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Hyperglycemia is prevalent and closely associated with pulmonary tuberculosis (PTB). This study aimed to investigate the effects of hyperglycemia on the outcomes of PTB treatment. This study comprised 791 patients with PTB in total. Patients with fasting plasma glucose levels of ≥ 6.1 mmol/L were diagnosed with hyperglycemia. Anthropometric and baseline demographic data were also collected. The treatment response was assessed based on clinical symptoms (sputum production, cough, chest pain, fever, hemoptysis, night sweats, loss of appetite, and fatigue), sputum smear, chest computed tomography (CT), and adverse gastrointestinal responses (vomiting, nausea, abdominal distension, diarrhea, and constipation). A generalized estimating equation (GEE) was used to evaluate these relationships. Hyperglycemia affected 266 (33.6%) of the 791 patients with PTB. In GEE analyses, patients with hyperglycemia exhibited a greater incidence of elevated tuberculosis (TB) scores (odds ratio (OR) 1.569; 95% CI 1.040-2.369), cough (OR 1.332; 95% CI 1.050-1.690), and night sweats (OR 1.694; 95% CI 1.288-2.335). Hyperglycemia was linked with a higher risk of positive sputum smears (OR 1.941; 95% CI 1.382-2.727). During therapy, hyperglycemia was also associated with an increased incidence of vomiting (OR 2.738; 95% CI 1.041-7.198), abdominal distension (OR 2.230; 95% CI 1.193-4.171), and constipation (OR 2.372; 95% CI 1.442-3.902). However, the CT results indicated that hyperglycemia did not affect pulmonary lesions in patients with TB. Patients with TB and hyperglycemia are at a higher risk of severe clinical manifestations, positive sputum smears, and adverse gastrointestinal effects and, therefore, the special situation of hyperglycemic patients should be considered in the prevention and treatment of TB.
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Hiperglicemia , Tuberculose Pulmonar , Humanos , Feminino , Masculino , Hiperglicemia/complicações , Pessoa de Meia-Idade , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/complicações , Resultado do Tratamento , Adulto , Estudos de Coortes , Antituberculosos/uso terapêutico , Idoso , Glicemia/metabolismo , Glicemia/análise , Escarro/microbiologiaRESUMO
Objective To investigate the value of monocyte to lymphocyte ratio(MLR)and neutrophil percentage to albumin ratio(NPAR)in predicting diabetic macular edema(DME).Methods One hundred and one diabetic retinopathy patients admitted to the Third Affiliated Hospital of Xinxiang Medical University from January 2018 to February 2023 were selected as the research subjects,and they were divided into DME group(n=56)and non-DME group(n=45)based on fun-dus examination results.The general data such as gender,age,course of diabetes and laboratory indicators were collected by consulting medical records.Fasting elbow venous blood was collected early in the morning of the next day after the diagnosis of DME in both groups,the monocytes(MONO)count,lymphocyte(LYM)count,white blood cell(WBC)count,percentage of neutrophils(NEUT),plasma albumin(ALB),glycosylated haemoglobin(HbA1c)were measured by full automatic blood routine analyzer,and MLR,NPAR were calculated.General information and laboratory indexes of patients in the two groups were compared,and risk factors for DME were analyzed by multivariate logistic regression,and receiver operator characteristic(ROC)curve was applied to evaluate the predictive value of MLR and NPAR for DME.Results The course of diabetes,MONO count,NEUT,MLR,NPAR,WBC count,and HbA1c level of patients between the DME group were significantly higher than those in the non-DME group(P<0.05);there was no statistically significant difference in gender,age,LYM count,and ALB level of patients between the two groups(P>0.05).Multivariate logistic regression analysis showed that increased levels of WBC,MLR,and NPAR were independent risk factors for the occurrence of DME(P<0.05).The ROC curve showed that the best cut-off value of MLR was 0.192,and the area under the curve(AUC)for the prediction of DME was 0.729(95%confidence interval:0.631-0.826),with a sensitivity of 58.9%and a specificity of 82.2%;while the best cut-off value of NPAR was 1.404,and the AUC for predicting DME occurrence was 0.884(95%confidence interval:0.820-0.949),with a sensitivity of 75.0%and a specificity of 91.1%;the AUC of MLR and NPAP for predicting the occurrence of DME was 0.906(95%confidence interval:0.851-0.906),with a sensitivity of 69.6%and a specificity of 93.3%.With MLR>0.192 as positive and NPAR>1.404 as positive,the parallel test of MLR and NPAR predicted the occurrence of DME with a sensitivity of 87.5%,a specificity of 71.1%,and an accuracy of 80.2%;while the tandem test of MLR and NPAR predicted the occurrence of DME with a sensitivity of 46.4%,a specificity of 97.8%,and an accuracy of 69.3%.Conclusion Increased levels of MLR and NPAR are independent risk factors for the occurrence of DME and have certain predictive value for DME.The predictive value of combined MLR and NPAR test for DME is higher than that of separate test,and parallel experiment is more helpful for the early prediction of DME.
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Objectives: Levonorgestrel intrauterine sustained release system (LNG-IUS) is an intrauterine hormonal contraceptive device. Breast cancer (BC) was the most common type of cancer in women in the world in 2020. The relationship between LNG-IUS and BC is controversial. We conducted an updated meta-analysis (larger sample capacity and including Asian data) to explore whether LNG-IUS can increase the risk of BC. Study design: We performed a thorough review of peer-reviewed publications from January 2005 through November 2022 using combinations of search terms for BC risk and LNG-IUS in the PubMed, Cochrane, Embase, Science Direct, and Web of Science databases. Studies reporting BC risk estimates among users of LNG-IUS were included according to the PRISMA criteria. Two authors independently evaluated all studies identified from the databases using Endnote software, and a third author resolved disagreements. The quality of evidence was evaluated using the NewcastleâOttawa Scale (NOS). A funnel plot was generated to assess publication bias. Results: We identified 3029 studies; 12 studies were included in our systematic review, and 6 studies involving 261,221 women were included in our meta-analysis. Two subgroup analyses were performed for different study designs. A total of 190,475 women were included in the meta-analysis of cohort studies, and the results were RR = 0.80 (95% CI 0.57-1.11, Z = 1.33, P = 0.18 > 0.05). The meta-analysis of the caseâcontrol studies included 70,746 women, and the results were OR = 1.38 (95% CI 0.98-1.94, Z = 1.85, P = 0.06 > 0.05). Conclusions: Evidence of an increased risk of BC was not observed among LNG-IUS users. Implications: There are inconsistencies in existing studies that prevent us from confirming whether LNG-IUS can increase the risk of BC. Our updated meta-analysis preliminarily suggested that LNG-IUS did not increase the risk of BC, providing evidence for more clinically safe use and thus providing a better choice for contraception.
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Objective:To learn about the iodine nutritional status of children aged 8 to 10 years in Xiamen City after the reform of salt industry system, and to provide scientific basis for reasonable prevention and control of iodine deficiency disorders.Methods:From 2017 to 2019, 6 districts were selected each year in Xiamen City 5 sampling districts were divided according to the oriation of east, west, south, north and center in each district. One town (street, hereinafter refered as to town) was selected from each sampling district. One primary school was selected from each town. For each primary school, at least 40 non-boarding children aged 8 to 10 years (age balanced, half male and half female) were selected. Edible salt samples in the households and random urine samples of children aged 8 to 10 years were collected, and salt iodine and urinary iodine contents were measured, while thyroid volume was examined by B-ultrasound.Results:From 2017 to 2019, the coverage rate of iodized salt in Xiamen City was 97.34% (1 206/1 239), 96.89% (1 214/1 253), and 93.33% (1 175/1 259), respectively; the consumption rate of qualified iodized salt was 96.13% (1 191/1 239), 95.61% (1 198/1 253), and 91.58% (1 153/1 259), respectively; the median urinary iodine was 182.90, 182.81, 164.00 μg/L, respectively. The prevalence of goiter of boys and girls was 1.01% (19/1 889) and 2.26% (42/1 862), respectively.Conclusions:After the reform of salt industry system, the iodine nutritional status of children aged 8 to 10 years is generally at an appropriate level in Xiamen City. However, the consumption rate of qualified iodized salt is reduced, which increases the risk of iodine deficiency for residents. Therefore, we should strengthen the propaganda of scientific iodine supplement, maintain a high consumption rate of qualified iodized salt, and prevent the harm of iodine deficiency.
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Objective:To investigate the clinical value of isolated fetal echogenic bowel (FEB) as an indicator for invasive prenatal diagnosis.Methods:This retrospective study enrolled 183 pregnant women who were diagnosed with isolated FEB and underwent invasive prenatal diagnosis in Fujian Maternity and Child Health Hospital from August 2013 to January 2021. Clinical data including the results of conventional karyotyping and chromosomal microarray analysis (CMA), cytomegalovirus (CMV) DNA loads in amniotic fluid and pregnancy outcomes were reviewed analyzed. Chi-square test was used for statistical analysis Results:Karyotyping was performed on all of the 183 fetuses and three (1.64%) aneuploidies (one case of trisomy 21, one trisomy 18 and one 47,XYY syndrome) were detected. One trisomy 21 and four pathogenic (P)/likely pathogenic (LP) copy number variation (CNV) were detected among 108 fetuses who received CMA. The detection rate of P/LP chromosomal abnormalities by CMA was higher than that by karyotyping, but there was no significant difference between them [4.63% (5/108) vs 0.93% (1/108), χ 2=1.54, P>0.05]. In addition, three cases of variants of uncertain significance (VOUS) were detected by CMA. CMV DNA loads of fetal cells in the amniotic fluid samples of the 166 cases were determined, and only one (0.6%) was positive (CMV DNA up to 7.01×10 6 copies/ml), and no abnormalities were found in karyotype analysis and CMA detection. A total of 176 cases were followed up, and among them only one case of intrauterine infection and seven cases (three aneuploidies and four P/LP CNV) of chromosomal abnormalities were terminated after genetic counseling. Three fetuses with VOUS and other 165 fetuses without chromosomal abnormalities had a good prognosis after birth. Conclusions:Isolated FEB may be the abnormal ultrasound finding in fetuses with chromosomal abnormalities or CMV infection. Prenatal genetic testing and the exclusion of intrauterine infection are important for management during pregnancy and prognosis assessment of FEB.
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OBJECTIVE@#To analyze the intrauterine phenotype and genotype of eight fetuses carrying a 16p11.2 microdeletion.@*METHODS@#5100 fetuses undergoing routine prenatal diagnosis were subjected to single nucleotide polymorphism-based microarray (SNP-array) analysis. Fetuses harboring a 16p11.2 microdeletion were analyzed for their ultrasonographic characteristics.@*RESULTS@#Eight fetuses were found to harbor a microdeletion in the 16p11.2 region. Among these, six had a typical 500-600 kb deletion, while the remaining two had an atypical 220 kb deletion at the distal part of 16p11.2. Four fetuses showed vertebral malformations, two had mild left ventriculomegaly, one had hydrocephalus, and one had pulmonary valve stenosis with regurgitation. The parents of five fetuses have accepted pedigree verification, and the results confirmed that the 16p11.2 microdeletions carried by fetuses all had a de novo origin.@*CONCLUSION@#The intrauterine phenotypes of fetuses carrying a 16p11.2 microdeletion may be variable, and the deletion can be effectively detected with the SNP-array assay.
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Feminino , Humanos , Gravidez , Deleção Cromossômica , Feto , Testes Genéticos , Fenótipo , Diagnóstico Pré-NatalRESUMO
OBJECTIVE@#To analyze the prenatal ultrasonic characteristics and genetic features of 14 fetuses with chromosome 22q11 microdeletion syndrome (22q11DS).@*METHODS@#4989 fetuses were analyzed by using single nucleotide polymorphism array (SNP array) in the Fujian Maternal and Child Health Hospital from November 2016 to November 2019.@*RESULTS@#SNP array showed that 11 fetuses had classic 3 Mb microdeletion in 22q11 region, one fetus had 2.0 Mb microdeletion, and two fetuses had 1.0 Mb microdeletion. The 1.0 Mb microdeletion in 22q11 region contains SNAP29 and CRKL genes, which may increase the risk of congenital renal malformation and cardiovascular malformation.@*CONCLUSION@#Prenatal ultrasonic characteristics of fetuses with 22q11 microdeletion syndrome vary, and SNP array is a powerful tool to diagnose such diseases, which can provide accurate genetic diagnosis and enable prenatal diagnosis.
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Feminino , Humanos , Gravidez , Síndrome da Deleção 22q11/diagnóstico por imagem , Deleção Cromossômica , Cromossomos Humanos Par 22/genética , Feto , Testes Genéticos , Diagnóstico Pré-Natal , UltrassomRESUMO
OBJECTIVE@#To assess the impact of confined placental mosaicism (CPM) on non-invasive prenatal testing (NIPT) and pregnancy outcomes.@*METHODS@#Copy number variation sequencing (CNV-seq) and single nucleotide polymorphism array (SNP-array) were carried out on placental specimen sampled from eight pregnancies with confirmed false-positive NIPT results. The impact of CPM on NIPT and pregnancy outcomes were analyzed based on the laboratory tests and clinical characteristics.@*RESULTS@#Five of the eight cases with false-positive NIPT results were proven to be CPM involving trisomy 9, 13, 21, 22, and X, respectively. The mosaic ratios for different placental regions have varied from 4% to 80%. Two fetuses with confirmed CPM showed fetal growth restriction (FGR) and additional ultrasound abnormalities, 1 fetus showed only FGR. The remaining two fetuses showed normal growth.@*CONCLUSION@#NIPT is highly sensitive to CPM, whilst CPM is an important cause for false-positive NIPT result. CPM may be associated with FGR. Investigation of the presence of CPM is important for both pre- and post-test genetic counseling and management of the pregnancy.
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Feminino , Humanos , Gravidez , Variações do Número de Cópias de DNA , Mosaicismo , Resultado da Gravidez , Diagnóstico Pré-Natal , TrissomiaRESUMO
Objective:To investigate the iodine nutritional status among children aged from 8 - 10 and pregnant women in Xiamen City before and after adjustment of salt iodine concentration, and scientifically evaluate the suitability of the new standard iodized salt adjustment policy for Xiamen City.Methods:In the pre-adjustment period (2011) and the post-adjustment period (2018), cross-sectional research methods and stratified cluster sampling methods were adopted in six districts of Xiamen City. The salt samples of residents and pregnant women, urine samples of children aged from 8 - 10 and pregnant women were collected to determine the iodine level; thyroid of children aged from 8 - 10 was examined. Changes in salt iodine, urine iodine and goiter prevalence before and after adjusting iodine content of salt were compared.Results:The median of salt iodine in residents after the adjustment (23.5 mg/kg) was significantly lower than that of before (28.9 mg/kg, Z = - 10.512, P < 0.05), the median of salt iodine in pregnant women after the adjustment (23.7 mg/kg) was significantly lower than that of before (29.2 mg/kg, Z = - 12.622, P < 0.05); the consumption rate of qualified iodized salt in residents after the adjustment (95.7%, 1 196/1 250) was significantly lower than that of before (97.1%, 1 608/1 656; χ 2 = 4.250, P < 0.05); before and after adjustment of salt iodine concentration, the consumption rate of qualified iodized salt in pregnant women was 94.7% (124/131) and 95.9% (579/604), respectively. No significant difference was found when comparing the consumption rate of qualified iodized salt in pregnant women (χ 2 = 0.015, P > 0.05). There was significant difference in median urinary iodine (from 204.2 to 183.9 μg/L, detected in 652, 1 250 urine samples, respectively) of children aged 8 - 10 years ( Z = - 3.583, P < 0.05); the difference of iodine nutritional status in pregnant women before and after adjustment of salt iodine concentration(130.2, 130.8 μg/L, detected in 132, 604 urine samples, respectively) was not significant ( Z = - 1.715, P > 0.05). The thyroid goiter rate of children aged 8 - 10 years had reduced from 1.1% (14/1 239) to 0.2% (2/1 253), the difference was statistically significant (χ 2 = 9.195, P < 0.05). Conclusions:As a whole, the measure of control and prevention of iodine deficiency disorders through iodized salt is implemented well in Xiamen City. After adjustment of salt iodine concentration, the iodine status of children aged from 8 to 10 is adequate, but the pregnant women has showed iodine deficiency.
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The pneumonia caused by the novel coronavirus (2019-nCoV), which began in December 2019, has become the most serious public health problem, threatening people's health and life. This threat is posing a severe challenge on the diagnosis and treatment of 2019-nCoV infection, the prevention and control of hospital cross infection of medical staff. It is suggested that in addition to strengthening the organization and leadership of the abovementioned work, establishing and improving the prevention and control mechanism deserve greater attention. Furthermore, special attention should be given to the safety of the medical staff, strengthening their infection monitoring and outbreak management. Medical staff in different work areas and positions should be placed under careful protection, cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments. These measures are proposed to provide a guidance for the prevention and control of 2019-nCoV nosocomial infection in the pediatric outpatient and ward.
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Severe pneumonia is a common disease in intensive care unit (ICU), which is characterized by acute onset, poor prognosis, and can cause multiple systems dysfunction. For critical ill patients, in a state of stress, catabolism is increased, and nutritional risk is extremely high. Proper nutrition treatment can reduce the decomposition of own tissues in the stress period and supplement the protein and energy needed by the body′s metabolism. Therefore, the nutritional treatment of severe pneumonia patients is particularly important. This paper mainly reviews the nutritional literatures of severe pneumonia and critical ill patients in recent years, in order to provide more appropriate nutritional treatment for severe pneumonia patients.
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Objective:To investigate the effects of sedatives on the activity of the diaphragm assessed by ultrasound and the timing of extubation in elderly patients after elective surgery.Methods:All 60 eligible elderly patients were randomly divided into three groups: the propofol group, the midazolam group and the control group(n=20, each group). Remifentanil was used in the three groups to keep the Critical Care Pain Observation Tool(CPOT)score less than 3.Patients in the propofol and midazolam groups were given propofol and midazolam sedation respectively, and the Richmond Agitation Sedation Scale(RASS)score was maintained at -2.Diaphragmatic activity was measured, the time from the end of the operation to extubation was recorded, and delirium was evaluated, and the above results were compared with those of the control group, which did not receive sedatives.Results:The activity of the diaphragm was lower in the propofol and midazolam groups than in the control group[(1.10±0.12)cm, (1.17±0.30)cm vs.(1.63±0.25)cm, F=30.170, P=0.000], and there was no significant difference between the propofol group and the midazolam group( t=25.340, P=0.615). There was no significant difference in duration of extubation among the propofol, midazolam and control groups[(1.41±2.08)d, (1.25±1.53)d vs.(1.19±1.40)d, F=0.089, P=0.915]. The incidence of delirium was higher in the midazolam group than in the propofol and control groups[55.0%(11/20), 20.0%(4/20) vs.15.0%(3/20), χ2=5.230, P=0.022, χ2=7.030, P=0.008)], but the difference between the propofol group and control group was not statistically significant( χ2=0.170, P=0.677). Conclusions:The application of sedatives after elective surgery has an effect on the activity of the diaphragm in elderly patients, and the effects of propofol and midazolam are similar.However, propofol and midazolam have no influence on the duration of extubation in elderly patients after elective surgery.Compared with propofol, midazolam increases the incidence of delirium in elderly patients after elective surgery.
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The epidemic of COVID-19 has become the topmost public health threat worldwide. The authors suggested that in addition to strengthening the organization and leadership of the abovementioned work, greater attention be paid to establishing and improving the prevention and control mechanism.Furthermore, special efforts should be given to the safety of the medical workers, by strengthening their infection monitoring and outbreak management. Medical workers in different work areas and positions should be placed under careful protection with due cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. Such special issues in the management of pediatric patients, as allocation of nurses, the screening and management of caregivers, the problem of breastfeeding, and the disinfection of children′s toys and diapers were discussed. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments, which aim to guide the prevention and control of COVID-19 nosocomial infection in the pediatric outpatient and ward.
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Objective To investigate the intervention effect of 1,25(OH)2D3 on serum level of parathyroid hormone,bone metabolic markers and muscle strength in the community elderly with low bone mass.Methods A total of 132 residents aged 60 years and over from Shanghai communities diagnosed as osteopenia or osteoporosis were enrolled and treated with 0.5 μg/d calcitriol for 3 months.Serum levels of parameters in blood biochemistry and bone metabolic markers were determined by Cobas Diagnosis System of Roche before and after treatment,and the handgrip strength of both left and right hands were measured at the same time.Results The average age of 132 patients was(66.1 ± 6.3) years,4 cases (all female) terminated their medication in advance,and 128 patients completed the treatment for three months.The baseline serum levels of 25 (OH)D and PTH were 19.6 ± 7.9 μg/L and 41.0 μg/L respectively.According to the median value of serum PTH before treatment,patients were divided into the two groups:the high PTH group and the low PTH group.Compared with the low PTH group,the serum levels of 25OHD and serum calcium were decreased in the high PTH group[(17.1 ± 7.0) μg/L vs.(22.1 ± 8.2) μg/L,2.4 mmol/L vs.2.5 mmol/L,P<0.05].After 3 months of intervention,serum levels of creatinine,urine calcium and left handgrip were significantly elevated[(68.2 ± 13.8) μmol/L vs.(65.2 ± 13.4) μmol/L,(5.9 ± 2.8)mmol/24 h vs.(4.4 ± 2.0) mmol/24 h,23.8 kg vs.21.0 kg,all P <0.05],while serum levels of PTH,eGFR,phosphorus were significantly decreased[35.5 ng/L vs.42.0 ng/L,(87.0 ± 17.0) ml/min vs.(93.1±17.9) ml/min,1.2 mmol/L vs.1.3 mmol/L,all P<0.05).There was a significant negative correlation between serum 25(OH)D and PTH before treatment(r=-0.312,P<0.05),but the negative correlation between them was no longer significant after 3 months of treatment (r =0.042,P > 0.05).A multivariate logistic regression analysis revealed that the increment of left handgrip strength greater than 25% (OR =0.138,95% CI:-0.002-8.383),the increment of serum calcium levels(OR =2.578,95%CI:1.0345-8.693)and age(OR =0.103,95%CI:0.035-0.345) were significantly correlated with the decrement of serum PTH levels greater than 30 % after three months of treatment.Conclusions Vitamin D diminution or deficiency is common in the elderly.The shortterm treatment of calcitriol can obviously reduce serum PTH,inhibit bone absorption and increase muscle strength.The effect of calcitriol on serum PTH is closely related to promoting calcium absorption and improving handgrip strength.
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Objective To analyze the iodine nutritional status among pregnant women,breasffeeding women,0-2 years old infants,8-10 years old children,18-45 years old women and men in both urban and rural areas of Xiamen 3 years after promotion of new standard iodized salt.Methods The Huli and Xiang'an were selected as the urban and rural study sites in Xiamen City,from March 2015 to March 2016.Each study site was further divided into five geographic locations (east,south,west,north and center).In each location,one township was randomly selected.In each town,2 tap water samples,60 salt samples of residents,and urine samples of 40 children aged from 8-10 years old,20 pregnant women,12 breastfeeding women,0-2 years old infants,18-45 years old women and men were collected to determine the iodine level.The water iodine and urinary iodine were detected by arsenic cerium catalytic spectrophotometry;salt iodine was detected by direct titration.Results The medians of salt iodine in urban and rural were 23.0 and 25.3 μg/L,respectively.The coverage rates of iodized salt in urban and rural area were 99.3% (298/300) and 94.0% (282/300),respectively.The consumption rates of qualified iodized salt were 93.7% (281/300) and 90.7% (272/300),respectively.The medians of tap water iodine in urban and rural were 4.1 and 4.4 μg/L,respectively.In urban and rural areas,the medians of urinary iodine of pregnant women were 167.6 and 119.6 μg/L,respectively.The medians of urinary iodine of breastfeeding women were 121.6 and 101.2 μg/L,respectively.The medians of urinary iodine of infants were 165.9 and 110.5 μg/L,respectively.The medians of urinary iodine of children were 208.9 and 167.2 μg/L,respectively.The medians of urinary iodine of women aged 18-45 were 132.5 and 154.5 μg/L,respectively.The medians of urinary iodine of men aged 18-45 were 131.7 and 154.5 μg/L,respectively.Conclusions After 3 year promotion of new standard iodized salt,the iodine status of pregnant women in urban,breastfeeding women,0-2 years old infants,children aged 8 to 10 and adults aged 18 to 45 is adequate,but the pregnant women in rural has showed iodine deficiency.So surveillance and health education should be continuously strengthened in the future.Scientific salt iodization should continue to ensure the amount of iodine intake.
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OBJECTIVE@#To determine the origin of supernumerary small marker chromosomes (sSMCs) carried by two fetuses.@*METHODS@#Single nucleotide polymorphism array (SNP-array) and fluorescence in situ hybridization (FISH) analysis were carried out on cells cultured from the amniotic fluid samples.@*RESULTS@#SNP-array analysis showed both fetuses to be arr[hg19]22q11.1q11.21(16 888 899-18 649 190)×4, with a duplicated 1.7 Mb region (16 888 899-18 649 190) leading to partial tetrasomy of 22q11.1-22q11.21. FISH confirmed that both fetuses were 47,XN,+mar.ish idic(22)(q11.2) (RP11-958H20 ++),which suggested a diagnosis of Cat-eye syndrome (CES). The appearance of abortuses were consistent with the diagnosis of CES.@*CONCLUSION@#Two fetuses with CES were diagnosed by genetic testing. The latter has provided a basis for genetic counseling.
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Feminino , Humanos , Gravidez , Aneuploidia , Transtornos Cromossômicos , Diagnóstico , Cromossomos Humanos Par 22 , Anormalidades do Olho , Diagnóstico , Feto , Hibridização in Situ Fluorescente , Cariotipagem , Diagnóstico Pré-NatalRESUMO
AIM: To explore the protective effect of phytosterol ester (PSE) on aortic aging in rats.ME-THODS: The female SD rats (12 months old, n=42) were randomly divided into control group, model group and PSE group.During the experiment, the rats in control group, model group and PSE group were treated with basic feed, high-fat diet (HFD) and HFD with 2% PSE (W/W) for 6 months, respectively.The morphological changes of the aorta were observed by HE staining and Masson staining, and the absolute area of smooth muscle cells and collagen fiber in the vascular wall were measured by image analysis.The levels of advanced glycosylation end products (AGEs), malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in the plasma were detected.The expression of silent information regulator 1 (SIRT1) and peroxisome proliferator-activated receptor γ (PPARγ) at mRNA and protein levels in the vascular tissue was determined by real time PCR and Western blot, respectively.RESULTS: PSE significantly lowered plasma TC and LDL-C, and increased plasma HDL-C level (P<0.05), but had no effect on plasma TG level.PSE significantly attenuated the thickening of intima and media of aging aortic, and decreased the migration of vascular smooth muscle cells (VSMC) and the amount of VSMC and collagen fiber in the aorta (P<0.05).PSE significantly reduced the contents of AGEs and MDA (P<0.05), but had no effect on the activity of SOD and CAT in the plasma.PSE also down-regulated the expression of PPARγ and up-regulated the expression of SIRT1 (P<0.05).CONCLUSION: PSE is able to attenuate the senescence process in the aorta by reducing the production of reactive oxygen species in plasma, and activating SIRT1, or inhibiting the expression of PPARγ in vascular tissues.
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Objective To compare ultrasound-and endoscopy-guided methods in nasogastrojejunal tube placement in critical ill patients at bedside.Methods A tot al of 95 critical ill patients planed to perform enteral nutrition (EN) were enrolled.They were divided randomly into ultrasound-guided group (48 patients)and endoscopy-guided group (47 patients).The success rate,the incidence of complications and the time they took were compared between two groups.Results Ultrasound guided group was compared to endoscopy guided group with a lower success rate (81.3% vs 100%,P =0.003),mainly because of the initial 24-stage having a very low success rate (66.7% vs 100%,P =0.000),but the success rate of the following 24 cases was significantly improved (95.8% vs 100%,P =0.338).Ultrasound guided group didn 't cause more complications (2.1% vs 0,P =1.000),and consumed less time [(13.3 ± 2.8)min vs (15.0 ± 1.4) min,P =0.000].Compared to the following 24 cases,the initial 24 cases of ultrasound guided group in nasogastrojejunal tube placement had the lower success rate (66.7% vs 95.8%,P =0.023),the longer time-consuming [(15.4 ±2.1)rin vs (11.2 ± 1.4) min,P =0.000],and but didnt cause more complications (4.2% vs 0,P =1.000).The success rate of different diseases [severe acute pancreatitis(SAP) vs cerebrovascular disease] hadn't statistically significant difference (94.9% vs 87.5 %,P =0.300),but the SAP group consumed less time [(12.6 ± 1.9)min vs (15.5 ± 2.0)min,P =0.000].Conclusions The placement of nasogastrojejunal tube under ultrasound guidance represented a safe,quick and effective method to provide enteral nutrition.
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Objective To investigate the coverage of iodized salt and the iodine status among children aged from 8-10 years in both urban and rural areas of Xiamen after promotion of new standard iodized salt,and to provide scientific evidence for adjustment of control strategy.Methods After 3 year promotion of new standard iodized salt,Huli and Xiang'an were selected as the urban and rural investigation sites,respectively in 2015.Each investigation site was further divided into five sampling areas,namely east,west,south,north and central.In each sampling area,one town was randomly selected and 2 tapping water samples were collected to determine the iodine level;in each town,4 villages were randomly selected and 15 residents were selected and edible salt samples were collected to determine the iodine level.Moreover,one primary school was selected in each town,and 40 children aged from 8-10 years old were randomly selected to perform thyroid examination and urinary iodine level determination.The water iodine was detected by arsenic cerium catalytic spectrophotometry;salt iodine was detected by direct titration;urinary iodine was detected by arsenic cerium catalytic spectrophotometry;thyroid was examined by B ultrasound.Results The iodine concentration was lower than 10 μg/L in drinking water in both urban and rural areas.The coverage rate of iodized salt in urban and rural areas was 99.3% (298/300) and 94.0% (282/300),respectively.The consumption rate of qualified iodized salt was 93.7% (281/300) and 90.7% (272/300),respectively.The prevalence of goiter was 3.8% (8/210) both in urban and rural areas.The prevalence of thyroid nodule was 17.6% (37/210) and 19.5% (41/210),respectively.No significance was found when comparing the prevalence of goiter and the prevalence of thyroid nodule (x2 =0.000,0.252,all P > 0.05).The median of urinary iodine was 208.9 and 167.2 μg/L,respectively.The statistical analysis found that the urban children had higher iodine level when comparing with rural counterparts (Z =4.030,P < 0.01).The prevalence of goiter in male and female was 2.4% (5/208) and 5.2% (11/212),respectively,and no significant difference was detected (x2=2.222,P> 0.05).The prevalence of thyroid nodule in male and female children was 13.5% (28/208) and 23.6% (50/212),respectively,the analysis showed that the female children had higher prevalence of thyroid nodule (x2 =7.115,P < 0.01).The median of urinary iodine in male and female children was 197.8 and 169.6 μg/L,respectively,and the urinary iodine level was significantly higher in male when comparing with female children (Z =2.218,P < 0.05).Conclusions After promotion of new standard iodized salt,the iodine nutrition of children aged from 8-10 years in both urban and rural areas of Xiamen were good.The goal of eliminating iodine deficiency disorders was achieved.The iodine supplement measure should be further promoted to ensure the adequate level of iodine in residents,adhere to the iodine supplement measure,promote a healthy lifestyle,ensure the amount of iodine intake.
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<p><b>OBJECTIVE</b>To establish a method for the prenatal diagnosis of 22q11 microdeletion syndrome.</p><p><b>METHODS</b>BACs-on-Beads (BoBs) and fluorescence in situ hybridization (FISH) were performed on a fetus for whom amniotic chromosomal culturing has failed and a pair of twin fetuses suspected for 22q11 deletion syndrome.</p><p><b>RESULTS</b>22q11 microdeletion was detected in all 3 fetuses by prenatal BoBs as well as FISH, with only one red signal detected at the DiGeorge/VCFS N25 site and two green signals on the 22q13.3 ARSA site.</p><p><b>CONCLUSION</b>The combination of prenatal BoBs and FISH can provide a method for the prenatal diagnosis of 22q11 microdeletion.</p>