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Objective To explore the value of the Physiology and Surgical Severity Score(POSSUM)scoring system in predicting postoperative complications in elderly patients with thoracic surgery,and to ana-lyze its correlation with Clavien-Dindo classification.Methods The data of 182 elderly patients who under-went thoracic surgery in this hospital from October 2019 to March 2023 were retrospectively analyzed.They were divided into the complication group and the non-complication group according to whether there were complications after surgery.The baseline data and POSSUM score of the two groups were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of POSSUM for post-operative complications in elderly patients.POSSUM of patients with different Clavien-Dindo classification was compared,and the correlation between POSSUM and Clavien-Dindo classification analyzed.Results The incidence of pulmonary infection was the highest in the complication group,followed by hypoproteinemia.POSSUM in the complication group was higher than that in non-complication group before operation,and the difference was statistically significant(P＜0.05).The ROC curve showed that the area under curve(AUC)value of POSSUM was 0.829;In the complication group,according to Clavien-Dindo classification,there were 5 cases of grade Ⅰ,47 cases of grade Ⅱ,8 cases of grade Ⅱ Ⅲ,7 cases of grade Ⅳ and 8 cases of grade V,the difference was statistically significant(P＜0.05).The correlation analysis showed that POSSUM score was positively correlated with Clavien-Dindo classification(r＞0.513,P＜0.05).Conclusion The POSSUM scoring system has a high value in predicting postoperative complications in elderly patients with thoracic surgery.
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Objective:To analyze the methylation characteristics of the lymphocyte-specific protein-tyrosine kinase (LCK) promoter region in the peripheral blood circulation of rheumatoid arthritis (RA) patients and its correlation with clinical indicators.Methods:Targeted methylation sequencing was used to compare the methylation levels of 7 CpG sites in the LCK promoter region in the peripheral blood of RA patients with healthy controls (HC) and osteoarthritis (OA) patients. Correlation analysis and ROC curve construction were performed with clinical information.Results:Non-parametric tests revealed that compared with HC [0.53(0.50, 0.57)] and OA patients [0.59(0.54, 0.62), H=47.17, P<0.001], RA patients [0.63(0.59, 0.68)] exhibited an overall increase in methylation levels. Simultaneously, when compared with the HC group [0.38(0.35, 0.41), 0.59(0.55, 0.63), 0.60(0.55, 0.64), 0.59(0.55, 0.63), 0.58(0.53, 0.62), 0.45(0.43, 0.49), 0.57(0.54, 0.61)], the RA group [0.46(0.42, 0.49), 0.70(0.65, 0.75), 0.70(0.66, 0.76), 0.70(0.65, 0.75), 0.69(0.64, 0.74), 0.55(0.51, 0.59), 0.68(0.63, 0.73)] showed a significant elevation in methylation levels at CpG sites cg05350315_60, cg05350315_80, cg05350315_95, cg05350315_101, cg05350315_104, cg05350315_128, and cg05350315_142, with statistically significant differences ( Z=-5.63, -5.89, -5.91, -5.89, -5.98, -5.95, -5.95, all P<0.001). Compared with the OA group [0.65(0.59, 0.69), 0.65(0.60, 0.69), 0.64(0.58, 0.68), 0.50(0.45, 0.54), 0.63(0.58, 0.67)], the RA group [0.70(0.66, 0.76), 0.70(0.65, 0.75), 0.69(0.64, 0.74), 0.55(0.51, 0.59), 0.68(0.63, 0.73)] exhibited a significant increase in methylation levels at CpG sites cg05350315_95, cg05350315_101, cg05350315_104, cg05350315_128, and cg05350315_142, with statistically significant differences ( Z=-3.56, -3.52, -3.60, -3.67, -3.62; P=0.036, 0.042, 0.031, 0.030, 0.030). Furthermore, Pearson correlation coefficient analysis revealed a positive correlation between the overall methylation level in this region and C-reactive protein (CRP) ( r=0.19, P=0.004) and erythrocyte sedimentation rate ( r=0.14, P=0.035). The overall methylation level of the LCK promoter region in the CRP (low) group [0.63 (0.58, 0.68)] was higher than that in the CRP (high) group [0.65(0.61, 0.70)], with statistically significant differences ( Z=2.60, P=0.009). Finally, by constru-cting a ROC curve, the discriminatory efficacy of peripheral blood LCK promoter region methylation levels for identifying RA patients, especially seronegative RA patients, from HC and OA groups was validated, with an AUC value of 0.78 (95% CI: 0.63, 0.93). Conclusion:This study provides insights into the methylation status and methylation haplotype patterns of the LCK promoter region in the peripheral blood of RA patients. The overall methylation level in this region is positively correlated with the level of inflammation and can be used to differentiate seronegative RA patients from the HC and OA patients.
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@#<b>Objective</b> To analyze the abnormality of radiation damage sensitive indices in radiation workers after operation of a third-generation nuclear power plant in Guangdong Province, China, and to provide a basis for promoting the occupational health management of radiation workers. <b>Methods</b> A two-way cohort study (2019—2021) was conducted to compare the radiation sensitive indices of occupational health examination in the exposed group (453 subjects) and the control group (160 subjects). <b>Results</b> In 2021, the free triiodothyronine (FT3) level of the exposed group was significantly higher than that of the control group [(5.57 ± 0.56) pmol/L <i>vs</i> (5.42 ± 0.60) pmol/L, <i> t</i> = 0.59, <i>P</i> < 0.05]. From 2019 to 2021, the exposed group showed significant changes in the average levels of platelet, hemoglobin, FT3, free thyroxine (FT4), and thyroid-stimulating hormone (<i>P</i> < 0.05); FT3 and FT4 first increased and then decreased, while TSH decreased continuously. <b>Conclusion</b> Long-term exposure to low-dose ionizing radiation from nuclear power plants can affect the platelet, hemoglobin, FT3, FT4, and thyroid-stimulating hormone of radiation workers, and the effect is relatively prominent on thyroid function by causing a tendency to hypothyroidism.
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Objective To determine the current prevalence and risk factors of metabolic syndrome (MS) among adult residents in Chinese developed areas.Methods The clinical data of 6614 adult residents,including 4051 women,from Guangdong and Jiangsu provinces from China Diabetes and Metabolic Disorders Study (2007-2008) were analyzed.Age and sex standardized prevalences of MS were calculated according to the criteria of Chinese Diabetes Society (CDS),US National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATP Ⅲ),International Diabetes Federation (IDF) and Joint Interim Statement (JIS),respectively.Logistic regression analysis was performed to identify the risk factors of MS.Results Age and sex standardized prevalences of MS were 17.88％ (CDS),28.50％ (ATP Ⅲ),21.99％ (IDF) and 31.50％ (JIS),respectively.The prevalences of residents with at least one metabolic abnormality were 67.86％ (CDS) 79.56％ (ATP Ⅲ),79.62％ (IDF) and 80.74％ (JIS),respectively.MS was more common in female than in male by the ATPⅢ and IDF criterion (ATPⅢ:30.63％ vs 26.45％,P ＜0.01 ; IDF:26.04％ vs 17.91％,P ＜ 0.01),while the prevalence was higher in male by CDS criteria (15.94％ vs 19.87％,P ＜0.01).There was no significant difference in the MS prevalence between the rural and the urban residents.Kappa test showed ATP Ⅲ and JIS criteria were most homogenous (κ =0.95,P ＜ 0.01).The risk factors for MS by the logistic regression model were male,older age,lower degree of education,family history of hypertension and obesity,drinker as well as uncontrolled diet.Conclusion The prevalence of MS is high in the adult residents of Chinese developed areas (Guangdong and Jiangsu provinces),whatever diagnostic criterion was used.Effective measures should be taken to control the modifiable MS risk factors.
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The plasma histamine concentration was elevated from the control level of 1.16? 0.28ng/ml to 11.42?5.2ng/ml 2-5 min after intravenous injection of Serratia mar-cescens endotoxin,and then declined gradually.The level was still slightly higher than the control 4 h later. The plasma noradrenaline(NA)and adrenaline (Ad) concentrations were increased from the control value of 1.13?0.28ng/ml and 1.05 ?0.32ng/ml to 7.33?1.86ng/ml and 10.04? 3.94ng/ml respectively. Six h later they were still significantly elevated.Arterial blood pressure was reduced to 24.16%of the control level 2-5 min after injection and to 69.2% 6 h later.Both cardiac output and cardiac index were decreased, but the peripheral resistance was increased during endotoxin shock. The significant dilatation of arterioles, venules and capillaries of bulbar conjunctiva microcirculation occurred 1-2 min after endotoxin injection, and the blood flow slowed down at the same time.Five min - six h after endotoxin injection arterioles constricted markedly, but capillaries and venules were still congested and distended.From this study, the interrelationship of some changes in the development of endotoxin shock were discussed.Endotoxin caused the congestion in microcirculatiolelen, reduction of blood returning to the heart and reduced peripheral resistance owing to the histamine released in large amounts. Drastic drop in blood pressure resulted in the increase of NA and Ad release reflexly, which led to the constriction of arterioles, the increase of the peripheral resistance and the restoration of the blood pressure to some extent.Since venules and capillaries were distended and congested,blood pressure and cardiac output still remained at lower level all the time during endotoxin shock.
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The neurogenic pulmonary edema (NPE) was produced consistently in rabbits by raising intracranial pressure (ICP) with an infusion of anticoagulat rabbit blood into subarachnoid space of the bilateral parietal regions. When ICP increased from 60mmHg to 140 mmHg, There was a rapid decrease in blood flow volume of the bilateral internal carotid arteries (ICABFV). At the same time, the frequency of cervical sympathetic discharge and the concentrations of plasma noradrenaline and adrenaline increased acutly accompanied by a rapid elevation of systemic arterial pressure (SAP). There was a decline in SAP and a further decrease in ICABFV and the animal died as ICP was sustained at 140mmHg for 5-20min. Autopsy revealed severe hemorrhagic pulmonary edema and the left ventricular and atrial enlargement. In the period of ICP rising, the NPE was prevented if SAP was kept at the baseline levels by withdrawing blood from femoral artery, The results suggest that decreased cerebral blood supply due to ICP rising is responsible for the massive sympathetic discharge and catecholamine release which contribute to SAP elevtion and left ventricular overload, the NPE is mediated by hemodynamic mechanism.