Objective:To analyze the manifestation and essence of the knowledge of Chinese animal zodiacs in normal and cognitive impaired Chinese elders by Animal Fluency Test (AFT).Methods:512 normal elders, 153 patients with amnesic mild cognitive impairment (aMCI) and 124 patients with Alzheimer disease (AD) were evaluated with AFT and other tests (the mini-mental state examination, auditory verbal memory test, etc).Results:AFT total correct numbers and non-zodiac-animal numbers rather than zodiac-animal numbers showed significant relationships with gender, education level, premorbid ability, general cognitive and memory functions (r=-0.107~0.311,P

Objective To investigate the executive function features of different subtypes of vascular cognitive impairment (VCI). Methods Sixty-four subjects with subcortical ischaemic vascular disease (SIVD) presumed by medical history and neuroimaging (cranial MRI) were recruited. The clinical and neuropsychological features of the 4 groups were compared: cognitive normal control (n=25), simple executive impairment of VCI-ND (s-VCI-ND, n=16), multi-domain impairment of VCI-ND (m-VCI-ND, n=26) and vascular dementia (VaD) patients (n=22). All participants underwent neuropsychological tests covering global cognitive function, executive function, memory function, language function and visual spatial skills. The executive tests included 15 independent subtest reflect set shifting, inhibition of prepotent responses, working memory, concept formation and fluency. Results Tower of Hanoi, self ordered pointing test and paced auditory serial addition test were not suitable for identification of VCI-ND because their finish rates were less 50%. Performance of trail making test (216.5±69.3 vs 137.4±37.9), Stroop color words test (115.4±30.1 vs 72.9±17.5), California cards sorting test-Chinese version (1.9±1.4 vs 2.7±1.2)and animal category fluency test(14.2±2.3 vs 17.7±4.4) had significant difference between s-VCI-ND group and cognitive normal control group (t=4.73, 5.72, 2.04 and 3.53, all P<0.05) and these tests were applicable and sensitive assessment tools in all executive tests. Time-consuming index showed more sensitivity than correct index in executive function. Neuropsychological deficits of m-VCI-ND patients showed lower than that of s-VCI-ND group and better than that of VaD patients. It was likely that the m-VCI-ND was a transition state between normal aging and VaD. Conclusion Executive dysfunction of VCI caused by SIVD is short of specificity. Some tests may appear earlier in screening of VCI-ND.

We evaluated the differential expression and function of chitinase 3‐like‐1 in macrophage stimulated by Sporothrix schenckii and Candida albicans fungicidal ability of macrophage after stimulation with Sporothrix schenckii and Candida albi‐cans separately was detected .The expression of CHI3L1 gene in macrophage stimulated by Sporothrix Schenckii and Candida albicans was evaluated with real‐time PCR .The function of CHI3L1 protein in macrophages against the reproduction of Sporo‐thrix schenckii and Candida albicans was detected in vitro .Results showed that macrophages could engulf and kill Sporothrix Schenckii and Candida albicans in vitro .The expression of CHI3L1 gene in macrophage stimulated by Candida albicans was increased obviously .At the same time ,CHI3L1 protein can damper the reproduction of Candida albicans .However ,the ex‐pression of CHI3L1 gene was not elevated when macrophage was stimulated by Sporothrix schenckii and CHI3L1 protein played little role in reproduction of Sporothrix schenckii .The expression of CHI3L1 gene in macrophage was elevated after stimulation with Candida albicans ,but was not elevated with Sporothrix Schenckii .In correspondence with differential ex‐pression ,CHI3L1 in macrophages could impair the reproduction of Candida albicans but had a weak function on Sporothrix schenckii which might contribute to the pathogenesis of spo‐rotricosis .

Objective To investigate the clinical efficacy of our self-designed adjustable weight-bearing brace for AO type B tibial shaft fractures managed by interlocking intramedullary nail.Methods A total of 68 consecutive patients with AO type 42-B tibial shaft fracture who had been managed from April 2013 to March 2015 hy interlocking intramedul]ary nail were recruited into our study.They were randomized into 2 equal groups (n =34).Group A received conventional therapy after operation while group B received auxiliary mauagement with our self-designed adjustable weight-bearing brace after conventional postoperative therapy for one week.The 2 groups were compared at postoperative 1,3 and 6 months and at the final follow-up in terms of visual analogue scale (VAS),weight-bearing status of the affected limb,time for fracture union,Radiographic Union Score for Tibial Fractures (RUST) and Johner-Wruhs scale.Results Of this series,62 cases were followed up for 12 to 18 months (average,14.7 months),5 ones were lost to the follow-up and one withdrew.The mean VAS scores at 3-month and 6-month follow-ups for group B were 2.5 ± 0.8 and 0.9 ± 0.6 respectively,significantly lower than those for group A (3.0 ± 0.9 and 1.4 ± 0.8 respectively) (P ＜ 0.05).In group A at 1-month,3-month and 6-month follow-ups,the weight-bearing status was 44.1％ ± 17.5％,72.0％ ±17.4％ and 86.4％ ±12.5％ while the mean RUST scores were 5.4±1.4,8.7±1.1 and 10.3 ± 1.1,respectively.In group B at 1-month,3-month and 6-month follow-ups,the weight-bearing status was 53.8％ ± 11.0％,84.1％ ± 12.2％ and 94.4％ ± 10.6％ while the mean RUST scores were 6.5 ± 0.8,9.9 ± 0.9 and 11.3 ± 0.8,respectively.There were significant differences between the 2 groups in the above indexes (all P ＜ 0.05).Group B achieved clinical fracture union after an average of 3.3 ±0.7 months,significantly faster than group A (3.9 ± 1.0 months) (P ＜ 0.05).According to the Johner-Wruhs scoring,group A had 19 excellent cases and 12 good ones while group B had 27 excellent ones and 4 good ones,showing a significant difference between the 2 groups (P ＜ 0.05).Conclusions Early application of our self-designed adjustable weight-bearing brace for patients with AO type B tibial shaft fracture managed by interlocking intramedullary nail can reduce postoperative pain,accelerate callus growth,shorten bony healing time and achieve satisfactory functional recovery.

Objective:This study aimed to analyze and summarize the clinicopathologic characteristics and treatment protocols of large cell lung carcinoma (LCLC). Methods:Clinicopathologic data of 83 cases with LCLC confirmed by pathology in 2012 were retrospectively reviewed. Results:Exactly 83 cases of LCLC accounted for 5.4%of lung cancer in 2012. Sixty-three cases were male and twenty were female. The average age was 60.4 years old. The average maximum diameter of the tumor was 4.6 cm. The common manifestations in imageology were peripheral type. Only four cases were correctly diagnosed by sputum exfoliocytology, biopsy of bronchofibroscope, and paracentesis before surgery. Sixty-three cases (76%) underwent surgical resection, and pulmonary lobectomy was mainly selected. Postoperative pathology diagnosis indicated that 39 cases were classic large cell carcinoma, 31 were large cell neu-roendocrine carcinoma, 2 were combined large cell neuroendocrine carcinoma, 8 were basaloid carcinoma, 2 were clear cell carcinoma, and 1 was lymphoepithelioma-like carcinoma. Each subtype of LCLC had respective characteristics of pathomorphology and immuno-histochemistry. Lymph node metastasis occurred in 62 cases (75%). Conclusion:The incidence rate of LCLC, which is a highly aggres-sive malignancy, is low. The clinical manifestation and imageology characteristics of LCLC do not have specificity, and its final diagno-sis depends on pathology diagnosis. Operation is the main treatment method. Improving the diagnosis rate of LCLC and further subdi-viding the pathological subtypes are important for a normalized comprehensive treatment of LCLC.

Objective: To explore deep vein thrombosis (DVT) occurrence in patients after right heart catheterization and the effect of anticoagulant therapy. Methods: A total of 171 consecutive patients with electrophysiological study (EPS) and/or radiofrequency catheter ablation (RFCA) in our hospital from 2015-01 to 2016-05 were enrolled. All patients had supra-ventricular tachycardia and completed a venous surgery, they were randomly divided into 2 groups: Anticoagulation group,n=87 and Non-anticoagulation group,n=84. Lower extremity vascular Doppler ultrasonography was performed at (24-48) h post-operation to compare the incidence of DVT between 2 groups. Results: There were 13/171 patients were excluded for not completing post-operative lower extremity vascular Doppler ultrasonography including 9 patients in Anticoagulation group and 4 in Non-anticoagulation group. 158 patients finished post-operative examination and follow-up study. Anticoagulation group had 7/78 (8.97%) patients suffered from DVT, Non-anticoagulation group had 41/80 (51.3%) patients suffered from DVT,P<0.001. Conclusion: The incidence of DVT was higher after right heart catheterization without anticoagulation; heparin treatment may reduce DVT occurrence in relevant patients.

Background: Hepatocyte growth factor (HGF)/cMet pathway is necessary for repair and regeneration following acute kidney injury (AKI). We evaluated the clinical potential of plasma HGF and soluble cMet as prognostic biomarkers for severe AKI requiring continuous renal replacement therapy (CRRT). Methods: One hundred thirty-six patients with severe AKI who participated in the VENUS (volume management under body composition monitoring in critically ill patients on CRRT) trial between 2017 and 2019 were enrolled in this study. We investigated associations between plasma HGF and cMet concentrations and all-cause mortality. Results: Plasma HGF and soluble cMet levels were positively correlated. Patients were divided into three groups based on their HGF and soluble cMet concentrations. The day D 0, D2, and D7 highest concentration HGF groups had significantly higher in-hospital mortality after adjusting for sex, body mass index, Acute Physiology and Chronic Health Evaluation II, and age-adjusted Charlson comorbidity index score, especially on D7 (hazard ratio, 4.26; 95% confidence interval, 1.71–10.62; p = 0.002). D7 soluble cMet level was also associated with mortality. Receiver operating characteristic curve analysis indicated that D7 HGF and soluble cMet levels were best at predicting mortality. Addition of plasma HGF and soluble cMet to conventional prognostic indices significantly improved the predictive value for mortality on D7. However, plasma HGF and soluble cMet were not associated with fluid status. Conclusion Plasma HGF and soluble cMet levels were significant predictors of the outcomes of severe AKI patients undergoing CRRT. There was no correlation between plasma HGF and soluble cMet levels and fluid balance.

As a leading cause of chronic kidney disease, clinical demand for noninvasive biomarkers of diabetic kidney disease (DKD) beyond proteinuria is increasing. Metabolomics is a popular method to identify mechanisms and biomarkers. We investigated urinary targeted metabolomics in DKD patients. Methods: We conducted a targeted metabolomics study of 26 urinary metabolites in consecutive patients with DKD stage 1 to 5 (n = 208) and healthy controls (n = 26). The relationships between estimated glomerular filtration rate (eGFR) or urine protein-creatinine ratio (UPCR) and metabolites were evaluated. Multivariate Cox analysis was used to estimate relationships between urinary metabolites and the target outcome, end-stage renal disease (ESRD). C statistics and time-dependent receiver operating characteristics (ROC) were used to assess diagnostic validity. Results: During a median 4.5 years of follow-up, 103 patients (44.0%) progressed to ESRD and 65 (27.8%) died. The median fold changes of nine metabolites belonged to monosaccharide and tricarboxylic acid (TCA) cycle metabolites tended to increase with DKD stage. Myo-inositol, choline, and citrates were correlated with eGFR and choline, while mannose and myo-inositol were correlated with UPCR. Elevated urinary monosaccharide and TCA cycle metabolites showed associations with increased morality and ESRD progression. The predictive power of ESRD progression was high, in the order of choline, myo-inositol, and citrate. Although urinary metabolites alone were less predictive than serum creatinine or UPCR, myo-inositol had additive effect with serum creatinine and UPCR. In time-dependent ROC, myo-inositol was more predictive than UPCR of 1-year ESRD progression prediction. Conclusion: Myo-inositol can be used as an additive biomarker of ESRD progression in DKD.

OBJECTIVE: To explore the prognostic value of early multiple detection indicators in combination with sequential organ failure assessment (SOFA) in sepsis patients. METHODS: A retrospective analysis was conducted. Patients with sepsis admitted to the department of critical care medicine of Huanggang Central Hospital of Yangtze University from May 2020 to May 2022 were selected as the research subjects. Coagulation indicators, inflammatory factors, blood routine, liver and kidney function, and blood gas analysis were collected at admission. Organ dysfunction was assessed based on the SOFA score within 24 hours after admission. Patients were divided into a survival group and a death group according to the outcome of 28 days in ICU. Differences in the above indicators between the two groups were compared. Multifactorial Logistic regression analysis was used to analyze prognostic factors of 28-day mortality in sepsis patients. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive performance of various indicators, the SOFA score, and the combine model for the 28-day outcome in patients with sepsis. RESULTS: A total of 101 patients with sepsis were enrolled, 56 patients survived and 45 patients died. Compared to the survival group, patients in the death group were older, the proportion of patients with septic shock was larger, the SOFA score, and the proportion of pulmonary infection were higher, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly prolonged, the prothrombin activity (PTA) was significantly shortened, and antithrombin (AT) was significantly decreased, the levels of hypersensitivity C-reactive protein (hs-CRP), blood urea nitrogen (BUN), total bilirubin (TBil), and lactic acid (Lac) were significantly increased, while the platelet count (PLT) was significantly decreased. Multifactorial Logistic regression analysis showed that pulmonary infection [odds ratio (OR) = 0.010, 95% confidence interval (95%CI) was 0.001-0.164, P = 0.001], AT (OR = 0.944, 95%CI was 0.910-0.978, P = 0.002), hs-CRP (OR = 1.008, 95%CI was 1.001-1.015, P = 0.017), Lac (OR = 1.619, 95%CI was 1.195-2.193, P = 0.002), and SOFA score (OR = 1.363, 95%CI was 1.076-1.727, P = 0.010) were independent prognostic factors for 28-day mortality in patients. A combined model was constructed using pulmonary infection, AT, hs-CRP, Lac, and SOFA score. ROC curve analysis showed that the area under the ROC curve (AUC) for the combine model in predicting sepsis prognosis was 0.936 (95%CI was 0.869-0.975, P < 0.001), which was higher in value compared to single indicators (AUC of AT, hs-CRP, Lac, and SOFA score were 0.775, 0.666, 0.802, 0.796, respectively, all P < 0.05). CONCLUSIONS The predictive ability of the SOFA score for sepsis patient outcomes is limited. The combine model combining infection site, AT, hs-CRP, and Lac shows better predictive ability.
Humans ; Organ Dysfunction Scores ; Retrospective Studies ; C-Reactive Protein ; ROC Curve ; Sepsis/metabolism* ; Prognosis ; Anticoagulants ; Antithrombin III ; Intensive Care Units