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Objective:To analyze the clinical and laboratory characteristics of patients with cryoglobulinemia.Methods:It is a cross-sectional study. The patients diagnosed with cryoglobulinemia in our hospital were enrolled from July 2017 to March 2023. The baseline information of patients, included age, gender, qualitative, and quantitative results of serum cryoglobulins, initial clinical manifestations, etiology, serum complement 3 and 4, and the renal pathological manifestations. The clinical and laboratory characteristics of patients with different types of cryoglobulinemia were analyzed.Results:There were 62 patients (30.7%) with type Ⅰ cryoglobulinemia, 58 patients (28.7%) with type Ⅱ cryoglobulinemia, and 82 patients (40.6%) with type Ⅲ cryoglobulinemia enrolled in this study. Among these patients, 56 of primary cryoglobulinemia, 76 of autoimmune diseases, 29 of tumor-related diseases, and 52 of infectious diseases were observed. Clinical symptoms related to skin lesions (124 cases, 61.4%) and kidney damage (87 cases, 43.1%) were the most common initial clinical manifestations and arthralgia/arthritis (50 cases, 24.8%), peripheral neuropathy (33 cases, 16.3%), fatigue (28 cases, 13.9%), fever (23 cases, 11.4%) were also observed in some patients. The clinical symptoms varied in different types of cryoglobulinemia. 29.0% patients (18/62) with type Ⅰ had fatigue, which was higher than those with type Ⅱ (10.3%, 6/58) and type Ⅲ (4.9%, 4/82) ( P<0.05); Kidney damage occurred in 56.9% (33/58) patients with type Ⅱ and 52.4% (43/82) patients with type Ⅲ, which was higher than that in type Ⅰ patients (17.7%, 11/62) ( P<0.05); Only 4 patients (4.9%, 4/82) with type Ⅲ had peripheral neuropathy, which was lower than those with type Ⅰ (17.7%, 11/62) and type Ⅱ (31.0%, 18/58) ( P<0.05). The quantity of cryoglobulins in patients with type Ⅲ cryoglobulinemia [122 (82, 177) mg/L] was significantly lower than that in patients with type Ⅰ [695(229, 3 499) mg/L] ( P<0.001) and type Ⅱ cryoglobulinemia [350 (107, 1 874) mg/L] ( P<0.001). Complement 4 decreased in 49.0% (99/202) of patients and complement 3 decreased in 42.6% (86/202) of patients. Membranoproliferative glomerulonephritis (36.0%, 9/25) and endocapillary proliferative glomerulonephritis (32.0%, 8/25) were the main renal pathological manifestations of cryoglobulin nephropathy. Conclusions:The most common clinical manifestations of cryoglobulinemia are skin and kidney damage. The clinical manifestations of patients with cryoglobulinemia vary in different types of cryoglobulins. Serum complement decreases in nearly half of cryoglobulinemia patients.
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Background@#Twenty-four-hour urinary free cortisol (UFC) measurement is the initial diagnostic test for Cushing’s syndrome (CS). We compared UFC determination by both direct and extraction immunoassays using Abbott Architect, Siemens Atellica Solution, and Beckman DxI800 with liquid chromatography-tandem mass spectrometry (LC-MS/MS). In addition, we evaluated the value of 24-hr UFC measured by six methods for diagnosing CS. @*Methods@#Residual 24-hr urine samples of 94 CS and 246 non-CS patients were collected.A laboratory-developed LC-MS/MS method was used as reference. UFC was measured by direct assays (D) using Abbott, Siemens, and Beckman platforms and by extraction assays (E) using Siemens and Beckman platforms. Method was compared using Passing–Bablok regression and Bland–Altman plot analyses. Cut-off values for the six assays and corresponding sensitivities and specificities were calculated by ROC analysis. @*Results@#Abbott-D, Beckman-E, Siemens-E, and Siemens-D showed strong correlations with LC-MS/MS (Spearman coefficient r = 0.965, 0.922, 0.922, and 0.897, respectively), while Beckman-D showed weaker correlation (r = 0.755). All immunoassays showed proportionally positive bias. The areas under the curve were 0.975 for Abbott-D, 0.972 for LCMS/MS, 0.966 for Siemens-E, 0.948 for Siemens-D, 0.955 for Beckman-E, and 0.877 for Beckman-D. The cut-off values varied significantly (154.8–1,321.5 nmol/24 hrs). Assay sensitivity and specificity ranged from 76.1% to 93.2% and from 93.0% to 97.1%, respectively. @*Conclusions@#Commercially available immunoassays for measuring UFC show different levels of analytical consistency compared to LC-MS/MS. Abbott-D, Siemens-E, and Beckman-E have high diagnostic accuracy for CS.
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{L-End}Objective To analyze the correlation between occupational burnout and sleep quality among steelworkers. {L-End}Methods A total of 11 491 steelworkers from a large steel enterprise in Gansu Province were selected as the research subjects using convenient sampling method. The Burnout Questionnaire and the Pittsburgh Sleep Quality Index Scale were used to investigate their occupational burnout and sleep quality. Hierarchical regression analysis was used to analyze the effects of occupational burnout on the sleep quality. {L-End}Results The detection rate of occupational burnout and sleep disorder were 50.4% and 39.0%, respectively. There was a positive correlation between the level of occupational burnout and the total score of sleep quality (Spearman correlation coefficient=0.454, P<0.05). The results of hierarchical regression analysis, adjusting for confounding factors such as gender, age, marital status, education level, alcohol consumption, exercise, weekly working hours, seniority, work shift, noise exposure, dust exposure, and high-temperature work, showed that the score of occupational burnout was positively related to the score of sleep quality(P<0.01), explaining 16.0% of the variance in the score of sleep quality among these steelworkers. {L-End}Conclusion The detection rate of occupational burnout and sleep disorders are relatively high among the steelworkers in this enterprise. Higher levels of occupational burnout are associated with poorer sleep quality. Alleviating occupational burnout among steelworkers may contribute to improving their sleep quality.
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Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) at Neiguan on dexmedetomidine-induced bradycardia in patients.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 20-50 yr, weighing 48-60 kg, scheduled for elective gynecological surgery under general anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: control group (group C) and TEAS group (group T). Dexmedetomidine 1 μg/kg was infused intravenously over 10 min followed by intravenous infusion 0.5 μg·kg -1·min -1 in two groups, and the patients in group T simultaneously received TEAS (frequency 2/100 Hz, disperse-dense wave, intensity 5-10 mA according to the current that could be tolerated) at bilateral Neiguan acupoints.The stimulator was only connected, and no current was given in group C. Before the infusion of dexmedetomidine (T 0) and at 10 min of dexmedetomidine infusion (T 1), mean arterial pressure (MAP) and heart rate (HR) was recorded, and electrocardiogram (ECG) was collected to calculate the PR interval, QT interval, QT interval, Tp-e interval and index of cardiac electrophysiological balance (iCEB). The development of arrhythmia was recorded. Results:Compared with the baseline value at T 0, HR was significantly decreased, and QT interval and PR interval were prolonged at T 1 in two groups, and iCEB was increased, and Tp-e interval was prolonged at T 1 in group C ( P<0.05). Compared with group C, HR was significantly increased, PR interval and Tp-e interval were shortened at T 1, and the incidence of bradycardia and atrioventricular block was increased in group T ( P<0.05). Conclusion:TEAS at Neiguan can decrease the risk of bradycardia induced by dexmedetomidine, and the mechanism may be related to shortening atrioventricular conduction time and reducing heterogeneity of ventricular repolarization in patients.
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Objective To evaluate the value of IVIM-DWI and DTI parameters in quantitative analysis and differential diagnosis of invasive breast carcinoma of no special type(NST).Methods We retrospectively analyzed 60 patients (63 lesions)who underwent MR examination in our hospital and all lesions were verified by pathologic results.MR protocol included DCE-MRI,IVIM-DWI using 14b values and DTI.The ADC,ADCslow,ADCfast,f,λ1of lesions were measured and compared by two independent samples t test between the benign lesions and NST.Logistic regression analysis was made using ADC,ADCslow,f,λ1as predictors in detecting and differentiating the NST,ROC analysis was performed to compare diagnostic performance based on the area under the curve(AUC).Results The ADC,ADCslow,ADCfast,f andλ1of NST were (1.49±0.63)×10-3mm2/s,(1.32±0.49)×10-3mm2/s,(25.98±21.84)×10-3mm2/s,0.20±0.13 and (4.98±0.47)×10-3mm2/s,these values of benign lesions were (2.31±0.66)×10-3mm2/s,(2.24±0.65)×10-3mm2/s,(18.71± 12.26)×10-3mm2/s,0.33±0.15 and(5.59±0.59)×10-3mm2/s.All parameters except ADCfast(P=0.271)had significantly statistical differences (P<0.000 1)between NST and benign lesions.The regression model showed that ADCslowwas an independent predictor in NST’s detection.Conclusion The ADC,ADCslow,f andλ1is helpful for differentiation between NST and benign lesions.The regression model is most valuable in NST detection and ADCslowis the preferred index.
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The proper orthogonai decomposition (POD) method for the instatiouary Navier-Stokes equations is considered. Several numerical approaches to evaluating the POD eigenfunctions are presented. The POD eigenfunctions are applied as a basis for a Galerkin projection of the instationary Navier-Stokes equations. And a low-dimensional ordinary differential models for fluid flows governed by the instationary Navier-Stokes equations are constructed. The numerical examples show that the method is feasible and efficient for optimal control of fluids.
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Two inequalities in the book Navier-Stokes Equations Theory and Numerical Analysis written by Roger Temam are improved via Schwarz's inequality and Young's inequality, and the coefficients of them are simplified from 21/4·31/2 and 21/2·33/4 to 21/4 and 23/4, respectively. Therefore, to some extent the approximating error can be reduced and the accuracy of approximation can be improved.
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We present an algorithm for numerical solution of transport equation in diffusive regimes, in which the transport equation is nearly singular and its solution becomes a solution of a diffusion equation. This algorithm, which is based on the Least-squares FEM in combination with a scaling transformation, presents a good approximation of a diffusion operator in diffusive regimes and guarantees an accurate discrete solution. The numerical experiments in 2D and 3D case are given, and the numerical results show that this algorithm is correct and efficient.