Acta Academiae Medicinae Sinica
Objective To investigate the mental health status of the floating population in Chengdu and explore its influencing factors.Methods A questionnaire-based survey was conducted on non-Chengdu household workers over 16 years old in four directions(east,south,west,and north)of Chengdu from June 2017 to June 2018 to collect their social demographic characteristics and mental health status information through respondent driven sampling method.The 12-item general health questionnaire(GHQ-12) was used to assess the mental health status of the respondents,and a multivariate logistic regression model was used to analyze the influencing factors of mental health.Results The average score of GHQ-12 was(1.09±1.61)and the detection rate of mental problems was 7.11%.The main mental problems were anxiety and nervousness.Multivariate unconditional logistic regression analysis showed that over 55 years old(OR=0.425,95%CI=0.213-0.847),junior middle school education(OR=0.541,95%CI=0.356-0.824),length of residence ≥5 years(5-9 years:OR=0.603,95%CI=0.394-0.923;≥10 years:OR=0.534,95%CI=0.346-0.823),annual income ≥18 000 yuan(18 000-35 999 yuan:OR=0.524,95%CI=0.328-0.836;36 000-59 999 yuan:OR=0.327,95%CI=0.190-0.565;≥60 000 yuan: OR=0.356,95%CI=0.192-0.662),and a good relationship with employers(OR=0.519,95%CI=0.363-0.742)were the protective factors for the mental health.Divorce/widowhood(OR=2.351,95%CI=1.341-4.124),plan to return hometown after 5 years(OR=1.805,95%CI=1.084-3.006)and not yet consideration of leaving Chengdu(OR=1.844,95%CI=1.269-2.681)were the risk factors.Conclusions The mental health of the floating population in Chengdu is generally good.However,floating individuals with poor marital status and/or poor sense of belonging to Chengdu are at higher risk of mental problems.The local government should formulate and improve the policies and measures related to social welfare and public services for the floating population and try to enhance their urban integration and sense of belonging,thus improving their mental health.
Objective To explore the values of minimal apparent diffusion coefficient(ADCMin),difference between ratios of apparent diffusion coefficients(ADCDR),and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the treatment of breast ductal carcinoma in situ with microinvasion(DCIS-Mi).Methods Totally 27 patients with DCIS-Mi and 31 patients with breast ductal carcinoma in situ(DCIS)were collected in our hospital from October,2016 to June,2018.Philips Ingenia 3.0T superconducting magnetic resonance scanner and dedicated phase-controlled array surface coil were used for breast examinations.ADCMin and maximum apparent diffusion coefficient(ADCMax)were selected from multiple regions of interest(ROI)in the apparent diffusion coefficients(ADC)figure,and ADCDR was calculated.In addition,DCE-MRI characteristics were analyzed.Results The ADCMin of DCIS-Mi was significantly lower than that of DCIS[(1.15±0.03)×10 3 mm 2/s vs.(1.34±0.04)×10 -3 mm 2/s,t=-7.192,P=0.002],the ADCDR was significantly higher than that of DCIS[(0.32±0.03)×10 -3 mm 2/s vs.(0.18±0.08)×10 -3 mm 2/s,t=-10.228,P<0.001],and the early enhancement rate of DCIS-Mi was higher than that of DCIS[159.71(157.82,162.49)% vs.147.29(143.59,160.22)%,Z=-3.578,P=0.007].The background parenchymal enhancement of DCIS-Mi was moderate,severe,and non-lump-like,mainly segmental,and the internal enhancement was heterogeneous or clustered circular.Multivariate Logistic regression analysis showed that non-internal characteristics of the mass,the edge of the mass,internal enhancement characteristics of the mass,time-intensity curve,early enhancement rate,ADCMin and ADCDR were the optimal variables for the diagnosis of DCIS-Mi,and the optimal variables were shown by receiver operating characteristic(ROC)curve analysis:the area under curve,sensitivity and specificity of ADCMin,ADCDR,non-tumor internal enhancement,and tumor internal enhancement were higher,with the critical values being 1.12×10 -3 mm 2/s,0.31×10 -3 mm 2/s,1.50,and 1.50,respectively.Conclusion DCE-MRI combined with ADC value(especially ADCMin,ADCDR,non-mass internal enhancement,and mass internal enhancement)is helpful in differentiating breast DCIS-Mi and DCIS.
Objective To investigate the effect of catalpol on high-fat diet(HFD)-induced nonalcoholic fatty liver disease(NAFLD)and its underlying molecular mechanisms.Methods Sixty C57BL/6J male mice were randomly divided into six groups:control group;HFD group;HFD+catalpol(100 mg/kg)group;HFD+catalpol(200 mg/kg)group;HFD+catalpol(400 mg/kg)group;and HFD+atorvastatin calcium(ATC)(30 mg/kg)group.The control group was fed a normal diet containing 4.4 kJ/g fat,whereas the other five groups were fed a high-fat diet containing 19.8 kJ/g fat.Mice in the catalpol or ATC treatment groups were administered by gavage for different doses of catalpol or ATC,whereas other mice were treated with saline.Body weight was measured once a week.Experiments were terminated after 18 weeks,and blood and liver samples were collected after an overnight fast(12 hours)for analysis.The body weight and liver weight were measured and the levels of serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),alanine aminotransferase(ALT),and aspartate transaminase(AST)as well as inflammatory factors tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,and IL-6 were determined by commercially available kits.Liver sections were stained with Oil Red O and HE to investigate the lipid accumulation and histopathological changes.The protein expressions of nuclear factor kappa-B(NF-κB)p65,inhibitor of nuclear factor kappa-B α(IκBα),B-cell lymphoma-2(Bcl-2),Bcl-2 associated x protein(Bax),and Caspase-3 were determined by Western blot.Results Compared to the model group,the body weight gains(all P=0.001),liver index(P=0.008,P=0.001,P=0.001),ALT(P=0.004,P=0.001,P=0.001),and AST(P=0.008,P=0.001,P=0.001)were significantly decreased in catalpol treatment groups,and the serum levels of TC(P=0.005,P=0.001),TG (all P=0.001),and LDL-C(all P=0.001)were also significantly decreased in middle and high dose groups,and the serum level of HDL-C was significantly increased in high group(P=0.009).Moreover,compared to the model group,the degree of liver injury and lipid accumulation were obviously decreased in the catalpol treatment groups according to the pathology.Similarly,the release of inflammatory factors was significantly inhibited by the treatment with catalpol.The results of Western blot showed that the protein levels of NF-κB p65(P=0.014,P=0.001,P=0.001)and Caspase-3(all P=0.001)in the livers of HFD-fed mice were significantly reduced by catalpol treatment.In addition,the protein level of IκBα(P=0.028,P=0.001,P=0.001)and the ratio of Bcl-2/Bax in high dose group(P=0.003)was increased by treatment with catalpol.Conclusion Catalpol can effectively improve the body weight gains,liver index,dyslipidemia,and lipid accumulation in HFD-fed mice and inhibit the release of inflammatory factors and hepatocyte apoptosis,thereby preventing the development of NAFLD induced by HFD.
Objective To investigate the value of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)in the diagnosis and differential diagnosis of posterior fossa solid hemangioblastoma(PFSH). Methods We retrospectively analyzed the clinical data of 15 PFSH patients and 58 patients with other hypervascular tumors in the posterior fossa(the latter included 23 cases of meningioma,5 cases of medulloblastoma,8 cases of acoustic neuroma,4 cases of hemangiopericytoma,5 cases of lymphoma,9 cases of metastatic tumor,3 cases of astrocytoma,and 1 case of choroid plexus papilloma)confirmed by operation and pathology.All patients underwent axial DWI scans,and the mean ADC value of solid part of the tumors and the adjacent normal cerebellar white matter were measured,and then the normalized ADC was calculated.In addition,t test was used to compare the differences in mean ADC and normalized ADC between these two groups,and receiver operating characteristic(ROC)curve was applied to analyze the diagnostic performance of normalized ADC. Results Of all the 15 PFSH patients,DWI appeared hypointense in 12 patients and isointense in 3 patients;the signals on ADC maps were isointense or hyperintense;the mean ADC value of PFSHs was(1.881±0.445)×10 -3mm 2/s and the normalized ADC was 2.70±0.62.In contrast,in 58 patients with other tumors in the posterior fossa,DWI appeared hyperintense in 51 cases,isointense in 3 cases,and hypointense in 4 cases;the mean ADC value was(0.771±0.202)×10 -3 mm 2/s,and the normalized ADC was 1.17±0.33.Thus,the ADC value and normalized ADC value were significantly higher in PFSH than in other tumors in the posterior fossa(t=9.419,P<0.001;t=9.184,P<0.001).The cut-off value of the normalized ADC for the diagnosis of solid hemangioblastoma was 1.89,with the sensitivity and specificity being 100%and 96.6%respectively,and the area under the ROC curve was 0.989. Conclusion ADC and normalized ADC are valuable in the differential diagnosis of PFSH from other tumors with abundant blood supply.
Objective To evaluate the bone strength and structure of patients with obstructive sleep apnea(OSA)by the high-resolution peripheral quantitative computed tomography(HR-pQCT)and to explore the relationship between OSA and osteoporosis. Methods Male patients who visited the Sleep Respiratory Center of our hospital from August 2017 to January 2019 were consecutively recruited.Clinical data including the results of Epworth sleep scale(ESS)scoring and overnight polysomnography were collected.HR-pQCT was used to compare the differences in bone geometry,density,and microstructure between OSA patients and non-OSA people;also,the radius and tibia on the non-dominant side were measured to explore the relationship between OSA and osteoporosis. Results A total of 83 subjects were enrolled in the study.The number of patients in the mild,moderate,and severe OSA groups and non-OSA group were 21,18,34,and 10,respectively.There was no significant difference in age,blood pressure,ESS score,sleep stage,and sleep efficiency among these four groups(P>0.05).Body mass index(BMI)and neck circumference were significantly different among these groups(F=4.234,P=0.008;F=3.100,P=0.031).There was no significant difference in the radius indicators(P>0.05).For tibia,there were significant differences among the four groups in the cortical area(Ct.Ar)(F=3.937,P=0.011).There were also significant differences in the bone microstructural indicators including trabecular thickness(Tb.Th)and cortical thickness(Ct.Th)(F=6.247,P=0.001;F=3.746,P=0.014),which were significantly lower in the three OSA groups than in the control group.Pairwise comparisons showed that the Ct.Ar in the severe OSA group was significantly higher than that in the mild OSA group(P=0.019)and Tb.Th in the control group was significantly higher than those in the mild and moderate OSA groups(P=0.006,P=0.001).Correlation analysis showed that,within a certain range,total volumetric bone mineral density(Tt.vBMD)and Tb.Th of radius and tibia were negatively correlated with age(r=-0.312,P=0.004;r=-0.328,P=0.002;r=-0.265,P=0.015;r=-0.280,P=0.010)and positively correlated with BMI(r=0.240,P=0.029;r=0.369,P=0.004;r=0.299,P=0.006;r=0.416,P=0.010).Stepwise multiple regression analysis showed that Tb.Th of radius and tibia were mostly correlated with BMI(β=0.262,P=0.008,R 2=0.243,F=6.270,P=0.000;β=0.494,P=0.000,R 2=0.186,F=7.243,P=0.000)and age(β=-0.216,P=0.030,R 2=0.243,F=6.270,P=0.000;β=-0.306,P=0.003,R 2=0.186,F=7.243,P=0.000).Tt.vBMD of radius had a certain correlation with sleep efficiency and with the decreasing nocturnal mean oxygen saturation caused by OSA(β=0.312,P=0.002, β=-0.249,P=0.012,R 2=0.327,F=7.482,P=0.000). Conclusions In non-elderly male populations,OSA mainly causes a decrease in Tb.Th and Ct.Th of the tibia.The changes in bone strength and structure are mainly related with age and body size and also have certain correlations with sleep efficiency and with the decreasing nocturnal mean oxygen saturation caused by OSA.
Objective To compare the incidence and prognosis of infections between elderly and non-elderly residents in a community of Beijing. Method Adult inpatients during the study period(from July 1,2012 to June 30,2014)living in Yuetan Subdistrict of Beijing were screened for infections,and patients with infections were included into the analysis. Results A total of 19 472 patients were screened,and infections were found in 3449 patients(17.7%).The incidence was significantly higher in the elderly than that in the non-elderly patients(21.5%vs.10.5%,χ 2=362.202,P<0.001).Lower respiratory tract was the most commonly affected site,followed by genitourinary system.The mortalsity rate of the elderly patients with infections was significantly higher than that of the non-elderly patients with infections(13.6%vs.3.4%,χ 2=56.829,P<0.001)and increased with age.Logistic regression analysis found that older age,emergency surgery,comorbid cancer,chronic cardiac insufficiency,higher Charlson comorbidity index,intra-abdominal infection,gastrointestinal infection,bloodstream infection,lower respiratory infection,and hospital-acquired infection were independent risk factors of death for the elderly patients. Conclusion The incidence of infections in the elderly patients living in Yuetan Subdistrict of Beijing is much higher than that of the non-elderly patients,and elderly infected patients had longer hospital length of stays and higher mortality rates than non-elderly infected patients.
Objective To explore the molecular mechanism underlying gastric carcinogenesis and progression by using gene expression profiling array together with bioinformatics. Methods Lentivirus short hairpin RNA targeting STIL(ShSTIL)and scrambled sequence RNA(ShCon)were transduced into the gastric cancer cell line SGC-7901.RNA extraction,complementary DNA synthesis,construction of biotin-labelled amplified RNA probes,and hybridization with gene expression profile were consecutively performed.We collected corresponding data and analyzed differentially expressing genes(DEGs),followed by the analysis of gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)enrichment,transcription factor regulating network,and protein-protein interacting networks. Results Compared with ShCon,a total of 417 and 87 genes were respectively down-regulated and up-regulated,respectively,in the ShSTIL group(P<0.05,fold change>1 or <-1).GO and KEGG enrichment analysis indicated that genes regulated by STIL were localized in cytoplasm,extracellular exosome,Golgi apparatus and various biomembranes,and were implicated in the ubiquitin-mediated proteolysis,P53 signaling pathway,and pathways regulating pluripotency of stem cells.Evaluation on genes enriched in KEGG pathways,regulation of transcription factors,and protein-protein interacting network demonstrated that IGF1R,STUB1,SKP2,and FOXO1 were localized at the centre of the network and played a key role in the development and progression of gastric cancer. Conclusion Through the protein-protein interactions,STIL may activate E3 ubiquitin ligase STUB1 or SKP2,promote the proteolysis of FOXO1-a transcription factor,regulate the expression of IGF1R,and thus promote gastric carcinogenesis and progression.
Objective To summarize and analyze the causes of hyponatremia in patients with brucellosis and explore the clinical manifestations of syndrome of inappropriate antidiuresis(SIAD)in patients with brucellosis. Methods The clinical data of 111 patients with acute brucellosis who were treated in Peking Union Medical College Hospital from September 2011 to December 2017 were retrospectively reviewed.Hyponatremia was defined by serum sodium level lower than 135 mmol/L.Clinical characteristics including medical histories,vital signs,and laboratory test findings were collected and analyzed. Results Hyponatremia was found in 14(12.6%)of 111 patients with brucellosis,among whom 3 patients were confirmed to be with SIAD,10 were suspected as SIAD,and 1 was diagnosis as hypopituitarism.Hypoalbuminemia,elevation of erythrocyte sedimentation rate,and high sensitivity C reactive protein were found in brucellosis patients with SIAD,along with severe complications such as infective endocarditis,septic shock,and anemia. Conclusion Hyponatremia is not a rare condition in brucellosis patients and may be caused by SIAD.
Objective To analyze the effectiveness and safety of intermittent lung inflation combined with rigid ureteroscopy in the treatment of upper ureteral stones that were not fully visible. Methods The clinical and imaging data of 56 patients with upper ureteral stone undergoing rigid ureteroscopic lithotripsy combined with intermittent lung inflation in Zhejiang Quhua Hospital from March 2016 to October 2017 were retrospectively analyzed.Intermittentt lung inflation was used to change and stabilize the position of ureteral calculi during the operation,so as to ensure the visual field of ureteroscopy.Holmium laser lithotripsy was performed to remove the stones.Urinary tract abdominal plain X-ray or CT urography was performed 1 and 3 months after the operation to evaluate the residual stones and the clinical efficacy. Results Stones were successfully removed after a single attempt in 48 patients.In 5 patients,stones escaped into the kidney during ureteroscopic lithotripsy,and thus flexible ureteroscopy were performed.In 3 patients,a second session of auxiliary procedure was required,among whom 2 patients received extracorporeal shock wave lithotripsy and 1 patient underwent extracorporeal shock wave lithotripsy+ureteroscopic lithotripsy.The stone-free rates 1 and 3 months after surgery were 94.6%(53/56)and 100%(56/56),respectively.No severe complication such as ureter perforation,gross hematuria,septic shock,or pneumothorax occurred during and after surgery. Conclusions Intermittent lung inflation in tracheal intubation under general anesthesia in patients with proximal ureteral stones that can not be fully visible during rigid ureteroscopic lithotripsy was feasible and reliable.It can effectively change the location of stones and thus enable safe and effective lithotripy.It expands the indications of rigid ureteroscopy for treating upper ureteral stones.
Objective To investigate the role of thioredoxin interacting protein(TXNIP)/ nucleotides-binding oligomerization domain-like receptor protein(NLRP)3 inflammasome in the sciatic nerve of streptozotocin(STZ)-induced diabetic rats. Methods The diabetic rat model was established by single intraperitoneal injection of STZ.The rats with matched sex and age were taken as normal control group.The blood glucose and body weight were monitored.The mechanical withdrawal threshold was measured by von Frey filaments at 12 weeks after the model was established.At 12 weeks,the rats were sacrificed and the sciatic nerves were separated for Luxol fast blue staining,the expressions of TXNIP,NLRP3,caspase-1,and interleukin(IL)-1β were detected by immunohistochemistry and Western blot method,and the levels of IL-1β and IL-18 in serum were measured by enzyme-linked immunosorbent assay(ELISA). Results The expression of TXNIP protein in the sciatic nerve of diabetic rats was 3.78±0.08,which significantly increased than that in the normal control group(0.99±0.06)(t=26.980,P<0.0001).Compared with the normal control group(0.97±0.05),the expression of NLRP3 protein in the diabetic group(2.44±0.16)was significantly higher(t=8.885,P<0.0001).The expression of cleaved caspase-1 was 4.45±0.19 in the diabetic group and 1.08±0.06 in the normal control group,and the difference was significant(t=16.900,P<0.0001).The expression of IL-1β protein in the diabetic group(4.50±0.16)was significantly higher than that(1.19±0.08)in the normal control group(t=18.630,P<0.0001).Compared with the normal control group,the levels of IL-1β [(110.50±8.80)pg/ml vs.(17.97±3.18)pg/ml,t=9.892,P<0.0001] and IL-18 [(591.70±8.78)pg/ml vs.(160.70±8.33)pg/ml,t=35.620,P<0.0001] in the serum of diabetic rats significantly increased. Conclusion The pathogenesis of diabetic peripheral neuropathy may be related to increased expression of TXNIP,activation of NLRP3 inflammasome,and downstream inflammation,which may provide a new target for diabetic peripheral neuropathy therapy.
Objective To analyze the research hotspots and trends of biomarkers for diseases based on genomics and thus provide basis for the future studies in this field. Method Based on the Web of Science,we analyzed the genomics-based biomarkers for diseases in literature published between 2006 and 2018 in terms of country and institutions,knowledge base,research hotspots,and trends by using bibliometric methods and CiteSpace software. Results A total of 998 articles were retrieved.The total number of articles has shown an upward trend and reached a peak of 112 in 2017 and 2018.Most articles(n=477)were from the United States,follwed by China(n=93).Nature,P Natl Acad Sci USA,PLoS One,Science,and New Engl J Med are core journals in this field.Keywords co-occurrence analysis identified four research hotspots:disease research,research method and technology,research level,and application purpose. Conclusion Research in functional genomics,cancer immunotherapy,genome-wide association and multi-omics techniques,personalized medicine,and precision medicine are research hotspots and frontiers in this field.
Objective To investigate the clinical value of serum tumor marker isocitrate dehydrogenase 1(IDH1)in the diagnosis of lung cancer. Methods The general data were collected in lung cancer patients and non-lung cancer patients.The serum level of IDH1 was detected by enzyme-linked immunosorbent assay to evaluate its clinical significance in diagnosing lung cancer. Results The serum IDH1 level was significantly higher in lung cancer patients than in non-lung cancer patients [(7.12±6.98)ng/ml vs.(2.09±1.83)ng/ml,t=11.540,P<0.001].The serum IDH1 level in patients with adenocarcinoma or squamous cell carcinoma was significantly higher than that in patients with small cell lung cancer [(7.91±7.26)ng/ml vs.(2.76±2.27)ng/ml, t=6.345,P<0.001].The sensitivity of IDH1 in detecting lung cancer,stage Ⅰ/Ⅱ lung cancer,and stage Ⅲ/Ⅳ lung cancer was 47.4%,49.1%,and 46.3%,respectively. Conclusions Serum IDH1 has high sensitivities and specificities in the diagnosis and differential diagnosis of non-small cell lung cancer(squamous cell carcinoma and adenocarcinoma)and small cell lung cancer as well as the auxiliary diagnosis of stage Ⅰ and Ⅱ lung cancer.It is a valuable marker for the auxiliary diagnosis of lung cancer.
Objective To investigate the normal structures of parotid duct by using magnetic resonance(MR)hydrography. Methods MR three-dimensional heavy T2-weighted imaging was performed in 21 normal subjects.After taking 200 mg of vitamin C orally for 3 minutes,the subjects underwent parotid duct coronal hydro-magnetic resonance imaging.The images were transferred to the GE AW4.5 workstation,on which multi-planner reformation was performed using Functool software.The numbers of the parotid duct,accessory parotid duct,segments,and its branches was counted and the length and diameter of the intra-and extra-parotid ducts were measured. Results Accessory ducts were found in 24 parotid glands(57.1%,24/42),with the average length being(9.54±9.98)mm and the average diameter being(0.87±0.88)mm.The intra-parotid ducts were found to be with 3 segments were in 3 cases(7.14%,3/42),with 2 segments in 19 cases(45.23%,19/42),and with 1 segment in 20 cases(47.62%,20/42).The average number of the branches of the first,second and third segment was 2.38,0.88,and 0.1,respectively.The average length of the intra-parotid duct was(36.97±7.97)mm,with its average diameter being(2.01±0.76)mm.The average length of extra-parotid duct was(34.98±10.25)mm,with its average diameter being(2.13±0.79)mm.The average length of the whole parotid duct was(71.95±11.47)mm,with its average diameter being(2.07±0.68)mm. Conclusion The parotid duct,the accessory parotid duct,and the segments and their branches of the intra-parotid duct can be accurately displayed by MR hydrography.
Objective To exploring a new minimally invasive method for the removal of moderate and severe glabellar frown lines. Method The corrugator supercilii muscles were subjected to blunt cutting and vacuum suction by using a self-made modified liposuction needle,and the obtained muscle particles were backfilled subcutaneously into the depression area between eyebrows to expand the wrinkles. Results Seventeen cases were followed up for six to twelve months after the operation.The glabellar wrinkles disappeared or became flatter in all patients. Conclusion The minimally invasive corrugator resection and backfill by using self-made modified liposuction needle can effectively remove the glabellar frown lines without forming scar.
Objective To evaluate the NoSAS score and the obstructive sleep apnea hypopnea syndrome(OSAHS)screening model for female snorers with obstructive sleep apnea(OSA)in females and compare the performance of these two tools. Methods A total of 425 females with suspected OSA who underwent overnight polysomnography(PSG)were consecutively recruited into this study.The above two questionnaires were completed.Based on the severity of OSA which was determined by apnea-hypopnea index(AHI),the patients were classified into four groups:non-OSA group(AHI<5 events/h),OSA group(AHI≥5 events/h),moderate-to-severe OSA group(AHI>15 events/h),and severe OSA group(AHI>30 events/h).The sensitivity,specificity,positive predictive values,negative predictive values,and the area under the receiver operating characteristics(ROC)curve of two questionnaires were calculated. Results The sensitivity of NoSAS score for OSA,moderate-to-severe OSA,and severe OSA groups were 57.3%,64.9%,and 69.5%,and its specificity was 83.5%,76.6%,and 70.9%,respectively.The sensitivity of the OSAHS screening model of female snorers was 62.7%,74.8%,and 75.8%,and its specificity was 92.5%,84.3%,and 74.5%,respectively.Both of these two screening tools had high specificity and performed well in ruling out non-OSA females.For patients with their AHI≥5 events/h,the results of NoSAS score and OSAHS screening model were in moderate to high consistency with those diagnosed by PSG,with a Kappa value of 0.401 and 0.541,respectively.The area under curve of these two tools was 0.792(95% CI=0.750-0.829)and 0.866(95% CI=0.830-0.897),respectively,showing moderate screening value.The area under curve of the OSAHS screening model of female snorers was significantly larger than that of NoSAS score(P =0.002,P =0.003,P =0.019). Conclusions Both the NoSAS score and the OSAHS screening model for female snorers have a moderate performance in diagnosing OSA in females,although the OSAHS screening model for female snorers has better performance.However,the sensitivity of the OSAHS screening model needs to be further improved.
Pulmonary cryptococcosis(PC)is a fungal infection that can be easily misdiagnosed due to its non-specific clinical features and imaging findings.This article reviews the imaging findings of PC,their relationships with pathology and immune status,and differential diagnosis of PC with other disease,so as to improve the clinical management of PC.
Corpus luteum is a temporary endocrine organ that is formed and regressed during the female reproductive cycle.It is developed from the residual follicular tissue after ovulation,which is associated with the rapid angiogenesis.Vascular endothelial growth factor(VEGF)is the most important stimulatory factor that regulates the luteal angiogenesis and also plays a key role during corpus luteum formation.VEGF is regulated by hypoxia-inducible factor(HIF)-1,which is a heterodimeric transcription factor consistent of HIF-1α and HIF-1β.The local hypoxia of ovary due to the ruptured follicle and the lack of new vascular networks induces HIF-1α expression and participates in the luteal formation through VEGF-dependent angiogenesis.The present article describes the functional and structural changes during the luteal formation from the local and hypoxic conditions immediately before and after ovulation,with an attempt to clarify the roles of hypoxia in luteal formation as well as ovarian physiology.
Cancer therapeutics-related cardiac dysfunction(CTRCD)is receiving more attention.Risk factors assessment before cancer therapy,cardiac function monitoring during and after cancer therapy,and early detection and treatment of myocardial injury are key to preventing clinical heart failure.The incidence and severity of cardiotoxicity can be reduced by measures such as reducing drug dose,adjusting administration route,and using low toxic drugs.Cardioprotective agents including anti-heart failure drugs and dexrazoxane are important for the prevention and treatment of CTRCD.Patients with advanced heart failure may also benefit from mechanical treatments including cardiac resynchronization therapy and mechanically-assisted ventricular devices.This article reviews the recent advances in the prevention and treatment of CTRCD.
Neuraxial opioid administration is one of the most common methods of anesthesia and analgesia,while itching is the most troublesome adverse effect.The current treatments for neuraxial opioid-induced pruritus still have certain limitations.This article reviews the current treatments and basic scientific findings(including neurotransmitters,opioid receptors,and signaling pathways)of pruritus caused by neuraxial opioids.Based on our recent findings on N-methyl-D-aspartate(NMDA)receptors and pruritus caused by neuraxial opioids,we provide new ideas for the treatment of itching caused by neuraxial opioids.Since NMDA receptors may play a key role in neuraxial opioid-induced pruritus,NMDA receptor antagonists can have certain therapeutic advantages.
Bladder urothelial carcinoma(BUC)is a common malignant tumor in the urinary system.Pt-based chemotherapy has long been a standard therapeutic method for resectable or metastatic BUC,but with poor outcomes.Immune checkpoint inhibitors specific to programmed death 1(PD-1)/programmed death-ligand 1(PD-L1)and cytotoxic T lymphocyte-associated protein 4(CTLA-4)pathways have shown significant antitumor activities,safety,and enduring reactivity in clinical trials,thus creating a new epoch for the treatment of advanced-stage BUC.This article reviews the relationships of BUC with PD-1/PD-L1 and CTLA-4 pathways,as demonstrated in clinical trials.In particular,the authors elucidate the clinical studies on the application of immune checkpoint inhibitors in different BUC stages and their optimal combining strategies,with an attempt to improve the clinical use of immune inhibitors for BUC treatment.
The magnetic resonance imaging findings of multicystic encephalomalacia are featured by bilateral frontal large cystic lesion with corpus callosum involvement,evident heterogeneous enhancement of the lesion margin,ring hyperintensity on diffusion weighted imaging,and high choline peak and low N-acetylaspartate peak of the enhanced lesion margin on magnetic resonance spectroscopy.This article reports a case of multicystic encephalomalacia.
Interfascial plane block is a quick,safe and simple technique that offers effective analgesia for video-assisted thoracotomy.However,the currently described methods still have certain limitations.We explored the application of a novel interfascial plane block method-iliocostal plane block in video-assisted thoracotomy,along with the use of stained cadaveric anatomy,with an attempt to shed new light on the analgesia for video-assisted thoracotomy.
