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1.
Ann Hepatol ; 29(2): 101281, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38135250

RESUMEN

INTRODUCTION AND OBJECTIVES: In a recent development, a cohort of hepatologists has proposed altering the nomenclature of non-alcoholic fatty liver disease (NAFLD) to metabolic-associated steatotic liver disease (MASLD), accompanied by modified diagnostic criteria. Our objective was to investigate the effect of the revised definition on identifying significant hepatic fibrosis. PATIENTS AND METHODS: From Jan 2009 to Dec 2022, a total of 428 patients with biopsy-proven hepatic steatosis were diagnosed with NAFLD. Patients were classified into subgroups according to MASLD and Cryptogenic-SLD diagnostic criteria. The clinical pathological features were compared between these two groups. Risk factors for significant fibrosis were analysed in the MASLD group. In total, 329 (76.9 %) patients were diagnosed with MASLD, and 99 (23.1 %) were diagnosed with Cryptogenic-SLD. RESULTS: Those with MASLD exhibited a higher degree of disease severity regarding histology features than Cryptogenic-SLD. The prevalence of significant fibrosis increased from 13 % to 26.6 % for one and two criteria present to 42.5 % for meeting three or more cardiometabolic risk factor (CMRF) criteria (p = 0.001). ALB (aOR:0.94,95 %CI:0.90-1.00; p = 0.030), lower levels of PLT (aOR:0.99, 95 %CI:0.99-1.00; p < 0.001), and more metabolic comorbidities (aOR:1.42,95 %CI:1.14-1.78; p = 0.012) were independent risk factors of significant fibrosis in MASLD. CONCLUSIONS: The new nomenclature of MASLD and SLD is more applicable to identifying significant fibrosis than NAFLD. Patients with three or more cardiometabolic risk factors are at higher risk of fibrosis.


Asunto(s)
Enfermedades Metabólicas , Enfermedad del Hígado Graso no Alcohólico , Humanos , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedades Metabólicas/diagnóstico , Enfermedades Metabólicas/epidemiología , Comorbilidad , Factores de Riesgo , Cirrosis Hepática/diagnóstico , Cirrosis Hepática/epidemiología
2.
China CDC Wkly ; 5(8): 180-183, 2023 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-37008671

RESUMEN

Introduction: In November 2021, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant was identified as the variant of concern and has since spread globally, replacing other cocirculating variants. To better understand the dynamic changes in viral load over time and the natural history of the virus infection, we analyzed the expression of the open reading frames 1ab (ORF1ab) and nucleocapsid (N) genes in patients infected with Omicron. Methods: We included patients initially admitted to the hospital for SARS-CoV-2 infection between November 5 and December 25, 2022. We collected daily oropharyngeal swabs for quantitative reverse transcriptase-polymerase chain reaction tests using commercial kits. We depicted the cycle threshold (Ct) values for amplification of ORF1ab and N genes from individual patients in age-specific groups in a time series. Results: A total of 480 inpatients were included in the study, with a median age of 59 years (interquartile range, 42 to 78; range, 16 to 106). In the <45-year-old age group, the Ct values for ORF1ab and N gene amplification remained below 35 for 9.0 and 11.5 days, respectively. In the ≥80-year-old age group, the Ct values for ORF1ab and N genes stayed below 35 for 11.5 and 15.0 days, respectively, which was the longest among all age groups. The Ct values for N gene amplification took longer to rise above 35 than those for ORF1ab gene amplification. Conclusion: The time to test negative varied among different age groups, with viral nucleic acid shedding taking longer in older age groups compared to younger age groups. As a result, the time to resolution of Omicron infection increased with increasing age.

3.
Neurochem Res ; 48(6): 1822-1834, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36723726

RESUMEN

Lignans are the main components of Syringa pinnatifolia Hemsl. (SP). Previous studies have shown that SP lignans (SPL) can considerably improve CCl4-induced acute liver injury in mice by the anti-oxidative stress (OS) mechanism. In this study, we investigated the antioxidant effects of SPL on cerebral ischemia/reperfusion injury (CIRI) and its underlying molecular mechanism. We developed a middle cerebral artery occlusion/reperfusion (MCAO/R) model in mice to achieve CIRI and orally administered SPL daily for 1-3 days. We evaluated neurological function deficits and performed hematoxylin and eosin staining. We further calculated the infarct volume. Malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx) in the brain were detected using corresponding kits. The transcription and protein levels of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase 1 (HO-1), and NAD(P)H quinone dehydrogenase 1 (NQO1) in brain tissues were analyzed by real-time reverse transcription polymerase chain reaction and western blotting, respectively. The results showed that SPL could remarkably ameliorate neurological functions and pathological damage in brain tissues, reducing the cerebral infarct volume. It also increased the SOD and GPx activities decreased the MDA levels as well as inhibited the expression of (NOX)2 and NOX4. We also found that the mRNA and protein levels of Nrf2, HO-1, and NQO1 in the CIRI mice increased transiently and peaked at 24 h of reperfusion, and then began to decline. SPL could reverse decreasing Nrf2 and HO-1 levels after 24 h. In conclusion, SPL can alleviate CIRI and OS by activating the Nrf2/HO-1 pathway.


Asunto(s)
Isquemia Encefálica , Lignanos , Daño por Reperfusión , Syringa , Ratas , Ratones , Animales , Ratas Sprague-Dawley , Syringa/metabolismo , Factor 2 Relacionado con NF-E2/metabolismo , Estrés Oxidativo , Antioxidantes/farmacología , Hemo-Oxigenasa 1/metabolismo , Isquemia Encefálica/tratamiento farmacológico , Isquemia Encefálica/metabolismo , Daño por Reperfusión/metabolismo , Lignanos/farmacología , Superóxido Dismutasa/metabolismo
4.
Front Public Health ; 11: 1282324, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38249414

RESUMEN

Objective: The study aimed to use supervised machine learning models to predict the length and risk of prolonged hospitalization in PLWHs to help physicians timely clinical intervention and avoid waste of health resources. Methods: Regression models were established based on RF, KNN, SVM, and XGB to predict the length of hospital stay using RMSE, MAE, MAPE, and R2, while classification models were established based on RF, KNN, SVM, NN, and XGB to predict risk of prolonged hospital stay using accuracy, PPV, NPV, specificity, sensitivity, and kappa, and visualization evaluation based on AUROC, AUPRC, calibration curves and decision curves of all models were used for internally validation. Results: In regression models, XGB model performed best in the internal validation (RMSE = 16.81, MAE = 10.39, MAPE = 0.98, R2 = 0.47) to predict the length of hospital stay, while in classification models, NN model presented good fitting and stable features and performed best in testing sets, with excellent accuracy (0.7623), PPV (0.7853), NPV (0.7092), sensitivity (0.8754), specificity (0.5882), and kappa (0.4672), and further visualization evaluation indicated that the largest AUROC (0.9779), AUPRC (0.773) and well-performed calibration curve and decision curve in the internal validation. Conclusion: This study showed that XGB model was effective in predicting the length of hospital stay, while NN model was effective in predicting the risk of prolonged hospitalization in PLWH. Based on predictive models, an intelligent medical prediction system may be developed to effectively predict the length of stay and risk of HIV patients according to their medical records, which helped reduce the waste of healthcare resources.


Asunto(s)
Infecciones por VIH , Humanos , Tiempo de Internación , Estudios Retrospectivos , Infecciones por VIH/epidemiología , Algoritmos , Aprendizaje Automático Supervisado
5.
Front Public Health ; 10: 1000942, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36424978

RESUMEN

Background: The introduction of antiretroviral therapy (ART) has resulted in marked reductions in morbidity among people living with HIV (PLWH). Monitoring the hospitalizations of PLWH is important in evaluating the quality of healthcare and forecasting the co-morbidity pattern. We aimed to describe the trends in the rates and causes of hospitalization among PLWH who initiated ART in an HIV-designated hospital in China. Methods: PLWH who initiated ART and were hospitalized in Beijing Ditan Hospital from 2008 to 2020 were selected for the study. Hospitalizations were classified based on AIDS-defining events (ADEs), non-AIDS-defining events (nADEs), and other causes. Hospitalization rates were calculated in terms of person-years, with risk factors determined by Poisson regression. The proportion of hospitalization causes at different ART treatment statuses was also evaluated. Results: A total of 9,404 patients (94.7% were male patients) were included, contributing to 49,419 person-years. Overall, 1,551 PLWH were hospitalized for 2,667 hospitalization events, among which 60.4% of hospitalizations were due to ADEs, 11.4% were due to nADEs, and 28.2% were due to other causes. Unadjusted hospitalization rates decreased for all causes and all three diagnostic categories with year. After adjusting for the variables that changed substantially over time, ADE-related [IRR, 1.01 (0.96-1.05)] and nADE-related hospitalization rates [IRR, 0.92 (0.84-1.01)] appeared stable. Hospitalization for ADEs constituted an increasing proportion over time (36.3% in 2008-57.4% in 2020), especially in ART-naive inpatients (43.8% in 2008-83.3% in 2020). The proportion of nADE-related hospitalizations remained low (9.0% in 2008-15.4% in 2020). Hospitalization rate was highest for patients treated with ART during the first 6 months after ART initiation (46.2%) when ADEs were still the leading cause of hospitalizations (30.6%). Older age, non-men who have sex with men transmission, late presenters, HIV viral load (VL) > 50 copies/mL, and CD4 counts ≤ 200 cells/µL were associated with a higher hospitalization risk (all P < 0.05). Conclusion: Despite some progress, ADEs remain the most common and serious problem among PLWH in China. In order to avoid deteriorating to the stage of needing hospitalization, more work is needed to diagnose and treat HIV infection earlier.


Asunto(s)
Infecciones por VIH , Humanos , Masculino , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Estudios Retrospectivos , Hospitalización , Factores de Riesgo , Hospitales
6.
J Interv Cardiol ; 2022: 8351304, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35847237

RESUMEN

Objectives: We aimed to compare coronary risk factors, burden of coronary artery disease (CAD), and 1-year prognosis of people living with HIV (PLWH) and HIV-negative controls who underwent percutaneous coronary intervention (PCI) for acute coronary syndromes (ACSs). Background: Cardiovascular disease is drawing more and more attention in PLWH since effective antiretroviral therapy (ART) has been available. Clinical characteristics and outcomes of PLWH undergoing PCI for ACS in China remain unknown. Methods: We compared demographic characteristics, angiographic features, and 1-year outcomes of 48 PLWH versus 48 HIV-negative controls matched for age (±2 years), sex, diabetes mellitus, and year of PCI (±2 years) in Beijing Ditan Hospital, Capital Medical University from January 2008 to November 2020. Results: In PLWH (mean age: 53.6 ± 10.6 years, 95.8% male, and 79.2% on ART), high-density lipoprotein cholesterol was lower than in HIV-negative controls; however, the statin use was more common, the incidence of hypertension was lower, and low-density lipoprotein cholesterol, and the body mass index were significantly lower than in controls. Two groups had a similar extent of coronary atherosclerosis as measured by the presence of multivessel diseases and the median Gensini score; however, lesions of PLWH were longer and were more likely to locate at the proximal segment of the coronary artery. In addition, the risk of major adverse cardiac and cerebrovascular events at 1 year was similar in both groups. Conclusion: PLWH undergoing PCI displayed similar CAD burden and 1-year prognosis compared with HIV-negative patients. Early detection of cardiovascular risk factors and appropriate secondary prevention of CAD in PLWH might alleviate the risk of severe adverse cardiovascular events.


Asunto(s)
Síndrome Coronario Agudo , Enfermedad de la Arteria Coronaria , Infecciones por VIH , Intervención Coronaria Percutánea , Síndrome Coronario Agudo/epidemiología , Síndrome Coronario Agudo/cirugía , Adulto , Colesterol , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/cirugía , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Intervención Coronaria Percutánea/efectos adversos , Factores de Riesgo , Resultado del Tratamiento
7.
Pain Physician ; 25(3): E481-E488, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35652777

RESUMEN

BACKGROUND: Postherpetic neuralgia (PHN), as the most common complication of herpes zoster (HZ), is very refractory to current therapies. Studies of HZ have indicated that early aggressive pain interventions can effectively prevent PHN; therefore, accurately predicting PHN in outpatients with HZ and treating HZ promptly, would be of great benefit to patients. Multiple logistic regression (MLR) has often been used to predict PHN. However, support vector machine (SVM) has been poorly studied in predicting PHN in outpatients with HZ. OBJECTIVE: The aim of our retrospective study was to analyze the data of outpatients with HZ to evaluate the use of SVM for predicting PHN by comparing it with MLR. STUDY DESIGN: A retrospective study. SETTING: Department of Anesthesiology in China. METHODS: The data of 732 outpatients with HZ from January 1, 2015 to May 31, 2020 were reviewed. Risk factors for having PHN in outpatients with HZ were screened using least absolute shrinkage and selection operator (LASSO) algorithm. Then, SVM and MLR were used to predict PHN in outpatients with HZ based on screened risk factors. The data from 600 patients were used for training set and another 132 patients for test set. The receiver operating characteristic (ROC) curve was drawn from the 132 test set of patients. The prediction accuracy of the models was assessed using the area under curve (AUC). RESULTS: The incidence of having PHN in outpatients with HZ was 19.4%. The risk factors selected by LASSO algorithm were gender, age, VAS scores, skin lesion area, initial treatment time, anxiety, sites of HZ (multiple skin lesions), types of HZ (bullous) and types of pain (knife cutting). The AUC for the SVM and MLR in test set were 0.884 versus 0.853. According to the ROC curve, the specificity and the sensitivity were 0.879 and 0.840 for SVM, and 0.780 and 0.840 for MLR, respectively. LIMITATIONS: Retrospective study and relatively small sample size. CONCLUSIONS: Both SVM and MLR had good discriminative power, but SVM has better performance in predicting PHN in outpatients with HZ, regarding the prediction accuracy and specificity.


Asunto(s)
Herpes Zóster , Neuralgia Posherpética , Herpes Zóster/complicaciones , Herpes Zóster/epidemiología , Humanos , Modelos Logísticos , Neuralgia Posherpética/prevención & control , Pacientes Ambulatorios , Estudios Retrospectivos , Máquina de Vectores de Soporte
8.
Cancer Biol Ther ; 23(1): 89-95, 2022 12 31.
Artículo en Inglés | MEDLINE | ID: mdl-35230928

RESUMEN

This study aimed to compare the treatment efficacy and tolerance between drug-eluting beads transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (cTACE) in hepatocellular carcinoma (HCC) patients with arterioportal fistula (APF). A total of 44 HCC patients with APF scheduled for DEB-TACE (N = 24, as DEB-TACE group) or cTACE (N = 20, as cTACE group) were recruited. Treatment response, hepatic function, and adverse events were assessed or recorded. Besides, progression-free survival (PFS) and overall survival (OS) were calculated. Total treatment response was better in the DEB-TACE group compared with the cTACE group (P = .012). Meanwhile, the objective response rate (87.5% versus 60.0%) was higher (P = .013), while the disease control rate (95.8% versus 85.0%) was similar in the DEB-TACE group compared to the cTACE group (P = .213). Besides, PFS (mean value: 12.2 (95%CI: 9.9-14.6) months versus 7.8 (95%CI: 5.6-10.0) months) (P = .037), but not OS (mean value: 20.0 (95%CI: 18.1-21.9) months versus. 18.6 (95%CI: 15.4-21.8) months) (P = .341) was prolonged in DEB-TACE group compared with cTACE group. Regarding the safety, Child-Pugh stage, albumin level, and bilirubin level after treatment were all similar between the DEB-TACE group and cTACE group (all P > .05); moreover, no difference was found in the occurrence of adverse events during or after treatment between the two groups (all P > .05). Moreover, subsequent analyses found that embolic materials for APF (microspheres) in the DEB-TACE group did not affect the treatment efficacy (all P > .05). DEB-TACE promotes treatment response and PFS compared with cTACE and shows good safety in HCC patients with APF.


Asunto(s)
Carcinoma Hepatocelular , Quimioembolización Terapéutica , Fístula , Neoplasias Hepáticas , Carcinoma Hepatocelular/patología , Quimioembolización Terapéutica/efectos adversos , Fístula/terapia , Humanos , Neoplasias Hepáticas/patología , Estudios Retrospectivos , Resultado del Tratamiento
9.
Front Psychiatry ; 12: 596428, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34867493

RESUMEN

Purpose: Understand the effects of the COVID-19 pandemic on depression in intensive care unit (ICU) nurses, analyze high-risk factors, and propose appropriate measures to maintain physical and mental health. Methods: A total of 78 nurses in ICU of Beijing Ditan Hospital affiliated with Capital Medical University (Beijing area, COVID-19 patient designated hospital) were investigated with self-rating depression scale (SDS). The Cronbach'sαcoefficient was 0.874, the content validity was 0.853, and the internal consistency was good. General information for the questionnaire: gender, marriage, education, age, title, length of service, ICU years of service, COVID-19 pandemic training, concerns about the COVID-19 pandemic, and current health status. Results: According to the SDS scale score, ICU nurses had a total depression score of 51.36 ± 11.667, and the prevalence rate of depression was 44.9% (35/78). Multi-line regression analysis shows that stress perception, work experience in critical diseases, education and other total scores are risk factors for the occurrence of depression. Conclusion: Work experience in critical illness (ß = 9.930, P < 0.001) had a positive predictive effect on the total score of depression, while stress perception (ß = -0.884, P < 0.001) and education (ß = -6.061, P < 0.001) had a negative predictive effect on the total score of depression, and explained 52.7% variation. These findings point to the need for interventions to address psychological distress and provide the necessary support.

10.
Front Psychol ; 12: 614193, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34531776

RESUMEN

Objective: To analyze the discrepancy between self-rating and professional evaluation of mental health status in coronavirus disease 2019 (COVID-19) cluster cases. Method: A total of 65 COVID-19 cluster cases admitted to Beijing Ditan Hospital Capital Medical University from June 14, 2020 to June 16, 2020 were included in the study. Mental health assessment was completed by self-rating and professional evaluation. The gaps between self-rating and professional evaluation in different demographic characteristics were compared. Results: The results of self-rating were inconsistent with those of professional evaluation. The gap was statistically different among certain demographic subgroups. As for anxiety, the gaps had remarkable statistics differences in subgroups of sex, monthly income, infection way, and anxiety/depression medical history. Similarly, in the terms of depression, the gaps had significant statistic differences in the subgroups of the medical history of anxiety/depression, history of physical disease, employment status and the insurance type, marriage, education (year), residing in Beijing (year), and the monthly income. Conclusion: Compared to the professional evaluation, patients had a higher self-rating, which may be related to some demographic characteristics. It suggests that screening can be conducted in patients with COVID-19 by self-rating first, and then professional evaluation should be carried out in the patients with suspicious or positive results.

11.
Am J Transl Res ; 13(7): 7677-7686, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34377244

RESUMEN

The present study aimed to compare the efficacy and safety of drug-eluting beads-transarterial chemoembolization (DEB-TACE) plus microwave ablation (MWA) versus (vs.) surgery in treating patients with hepatocellular carcinoma (HCC) adjacent to gallbladder. Totally 54 patients with HCC adjacent to gallbladder were included and divided into two groups: DEB-TACE plus MWA group (n = 24) and surgery group (n = 30). Treatment response, relapse-free survival (RFS), progression-free survival (PFS), overall survival (OS) and adverse events were assessed and documented. For DEB-TACE plus MWA group, complete response rate, objective response rate and disease control rate were 79.2%, 95.8% and 100.0% after one-month post treatment, respectively. In terms of survival profiles, DEB-TACE plus MWA group presented similar RFS (28.2 (95% CI: 12.5-43.9) months vs. 26.6 (95% CI: 19.2-34.1) months) (P = 0.930), PFS (21.2 (95% CI: 1.6-40.8) months vs. 26.6 (95% CI: 19.2-34.1) months) (P = 0.541), and OS (41.4 (95% CI: 35.0-47.9) months vs. 59.7 (95% CI: 51.7-67.7) months) (P = 0.138) compared with surgery group, and further multivariate Cox's regression analysis validated that, after adjustment of confounding factors, DEB-TACE plus MWA group exhibited no difference of RPS, PFS or OS compared with surgery group. Regarding safety, the intraoperative adverse event incidence was higher in DEB-TACE plus MWA group compared with surgery group (P = 0.008), while two groups exhibited no difference of postoperative adverse event incidence (P = 0.618). In conclusion, DEB-TACE plus MWA presents to be an optional treatment strategy in patients with HCC adjacent to gallbladder.

12.
BMC Infect Dis ; 20(1): 910, 2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-33261583

RESUMEN

BACKGROUND: Both COVID-19 and influenza A contribute to increased mortality among the elderly and those with existing comorbidities. Changes in the underlying immune mechanisms determine patient prognosis. This study aimed to analyze the role of lymphocyte subsets in the immunopathogenesisof COVID-19 and severe influenza A, and examined the clinical significance of their alterations in the prognosis and recovery duration. METHODS: By retrospectively reviewing of patients in four groups (healthy controls, severe influenza A, non-severe COVID-19 and severe COVID-19) who were admitted to Ditan hospital between 2018 to 2020, we performed flow cytometric analysis and compared the absolute counts of leukocytes, lymphocytes, and lymphocyte subsets of the patients at different time points (weeks 1-4). RESULTS: We reviewed the patients' data of 94 healthy blood donors, 80 Non-severe-COVID-19, 19 Severe-COVID-19 and 37 severe influenza A. We found total lymphocytes (0.81 × 109/L vs 1.74 × 109/L, P = 0.001; 0.87 × 109/L vs 1.74 × 109/L, P < 0.0001, respectively) and lymphocyte subsets (T cells, CD4+ and CD8+ T cell subsets) of severe COVID-19 and severe influenza A patients to be significantly lower than those of healthy donors at early infection stages. Further, significant dynamic variations were observed at different time points (weeks 1-4). CONCLUSIONS: Our study suggests the plausible role of lymphocyte subsets in disease progression, which in turn affects prognosis and recovery duration in patients with severe COVID-19 and influenza A.


Asunto(s)
Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , COVID-19/inmunología , Virus de la Influenza A/genética , Gripe Humana/inmunología , SARS-CoV-2/genética , Índice de Severidad de la Enfermedad , Adulto , Anciano , Beijing/epidemiología , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/virología , Comorbilidad , Estudios Transversales , Progresión de la Enfermedad , Femenino , Citometría de Flujo , Humanos , Gripe Humana/epidemiología , Gripe Humana/virología , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos
13.
Biosci Trends ; 13(2): 136-144, 2019 May 12.
Artículo en Inglés | MEDLINE | ID: mdl-30930360

RESUMEN

We construct and validate a non-invasive clinical scoring model to predict mortality in HIV/TB patients at end stage of AIDS in China. There were 1,007 HIV/TB patients admitted to Beijing Ditan Hospital from August 2009 to January 2018 included in this study, who were randomly assigned to form derivation cohort and validation cohort. A clinical scoring model was developed based on predictors associated with mortality identified with Cox proportional hazard models. The discrimination and accuracy of model were further validated using the area under the ROC curves. The derivation and validation cohort consisted of 807 and 200 patients in 8:2 ratio, respectively. In derivation cohort, anemia (HGB < 90g/L), tuberculous meningitis, severe pneumonia, hypoalbuminemia, unexplained infections or space-occupying lesions, and malignancies remained independent risk factors of mortality in HIV/TB co-infected patients, and included in this clinical scoring model. The model indicated good discrimination, including AUC = 0.858 (95% CI: 0.782-0.943) in the derivation cohort, and AUC = 0.867 (95% CI: 0.832-0.902) in validation cohort, respectively. The predicted scores were categorized into two groups to predict the mortality: low-risk (0-2 points with mortality with 3.6-9.1%) and high-risk (4-16 points with mortality with 26.42-74.62%), in which 54.55% and 74.62% of patients with score of 5 to 11 and 12-16 were died among high-risk group. Kaplan-Meier curve indicated a significant difference in the cumulative mortality in the two groups by log-rank test (p < 0.001). A clinical scoring model to assess the prognosis in HIV/TB patients at end stage of AIDS was constructed based on simple laboratory and clinical features available at admission, which may be an easy-to-use tool for physicians to evaluate the prognosis and treatment outcome in HIV/TB co-infected patients. The model was also applicable for predicting the death of end-stage HIV/TB patients within a 12 months period after discharge.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/mortalidad , Coinfección/mortalidad , Modelos Teóricos , Tuberculosis/mortalidad , Adulto , China/epidemiología , Estudios de Cohortes , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Reproducibilidad de los Resultados , Factores de Riesgo
14.
Biomed Res Int ; 2019: 6057028, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30906778

RESUMEN

We aimed to develop and validate a predictive model to evaluate in-hospital mortality risk in HIV/AIDS patients with PCP in China. 1001 HIV/AIDS patients with PCP admitted in the Beijing Ditan hospital from August 2009 to January 2018 were included in this study. Multivariate Cox proportional hazard model was used to identify independent risk factors of death, and a predictive model was devised based on risk factors. The overall in-hospital mortality was 17.3%. The patients were randomly assigned into derivation cohort (801cases) and validation cohort (200 cases) in 8:2 ratio, respectively, in which in derivation cohort we found that 7 predictors, including LDH >350U/L, HR>130 times/min, room air PaO2 <70mmHg, later admission to ICU, Anemia (HGB≤90g/L), CD4<50cells/ul, and development of a pneumothorax, were associated with poor prognosis in HIV/AIDS patients with PCP and were included in the predictive model. The model had excellent discrimination with AUC of 0.904 and 0.921 in derivation and validation cohort, respectively. The predicted scores were divided into two groups to assess the in-hospital mortality risk: low-risk group (0-11 points with mortality with 2.15-12.77%) and high-risk group (12-21 points with mortality with 38.78%-81.63%). The cumulative mortality rate also indicated significant difference between two groups with Kaplan-Meier curve (p<0.001). A predictive model to evaluate mortality in HIV/AIDS patients with PCP was constructed based on routine laboratory and clinical parameters, which may be a simple tool for physicians to assess the prognosis in HIV/AIDS patients with PCP in China.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Síndrome de Inmunodeficiencia Adquirida/mortalidad , VIH-1 , Mortalidad Hospitalaria , Neumonía por Pneumocystis/mortalidad , Infecciones Oportunistas Relacionadas con el SIDA/terapia , Síndrome de Inmunodeficiencia Adquirida/terapia , Adulto , China/epidemiología , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía por Pneumocystis/terapia , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
15.
Int J Biol Macromol ; 127: 511-519, 2019 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-30660568

RESUMEN

Superadsorbent hydrogel was prepared from lignin and montmorillonite for Cu(II) ions removal, and the chemical structure and morphology of the hydrogel were characterized by FT-IR, XRD, SEM and XPS. The swelling kinetics of the prepared hydrogel was investigated, and the result showed that the swelling process fit the Schott second-order dynamic equation. The influences of pH, contact time, Na+ concentration, and initial Cu(II) ion concentration on adsorption were studied, and the maximum adsorption value was 1.17 mmol/g, and the adsorption was rapid during the initial 5 h period, and copper ions adsorption on the superadsorbent hydrogel is a favorable process. The results also indicated that the adsorption kinetics was in accordance with the pseudo-second-order kinetic model and the adsorption isotherm conformed to the Freundlich model. FT-IR and XPS analysis revealed that the adsorption behavior was mainly due to ion exchange. The desorption ratios of copper ions from the superadsorbent were >0.8, and the regeneration efficiency was >80% after five cycles reuse, and the results show the excellent desorption performance and reusability of the prepared hydrogel.


Asunto(s)
Bentonita/química , Cobre/química , Lignina/química , Contaminantes Químicos del Agua/química , Purificación del Agua , Agua/química , Adsorción
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