Mortality risk of patients with intestinal obstruction.

BACKGROUND: Intestinal obstruction represents a severe intestinal disease associated with higher mortality rates. However, the determinants of mortality in patients with intestinal obstruction remain inadequately understood. This study sought to elucidate the potential risk factors associated with mortality in the context of intestinal obstruction during the COVID-19 pandemic. METHODS: A retrospective analysis was performed on a cohort of 227 patients diagnosed with intestinal obstruction at the First Hospital of Hebei Medical University, spanning the period from September 7, 2022, to January 7, 2023. The primary endpoint of the study was mortality within four weeks following discharge. Univariate and multivariable logistic regression models were utilized to evaluate the risk factors associated with mortality outcomes. RESULTS: A cohort of 227 patients diagnosed with intestinal obstruction (median age, 59.02 years [IQR, 48.95-70.85 years]) was included in our study. Malignant bowel obstruction (MBO) and COVID-19 were identified as independent risk factors for mortality among these patients. Notably, the mortality rate increased significantly to 38.46% when MBO was concomitant with COVID-19. Furthermore, postoperative pulmonary complications (PPC) (OR, 54.21 [death]; 95% CI, 3.17-926.31), gastric cancer (OR, 9.71 [death]; 95% CI, 1.38-68.18), VTE (Caprini Score ≥ 5) (OR, 7.64 [death]; 95% CI, 1.37-42.51), and COVID-19 (OR, 5.72 [death]; 95% CI, 1.01-32.29) were all determined to be independent risk factors for postoperative mortality. Additionally, gastric cancer could have emerged as one of the most severe risk factors for mortality in individuals with intestinal obstruction within the cohort of cancer patients, of which gastric cancer exhibited higher mortality rates compared to individuals with other forms of cancer. CONCLUSION: The study identifies MBO, gastric cancer, COVID-19, PPC, and VTE as potential risk factors for mortality in cases of intestinal obstruction. These findings highlight the necessity for continuous monitoring of indicators related to these mortality risk factors and their associated complications, thereby offering valuable insights for the management and treatment of intestinal obstruction.

Improvement of Polycystic Ovary Syndrome Symptoms in Obese Patients.

Background: Polycystic ovary syndrome (PCOS) causes normogonadotrophic anovulation, where women experience abnormal and irregular ovulations due to dysfunctions in the hypothalamic-pituitary that ensure normal levels of estradiol are maintained. This study aims to investigate the improvement of PCOS symptoms in obese patients after undergoing bariatric surgery. Methods: We conducted a retrospective study at The First Hospital of Hebei Medical University from 2020 to 2022. We recruited 65 females; the inclusion criteria involved patients who were obese and experiencing infertility issues due to PCOS, patients who consented to undergo bariatric surgery, patients who were aged 22 years to 40 years, and patients who had a post-surgical BMI of ≤ 35 kg/m2. We excluded patients with medical disorders and complications, aged 40 years and above, and patients who showed a post-surgical operation BMI of greater than 35 kg/m2. Results: The patients recorded an average pre-operating BMI of 44 kg/m2 with a mean age of 28 years. Most participants had an average menstrual cycle of 60 to 90 days, with 44% of patients reporting normal menstruation. At 6 months, post-surgery, the average level of prolactin was 11.39 ng/mL, progesterone was 0.4ng/dL, SHBG at 24 nmol/L, estradiol at 24.6 pg/mL, testosterone at 34 pg/mL, LH at 10.2 mIU/ml and FSH at 5.6 mIU/ml. Discussion: Bariatric surgery enhances a reduction in body weight due to lowering BMI levels of serum and total testosterone. The increased sensitivity to insulin reduces resistance to insulin and enhances regulation of hormones. Ovulation and menstrual cycle were restored in women with PCOS due to weight loss and positive regulation of hormones. Moreover, the effects of chronic low-grade inflammations were eliminated due to a significant reduction in the adipose mass and enhanced metabolic parameters. Conclusion: We observed that bariatric surgery improved PCOS symptoms in obese women. Bariatric surgery combined with sustainable weight loss, shows promising improvements in menstrual regularity, hormonal balance, fertility and pregnancy rates for obese women with PCOS, potentially offering them a valuable option for achieving conception.

Occurrence, distribution, potential sources, and risks of organophosphate esters in fresh snow on Urumqi Glacier No. 1, eastern Tien Shan, China.

Organophosphate esters (OPEs), extensively used as flame retardants, are widely detected in various regions and environments. The potential toxicity of OPEs has caused great concern in recent years. Based on the global distillation model, the Tien Shan glaciers, such as Urumqi Glacier No. 1, could be as a potential "sink" for OPEs. However, little is known about the concentration, distribution, potential sources, and ecological risks of OPEs in Tien Shan glaciers. In this study, fresh snow samples were collected at various altitudes on the Urumqi Glacier No. 1, eastern Tien Shan, China. The total concentrations of ten OPEs (Σ10OPEs) ranged from 116 to 152 ng/L. The most abundant OPE was tris-(2-chloroisopropyl) phosphate (TCIPP), contributing to 74 % of the total OPEs. Σ10OPEs, tri-n-butyl phosphate (TnBP), and TCIPP concentrations showed positive correlations with altitude, indicating the effect of cold condensation on OPEs deposition. Based on air mass back-trajectory analysis and principal component analysis, we found that emissions from both traffic and household products in indoor environment were the important sources, and OPEs on the Urumqi Glacier No. 1 might mainly originate from Europe. Our assessment also showed triphenyl phosphate (TPhP) posed a low ecological risk in snow. This is the first systematic study of OPEs on the Tien Shan glaciers.

[Acute toxicity and immunoprotection of recombinant apxI toxin of Actinobacillus pleuropneumoniae in mice].

Acute toxicity and immunoprotection of Actinobacillus pleuropneumoniae (APP) ApxI toxin recombinant proteins (include crude inclusion bodies and refolded recombinant protein) were evaluated in mice, and compared with the natural ApxI extracted from culture supernatant of APP serotype 10. In the acute toxicity experiment, the three proteins were intraperitoneally injected into Kunming mice in a dose of 200microg per mouse. The body and organ weight, heamatological and biochemical indexes were examined at 24h, 7 days and 14 days post administration. There was no death after the intraperitoneal administration of the three proteins, and no significant change was found in the body weight, organ indexes, heamatological and biochemical indexes. To study their immunoprotection, the three proteins were emulsified with Freund's adjuvant respectively and vaccinated the mice twice with a 2-week of interval. Two weeks after the second vaccination, the mice were challenged intraperitoneally with a lethal dose of APP serotype 10 (1.09 x 10(8) cfu), and serums were examined by an ApxI-specific ELISA. The results revealed that the recombinant protein had a good immunogenicity and could induce protection immune reaction.

[Cloning and expression of the Apx IVA gene of Actionbacillus pleuroneumoniae and development of an indirect ApxIVA-ELISA].

Apx IV, a forth RTX toxin indentified in Actionbacillus pleuropneumoniae recently, is expressed by all A. pleuropneumoniae regardless the serotypes and inducible only in vivo toxin, so it is the optimal to develop species-specific and differentiated diagnostic assay. Here the 2445bp DNA fragment of apxIVA gene of A. pleuroneumoniae was amplified and fused in-frame to the downstream of the T7 promoter and 6 His Tag of the prokaryotic expression vector pET-28b. The construct was transformed into E. coli BL21(DE3). After induction by 1.0 mol/L IPTG, a recombinant protein about 90 kD in size, designed as ApxIVAN, was detected, which was present as inclusion bodies and reacted specifically with swine antisera to the APP-serotype-1 by dot-blot. An indirect ELISA (ApxIVA-ELISA) was developed using purified recombinant ApxIVAN from the inclusion bodies as described previously, which had excellent specificity to A. pleuroneunoniae. Using the ApxIVA-ELISA, the ApxIV antibodies were not detected in the inactivated APP bacterins vaccinated pigs, but were detected in A. pleuropneumoniae serotype 1, 2 and 7 infected pigs and mice. These results suggested that ApxIVA-ELISA can be used not only to detect all serotypes of APP, but also to differentiate the naturally infected and inactivated vaccine immunized pigs.