Causal relationship between atrial fibrillation/warfarin and cutaneous melanoma: a two-sample Mendelian randomization study.

Purpose: In recent years, the relationship between malignant tumors and atrial fibrillation has attracted more and more attention. Atrial fibrillation can also cause a series of adverse events, such as the risk of thromboembolism. Also, Warfarin is often used here. But, the relationship between cutaneous melanoma and atrial fibrillation, and between cutaneous melanoma and warfarin is still unclear. Therefore, we used a two-sample Mendelian randomization to assess the causal relationship between atrial fibrillation/warfarin and cutaneous melanoma (cM). Methods: Firstly, atrial fibrillation (ukb-b-11550; nCase = 3,518, nControl = 459,415) and warfarin (ukb-b-13248; nCase = 4,623, nControl = 458,310) as exposures, with genome-wide association studies (GWAS) data from the United Kingdom Biobank. And cM (ieu-b-4969; nCase = 3,751, nControl = 372,016) as outcome, with GWAS data from the IEU Open GWAS project. Subsequently, single-nucleotide polymorphisms (SNPs) were filtered from GWAS studies using quality control measures. In addition, two-sample Mendelian randomization (MR) analysis was performed to explore the causal relationship between atrial fibrillation or warfarin and cM and used inverse variance weighting (IVW) as the primary analytical method. Finally, relevant heterogeneity and sensitivity analysis were performed to ensure the accuracy of the results. Results: A causal relationship between atrial fibrillation and cutaneous melanoma was observed, and between warfarin and cutaneous melanoma. Conclusion: The atrial fibrillation may play a causal role in the development of cutaneous melanoma, but the mechanism and the causal relationship between warfarin and cutaneous melanoma needs to be further elucidated.

Interpretation of Gamma-ray spectrometry method for the determination of radionuclides in environmental and biological samples / 中国辐射卫生

Abstract@#As a rapid analytical method for both the types and activities of γ radionuclides, the γ-ray spectrometry method is widely used in the measurement of γ radionuclides in environmental and biological samples. The Gamma-ray Spectrometry Method for the Determination of Radionuclides in Environmental and Biological Samples (GB/T 16145—2022）was implemented  on  July  1,  2023,  replacing  the Determination of Radionuclides in Soil by Gamma Spectrometry (GB/T 11743—2013), Determination of Radionuclides in Water by Gamma Spectrometry (GB/T 16140—2018), Gamma Spectrometry Method of Analyzing Radionuclides in Biological Samples (GB/T 16145—2020), and Determination of Radionuclides in Air by Gamma Spectrometry (WS/T 184—2017). The background of the revised standard, the content and basis of the main revisions, and some issues that need to be discussed are briefly explained in this paper, in order to provide a useful reference for the detection of radioactivity in soil, water, biological, and air samples, as well as samples of similar matrices.

Exposure due to radionuclides in food other than during a nuclear or radiological emergency — Introduction to IAEA Safety Reports Series No. 114 / 中国辐射卫生

This paper briefly introduces the main content of IAEA Safety Reports Series No. 114. The aim is to further understand the status and development of exposure due to radionuclides in food other than during a nuclear or radiological emergency, as well as to provide references for the revision and improvement of the limited concentration standard of radioactive substances in food in China.

Heme oxygenase-1 enhances the anti-HBV effect of IFN-αby inducing the expression of antiviral proteins / 安徽医科大学学报

Objective To investigate the role of heme oxygenase-1(HO-1)on HBV replication and the antiviral effect of HO-1 combined with α-interferon(IFN-α).Methods HepG2.2.15 cells and HBV1.3-transfected HepG2 cells(HepG2-HBV1.3)were used as HBV replicating cell models;Hemin treated HepG2.2.15 and HepG2-HBV1.3 cells,to induce the expression of HO-1 molecules.CCK-8 method was used to assess the toxic effects of Hemin on HepG2 and HepG2.2.15;chemiluminescence method was used to analyze HBsAg and HBeAg in the supernatants of Hemin-treated group and si-HO-1 and other experimental groups;RT-qPCR was used to ana-lyze HO-1,IFN-β and HBV-DNA;Western blot was used to analyze the expression of IRF-3 and the expression of related molecules in the JAK/STAT signaling pathway;Hemin combined with IFN-α treated HepG2.2.15 to moni-tor whether HO-1 had synergistic IFN-α antiviral effect.Results Hemin dose-dependently induced HO-1,and HO-1 was induced to exert a significant anti-HBV effect,while the expression of IFN-β,IRF-3,and IRF-9 and MxA,downstream molecules of the JAK/STAT signaling pathway,were all increased.Silencing HO-1 expression reversed the antiviral effect in the Hemin-induced group,and at the same time,type Ⅰ interferon IFN-β showed low expression,and the expression of IRF-9 and MxA in the JAK/STAT signaling pathway was inhibited as well.He-min combined with IFN-α exerted stronger antiviral effects.Conclusion HO-1 can exert an anti-HBV effect,which may be due to increased phosphorylation of IRF-3 to induce type Ⅰ interferon expression and thus activate the JAK/STAT signaling pathway to exert an antiviral effect;HO-1 can synergize with IFN-α to exert an antiviral effect.

Incidence of venous thromboembolism in esophageal cancer: a real-world study of 8 458 cases / 中华消化外科杂志

Objective:To investigate the incidence of venous thromboembolism (VTE) in patients with esophageal cancer (EC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 8 458 EC patients who were admitted to Sichuan Cancer Hospital from January 2017 to December 2021 were collected. There were 6 923 males and 1 535 females, aged (64±9)years. There were 3 187 patients undergoing surgical treatment, and 5 271 cases undergoing non-surgical treatment. Observation indicators: (1) incidence of VTE in EC patients; (2) treatment and outcomes of patients with VTE. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the nonparameter rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparameter rank sum test. Results:(1) Incidence of VTE in EC patients. Of 8 458 EC patients, 175 cases developed VTE, with an incidence rate of 2.069%(175/8 458). Among 175 VTE patients, there were 164 cases of deep venous thrombosis (DVT), 4 cases of pulmonary embolism (PE), 7 cases of DVT and PE. There were 59 surgical patients and 116 non-surgical patients. There was no significant difference in thrombus type between surgical and non-surgical EC patients with VTE ( χ2=1.95, P>0.05). Of 3 187 surgical patients, the incidence of VTE was 1.851%(59/3 187), including an incidence of 0.157%(5/3 187) of PE. PE accounted for 8.475%(5/59) of surgical patients with VTE. Of 5 271 non-surgical patients, the incidence of VTE was 2.201%(116/5 271), including an incidence of 0.114%(6/5 271) of PE. PE accounted for 5.172%(6/116) of non-surgical patients with VTE. There was no significant difference in the incidence of VTE or PE between surgical patients and non-surgical patients ( χ2=1.20, 0.05, P>0.05). (2) Treatment and outcomes of patients with VTE. Among 175 EC patients with VTE, 163 cases underwent drug treatment, and 12 cases did not receive treatment. Among 163 cases with drug therapy, 158 cases underwent anticoagulant therapy, 5 cases were treated with thrombolysis. All the 163 patients were improved and discharged from hospital. Conclusions:The incidence of VTE in patients with EC is relatively low, as 2.069%. There is no significant difference in the incidence of VTE or thrombus type between surgical EC patients and non-surgical EC patients.

New advances in stroke and cerebral embolism protection devices in transcatheter aortic valve replacement / 中国介入心脏病学杂志

Stroke is one of the most serious complications of transcatheter aortic valve replacement(TAVR),tremendously increasing mortality and the loss of neurocognitive function.Since TAVR is expected to further spread into lower-risk patient groups,there will be greater emphasis to obviate such serious complications.One possible technique for preventing stroke is using cerebral embolic protection devices(CEPDs).CEPDs are designed for capturing or deflecting emboli that are enter route to the brain and hence to protect the brain from embolism.Since this is a rapidly growing field with recent advances,and the impact of CEPD on preventing neurological events is still limited,there is an urgent need for understanding the role of CEPD in preventing clinically significant strokes.Although their clinical utilization is increasing,the risk factors for stroke related to TAVR and evidence for using CEPDs are not yet clear.In this review,we present an overview of the available literature on TAVR related stroke and CEPD,and outline recent advances within this field.

Prognosis analysis of marginal heart donor in heart transplantation / 中华胸心血管外科杂志

Objective:To investigate the prognosis of marginal donor heart in heart transplantation.Methods:The clinical data of consecutive heart transplant recipients and donors in Zhengzhou 7th. People’s Hospital from April 2018 to November 2022 were retrospectively included. According to the definition of marginal donor hearts, the patients were divided into conventional donor hearts group (117 cases) and marginal donor hearts group ( 62 cases), the data before and after heart transplantation of the two groups were analyzed.Results:The main reason for the formation of marginal donor hearts was the cold ischemia time of donor hearts >6 h; it was easier to receive marginal donor hearts with ECMO and MV before operation; the use of marginal donor hearts in heart transplantation increased postoperative mechanical ventilation time, surgical post-intensive care unit length of stay; patients with marginal donors had lower survival than conventional donors, but did not produce a significant difference in survival after heart transplantation.Conclusion:The application of marginal donor heart in heart transplantation is an effective method to solve the shortage of heart organs and reduce the death of transplant waiting persons.

Effects of miR-155 on apoptosis of chronic myeloid leukemia cells and expression of heat shock proteins / 安徽医科大学学报

Objective @# To explore the effects of microRNA-155 (miR-155) on apoptosis of chronic myeloid leukemia ( CML) cells，and the influence of miRNA-155 regulating the expression of heat shock proteins ( HSP) 27， HSP60，HSP70．@*Methods @#Reverse transcription-quantitative real-time PCR ( RT-qPCR) was used to detect the expression levels of miR-155 in CML-resistant imatinib (IM) cell line K562-G and CML cell line K562 ．K562-G cells were infected with the lentivirus carrying miR-155 or the negative control lentivirus ，and they were named miR-155 group and control group．The effect of miR-155 on the proliferation of drug-resistant cells was detected by cell counting kit-8 ( CCK-8) method. RT-qPCR and Western blot were used to detect the effect of miR-155 on the expression of heat shock proteins HSP27，HSP60，HSP70．Flow cytometry was used to detect the percentage of cell apoptosis in miR-155 group and control group. @*Results @#ompared with K562 cells，miR-155 showed low expres- sion in K562-G cells (P ＜0. 05) ．The proliferation of miR-155 group cells decreased significantly from the 36th hour (P＜0. 05) ．Compared with the control group，in the miR-155 group，HSP60 and HSP70 increased (P < 0. 05) ，while HSP27 decreased (P＜0. 01) ．The apoptosis rate of miR-155 group was higher than that of control group (P＜0. 05) ．@*Conclusion @#miR-155 promotes the apoptosis of chronic myeloid leukemia cells，increases the expression of HSP60 and HSP70，and decreases the expression of HSP27 .

Transfer of cascade coincidence summing correction factors / 中国辐射卫生

Objective To further extend the application of coincidence summing correction factor transfer experiments through the analysis of relevant measurements. Methods The passive efficiency was simulated using BE5030 high-purity germanium (HPGe) γ-energy spectrometer equipped with LabSOCS, and the total efficiency was simulated using LabSOCS in GENIE 2000 spectrum analysis software, which was used for calculating the coincidence summing correction factor. The coincidence summing correction factor transfer experiments were performed using the measurements with the point source containing 134Cs, 60Co, and 137Cs as well as the body source to obtain the coincidence summing correction factors of other HPGe γ-energy spectrometers. Results The coincidence summing correction factors for 134Cs and 60Co were obtained using the BE5030 γ-energy spectrum. In verification by certificate activity, the absolute value of the maximum deviation was within 3.53%. Using coincidence summing correction factor transfer experiments, these factors were transferred to other high-purity germanium γ spectrometers. In verification by certificate activity, the absolute value of the maximum deviation was within 5.86%. Conclusion The coincidence summing correction factors calculated using simulated total efficiency by calling LabSOCS in the GENIE 2000 spectrum analysis software are effective in correction, and can be used as correction factors in standard laboratories. Through coincidence summing correction factor transfer experiments, the coincidence summing correction of other high-purity germanium γ-energy spectrometers can be achieved, which broadens the application of coincidence summing correction method.

Effect of Physical Activity on the Association Between Diet and Constipation: Evidence From the National Health and Nutrition Examination Survey 2007-2010

Background/Aims@#Previous studies have shown that diet and physical activity can influence constipation. However, the combined effect of diet and physical activity on constipation remains unclear. @*Methods@#Constipation was defined based on stool consistency and frequency, while overall diet quality was assessed using Healthy Eating Index (HEI)-2015 scores. Participants were categorized into low (metabolic equivalent [MET]-min/wk < 500) and high physical activitygroups (MET-min/wk ≥ 500). The association between diet and constipation across physical activity groups was analyzed using surveylogistic regression and restricted cubic splines. @*Results@#Higher HEI-2015 scores were associated with reduced constipation risk in the high physical activity group when constipation was defined by stool consistency (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97-0.99). However, in the low physical activity group, increased HEI-2015 scores did not significantly affect constipation risk (OR, 1.01; 95% CI, 0.97-1.05). Similar results were found when constipation was defined based on stool frequency. In the high physical activity group, increased HEI-2015 scores were significantly associated with a reduced constipation risk (OR, 0.96; 95% CI, 0.94-0.98). Conversely, in the low physical activity group, increased HEI-2015 scores did not affect the risk of constipation (OR, 0.96; 95% CI, 0.90-1.03). @*Conclusions@#Our findings suggest that a higher HEI-2015 score is negatively associated with constipation among individuals with high physical activity levels but not among those with low physical activity levels. This association was consistent when different definitions of constipation were used. These results highlight the importance of combining healthy diet with regular physical activity to alleviate constipation.

Analysis of food sample composition for gamma spectrometry-based sourceless efficiency simulation / 中华放射医学与防护杂志

Objective:To recommend reference composition for sourceless efficiency calibration of food gamma spectrometry by analyzing the composition of common foods based on a combination of sourceless efficiency calibration and active validation.Methods:Thirty common types of food samples in countrywide monitoring of radioactively contaminated foods were analyzed to statistically determine the reference composition of grains and vegetables. Combined with the parameters provided for white quinoa standard source, LabSOCS was applied to carry out the simulation of sourceless efficiency for its different compositions, and to calculate its measured activity, and analyzing its relative deviation to the those given in the certificate.Results:The analytical result of these 30 types of food samples showed that the five elements C, H, O, N and S accounted for 77.0%-93.7% of the food composition, being the main component of these samples. By applying white quinoa′s components and grain-based reference components to the simulation of the sourceless efficiency of white quinoa standard sources, the relative deviations of activity calculations to their certificated activities were in the range of 0.37%-5.86% and 0.38%-5.87% in absolute value, respectively.Conclusions:The white quinoa′s composition and the grain reference composition were applied to the sourceless efficiency simulation of the white quinoa standard source, and the relative deviation of the calculated measured activity to the activity of the standard source certificate was basically identical, so that if the gamma spectrometry-based sourceless efficiency simulation is used to measure the unknown composition of the food samples and it is inconvenient to carry out the analysis of the food samples′ compositions, especially in the case of emergency, it can be referred to the use of the reference compositions obtained in the present study.

Meta-analysis of efficacy and safety of aspirin versus other anticoagulants in the prevention of thromboembolism after orthopedic surgery / 中国药房

OBJECTIVE To evaluate the clinical efficacy and safety of aspirin versus other anticoagulants in the prevention of thromboembolism after orthopedic surgery. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， Wanfang data and VIP， randomized controlled trials （RCTs） and cohort studies about aspirin （trial group） versus other anticoagulants （control group） were collected during the inception and June 1st， 2023. After literature screening， data extraction and quality evaluation， the meta-analysis was conducted by using RevMan 5.4 software. RESULTS A total of 22 studies were included， involving 9 RCTs and 13 cohort studies. RCT results showed that the incidences of deep vein thrombosis （DVT） [RR＝1.81， 95%CI（1.36， 2.40）， P＜0.000 1] and postoperative pulmonary embolism （PE） [RR＝1.55， 95%CI（1.01， 2.40）， P＝0.05] in trial group were significantly higher than control group. There was no statistically significant difference in the incidences of postoperative massive bleeding， postoperative surgical site infection， all-cause death， or any bleeding after surgery between 2 groups. In the cohort study， the incidence of any bleeding in trial group was significantly lower than control group [RR＝0.71，95%CI （0.64， 0.79）， P＜0.000 1]， while the differences in other indicators were not statistically significant （P＞0.05）. The results of subgroup analysis based on different anticoagulants showed that in RCT， the incidences of DVT and PE after surgery in patients using low-molecular-weight heparin （LMWH） were significantly lower than using aspirin （P＜0.05）； in the cohort study， the incidences of DVT and PE after surgery were significantly lower in patients using direct oral anticoagulants （DOAC） than using aspirin （P＜0.05）. There was no statistically significant difference in the incidence of major bleeding between patients using aspirin and using DOAC and LWMH （P＞0.05） in both RCT and cohort study. CONCLUSIONS Aspirin is equally safe as other anticoagulants for the prevention of thromboembolism after orthopedic surgery， but its efficacy may not be as good as other anticoagulants. After orthopedic surgery， other anticoagulants should be preferred to prevent venous thromboembolism， and aspirin should be carefully considered.

Evolution of peptide YY analogs for the management of type 2 diabetes and obesity.

Peptide YY (PYY) is a gastrointestinal hormone consisting of 36 amino acids, that is predominantly secreted by intestinal l-cells. Originally extracted from pig intestines, it belongs to the pancreatic polypeptide (PP) family, but has functions distinct from those of PP and neuropeptide Y (NPY). PYY is a potential treatment for type 2 diabetes mellitus (T2DM) because of its ability to delay gastric emptying, reduce appetite, decrease weight, and lower blood glucose. However, the clinical use of PYY is limited because it is rapidly cleared by the kidneys and degraded by enzymes. In recent years, researchers have conducted various structural modifications, including amino acid substitution, PEGylation, lipidation, and fusion of PYY with other proteins to prolong its half-life and enhance its biological activity. This study presents an overview of the recent progress on PYY, including its physiological functions, metabolites and structure-activity relationships.

Cost-effective one-spot hydrothermal synthesis of graphene oxide nanoparticles for wastewater remediation: AI-enhanced approach for transition metal oxides.

Outer ear infections (OEs) affect millions of people each year and are associated with significant medical costs.The usage of multiple antibiotics to treat ear contamination is a concern because it can have an environmental impact, especially on soil and water.The increased use of antibiotics has exposed bacterial ecosystems to high concentrations of antibiotic residues.Although there have been efforts to minimize the impact of antibiotics, adsorption methods have yielded better and more viable results, and carbon-based materials are effective for environmental remediation.Graphene oxide (GO) is a versatile material used in various applications such as nanocomposites, antibacterial agents, photocatalysis, electronics, and biomedicine.GO can act as an antibiotic carrier and affect the antibacterial efficacy of antibiotics.However, the processes responsible for the antibacterial activity of GO and antibiotics in treating ear infections are unknown.This study investigates the effect of GO on the antibacterial activity of tetracycline (TT) against Escherichia coli (E.coli)-negative bacteria.Artificial Neural Network-Genetic Algorithm (ANN-GA) was applied to analyze data on the effectiveness of different doses and combinations of graphene oxide and antibiotics in treating ear infections.This study could help identify the most effective treatment protocols and potentially reduce the risk of antibiotic resistance.The R-squared (R2) value, RMSE, and MSE all fall within the proper levels for fitting criteria, with R2 ≥ 0.97 (97%), RMSE ≤ 0.036064, and MSE ≤ 0.00199 (6% variance).The outcomes showed high antimicrobial activity, resulting in a 5-log decline of E.coli.In experiments, GO was shown to coat the bacteria, interfere with their cell membranes, and aid in the prevention of bacterial growth, although this effect was somewhat weaker for E.coli.The concentration and duration at which bare GO can kill E.coli are both important factors.The antibacterial activity of antibiotics can be either boosted or reduced by the presence of GO, depending on the GO's interaction with the antibiotic, the GO's contact with the microbe, and the sensitivity of the bacteria to the antibiotic.The antibacterial efficiency of the combination of GO and antibiotics varies depending on the specific antibiotic and microorganism being targeted.

Emerging roles of oxyntomodulin-based glucagon-like peptide-1/glucagon co-agonist analogs in diabetes and obesity.

Oxyntomodulin (OXM) is an endogenous peptide hormone secreted from the intestines following nutrient ingestion that activates both glucagon-like peptide-1 (GLP-1) and glucagon receptors. OXM is known to exert various effects, including improvement in glucose tolerance, promotion of energy expenditure, acceleration of liver lipolysis, inhibition of food intake, delay of gastric emptying, neuroprotection, and pain relief. The antidiabetic and antiobesity properties have led to the development of biologically active and enzymatically stable OXM-based analogs with proposed therapeutic promise for metabolic diseases. Structural modification of OXM was ongoing to enhance its potency and prolong half-life, and several GLP-1/glucagon dual receptor agonist-based therapies are being explored in clinical trials for the treatment of type 2 diabetes mellitus and its complications. In the present article, we provide a brief overview of the physiology of OXM, focusing on its structural-activity relationship and ongoing clinical development.

Analysis of the efficacy of allogeneic hematopoietic stem cell transplantation on 9 children with Epstein-Barr virus-positive lymphoproliferative diseases / 中华实用儿科临床杂志

Objective:To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on the childhood Epstein-Barr virus(EBV)-positive lymphoproliferative diseases(EBV + LPD). Methods:The clinical features, treatment course, and prognosis of 9 children with EBV + LPD who underwent allo-HSCT in Children′s Hospital Affiliated to Zhengzhou University from July 2019 to July 2022 were analyzed retrospectively. Results:All the 9 children underwent histopathological examination, including 6 patients with EBV-positive T-cell lymphoproliferative disease (EBV + T-LPD), 1 with pulmonary lymphomatoid granuloma, and 2 with systemic EBV-positive T-cell lymphoma.There were 6 males and 3 females, with the median age of 5.8 (1.5-13.0) years.At the initial diagnosis, plasma and peripheral EBV-DNA copy at the initial diagnosis was (5.67-865.00)×10 2/mL, and (5.13-1 250.00)×10 2/mL, respectively.The EBV-DNA load of cerebrospinal fluid increased to (5.18-291.00)×10 2/mL in 3 cases.The whole exon sequencing data showed no abnormality in 3 cases, pulmonary lymphomatoid granuloma with the IL2RG mutation in 1 case and EBV + T-LPD with a hemizygous mutation in the SH2D1A gene as the pathogenic mutation in 1 case.Pathogenic mutations were not detected in the remaining 4 cases.The course of disease before transplantation was 5.4(3.0-10.0) months.Disease status before transplantation was as follows: all 3 cases of lymphomas had partial regression; 2 cases of EBV + T-LPD had active disease; and 4 cases had no active disease.Among the donors, there were 5 cases of half-matched relatives, 2 cases of full-matched siblings and 2 cases of unrelated full-matched donors.The median number of mononuclear cells in peripheral blood and/or bone marrow hematopoietic stem cell was 6.60(3.64-12.18)×10 8/kg, while the median implantation time of neutrophils was 18(9-23) days.One month after the transfusion of hematopoietic stem cells, plasma EBV-DNA copy was negative in all cases, and peripheral EBV-DNA copy was negative in 7 cases.The copy number in the other 2 cases was 10 2/mL.At the 3-month evaluation, plasma and peripheral EBV-DNA copy were negative in all cases.In addition, 3 cases of lymphomas achieved radiographic complete remission, and 6 cases of EBV + T-LPD were inactive.All transplant-related complications were effectively controlled after medication.Following the median follow-up of 24 (11-42) months, all patients had disease-free survival.Serious impact on the quality of life due to graft versus host disease was not reported. Conclusions:allo-HSCT is an effective treatment of childhood EBV + LPD, which is able to control transplant-related complications.Children with EBV + LPD can achieve long-term disease-free survival through transplantation.

Design of portable neck muscle training device for pilots / 医疗卫生装备

Objective To design a portable neck muscle training device to improve muscle strength around the neck and neck stability in pilots to reduce the incidence of neck disorders.Methods A portable neck muscle training device for pilots was designed based on a self-developed adaptive admittance force tracking control algorithm,which was composed of a damping generator,a transmission system,a fixation clamping mechanism,a head-mounted terminal,a control system,a power supply,a communication bus and a mobile App realized with Android Studio integrated development environment.Results The training device developed could be used for training of neck flexion,extension and rotation,which increased pilots'neck and shoulder activity angle,cervical curvature and strength intensity of each muscle group.Conclusion The training device gains advantages in portability,real-time feedback and low cost,and can be used for targeted training of neck muscles.[Chinese Medical Equipment Journal,2023,44(11):21-26]

Risk factors and prognostic analyses of acute kidney injury after heart transplantation / 中华器官移植杂志

Objective:This study aims to investigate the incidence, risk factors, and prognosis of acute kidney injury after heart transplantation.Methods:Clinical data of 180 recipients of heart transplantation at Zhengzhou Seventh People's Hospital from April 2018 to November 2022 are retrospectively analyzed. According to whether AKI occurred 7 days after surgery, the recipients are divided into a non AKI group(85 cases)and an AKI group(95 cases). The baseline data, general perioperative conditions, and clinical data of the two groups of recipients are compared using chi square test and rank sum test to identify possible influencing factors for AKI after heart transplantation.Determine independent risk factors through binary logistic regression.The Kaplan Meier method is used to draw survival curves to further clarify the impact of AKI on the survival and cumulative hospitalization of heart transplant recipients.Results:The incidence of postoperative AKI in 180 recipients of this study is 52.7%(95/180). Univariate analysis showed that there are statistically significant differences in recipient age, preoperative albumin, platelet count, graft cold ischemia time, and surgical time between the AKI group and the non AKI group(all P<0.05). Further multivariate analysis showes that recipient age( OR=1.021, 95% CI: 1.001~1.043, P=0.043), surgical time( OR=1.005, 95% CI: 1.001~1.008, P=0.005), platelet count( OR=0.995, 95% CI: 0.990~1.000, P=0.034), and donor cold ischemia time ( OR=0.996, 95% CI: 0.993~0.996, P=0.004)are independent risk factors for AKI after heart transplantation. Prognostic analysis showed that 35.7%(25 cases)of the AKI group received continuous renal replacement therapy(CRRT)after surgery, and 31.9%(23 cases) received aortic balloon counterpulsation(IABP)after surgery. Compared with 0 and 8.9%(7 cases)of the AKI group without AKI, the differences are statistically significant(all P<0.01). Compared with the non AKI group, the invasive mechanical ventilation time is 614 (504, 707) hours and 540 (460, 610) hours( P<0.01), the stay time in the intensive care unit is 12(8, 16)days and 10(6, 15)days( P=0.050), and the estimated glomerular filtration rate(eGFR)on the 7th day after surgery is 10(6, 15)ml/(min·1.73 m 2)and 68(57.5, 91.0)ml/(min·1.73 m 2)( P<0.01), with statistical significance. The cumulative survival rate of the AKI group after heart transplantation is lower than that of the non AKI group, and the cumulative hospitalization rate Is higher than the latter. The differences between the groups are statistically significant(all P<0.01). Conclusions:The incidence of AKI after heart transplantation is relatively high, and recipient age, platelet count, graft cold ischemia time, and surgical time are independent risk factors for AKI. Recipients with AKI after heart transplantation have a higher proportion of postoperative use of CRRT and IABP, longer invasive mechanical ventilation time and monitoring room stay time, and lower eGFR on the 7th day after surgery; at the same time, recipients with AKI after heart transplantation have a lower postoperative survival rate and a higher cumulative hospitalization rate.

Influencing factors for continuous renal replacement therapy after heart transplantation / 中华器官移植杂志

Objective:To explore the influencing factors of continuous renal replacement therapy(CRRT)after heart transplantation(HT).Methods:For this retrospective cohort study, the relevant clinical data were retrospectively reviewed for 145 recipients undergoing HT at No.7 Municipal People's Hospital from April 2018 to December 2022.They were assigned into two groups of non-CRRT(n=124)and CRRT(n=21). And t, χ2or rank-sum test was utilized for comparing baseline data, intraoperative and postoperative general conditions of two groups.Variables with P<0.05 in univariate analysis and significant indicators in previous studies were included in multivariate logistic regression analysis to analyze the influencing factors of CRRT post-HT.Receiver operating characteristic curve(ROC)was utilized for selecting the optimal predictive cut-off value. Results:Among them, 66 cases(45.52%)developed AKI and 21(14.48%)required CRRT.Through univariate analysis, preoperative estimated glomerular filtration rate(eGFR), erythrocyte count, platelet, hemoglobin, total bilirubin, intraoperative volume of blood loss, volume of blood transfusion, urine volume, operative duration, cardiopulmonary bypass time, postoperative mechanical ventilation time, ICU stay and postoperative acute kidney injury were compared.The inter-group differences were statistically significant( P<0.05). Further multivariate logistic regression analysis revealed that preoperative hemoglobin level( OR=0.869, 95% CI: 0.770-0.980, P=0.022), preoperative platelet count( OR=0.959, 95% CI: 0.925-0.993, P=0.019), intraoperative volume of hemorrhage( OR=1.004, 95% CI: 1.000-1.009, P=0.049), intraoperative urine volume( OR=0.997, 95% CI: 0.993-1.000, P=0.035), operative duration( OR=1.022, 95% CI: 1.000-1.044, P=0.047)and mechanical ventilation time( OR=1.036, 95% CI: 1.005-1.069, P=0.024)were the independent influencing factors of CRRT post-HT.ROC curve results indicated that area under curve(AUC)of operative duration, mechanical ventilation time and intraoperative volume of hemorrhage were 0.745(95% CI: 0.636-0.855), 0.835(95% CI: 0.735-0.934)and 0.669(95% CI: 0.506-0.830)with a sensitivity of 0.714, 0.857, 0.571 and a specificity of 0.710, 0.685, 0.895.And the cut-off values were 283.5 min, 25.46 h and 825 ml respectively. Conclusions:Hemoglobin level, preoperative platelet count, intraoperative volume of hemorrhage, urine volume, operative duration, mechanical ventilation time and intraoperative urine volume are independent influencing factors of CRRT post-HT.Operative duration >283 min, mechanical ventilation time >25.46 h and intraoperative volume of hemorrhage >825 ml have some predictive values for CRRT post-HT.

Detection and multi⁃locus sequence typing of low⁃affinity penicillin⁃binding protein of β⁃lactam resistant Enterococcus faecalis / 安徽医科大学学报

Objective @# To detect the low⁃affinity penicillin⁃binding protein drug resistance , pbp4 gene , and multi⁃ locus sequence typing (MLST) of clinically isolated E. faecalis .@*Methods @#78 clinical isolates of E. faecalis were collected , and their drug resistance was detected by automated instruments ; the mutation of pbp4 gene mutation was analyzed by PCR amplification and MLST . @*Results @# 78 strains of E. faecalis were highly resistant to ciprofloxacin , levofloxacin , rifampicin , erythromycin , tetracycline and high concentration of gentamicin , and were resistant to penicillin and gentamicin . The ampicillin resistance rate was 10. 3% , and no strains were found to be resistant to nitrofurantoin , vancomycin , teicoplanin and linezolid ; 8 strains of 78 E. faecalis had amplified TEM genes , and all of them were resistant to penicillin and ampicillin resistance , with a positive rate of 10. 3% ; the allelic profiles and sequence types of 78 strains of E. faecalis which were divided into 16 sequence types , of which ST179 and ST16 were the most , with 21 and 21 strains , respectively . 20 strains , accounting for 26. 9% and 25 . 6% , the rest were ST6 type 8 strains (10. 3% ) , ST4 type 7 strains (9 . 0% ) , ST585 type 6 strains (7 . 7% ) , ST480 type 4 strains (5 . 1% ) , ST28 strains 3 strains (3 . 8% ) of the ST type were detected , and only 1 strain was detected for the oth⁃ er ST types . The analysis of the relationship between ST types and drug resistance showed that E. faecalis with the same ST type had similar drug resistance profiles . @*Conclusion @#The resistance mechanism of E. faecalis to β ⁃lactam antibiotics is mainly caused by the production of β⁃lactamase mediated by TEM gene , which is not necessarily related to the mutation of pbp4 gene . The isolates of E. faecalis are mainly CC16 ( including ST16 and ST179) clones and drug resistance is serious . It is necessary to guide clinical medication and strengthen nosocomial infection monitoring according to its characteristics .