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Objective:To explore the balance performance of young adults under the interference of different cognitive tasks,and the moderating effect of long-term physical exercise. Method:The static and dynamic balance of healthy young people with physical exercise habit and without physical exercise habit were tested under the interference of different cognitive tasks.One-way repeated mea-sures ANOVA was performed with the group variable(Group)as the between-subjects factor and the results of multiple balance tests(Task)as the within-subjects variable. Result:Long term physical exercise had a positive moderating effect on the static balance during calculation,singing,and writing interference,the static mediolateral symmetrical balance during writing interference,the static anteroposterior symmetrical balance during singing interference,and the dynamic balance during comput-ing interference(P<0.05).The dual-task cost of young people was significantly reduced when they are dis-turbed by the corresponding cognitive tasks(P<0.05).However,it had a negative regulatory effect on the stat-ic mediolateral balance of calculation interference,the static anteroposterior balance of reading interference,and the dynamic mediolateral balance of calculation and singing interference(P<0.05). Conclusion:Long term physical exercise has a significant moderating effect on young people's dynamic and static balance performance when different cognitive tasks are disturbed.
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@#Objective To discuss the correlation of serum visceraladiposetissue-derived serineproteinase inhibitor(vaspin)and atrial fibrosis biochemical markers in atrial fibrillation(AF)patients.Methods The subjects were selected from inpatients in Shanghai Putuo District People's Hospital during January 2021 to October 2022.Enzyme linked immunosorbent assay(ELISA)was used to determine the levels of serum vaspin,C-terminal propeptide of prollagen type Ⅰ(PⅠCP),matrix metalloproteinase-1(MMP-1),N-terminal type Ⅲ collagen peptide(PⅢNP),tissue matrix metalloproteinase inhibitory factor-1(TIMP-1)of paroxysmal atrial fibrillation(PAF)group,persistent atrial fibrillation(PeAF)group,and control group.The correlation between serum vaspin and the above serum biochemical markers was analyzed.Results ①Levels of serum vaspin(9.51±1.47)ng/ml,PⅠCP(704.83±120.45)ng/ml,MMP-1(5.92±0.73)ng/ml,PⅢNP(63.34±12.24)ng/ml,and TIMP-1(7.56±0.90)ng/ml in PeAF group were significantly higher than those of PAF group and control group(P<0.05);②vaspin was significantly and positively correlated with PⅠCP,MMP-1,PⅢNP,TIMP-1 in PAF group and PeAF group.Conclusion Serum vaspin level of AF patients were significantly high and positively correlated with atrial fibrosis biochemical markers,which indicated that serum vaspin level might be closly related to atrial fibrosis in AF patients.It may be a potential marker to identify the degree of fibrosis in atrial fibrillation.
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Objective To investigate the effects of formononetin (FMN) on cognitive behavior and inflammation in aging rats with chronic unpredictable mild stress (CUMS). Methods SD rats aged about 70 weeks were divided into healthy control group, CUMS model group, CUMS combined with 10 mg/kg FMN group, CUMS combined with 20 mg/kg FMN group and CUMS combined with 1.8 mg/kg fluoxetine hydrochloride (Flu) group. Except for healthy control group, other groups were stimulated with CUMS and administered drugs for 28 days. Sugar water preference, forced swimming experiment and open field experiment were used to observe the emotional behavior of rats in each group. HE staining was used to observe the pathological injury degree of brain equine area. The contents of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) were detected by the kit. The apoptosis was tested by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) in the brain tissue. The levels of tumor necrosis factor α (TNF-α), inducible nitric oxide synthase (iNOS) and interleukin 6 (IL-6) in peripheral blood were measured by ELISA. Western blot analysis was used to detect Bcl2, Bcl2 associated X protein (BAX), cleaved caspase-9, cleaved caspase-3, Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), and phosphorylated nuclear factor κB p65 (p-NF-κB p65) in brain tissues. Results Compared with CUMS model group, sugar water consumption, open field activity time, open field travel distance and swimming activity time significantly increased in the CUMS combined with 20 mg/kg FMN group and the CUMS combined with 1.8 mg/kg Flu group. The number of new outarm entry increased significantly, while the number of initial arm entry and other arm entry decreased significantly. The pathological damage of brain equine area was alleviated, and the contents of 5-HT and 5-HIAA were significantly increased. The ratio of BAX/Bcl2 and the expression of cleaved caspase-9 and cleaved caspase-3 protein as well as the number of apoptotic cells were significantly decreased. The contents of TNF-α, iNOS and IL-6 were significantly decreased. The protein levels of TLR4, MyD88 and p-NF-κB p65 were significantly decreased. Conclusion FMN can inhibit the release of inflammatory factors by blocking NF-κB pathway and improve cognitive and behavioral ability of CUMS aged rats.
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Ratas , Animales , Caballos , FN-kappa B/metabolismo , Transducción de Señal , Proteína X Asociada a bcl-2/metabolismo , Receptor Toll-Like 4/metabolismo , Caspasa 3/metabolismo , Caspasa 9/metabolismo , Interleucina-6/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Factor 88 de Diferenciación Mieloide , Ácido Hidroxiindolacético/farmacología , Serotonina/metabolismo , Ratas Sprague-Dawley , Hipocampo/metabolismo , CogniciónRESUMEN
Objective To analyze the death-related factors of elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) treated by sequential mechanical ventilation,so as to provide evidence for clinical practice. Methods The clinical data of 1204 elderly patients (≥60 years old) with AECOPD treated by sequential mechanical ventilation from June 2015 to June 2021 were retrospectively analyzed.The probability and influencing factors of death were analyzed. Results Among the 1204 elderly patients with AECOPD treated by sequential mechanical ventilation,167 (13.87%) died.Multivariate analysis showed that plasma procalcitonin ≥0.5 μg/L (OR=2.762, 95%CI=1.920-3.972, P<0.001),daily invasive ventilation time ≥12 h (OR=2.202, 95%CI=1.487-3.262,P<0.001),multi-drug resistant bacterial infection (OR=1.790,95%CI=1.237-2.591,P=0.002),oxygenation index<39.90 kPa (OR=2.447,95%CI=1.625-3.685,P<0.001),glycosylated hemoglobin >6% (OR=2.288,95%CI=1.509-3.470,P<0.001),and acute physiology and chronic health evaluation Ⅱ score ≥25 points (OR=2.126,95%CI=1.432-3.156,P<0.001) were independent risk factors for death in patients with AECOPD treated by sequential mechanical ventilation.Oral care>twice/d (OR=0.676,95%CI=0.457-1.000,P=0.048) and sputum excretion>twice/d (OR=0.492, 95%CI=0.311-0.776, P=0.002) were independent protective factors for death in elderly patients with AECOPD treated by sequential mechanical ventilation. Conclusions The outcomes of sequential mechanical ventilation in the treatment of elderly patients with AECOPD are affected by a variety of factors.To reduce the mortality,we put forward the following measures:attaching great importance to severe patients,restoring oxygenation function,shortening unnecessary invasive ventilation time,controlling blood glucose,preventing multidrug resistant bacterial infection,oral care twice a day,and sputum excretion twice a day.
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Humanos , Anciano , Persona de Mediana Edad , Respiración Artificial/métodos , Estudios Retrospectivos , Enfermedad Pulmonar Obstructiva Crónica/terapia , EsputoRESUMEN
As the incidence of diabetes mellitus is rapidly increasing worldwide,that of related complications,such as diabetic kidney disease(DKD),also increases,conferring a heavy economic burden on the patients,families,society,and government.Diabetes mellitus complicated with chronic kidney disease(CKD)includes DKD and the CKD caused by other reasons.Because of the insufficient knowledge about CKD,the assessment of diabetes mellitus complicated with CKD remains to be improved.The therapies for diabetes mellitus complicated with CKD focus on reducing the risk factors.In clinical practice,DKD may not be the CKD caused by diabetes.According to clinical criteria,some non-diabetic kidney disease may be misdiagnosed as DKD and not be treated accurately.This review summarizes the status quo and research progress in the assessment,diagnosis,and treatment of diabetes mellitus complicated with CKD and predicts the directions of future research in this field.
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Humanos , Diabetes Mellitus Tipo 2/complicaciones , Nefropatías Diabéticas/etiología , Insuficiencia Renal Crónica/terapia , Factores de Riesgo , Diabetes Mellitus/terapiaRESUMEN
Objective: To examine the clinical value of fluorescence-guided indocyanine green (ICG) laparoscopic anatomical hepatectomy in the treatment of primary hepatocellular carcinoma. Methods: Data from patients diagnosed with hepatocellular carcinoma and who underwent laparoscopic hepatectomy with ICG fluorescence navigation in the Department of Liver Surgery and Liver Transplantation Center of West China Hospital between September 2020 and May 2022 were retrospectively collected. There were 53 males and 19 females, with an age of (55.5±12.9)years(range:42.6 to 68.4 years). Among them, 13 of the cases underwent laparoscopic anatomical liver resection(LALR) guided by tans-arterial ICG,43 of the cases received LAIR guided by portal vein negative ICG, and 16 of the cases received LALR positive by portal vein. Comparison among the three groups was performed by one-way ANOVA; and the rank sum test was used for comparison between groups. The counting data was expressed as percentage,and the χ2 test or Fisher's exact probability method was used for comparison between groups. Results: (1) Postoperative pathology: Resection R0 was achieved in all operations. The maximum tumor diameter of the patients in the arterial staining group, the reverse staining group, and the positive staining group(M (IQR)) was 2.5 (2.4) cm, 3.0 (2.5) cm and 3.0(2.4) cm,respectively. There were no statistically significant differences in the maximum tumor diameter between the three groups (P=0.364). The minimum tumor margin was 1.1 (1.1) cm, 1.0 (1.0) cm, 1.1 (1.6) cm in the the arterial staining group, reverse staining group and the positive staining group, respectively. There was no significant difference in the margin among the three groups (P=0.878). (2) Operation conditions: the operation time of the arterial staining group, the negative staining group, and the positive portal staining group was (348±93)minutes,(277±112)minutes,and (295±116)minutes,respectively. There were no significant differences in operation time among the three groups (P=0.134). The intraoperative blood loss of the three groups was 80(150)ml,200(350)ml,and 100(150)ml,respectively. There was no statistically significant difference in intraoperative bleeding volume between the three groups(P=0.743). All cases were not transfused during the operation and were not converted to laparotomy. ALT in the arterial staining group was higher than in the negative staining group in the first two days after the operation ((559±398)IU/L307(257) IU/L, q=235.5,P=0.004;(611±389)IU/L(331±242) IU/L, q=265.2, P=0.002). There was only one case of a grade III complication (Clavien-Dindo grading system) postoperative complication in the negative and positive staining group of the portal vein, respectively. Tumor markers in all patients decreased to the normal range after 2 months of operation. Conclusion: Laparoscopic anatomical hepatectomy guided by ICG fluorescence through arterial staining and portal vein staining is safe and feasible for primary hepatocellular carcinoma treatment.
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Background Inflammatory bowel disease (IBD) is a common chronic intestinal disease. Protopine isolated from different plants has been investigated to understand its special functions on varied diseases. However, the regulatory effects of protopine on the progression of IBD remain unclear. Our study is aimed to explore the effects of protopine on the progression of IBD and its underlying regulatory mechanism of action. Methods The cell viability was assessed through MTT colorimetric assay. The protein expressions of genes were examined by Western blot analysis. The cell apoptosis and reactive oxygen species level were measured using flow cytometry. The levels of inflammation and oxidative stress-related proteins were tested through enzyme-linked-immunosorbent serologic assay. The intracellular Ca2+ concentration and mitochondrial membrane potential were measured through immunofluorescence assay. Results First, different concentrations of lipopolysaccharide (LPS) were treated with NCM460 cells to establish IBD cell model, and 5-μg/mL LPS was chosen for followed experiments. In this study, we discovered that protopine relieved the LPS-induced inhibited intestinal epithelial cell viability and enhanced cell apoptosis. Moreover, protopine attenuated LPS-stimulated inflammation activation and oxidative stress. Further experiments illustrated that the increased intracellular Ca2+ concentration and decreased mitochondrial membrane potential stimulated by LPS were reversed by protopine treatment. Finally, through Western blot analysis, it was demonstrated that protopine retarded the activated NLR family pyrin domain containing 3 (NLRP3) and nuclear factor kappa B (NF-κB) signaling pathways mediated by LPS. Conclusion Protopine alleviated LPS-triggered intestinal epithelial cell injury by inhibiting NLRP3 and NF-κB signaling pathways to reduce inflammation and oxidative stress. This discovery may provide a useful drug for treating IBD (AU)
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Humanos , Células Epiteliales/metabolismo , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Lipopolisacáridos/metabolismo , Lipopolisacáridos/farmacología , FN-kappa B/metabolismo , Estrés Oxidativo , Transducción de Señal , Inflamación/tratamiento farmacológico , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismoRESUMEN
Cultivating salt-alkali tolerant rice varieties is one of the important ways to meet the increasing food demand of growing global population. In this study, twenty-one rice germplasms with different salt-alkali tolerance were treated with six salt-alkali concentrations at germination and seedling stages. The germination potential, germination rate, shoot length, root length, root number, fresh weight of shoot and seedlings were measured. The average value of salt damage rate was used to evaluate the salt-alkali tolerance. As the salt-alkali concentration increases, the inhibition on seed germination and growth became more obvious. Upon treatment with 1% NaCl plus 0.25% NaHCO3, the salt damage rate of germination rate has the largest variation, ranging from 0% to 89.80%. The salt damage rate of each trait shows a similar trend at all concentrations. Four germplasm resources with strong salt-alkali tolerance (Dajiugu, Nippobare, Mowanggu and 02428) and 7 sensitive germplasms were screened. The salt-tolerant gene sequence of 4 salt-alkali tolerant varieties and 3 sensitive germplasms were analyzed. OSHAL3 and OsRR22 were identical among the 7 germplasms, but SKC1 and DST showed clear variations between the salt-alkali tolerant and sensitive germplasms. Besides the salt-alkali tolerant germplasm resources, this study can also serve as a reference for mining of genes involved in salt-alkali tolerance and breeding of salt-alkali tolerant rice varieties.
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Álcalis , Germinación , Oryza/genética , Fitomejoramiento , Plantones/genéticaRESUMEN
Objective To explore the clinical characteristics and treatment of Pseudomonas peritoneal dialysis-associated peritonitis(PsP). Methods The data of patients receiving peritoneal dialysis in four tertiary hospitals in Jilin province from 2015 to 2019 were retrospectively analyzed.According to the etiological classification,the patients with peritoneal dialysis-associated peritonitis(PDAP)were classified into PsP group and non-PsP group.The incidence of PsP was calculated,and the clinical characteristics and treatment outcomes of the two groups were compared.Kaplan-Meier method was used to draw the survival curve,and Cox regression was performed to analyze the risk factors affecting the technical failure of PsP.The treatment options of Pseudomonas aeruginosa-caused PDAP and the drug sensitivity of PsP were summarized. Results A total of 1530 peritoneal dialysis patients with complete data were included in this study,among which 439 patients had 664 times of PDAP.The incidence of PsP was 0.007 episodes/patient-year.PsP group had higher proportion of refractory peritonitis(41.38% vs.19.69%,P=0.005),lower cure rate(55.17% vs.80.79%, P=0.001),and higher extubation rate(24.14% vs.7.09%,P=0.003)than non-PsP group.The technical survival rate of PsP group was lower than that of non-PsP group(P<0.001).Multivariate Cox regression analysis showed that Pseudomonas aeruginosa was an independent risk factor for technical failure in patients with PsP(HR=9.020,95%CI=1.141-71.279,P=0.037).Pseudomonas was highly sensitive to amikacin,meropenem,and piperacillin-tazobactam while highly resistant to compound sulfamethoxazole,cefazolin,and ampicillin. Conclusion The treatment outcome of PsP is worse than that of non-PsP,and Pseudomonas aeruginosa is an independent risk factor for technical failure of PsP.
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Humanos , Diálisis Peritoneal/efectos adversos , Peritonitis/etiología , Pseudomonas , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Objective:To investigate the differences in microbiological examination results between alcohol abuse and no alcohol abuse in adult ICU patients and the association between alcohol abuse and these differences.Methods:The adult patients with microbiological examination results were selected from the MIMIC-Ⅲ database and divided into two groups according to whether they had alcohol abuse. The two groups were matched by propensity score, and the similarities and differences in microbiological examination results were evaluated between the two groups after matching. The measurement data of non normal distribution were expressed by M ( Q1, Q3). Wilcoxon rank sum test was used for the comparison of the two groups, and the comparison of counting data was used χ 2 test or Fisher exact probability method. Results:After matching, the alcohol abuse patients were more likely to use mechanical ventilation (47.06% (1 379/2 930) vs. 52.66% (1 543/2 930), χ 2=18.14, P<0.001), had a higher positive rate in sputum samples (44.30% (400/903) vs. 49.41% (501/1 014), χ 2=4.81, P=0.028) and had a lower positive rate in other samples (26.85% (653/2 432) vs. 21.67% (541/2 496), χ 2=17.69, P<0.001). In blood samples, the percentage of Gram-negative bacteria was lower in the alcohol abuse group (26.87% (126/469) vs. 17.25% (74/429), χ 2=11.42, P<0.001), while the percentage of Gram-positive bacteria was higher (78.46% (368/469) vs. 86.01% (369/429), χ 2=8.17, P=0.004). The percentage of patients with Pseudomonas aeruginosa (3.75% (110/2 930) vs. 2.08% (61/2 930), χ 2=13.88, P<0.001) and Enterococcus sp. (8.19% (240/2 930) vs. 6.45% (189/2 930), χ 2=6.29, P=0.012) was lower in the alcohol abuse group. However, there was a higher percentage of patients with methicillin-resistant Staphylococcus aureus (2.32% (68/2 930) vs. 3.28% (96/2 930), χ 2=4.57, P=0.032) and Haemophilus influenzae (1.30% (38/2 930) vs. 2.01% (59/2930), χ 2=4.19, P=0.041) in the alcohol abuse group. For Staphylococcus aureus (61.10% (322/527) and 52.66% (267/507), χ 2=7.16, P=0.007) and Enterococcus sp. (75.83% (160/211) and 63.64% (56/88), χ 2=4.02, P=0.045), the alcohol abuse group had a lower resistance to levofloxacin; for Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae, the alcohol abuse group had a lower resistance to cephalosporins (all P<0.05). Conclusions:In adult ICU, alcohol abuse might increase the risks of using mechanical ventilation, and patients with alcohol abuse might be more prone to have respiratory tract infections. Alcohol abuse patients with blood infections were less likely to be infected with Gram-negative bacteria, but had a higher probability of Gram-positive bacteria infection. What is more, Alcohol abuse might increase the risks of infections with Haemophilus influenzae and methicillin-resistant Staphylococcus aureus. In alcohol abuse patients, the infection of Staphylococcus aureus, Enterococcus sp., Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae was less resistant to many antibiotics than that in no alcohol abuse patients.
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Objective:To explore the lag effect and correlation between daily average temperature and the incidence of other infectious diarrhea in Hebei Province.Methods:The data of meteorological factors (including temperature and average daily temperature) and the daily incidence of other infectious diarrhea in Zhangjiakou City, Chengde City, Tangshan City, Qinhuangdao City, Baoding City, Langfang City, Cangzhou City, Shijiazhuang City, Hengshui City, Xingtai City, and Handan City in Hebei Province from 2017 to 2020 were collected. Eleven prefecture-level cities were divided into four regions, including east, north, middle and south regions. Distributed lag non-linear model was applied to examine the non-linear associations and the lag effect of daily mean temperature on daily incidence of other infectious diarrhea. Meanwhile, the cold and hot effects were used to estinuate the lag-response relationship on the incidence of other infectious diarrhea.Results:A total of 231 008 cases of other infectious diarrhea were reported in Hebei Province. The seasonal distribution was obvious, showing a bimodal distribution of large peaks in summer and small peaks in winter. An inverse S-shaped association between average daily temperature and cumulative risk ratio ( RR) of other infectious diarrhea was observed in Hebei Province. Both high temperature (higher than 27.50 ℃) and low temperature (less than 13.67 ℃) could increase the risk of other infectious diarrhea. When the temperature was lower than 13.00 ℃, the lag time and RR had a U-shaped association (lag four to seven days, 23 to 30 days). Meanwhile, when it was higher than 13.00 ℃, it had an inverted U-shaped association (lag 5 to 21 days). A comparison of four regions of Hebei Province showed that the lag time from south to north was extended from six days to 30 days at low temperature effects with temperature P5=-7.24 ℃. When the temperature getting hot ( P95=28.25 ℃), the risk occurred at lag 0 days, and the lag time gradually got short from north to south. Thus, the high temperature effect reached maximum quickly with a relative short duration. Conclusions:The inverse S-shaped non-linear association between daily average temperature and the incidence of other infectious diarrhea in Hebei Province is observed. Both low temperature and high temperature are associated with increased risk of other infectious diarrhea. But the impact of low temperature is more notable, which has a relative long duration.
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Objective:To explore the morphology of coronoid process fracture in terrible triad injury based on Adams classification.Methods:A retrospective cross-sectional study was used to analyze the three-dimensional CT data of 51 patients with terrible trind injury treated at First Affiliated Hospital of Fujian Medical University from January 2013 to August 2021, including 33 males and 18 females, aged 18-88 years [(44.7±12.0)years]. The model of ulna coronoid process fracture was established by three-dimensional CT reconstruction technology and was classified according to Adams coronoid process fracture classification. Type I was the coronoid process tip fracture, type II the coronoid process transverse fracture, type III the base fracture of the coronoid process, type IV anterior internal fracture the anteromedial oblique fracture of the coronoid process, and type IV anterior external fracture the anterolateral oblique fracture of the coronoid process. According to the characteristics of the coronoid fracture fragment, type IV anterior external fracture was divided into two subtypes: α subtype involving the coronoid tip and β subtype without involving the coronoid tip. Then, the proportion, height, surface area and volume of different types of coronoid fractures were measured. The proportion, height, surface area and volume of fracture fragments of two subtypes of type IV anterior external fracture were measured, as well as the area of ulnar trochlear joint, area of trochlear joint of ulnar fracture fragment, proportion of the area of trochlear joint affected by the ulnar fragment, area of proximal radioulnar joint, area of proximal radioulnar joint of ulnar fracture fragment and proportion of the area of proximal radioulnar joint affected by the ulnar fragment.Results:Among the patients with terrible triad injury, the ulnar coronoid process fracture was Adams type I in 17 patients (33%), type II in 4 (8%), type III in 4 (8%), type IV anterior internal fracture in 4 (8%) and type IV anterior external fracture in 22 (43%). The height of fracture fragment of type I, type II, type III, type IV anterior internal fracture and type IV anterior external fracture was (3.7±1.9)mm, (10.8±1.1)mm, (14.4±1.2)mm, (5.2±2.4)mm and (6.7±2.6)mm, respectively; the surface area was 63.7(21.4, 221.0)mm 2, 1 086.8(606.8, 1 434.2)mm 2, 1 658.8(1 335.6, 1 695.4)mm 2, 437.3(185.6, 437.3)mm 2 and 511.8(198.8, 646.5)mm 2, respectively; the volume was 46.3(21.4, 180.5)mm 3, 938.7(629.8, 1 011.3)mm 3, 1 797.4(1 520.2, 1 903.7)mm 3, 429.3(138.1, 992.4)mm 3 and 461.9(144.9, 707.1)mm 3, respectively. There were significant differences in the height, surface area and volume of coronoid process fracture with different Adams classification (all P<0.01). Among 22 patients with type IV anterior external fracture, 12 patients were with α subtype and 10 with β subtype. The fracture height of α and β subtypes was (8.6±2.6)mm and (5.0±2.4)mm, respectively; the surface area was 633.2 (530.3, 727.4)mm 2 and 181.4 (136.7, 450.3)mm 2, respectively; the volume was 692.8 (477.6, 778.0)mm 3 and 128.0 (74.2, 405.1)mm 3, respectively. The height, surface area and volume of fracture fragment were significantly different between the two subtypes (all P<0.01). The area of ulnar trochlear joint of α and β subtypes were 901.4(755.1, 1 060.6)mm 2 and 835.2(767.7,909.3)mm 2, respectively; the area of trochlear joint of α and β subtype fragment was 104.1(79.4, 139.9)mm 2 and 38.8(21.3, 58.1)mm 2, respectively; the proportion of the area of trochlear joint affected by α and β subtype fragment was 0.12(0.09, 0.15) and 0.05(0.03, 0.07), respectively. There was no significant difference between α and β subtypes in the area of trochlear joint of ulna ( P>0.05), but the area of trochlear joint of α subtype fragment and proportion of the area of trochlear joint affected by α subtype fragment were higher than those of β subtype fragment (all P<0.01). The area of proxima radioulnar joint of α and β subtypes was 147.9(111.7,164.2)mm 2 and 137.0(118.7,166.7)mm 2, respectively; the area of proximal radioulnar joint of α and β subtypes fragment was 17.7(13.4, 52.2)mm 2 and 6.1(2.6, 20.0)mm 2, respectively; the proportion of the area of proximal radioulnar joint affected by α and β subtypes fragment was 0.12(0.10, 0.35) and 0.05(0.03, 0.15), respectively. There were no significant differences between the two subtypes in proximal radioulnar joint damage (all P>0.05). Conclusions:Adams type IV fracture of the coronoid process of the ulna occupies a large proportion in terrible triad injury, and the type IV anterior external fracture is the main type containing two subtypes with differences in fragment size and shape. However, the injuries to the proximal radioulnar joint surface are similar for the two subtypes, so the injuries of type IV anterior external fracture with different sizes to the proximal radioulnar joint surface should not be neglected in clinical treatment.
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Objective:To compare and analyze the clinical features of patients with severe coronavirus disease 2019 (sCOVID-19) and severe community acquired pneumonia (sCAP) who meet the diagnostic criteria for severe pneumonia of the Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS).Methods:A retrospective comparative analysis of the clinical records of 116 patients with sCOVID-19 admitted to the department of critical care medicine of Wuhan Third Hospital from January 1, 2020 to March 31, 2020 and 135 patients with sCAP admitted to the department of critical care medicine of Shanghai First People's Hospital from January 1, 2010 to December 31, 2017 was conducted. The basic information, diagnosis and comorbidities, laboratory data, etiology and imaging results, treatment, prognosis and outcome of the patients were collected. The differences in clinical data between sCOVID-19 and sCAP patients were compared, and the risk factors of death were analyzed.Results:The 28-day mortality of sCOVID-19 and sCAP patients were 50.9% (59/116) and 37.0% (50/135), respectively. The proportion of arterial partial pressure of oxygen/fraction of inspired oxygen (PaO 2/FiO 2)≤250 mmHg (1 mmHg ≈ 0.133 kPa) in sCOVID-19 patients was significantly higher than that of sCAP [62.1% (72/116) vs. 34.8% (47/135), P < 0.01]. The possible reason was that the proportion of multiple lung lobe infiltration in sCOVID-19 was significantly higher than that caused by sCAP [94.0% (109/116) vs. 40.0% (54/135), P < 0.01], but the proportion of sCOVID-19 patients requiring mechanical ventilation was significantly lower than that of sCAP [45.7% (53/116) vs. 60.0% (81/135), P < 0.05]. Further analysis of clinical indicators related to patient death found that for sCOVID-19 patients PaO 2/FiO 2, white blood cell count (WBC), neutrophils (NEU), neutrophil percentage (NEU%), neutrophil/lymphocyte ratio (NLR), total bilirubin (TBil), blood urea nitrogen (BUN), albumin (ALB), Ca 2+, prothrombin time (PT), D-dimer, C-reactive protein (CRP) and other indicators were significantly different between the death group and the survival group, in addition, the proportion of receiving mechanical ventilation, gamma globulin, steroid hormones and fluid resuscitation in death group were higher than survival group. Logistic regression analysis showed that the need for mechanical ventilation, NLR > 10, TBil > 10 μmol/L, lactate dehydrogenase (LDH) > 250 U/L were risk factors for death at 28 days. For sCAP patients, there were significant differences in age, BUN, ALB, blood glucose (GLU), Ca 2+ and D-dimer between the death group and the survival group, but there was no significant difference in treatment. Logistic regression analysis showed that BUN > 7.14 mmol/L and ALB < 30 g/L were risk factors for 28-day death of sCAP patients. Conclusions:The sCOVID-19 patients in this cohort have worse oxygen condition and symptoms than sCAP patients, which may be due to the high proportion of lesions involving the lungs. The indicators of the difference between the death group and the survival group were similar in sCOVID-19 and sCAP patients. It is suggested that the two diseases have similar effects on renal function, nutritional status and coagulation function. But there were still differences in risk factors affecting survival. It may be that sCOVID-19 has a greater impact on lung oxygenation function, inflammatory cascade response, and liver function, while sCAP has a greater impact on renal function and nutritional status.
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Objective:To evaluate the effect of thymosin alpha 1 on the prognosis of patients with coronavirus disease 2019 (COVID-19).Methods:A retrospective cohort study was performed to collect clinical data of 95 patients treated by Shanghai Aid Medical Team in Wuhan Third Hospital during January 31, 2020 and March 4, 2020, who were confirmed COVID-19. They were divided into two groups according to whether they were treated with thymosin alpha 1 after admission. The 28-day mortality (primary outcome), and 28-ventilator-free-day, lymphocyte count (LYM) level, C-reactive protein (CRP) level (secondary outcomes) were compared between two groups. Survival analysis was performed using the Kaplan-Meier curve. The effect of thymosin alpha 1 on 28-day survival was evaluated with Cox regression model.Results:Among the 95 patients, there were 31 cases in thymosin group and 64 cases in non-thymosin group; 29 patients died 28 days after admission, including 11 cases (35.5%) in thymosin group and 18 cases (28.1%) in non-thymosin group. Kaplan-Meier survival curve showed that thymosin alpha 1 could improve the 28-day survival of patients with COVID-19, but the univariate Cox model analysis showed that the difference was not statistically significant [hazard ratio ( HR) = 0.48, 95% confidence interval (95% CI) was 0.20-1.14, P = 0.098]; multivariate Cox model analysis showed that thymosin alpha 1 was the factor to improve the 28-day mortality ( HR = 0.15, 95% CI was 0.04-0.55, P = 0.004), old age ( HR = 1.10, 95% CI was 1.05-1.15, P < 0.001), accompanied by chronic renal dysfunction ( HR = 42.35, 95% CI was 2.77-648.64, P = 0.007), decrease of LYM at admission ( HR = 0.15, 95% CI was 0.04-0.60, P = 0.007) and the use of methylprednisolone ( HR = 4.59, 95% CI was 1.26-16.67, P = 0.021) were also risk factors for the increase of 28-day mortality. The use of immunoglobulin and antiviral drugs abidol and ganciclovir did not affect the 28-day mortality. After adjustment for age, gender, LYM and other factors, weighted multivariate Cox analysis model showed thymosin alpha 1 could significantly improve the 28-day survival of COVID-19 patients ( HR = 0.45, 95% CI was 0.25-0.84, P = 0.012). In terms of secondary outcomes, no statistical difference (all P > 0.05) was found between two groups in days without ventilator at 28 days after admission (days: 17.97±13.56 vs. 20.09±12.67) and the increase of LYM at 7 days after admission [×10 9/L: -0.07 (-0.23, 0.43) vs. 0.12 (-0.54, 0.41)]. But the decrease of CRP at 7 days after admission in thymosin alpha group was significantly greater than that in non-thymosin group [mg/L: 39.99 (8.44, 82.22) vs. 0.53 (-7.78, 22.93), P < 0.05]. Conclusion:Thymosin alpha 1 may improve 28-day mortality and inflammation state in COVID-19 patients.
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Objective:To analyze the relationship between blood electrolytes and the prognosis of patients with severe coronavirus disease 2019 (COVID-19) and to provide assistance for clinical decision-making.Methods:The clinical data of patients with severe COVID-19 admitted to intensive care unit (ICU) of the Wuhan Third Hospital by the Shanghai aid-Hubei medical team from January 21 to March 4, 2020 were collected. Excluding ineligible patients, 110 patients were finally enrolled. The patients' gender, age, temperature, heart rate, systolic and diastolic blood pressure, clinical symptoms at admission, time of symptom onset, duration of fever, and relevant indicators at admission to ICU (including blood potassium, chloride, sodium, calcium, phosphorus, and magnesium, etc.) and prognosis were analyzed. The patients were grouped by blood potassium or calcium levels or blood potassium/calcium ratio. The Kaplan-Meier survival curves were used to analyze the survival of patients in each group. The relationship between the potassium/calcium ratio and the prognosis was analyzed using restricted cubic spline plots. The relationship between each index in the different models and the prognosis was analyzed using Cox regression models.Results:Among 110 severe COVID-19 patients, 78 cases survived, and 32 cases died. Compared with the surviving group, patients in the death group had higher blood potassium levels [mmol/L: 4.25 (3.80, 4.65) vs. 3.90 (3.60, 4.20), P < 0.05] and lower blood calcium levels (mmol/L: 2.00±0.14 vs. 2.19±0.18, P < 0.05). The Kaplan-Meier survival curves showed that patients in the potassium > 4.2 mmol/L group had a worse prognosis than the potassium < 3.8 mmol/L group and the potassium 3.8-4.2 mmol/L group ( P = 0.011), patients in the calcium > 2.23 mmol/L group had a better prognosis than the calcium < 2.03 mmol/L group and the calcium 2.03-2.23 mmol/L group, and the lower calcium group had a worse prognosis ( P = 0.000 15). Cox regression analysis showed that the hazard ratio ( HR) of blood potassium and calcium were 2.08 and 0.01, respectively, in model 1 (single blood potassium or calcium) and in model 2 (model 1 plus age and gender), the HR of blood potassium and calcium were 1.98 and 0.01 respectively, which were significantly associated with patient prognosis (all P < 0.05). Patients in the group with the potassium/calcium ratio > 1.9 had higher blood potassium levels and a higher proportion of mechanical ventilation, lower calcium levels and lower proportion of survival, and longer time of ICU admission compared with the groups with the potassium/calcium ratio < 1.7 and 1.7-1.9. The Kaplan-Meier survival curves showed that the survival rate of the potassium/calcium ratio > 1.9 group was the lowest ( P < 0.000 1), and there was no statistically significant difference in survival between the potassium/calcium ratio < 1.7 group and the potassium/calcium ratio 1.7-1.9 group. A restricted cubic spline plot corrected for age and gender showed that patients in the potassium/calcium ratio > 1.8 group had HR values > 1. Cox regression analysis corrected for other indicators showed that the potassium/calcium ratio was still associated with patient prognosis ( HR = 4.85, P = 0.033). Conclusions:Blood potassium, calcium, and the potassium/calcium ratio at ICU admission are related to the prognosis of patients with severe COVID-19, and the potassium/calcium ratio is an independent risk factor for the death of patients. The higher the potassium/calcium ratio, the worse the prognosis of patients.
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Objective:To establish the biology reference interval (RI) of peripheral blood procalcitonin (PCT) for children between 3 days and 6 years old in China.Methods:Totally 3 353 reference individuals with apparent health or no specific diseases were recruited in 18 hospitals throughout the country during October 2020 to May 2021. Reference individuals were divided into four groups: 3-28 days, 29 days - 1 year, 1-3 years and 4-6 years. Vein blood or capillary blood were collected by percutaneous puncture from every reference individual. The PCT level in serum and the capillary whole blood were assayed by Roche Cobas e601 and Norman NRM411-S7 immunoanalyzer. Outliers were deleted and 95th percentiles of every group were provided as RIs. Man-Whitney U test or Kruskal-Wallis test were used performed to assess the difference among different gender, age or method groups. Results:The difference of PCT distribution between male and female is not statistically significant, but the difference between serum and capillary whole blood is statistically significant. The differences between age groups are significant too. For Roche e601, serum PCT RI of 3-28 days group is <0.23 μg/L, 29 days - 6 years are <0.11 μg/L. For NRM411, Serum PCT RI of 3-28 days group is <0.21 μg/L, 29 days - 1 year: <0.09 μg/L, 1 - 6 years: <0.10 μg/L. For whole blood PCT, RI of 3-28 days group is <0.26 μg/L, 29 days - 6 years is <0.15 μg/L.Conclusions:Serum and capillary whole blood PCT have different RIs, however, capillary whole blood PCT testing is valuable in pediatric application. Children in 3-28 days show higher PCT levels than other age group. To establish the RIs and understand the differences among different groups are essential for the interpretation and clinical application of peripheral blood PCT testing results.
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Objective:To provide normal reference thresholds for clinical dynamic monitoring of the risk of microthrombus during pregnancy, we aimed to establish reference intervals of D-dimer in healthy pregnant women during different periods of gestation in Xi′an.Method:From December 2020 to March 2022, a total of 1502 healthy pregnant women and healthy non-pregnant women (healthy non-pregnant control group) who received routine prenatal examination in Northwest Women and Children′s Hospital were recruited in the study by questionnaire, including 1236 healthy pregnant women and 266 healthy non-pregnant control group. Plasma D-dimer concentration was detected by STA-R Evolution automatic blood coagulation analyzer and the concentration levels of D-dimer in different pregnancies and age groups were calculated using Graph Prism 9.0 software. In addition, 20 samples were collected in each pregnancy to verify the established reference interval.Results:There was no significant difference in plasma D-dimer levels between<30 years old and ≥30 years old at different gestational weeks. Plasma D-dimer level in healthy pregnant women group was significantly higher than that in healthy non-pregnant women group of the same age (P<0.05). With the increase of gestational week, plasma D-dimer level in pregnant women increased significantly, and plasma D-dimer level at different gestational weeks ≤13 weeks, 13+ 1-20 weeks, 20+ 1-27 weeks, 27+ 1-35 weeks, ≥35 +1 week were 0.33 (0.26, 0.47) μg/ml, 0.41 (0.30, 0.51) μg/ml, 0.71 (0.48, 0.94) μg/ml, 0.91 (0.70, 1.27) μg/ml, 1.30 (0.96, 1.72) μg/mlrespectively. Unilateral reference interval acuities were≤0.89 μg/ml, ≤1.53 μg/ml, ≤2.44 μg/ml, ≤2.74 μg/ml, ≤3.82 μg/ml respectively. The reference range established in this study was verified by 20 independent samples from each of the 5 gestational age groups, and the results were acceptable. Conclusion:This study preliminarily established the reference interval of plasma D-dimer in healthy pregnant women at different gestational weeks in Xi ′an area, which is helpful for the auxiliary diagnosis of thrombotic diseases during pregnancy.
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Objective:In the process of fat grafting, there is no good solution to achieve delicate filling while retaining the viability of fat particle. There was still no research on the composition and activity of delicate fat particle. In this study, two different methods for delicate fat process were established to explore the feasibility and clinical efficacy.Methods:From December 2015 to June 2016, 5 patients (22-31 years old, with average 26.2 years) with abdominal liposuction in Shanghai Ninth People's Hospital were inclueded. The fat particles were obtained by floating method and filtration method respectively, and compared with emulsified fat/nanofat and traditional fat grafts. The cell viability and composition of adipose tissue were compared in each group through cell viability test, flow analysis and tissue staining.Results:The fat particles obtained by floating and filtration methods, emulsified fat could pass through OT needle. Cell viability test revealed the presence of living cells in the fat obtained by both methods, but not in the emulsified fat. Flow analysis showed that the expression of CD90 in floating group was higher than that in control group ( P=0.048). Conclusions:The delicate fat particle can be obtained by floating or filtration method, which can preserves the tissue integrity and cell viability; meanwhile it can achieve fine needle injection and clinical application.
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Objective: To systematically review the efficacy and safety of oral Acetaminophen for premature infants with patent ductus arteriosus (PDA). Methods: Databases including Ovid, EMbase, Pubmed, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINHAL), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), WanFang Data, China Science and Technology Journal Database were searched to collect the randomized controlled trials (RCTs) about Acetaminophen for premature infants with PDA from inception to January 1, 2021. Quality assessment was performed through bias risk evaluation according to the Cochrane Handbook 5.1.0, and then the homogeneous studies were analyzed using Revman 5.4 software. Results: A total of 16 RCTs were included, which were divided into for four subgroups: subgroup I (oral acetaminophen vs. oral ibuprofen, 13 RCTs), subgroup II (oral acetaminophen vs. intravenous indomethacin, 1 RCT), subgroup III (oral acetaminophen vs intravenous ibuprofen, 1 RCT), and subgroup IV (oral acetaminophen vs intravenous placebo, 1 RCT). In subgroup I, There was no significant difference in the ductal closure rate after the first course of drug administration [typical relative risk (RR) 0.97, 95% confidence interval (CI) 0.90 to 1.05], the accumulated ductal closure rate after two course of treatment (RR 0.96, 95% CI 0.91-1.02), and mortality (RR 1.06, 95% CI 0.75-1.49) between treatment with oral acetaminophen versus oral ibuprofen (p > 0.05); compared with oral ibuprofen, oral acetaminophen was associated with a significant reduction in the incidence of gastrointestinal bleeding/stool occult blood positive (RR 0.51, 95% CI 0.32 to 0.82)and oliguria (RR 0.62, 95% CI 0.42-0.91) (p < 0.05). Conclusion: The meta analysis approves the facts that there is no significant difference in the efficacity in premature infants with PDA between oral acetaminophen and buprofen or indometacin, but compared to ibuprofen, oral acetaminophen may decrease the incidence of oliguria and gastrointestinal bleeding. More reliable conclusions should be made through large-size, multi-center, well-designed RCTs.
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Objective To explore the factors related to tympanic membrane perforation in children with acute suppurative otitis media,and to provide reference for clinical practice. Methods We reviewed the clinical data of 1274 children with acute suppurative otitis media from February 2017 to May 2020,and analyzed the factors related to tympanic membrane perforation. Results Tympanic membrane perforation occurred in 67 out of the 1274 children with acute suppurative otitis media,with the incidence of 5.27%.The univariate analysis showed that 11 factors including the duration of onset(