The Bidirectional Relationship between Chronic Kidney Disease and Hyperuricemia: Evidence from a Population-Based Prospective Cohort Study.

BACKGROUND: Although several studies have examined the association between chronic kidney disease (CKD) and hyperuricemia (HUA), the direction of the association remains unclear. We aimed to investigate whether there was a bidirectional association between them. METHODS: The present study was conducted in three analyses. Analysis I included 25,433 participants free of HUA at baseline to evaluate the associations between CKD and estimated glomerular filtration rate (eGFR) with incident HUA. Analysis II had 28,422 participants free of CKD at baseline to analyze the relationships between HUA and serum uric acid (sUA) with new-onset CKD. Cox proportional hazards regression models were applied to evaluate the association involved in Analysis I and II. Analysis III included 31,028 participants with complete data and further dissected the bidirectional association between sUA and eGFR using cross-lag models. RESULTS: New-onset HUA and CKD were observed in the first round of the follow-up study among 1597 and 1212 participants, respectively. A significantly higher risk of HUA was observed in individuals with CKD compared to individuals without CKD (HR = 1.58, 95% CI: 1.28-1.95). The adjusted HRs (95% CIs) of HUA were 3.56 (2.50-5.05) for the participants in the group of eGFR less than 60 mL·min-1·1.73 m-2, 1.61 (1.42-1.83) for those in the group of eGFR between 60 and 90 mL·min-1·1.73 m-2, and 1.74 (1.42-2.14) for those in the group of eGFR more than 120 mL·min-1·1.73 m-2, compared with the group of eGFR between 90 and 120 mL·min-1·1.73 m-2. A higher risk of CKD was also observed in individuals with HUA compared to individuals without HUA (HR = 1.28, 95% CI: 1.12-1.47). Compared with the first quintile of sUA, the adjusted HR (95% CI) of CKD was 1.24 (1.01-1.51) for the participants in the fourth quantile. There was a bidirectional relationship between sUA and eGFR, with the path coefficients (ρ1 = -0.024, p < 0.001) from baseline eGFR to follow-up sUA and the path coefficients (ρ2 = -0.015, p = 0.002) from baseline sUA to follow-up eGFR. CONCLUSIONS: The present study indicated that CKD and HUA were closely associated, and there was a bidirectional relationship between sUA and eGFR.

A study on the changing trend and influencing factors of hospitalization costs of schizophrenia in economically underdeveloped areas of China.

The public health problems caused by schizophrenia are becoming increasingly prominent and can place a huge economic burden on society. This study takes Gansu Province as an example to analyze the level and changing trend of the economic burden of schizophrenia inpatients in economically underdeveloped areas of China. Using a multi-stage stratified cluster sampling method, 39,054 schizophrenics from 197 medical and health institutions in Gansu Province were selected as the research objects, and their medical expenses and related medical records were obtained from the medical information system. The rank sum test and Spearman rank correlation were used for univariate analysis. Quantile regression and random forest were used to analyze the influencing factors. The results show that the average length of stay of schizophrenics in Gansu Province of China was 52.01 days, and the average hospitalization cost was USD1653.96 from 2014 to 2019. During the six years, the average hospitalization costs per time decreased from USD2136.85 to USD1401.33. The average out-of-pocket costs per time decreased from USD1238.78 to USD267.68. And the average daily hospitalization costs increased from USD38.18 to USD41.25. The main factors influencing hospitalization costs are length of stay, proportion of medications, and schizophrenic subtype. The hospitalization costs per time of schizophrenics in Gansu Province have decreased but remain at a high level compared to some other chronic non-communicable diseases. In the future, attention should be paid to improving the efficiency of medical institutions, enhancing community management, and promoting the transformation of the management model of schizophrenia.

Kawasaki disease coronary artery lesions prediction with monocyte-to-high-density lipoprotein ratio.

OBJECTIVE: The aim of this study was to evaluate the predictive value of the monocyte-to-high-density lipoprotein ratio (MHR) in Kawasaki disease (KD) complicated with coronary artery lesions (CALs) and to construct a nomogram prediction model. METHODS: The medical records of KD inpatients diagnosed in the Department of Pediatrics of Lanzhou University Second Hospital from May 2015 to September 2021 were retrospectively analyzed. ROC curves were applied to evaluate the predictive value of MHR in KD complicated with CALs, and logistic regression analysis was used to screen independent risk factors. We constructed a nomogram model and performed internal validation. RESULTS: A total of 568 KD patients were enrolled in the study. MHR was significantly higher in KD patients complicated with CALs and was identified as an independent risk factor for CALs (OR: 1.604, 95% CI: 1.292-1.990). The area under the ROC curve for MHR in predicting CALs was 0.661. The C-index of the nomogram model constructed by incorporating MHR was 0.725 (95% CI: 0.682-0.768), and the calibration curve revealed good agreement between the predicted and actual probabilities. CONCLUSIONS: MHR may not be suitable as a single biomarker to predict the occurrence of CALs, but the nomogram model constructed in combination with other independent risk factors had acceptable predictive performance. IMPACT: The inflammatory response plays an important role in the pathogenesis of Kawasaki disease. The monocyte-to-high-density lipoprotein ratio is a novel systemic inflammation marker. The monocyte-to-high-density lipoprotein ratio is an independent risk factor for Kawasaki disease complicated with coronary artery lesions. The nomogram established by incorporating the monocyte-to-high-density lipoprotein ratio has satisfactory predictive performance for coronary artery lesion formation.

Ternary Electrical Memory Devices Based on Polycarbazole: SnO2 Nanoparticles Composite Material.

In this paper, a D-A polymer (PIB) containing carbazole as the donor group in the main chain and benzimidazole benzisoindolinone as the acceptor group was synthesized by Suzuki reaction. The Suzuki reaction, also known as the Suzuki coupling reaction, is a relatively new organic coupling reaction in which aryl or alkenyl boronic acids or boronic acid esters react with chlorine, bromine, iodoaromatic hydrocarbons or alkenes under the catalysis of zerovalent palladium complexes cross-coupling. A series of devices were fabricated by a spin-coating approach, and the devices all exhibited ternary resistance switching storage behavior. Among them, the composite device with the mass fraction of SnO2 NPs of 5 wt% has the best storage performance, with a threshold voltage of -0.4 V and a switching current ratio of 1:101.5:104.5. At the same time, the current of the device remained stable after a 3-h test. Furthermore, after 103 cycles, the current has no obvious attenuation. The device has good stability and continuity. Moreover, the conduction mechanism is further revealed. Inorganic nanoparticle composite devices have splendid memory performances and exhibit underlying application significance in storing data.

[Compliance on hand-hygiene among healthcare providers working at secondary and tertiary general hospitals in Chengdu].

OBJECTIVE: To evaluate the compliance on hand-hygiene and related factors among healthcare providers working at secondary and tertiary hospitals in Chengdu. METHODS: On-site observations regarding hand-hygiene compliance and facilities were conducted in 6 hospitals in Chengdu. Doctors and nurses were asked and recorded about their knowledge regarding hand-hygiene. RESULTS: Of 1535 activities where hand-hygiene was deemed necessary, under observating healthcare providers would perform hand-hygiene procedures 17.8% of the time (12.8% of the time before touching a patient, 21.0% of the time before touching objects around a patient, 27.3% of the time after touching a patient, and 31.5% of the time after removing gloves). Only 2.2% of the treating rooms were equipped with foot-operated or automatic faucets;of these only 24.5% had soap or alcohol-based hand-sanitizer, and 6.3% had paper towel or other hand-drying equipment. 92.8% of the healthcare providers knew of the six-step method on hand-washing. More than 90.0% of the healthcare providers knew that both palm and back of the hands as well as the front and back of the fingers should be washed. However, only 22.8% knew that the hand-washing procedure should last ≥ 15 seconds. Rates on hand hygiene among chief or more senior physicians (14.6%), attending physicians (9.2%) and junior doctors (15.6%), nurses in chief (25.0%), senior nurses (26.3%) and junior nurses (20.5%) showed no significant differences (P > 0.05). Similarly, scores on related knowledge between chief or senior physicians (12.4 ± 3.2), attending physicians (13.6 ± 3.3) and junior doctors (13.4 ± 2.9), nurses in charge (15.2 ± 2.0), senior nurses (14.8 ± 2.1) and junior nurses (14.3 ± 2.6) also showed no significant differences (P > 0.05). Rate on hand hygiene among nurses (22.7%) was significantly higher than that of the doctors (13.6%). Rate of hand hygiene among 50 - 59 years old healthcare providers (7.4%) was significantly lower than those of all the other age groups (17.1% - 25.0%); rate of female health care providers (19.5%) was significantly higher than that of males (13.8%). Similarly, the nurse's knowledge score (14.7 ± 2.3) was significantly higher than that of the doctors (13.2 ± 3.1). Among 50 - 59 years old healthcare providers, the rate was (12.2 ± 3.8) significantly lower than that of 20 - 29 (14.0 ± 2.6), 30 - 39 (14.3 ± 2.9) and 40 - 49 year olds (13.8 ± 2.7). Again, the knowledge score of females (14.5 ± 2.5) was significantly higher than that of males (12.7 ± 3.2) (P < 0.05). CONCLUSION: The high-level knowledge on hand-hygiene among healthcare providers in this area did not translate into good practices. Also, most of the hospitals had poor hand-hygiene equipment. We recommend that training and periodic monitoring be conducted, and hand-hygiene equipment be improved to facilitate hand-hygiene practices among healthcare providers.

[Current situation and surveillance on dengue fever in China, 2005 - 2007].

OBJECTIVE: To provide scientific evidence for prevention and control program on dengue fever through analyzing the situation of dengue fever in China, from 2005 to 2007. METHODS: Data was collected from Internet-based National Notifiable Infectious Disease Reporting System, National Enhanced Dengue Fever Surveillance System and field investigation on dengue outbreaks, described and analyzed with descriptively and by SPSS statistical software. RESULTS: There was a total number of 1623 dengue cases (including 1356 laboratory confirmed cases and 267 probable cases) and 1 death case reported in China from 2005 to 2007. Among the identified cases, 151 were imported from foreign countries as the Southeast Asian countries, accounting for 9.3%, while the rest 1472 cases were reported from local infections, identified only in 9 cities from Guangdong and Fujian provinces. Data from the monitoring program on Aedes Mosquitoes indicated that: The indicators of BI from 84.6% of the sentinels were over 5, and BI from 72.2% of the sentinels were over 10. This index was especially at a higher level during summer in the southern areas of China. Aedes albopictus was found in all the sentinel sites while Aedes aegypti was only found in Hainan and in limited counties of Guangdong. No dengue virus was isolated from mosquito vectors collected from national sentinel sites, whereas positive results had been detected by PCR test in Guangdong province. CONCLUSION: It was assumed that a sustainable local circulation of dengue virus had not yet been established successfully in Mainland China according to the surveillance data. However, more local outbreaks reported in Guangdong and Fujian with the wide distribution and high-level density of aedes mosquito, low antibody level in healthy population and the increasing number of imported dengue cases, there is a potential of Dengue outbreaks in southern China. An integrated mosquito vector monitoring and management system is needed in high risk area to reduce the transmission of dengue fever.

[Assessment of current hospital capacity in Beijing in responding to potential influenza pandemic: an application on Flu Surge model].

INTRODUCTION: Based on the estimate results of the capacity and preparedness of Beijing hospitals to respond to pandemic influenza, using flu surge model to evaluate its applicable hypothesis and to provide government with sentient strategy in planning pandemic influenza. Through collection of medical resources information, we calculated the possible impaction on hospitals by Flu Surge model and explored the applicable hypothesis in model operation through a questionnaire, direct observation and group discussion in 3 hospitals in Beijing. Based on flu surge model estimation during a 6-week epidemic from a pandemic virus with 35% attack rate, Beijing would have had an estimation of 5 383 000 influenza illnesses, 2 691 500 influenza outpatients, 76 450 influenza hospitalizations and 14 508 excess deaths. For a 6-week period with 35% attack rate, there would be a peak demand for 8% of beds, 210% of ICU beds, and 128% of ventilators estimated. Outpatients in different level hospital were quite disproportionated with 1742/ hospital/day, 650/hospital/day, and 139/hospital/day respectively. The sampled health workers had a mastery of 63.4% of the total knowledge and skills of diagnosing and treating of influenza, 73.5% of them washed their hands and 63.5% used PPE correctly. The total beds capacity, medical beds capacity and respiratory medical beds capacity would increase 8%, 35% and 128% respectively. CONCLUSION: The estimation results could be referenced when planning the pandemic strategy, but the results should be treated objectively when considering the hypothesis and practical situation in this model being used.