Construction and validation of a Nomogram model of intracranial infection after neurosurgery / 中国感染控制杂志

Objective To explore the risk factors for intracranial infection in patients after neurosurgery,con-struct and validate a Nomogram prediction model.Methods Data of 978 patients who underwent neurosurgery in a hospital in Nanjing from January 1,2019 to December 31,2022 were retrospectively analyzed.Independent risk fac-tors were screened through logistic univariate and multivariate analyses.Modeling variables were screened through Lasso regression.A Nomogram model was constructed and internally validated by logistic regression.Effectiveness of the model was evaluated with receiver operating characteristic(ROC)curve,calibration curve and decision curve.Results Among 978 patients underwent neurosurgery,293 had postoperative intracranial infection,with an inci-dence of healthcare-associated infection of 29.96％.There was no significant difference in age,gender,proportion of coronary heart disease,cerebral infarction,diabetes and hypertension between the infected group and the non-in-fected group(all P＞0.05).Multivariate logistic analysis showed that postoperative intracranial hypertension,fe-ver,increased neutrophil percentage in blood routine examination,turbid cerebrospinal fluid,positive Pan's test,decreased glucose concentration,abnormal ratio of cerebrospinal fluid/serum glucose,positive microbial culture,absence of indwelling external ventricular drainage tubes,presence of indwelling lumbar cistern drainage tubes,use of immunosuppressive agents,and long duration of surgery were independent risk factors for postoperative intracra-nial infection in patients who underwent neurosurgery(all P＜0.05).Fifteen variables were screened out through Lasso regression.Fourteen variables were finally included for modeling after collinear screening,missing data impu-tation(random forest method)and checking pairwise interaction items.A Nomogram prediction model was con-structed,with the area under ROC curve,sensitivity,specificity,and accuracy of 0.885,0.578,0.896,and 0.704,respectively.Internal validation of the model was conducted.The modeling and validation groups presented similar effects.The calibration curve and decision curve also indicated that the model had good predictive efficacy.Conclusion The constructed Nomogram prediction model for postoperative intracranial infection after neurosurgery is scientific,and the prediction indicators are easy to obtain.The model presents with high stability,reliability,and application value,thus can provide reference for the assessment of postoperative intracranial infection after neuro-surgery.

HBsAg seroconversion after entecavir therapy for 7 years following a poor response to interferon-α 2b monotherapy in a HBeAg-negative patient with chronic hepatitis B / 南方医科大学学报

We report a rare case of HBsAg seroconversion after 7 years of entecavir therapy in a 48-year-old HBeAg-negative CHB male patient with chronic hepatitis B (CHB). After a poor response to a 48-week interferon-α 2b therapy, the patient received long-term entecavir therapy. Serum ALT levels became normal and HBV DNA viral load was undetectable at the 10th week after commencement of entecavir treatment, and seroconversion of HBsAg was detected after 7 years of entecavir therapy.

Combined therapy with daclatasvir plus asunaprevir for chronic hepatitis C genotype 1b: a case report / 南方医科大学学报

The combination therapy with daclatasvir and asunaprevir can achieve a high sustained viral response rate against hepatitis C virus (HCV) genotype 1, but so far this regimen has not been reported in the treatment of Chinese patients with chronic hepatitis C (CHC) genotype 1b. Here we report a case of CHC genotype 1b in a 44-year-old female chinese patient who was treated with this regimen for 24 weeks. The patient showed sustained viral response after the treatment and was clinically cured. During the treatment, the patient experienced a transient elevation of serum total bilirubin accompanied by lowered hemoglobin fluctuating between 100 and 110 g/L.

Impact of body mass index on blood pressures in a college student population / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the morbidity of hypertension and prehypertension and analyze the association between body mass index (BMI) and blood pressure in Chinese college students.</p><p><b>METHODS</b>This epidemiological study involved 490 Chinese college students (aged 15-25 years, mean 18.9∓1.2 years), and their body height, body weight, blood pressure and heart rate were recorded. The BMI was divided into four groups according to Chinese population standard classification.</p><p><b>RESULTS</b>Most students were southern Han Chinese. The incidences of overweight plus obesity and obesity were 12.9% and 4.1%, respectively. The morbidity of hypertension was 0.8% in this student population. The incidences of hypertension and pre-hypertension were higher in high BMI groups than those in low BMI groups. The systolic blood pressures were significantly higher in over-weight and obese groups than in the normal BMI and lean groups. BMI was positively correlated to systolic and diastolic blood pressures in this population.</p><p><b>CONCLUSION</b>High BMI is a predictor of elevated blood pressure in adolescent students.</p>

Impact of genetic variation of tumor necrosis factor-alpha on gestational hypertension / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The mechanisms responsible for the pathogeneses of gestational hypertension and preeclampsia are unclear. Tumor necrosis factor-alpha (TNF-alpha) is a pro-inflammatory Th(1)-type cytokine. TNFA gene is located in the human leukocyte antigen (HLA) class III region of the major histocompatibility complex (MHC) on chromosome 6. The high TNF-alpha mRNA expression may be associated with the TNF2 (A) allele, which is the polymorphism of TNF-alpha at position -308 in promoter region. This study assessed whether the TNF2 (A) allele at position -308 plays a role in the alteration of blood pressure (BP) and urinary protein excretion during pregnancy.</p><p><b>METHODS</b>The original prospective cohort study comprised 1623 pregnant women from January 2000 to October 2001. The G/A polymorphism was done by restriction fragment length polymorphism (RFLP) analysis with Nco I enzyme.</p><p><b>RESULTS</b>The distributions of the G/A polymorphism of TNF-alpha in the promoter region at position -308 were wild-type 72.4% and variant 27.6%, respectively. The frequency of TNF2 (A) allele was approximately 0.15 for Caucasian pregnant women in the study. It was not significantly different in the distributions of genotypes and G/A allele frequencies among the three groups of pregnant women with gestational hypertension, preexisting hypertension and normal blood pressure (P > 0.05). The maternal blood pressure in the third trimester was significantly higher in the group of women possessing the TNF2 (A) allele compared to homozygous for the TNF1 (G) allele (systolic BP, P < 0.01 and diastolic BP, P < 0.05). The elevated blood pressure in the TNF2 (A) group was accompanied by higher urinary protein excretion in the third trimester (P < 0.05). The blood pressure and urinary protein excretion did not change apparently between the two groups in the first and second trimesters (P > 0.05).</p><p><b>CONCLUSIONS</b>Maternal TNF2 (A) allele of TNF-alpha promoter region at position -308 could play a role in the alteration of blood pressures and/or enhancement of urinary protein excretion during pregnancy, and might play an important role in the development of both gestational hypertension and preeclampsia.</p>