SIONS:The modified MDT has good content validity and interrater reliability,and can be used to evaluate discharged medication discrepancies in China.
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<p><b>OBJECTIVE</b>To explore the relationship between the renal dysfunction rate and metabolic syndrome(MS), stratified by age.</p><p><b>METHODS</b>People took part in physical check-up in a certain tertiary hospital from March 2010 to September 2012, were enrolled in this study. Estimated glomerular filtration rate (eGFR), -a renal dysfunction indicator, was calculated by modified MDRD equation [<60 ml/min(1.73 m(2))]. Associations between the renal dysfunction rate and factors as age, gender and MS traits, were assessed by stratified analysis.</p><p><b>RESULTS</b>Eligible data from 75 469 subjects were used. The prevalence rates of renal dysfunctions appeared to be 0.05%,0.20%, 1.68% in 18 to 44 year-olds (youth), 45 to 59 year-olds (middle) and 60 year-olds or above (old), respectively. Participants with MS showed a significantly higher risk than those without, in the elderly only (P < 0.05)but not in the other 2 groups (P > 0.05). Participants with 2 components of MS in middle-aged, 3 or 5 components of MS in the elderly showed a significantly high incidence (P < 0.05), but no significant differences seen in other subgroups (P > 0.05). Increasing trend was not seen in all the 3 groups (P > 0.05). Elevated blood pressure (BP+) in youth and middle-aged groups, decreased high density lipoprotein (HDL-C) in middle-aged and elderly groups and elevated fasting plasma glucose (FPG+) in elderly group could all cause the abnormality rate of eGFR which showed significantly high incidence rates in the subgroup analysis (P < 0.05). The maximum of population attributable risk proportion (PAR%) was 41.91% in youth when having elevated BP. Relationship between renal dysfunction rate and triglyceride (TG)/obesity was not identified.</p><p><b>CONCLUSION</b>The prevalence of renal dysfunction was found low, in Xuzhou. The incidence was not associated with the numbers but might relate to the nature of certain components of MS. Increased BP showed both short-term and mid-term effects. Decreased HDL-C, however, indicated both mid-term and long-term effects. The elevated FPG only appeared long-term effects. Increased TG and obesity did not show significant effects in these observed samples. PAR% of increased BP seemed to be the most important factors which might lead to renal dysfunction.</p>
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Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Taxa de Filtração Glomerular , Rim , Síndrome Metabólica , Fatores de RiscoRESUMO
Objective To explore the relationship between the renal dysfunction rate and metabolic syndrome(MS),stratified by age. Methods People took part in physical check-up in a certain tertiary hospital from March 2010 to September 2012,were enrolled in this study. Estimated glomerular filtration rate(eGFR),-a renal dysfunction indicator,was calculated by modified MDRD equation[<60 ml/min(1.73 m2)]. Associations between the renal dysfunction rate and factors as age,gender and MS traits,were assessed by stratified analysis. Results Eligible data from 75 469 subjects were used. The prevalence rates of renal dysfunctions appeared to be 0.05%,0.20%,1.68%in 18 to 44 year-olds(youth),45 to 59 year-olds(middle)and 60 year-olds or above(old),respectively. Participants with MS showed a significantly higher risk than those without,in the elderly only(P<0.05)but not in the other 2 groups(P>0.05). Participants with 2 components of MS in middle-aged, 3 or 5 components of MS in the elderly showed a significantly high incidence (P<0.05),but no significant differences seen in other subgroups(P>0.05). Increasing trend was not seen in all the 3 groups(P>0.05). Elevated blood pressure(BP+)in youth and middle-aged groups,decreased high density lipoprotein(HDL-C)in middle-aged and elderly groups and elevated fasting plasma glucose (FPG+)in elderly group could all cause the abnormality rate of eGFR which showed significantly high incidence rates in the subgroup analysis(P<0.05). The maximum of population attributable risk proportion (PAR%) was 41.91% in youth when having elevated BP. Relationship between renal dysfunction rate and triglyeride(TG)/obesity was not identified. Conclusion The prevalence of renal dysfunction was found low,in Xuzhou. The incidence was not associated with the numbers but might relate to the nature of certain components of MS. Increased BP showed both short-term and mid-term effects. Decreased HDL-C,however,indicated both mid-term and long-term effects. The elevated FPG only appeared long-term effects. Increased TG and obesity did not show significant effects in these observed samples. PAR%of increased BP seemed to be the most important factors which might lead to renal dysfunction.
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Objective To explore the relationship between the renal dysfunction rate and metabolic syndrome(MS),stratified by age. Methods People took part in physical check-up in a certain tertiary hospital from March 2010 to September 2012,were enrolled in this study. Estimated glomerular filtration rate(eGFR),-a renal dysfunction indicator,was calculated by modified MDRD equation[<60 ml/min(1.73 m2)]. Associations between the renal dysfunction rate and factors as age,gender and MS traits,were assessed by stratified analysis. Results Eligible data from 75 469 subjects were used. The prevalence rates of renal dysfunctions appeared to be 0.05%,0.20%,1.68%in 18 to 44 year-olds(youth),45 to 59 year-olds(middle)and 60 year-olds or above(old),respectively. Participants with MS showed a significantly higher risk than those without,in the elderly only(P<0.05)but not in the other 2 groups(P>0.05). Participants with 2 components of MS in middle-aged, 3 or 5 components of MS in the elderly showed a significantly high incidence (P<0.05),but no significant differences seen in other subgroups(P>0.05). Increasing trend was not seen in all the 3 groups(P>0.05). Elevated blood pressure(BP+)in youth and middle-aged groups,decreased high density lipoprotein(HDL-C)in middle-aged and elderly groups and elevated fasting plasma glucose (FPG+)in elderly group could all cause the abnormality rate of eGFR which showed significantly high incidence rates in the subgroup analysis(P<0.05). The maximum of population attributable risk proportion (PAR%) was 41.91% in youth when having elevated BP. Relationship between renal dysfunction rate and triglyeride(TG)/obesity was not identified. Conclusion The prevalence of renal dysfunction was found low,in Xuzhou. The incidence was not associated with the numbers but might relate to the nature of certain components of MS. Increased BP showed both short-term and mid-term effects. Decreased HDL-C,however,indicated both mid-term and long-term effects. The elevated FPG only appeared long-term effects. Increased TG and obesity did not show significant effects in these observed samples. PAR%of increased BP seemed to be the most important factors which might lead to renal dysfunction.
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Objective To investigate risk factors for healthcare-associated infection(HAI)in patients with craniocerebral operation,and provide reference for the prevention and control of HAI.Methods A total of 4 246 cases of craniocerebral surgery in a neurosurgery department from January 2010 to December 2012 were enrolled in the study,the risk fac-tors for HAI were analyzed.Results Of 4 246 cases of craniocerebral surgery,393 patients developed 446 times of post-operative HAI,HAI incidence rate was 9.26%,case infection rate was 10.50%,which were higher than inci-dence (2.02%)and case infection rate (3.02%)of HAI of all hospital during the same period,the difference was statistically significant (χ2 =811 .06,629.30,respectively,P 7 d,antimicrobial use >7 d,central venous and urinary tract cathe-terization,invasive ventilator were risk factors for HAI in patients with craniocerebral operation.Conclusion The incidence of HAI in patients with craniocerebral operation is high,effective preventive and control measures accord-ing to risk factors should be strengthened to reduce the incidence of HAI.
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Objective To observe the distribution of macular thickness and its relationship with axial length, gender, refraction status and race in six-year-old children. Methods 1543 six-year-old children from 34 schools in Sydney were randomly selected. The thickness of center macula(CM), inner macula(IM)and outer macula (OM)were measured by optical coherence tomography (OCT), the differences of macular thickness between different genders and races were comparatively analyzed. The axial length and refraction status of all children were measured by IOL Master and autorefractor RK-F1 respectively. Results The CM, IM and OM thickness of all those six-year-old children were normally distributed,on average they were 193.6, 264.3 and 236.9 μm respectively, the differences were statistically significant (t = 0.40,0. 08,0.20;P<0. 05). The CM,IM and OM average thickness was 194.2,264.9,229.0 μm for boys and 189.3,262.5,231.5 μm for girls respectively. CM and IM thickness of boys were thicker than those in girls(t=0. 15,0. 11;P<0. 05). The CM, IM and OM average thickness was 196.0,265.2,237.5 μm for White kids,186.0,262.3,236.5 μm for East Asia kids and 193.4,263.7,233.8 μm for Central East kids respectively.The CM and IM thickness of White and Central East children were significantly thicker than East Asia children (t=0. 12,0.15; P<0.05). There was no difference between these three races in OM thickness(t=0. 16,P=0.6). The IM and OM were thinner with longer axial length (P<0. 05). The CM,IM and OM thickness was thicker with higher hyperopic degrees (P <0. 05). Conclusions Macular thickness was normally distributed in six-year-old children and was significantly affected by gender, race, axial length and refraction status.
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Objective To evaluate the effect of rocuronium on entropy to endotracheal intubation during anesthesia induction with propofol. Methods Forty patients anesthetized induction with propofol using a target-controlled infusion were randomly divided into two groups: rocuronium group (R group, 20 cases) received 0.6 mg/kg rocuronium or saline group (S group, 20 cases) received saline. 2-3 min later, endotracheal intubation was performed. Response entropy(RE) and state entropy(SE) were recorded during baseline(Ta), at steady state(Tb), 2 min after rocuro nium or saline administration (Tc) and 0, 1, 2 and 3 min after endotracheal intubation (T0, T1, T2, T3). Results At T2, the RE-SE was higher in S group than that in R group. Endotracheal intubation induced increasing in RE and SE. Comparing T2 and T0 values in R group and S group, SE increased from 42 ± 7 to 50 ± 8 and 43 ± 13 to 55 ± 12, and RE increased from 45 ± 6 to 54 ± 9 and 48 ± 16 to 66 ± 15, respectively. At T0, RE and RE-SE were higher in S group. Conclusion Rocuronium affects RE-SE and RE and RE-SE responses to endotracheal intubation and may confound interpretation of entropy monitoring.
RESUMO
A homozygous A to G transition (AGT to GGT) in codon 16 of growth hormone receptor (GHR) gene was found in one patient with idiopathic short stature(ISS), resulting in an amino acid change(Ser16Gly). This may be a novel GHR gene mutation; and another novel Arg43Gln GHR gene polymorphism was found in Chinese people.