The informed consent right of people who are investigated should be respected during the epidemiology survey,and there're many ethical problems about the way of inquiry,the fund of investigation,the protection of personal secrets and the compensation to people who are investigated.We should strengthen the training of investigators in order to promote the development of epidemiblogy survey.

Anordrin, which has been widely used as an oral contraceptive tablet in China, administered intra-vaginally at different levels of dose possessed marked antifertiiity effects in Sprague Dawley rats. The anti-implantation efficiency of the compound given intra-vaginally was superior to that of oral dosing in some respects. This kind of medication was feasible, convenient to use and with no serious side effects. Our investigation provides the experimental date for clinical study of using this drug vaginally.

Objective To investigate ventricular remodeling and glucose transporter 4(GLUT4) expression in rat with type 2 diabetes mellitus(DM) complicated with myocardial infarction (MI), as well as the effects of ramipril on ventricular remodeling and CLUT4 expression. Method Diabetic animal model (DM) was produced by cholesterol-diet and intraperitoneal injedtion of streptozotocin (STZ,30 mg/kg). The successful model was identified based on the blood gulcose value > 6.7 mmol/L. Left anterior descending coronary artery was ligated to produce the model of MI. 46 wistar rats were randomly(random number) divided into 5 groups: DM + MI + placebo group(placebo group, n = 9), DM + MI + ramipril group(ramipril group, n = 10), DM + sham-operation group (DM group, n = 10),non-DM group + MI (MI group, n = 9), and non-DM + sham-operation group (n = 8). After six weeks, echocardiographic studies was performed ; Left ventricular mass index (LVMI), myocardial infarct size and myocardial collagen volume fraction(CVF) of non-infarction area were also detected. GLUT4 mRNA in the myocardium away from infarction region was measured with real-time fluorescent quantitative RT-PCR and the expression of GLUT4 protein was measured with western blot. Analysis of variance was used to compare the groups. P -values< 0.05 were considered to indicate statistically significant differences. Results Compared with Ml group and DM group,EF[(32 ±3)% vs. (65 ±4)%, P <0.01 and (32 ±3)% vs. (38 ±4)%, P <0.05 respectively] significantly decreased,while E/A ratio (P < 0.01), LVMI (P < 0.05) and CVF (P < 0.05) obviously increased in placebo group. The expression of GLUT4 mRNA and protein were similar between placebo group and DM group, however, much lower than those in MI group(P<0.01).In rampiril group, E/A ratio (P < 0.01), LVMI(3.1±0.2 vs.4.2±0.4, P <0.01) and CVF(P < 0.05) significantly decreased compared with placebo group, while EF[(45±3)% vs.(32±3)%, P <0.01] and the expression of GLUT4 mRNA and protein (P < 0.05) increased. Conclusions Rampiril could improve left ventricular hypertrophy and systolic/di-astolic dysfunction, increase the expression of GLUT4 mRNA and protein in diabetic rats complicated with MI.

Objective To observe the effect of Xuebijing on coagulation function in patients with sepsis. Methods Sixty-two patients with severe sepsis were admitted to Department of Emergency and Intensive Care Unit (ICU) of Kunming Municipal Hospital of Traditional Chinese Medicine from February 2015 to June 2017, and they were divided into Xuebijing group and routine treatment control group according to the random number table method, 31 cases in each group. Both groups were treated with symptomatic supportive therapy, and the Xuebijing group was treated with Xuebijing injection 50 mL intravenous drip on the basis of routine treatment, twice a day for consecutive 7 days. The differences in platelet count (PLT), 5 items of coagulation: D-dimer, fibrinogen (Fib), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score were compared between the two groups before and after treatment. Results After treatment, in both groups, the levels of PLT and Fib were significantly higher than those before treatment, the level of D-dimer, APACHE Ⅱ were obviously lower than those before treatment, APTT, PT and TT were significantly shorter than those before treatment, and the changes in Xuebijing group were more marked than those in the routine treatment control group [PLT (×109/L):186.63±45.29 vs. 119.96±59.76, Fib (g/L): 3.88±1.82 vs. 2.33±1.33, D-dimer (mg/L): 0.40±0.11 vs. 0.65±0.14, APTT (s): 30.95±8.48 vs. 42.25±7.73, PT (s): 10.97±1.51 vs. 13.16±2.22, TT (s): 16.17±1.28 vs. 18.98±1.12, APACHE Ⅱ score: 6.62±2.91 vs. 12.87±4.54, all P ＜ 0.05]. Conclusion Xuebijing can regulate coagulation disorder in patients with severe sepsis, ameliorate the disease condition of patients, block the deterioration of disease development, and improve the prognosis of patients.

Objective:To explore the clinical characteristics of adult-onset non-radiographic axial spondyloarthritis (nr-axSpA) in different genders.Methods:A total of 662 patients with adult-onset nr-axSpA (age at disease onset ≥16 years) who visited the Rheumatology Department of the First Affiliated Hospital of Shantou University Medical College from 1999 to 2020 were included in the study. Comparisons of baseline demographic and clinical characteristics between different genders were performed.Results:Overall, the male-to-female ratio was 1.17∶1, and the prevalence of human leukocyte antigen-B27 (HLA-B27) positivity was 71.8%(475/662). The median baseline disease duration and age at diagnosis was 1.6 (0.5, 4.0) years and 25.0 (21.0, 33.0) years respectively. The males had a significantly earlier age at disease onset and diagnosis [21.0 (18.0, 28.0) vs 25.0 (21.0, 30.0), Z=5.63, P<0.001; 24.0 (19.0, 32.0) vs 27.0 (23.0, 34.5), Z=4.90, P<0.001, respectively] than females. HLA-B27 positivity was more frequent in males than in females [78.4% (280/357) vs 63.9%(195/305), χ2=17.06, P<0.001]. The prevalence of inflammatory back pain (IBP), morning stiffness, nocturnal pain, enthesitis, hip and groin pain were higher in males, whereas females showed a higher prevalence of small joint involvement of the hands. At baseline, males had higher median ankylosing spondylitis disease activity score (ASDAS)-C-reaction protein (CRP) [3.0(2.3, 3.8) vs 2.4(2.0, 3.0), Z=5.59, P<0.001] and a greater prevalence of high disease activity ASDAS-CRP>2.1 [81.9%(185/227) vs 67.9%(133/195), χ2=11.08, P=0.001] than females. The proportions of male patients with elevated CRP levels and erythrocyte sedimentation rate (ESR) were also higher than those of female patients [49.0%(175/357) vs 27.9%(85/305), χ2=30.85, P<0.001; 49.3%(176/357) vs 33.4%(102/305), χ2=16.98, P<0.001, respectively]. Conclusion:The adult-onset nr-axSpA in China is characterized by a comparable sex ratio. Males have an earlier age at disease onset and are higher HLA-B27 positivity with higher prevalence of IBP, enthesitis, hip and groin pain, as well as high disease activity.

Objective To predict the risk of in-hospital death in patients with chronic heart failure(CHF)complicated by lung infections using interpretable machine learning.Methods The clinical data of 1415 patients diagnosed with CHF complicated by lung infections were obtained from the MIMIC-IV database.According to the pathogen type,the patients were categorized into bacterial pneumonia and non-bacterial pneumonia groups,and their risks of in-hospital death were compared using Kaplan-Meier survival curves.Univariate analysis and LASSO regression were used to select the features for constructing LR,AdaBoost,XGBoost,and LightGBM models,and their performance was compared in terms of accuracy,precision,F1 value,and AUC.External validation of the models was performed using the data from eICU-CRD database.SHAP algorithm was applied for interpretive analysis of XGBoost model.Results Among the 4 constructed models,the XGBoost model showed the highest accuracy and F1 value for predicting the risk of in-hospital death in CHF patients with lung infections in the training set.In the external test set,the XGBoost model had an AUC of 0.691(95%CI:0.654-0.720)in bacterial pneumonia group and an AUC of 0.725(95%CI:0.577-0.782)in non-bacterial pneumonia group,and showed better predictive ability and stability than the other models.Conclusion The overall performance of the XGBoost model is superior to the other 3 models for predicting the risk of in-hospital death in CHF patients with lung infections.The SHAP algorithm provides a clear interpretation of the model to facilitate decision-making in clinical settings.

Objective To investigate the relative mechanism of Maimendong Tang (Ophiopogon Decoction) in amelioration of lung function and endoplasmic reticulum stress (ERS) in rats with bleomycin-induced pulmonary fibrosis.Methods Male healthy SD rats were randomly divided into normal group, model group, Maimendong Tang group 1 and Maimendong Tang group 2.The rat model of pulmonary fibrosis was established by bleomycin pulverization via tracheal intubation.On the 14 t h d after modeling, Maimendong Tang was intragastrically given to Maimendong Tang group1 and Maimendong Tang group 2 twice a day for 20 d continuously.The general conditions were observed, and pathological changes of lung tissue were observed after HE and Masson staining.The forced vital capacity (FVC) , 0.4 second rate (FEV0.4/FVC) , mass FVC, inspiratory resistance (Ri) , expiratory resistance (Re) and dynamic pulmonary compliance (Cydn) were detected by using spirometer.The expressions of glucose regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP) protein in lung tissue were analyzed by using Western blotting assay and immunohistochemistry staining technique.Results Compared with normal group, FVC, FVC/lung mass and Cydn decreased, and 0.4 second rate increased in model group.Compared with model group, FVC increased and 0.4 second rate decreased and Cydn increased in Maimendong Tang group 1 and Maimendong Tang group 2, and mass FVC increased in Maimendong Tang group 2.Pathological sections showed that there were chronic inflammatory cell infiltration in consolidation zone of lung tissue and massive collagen deposition, GRP78 and CHOP with high expressions were mainly positioned in vesicular type Ⅱ alveolar epithelial cells (AECⅡs).The inflammation was relieved, collagen deposition was decreased, protein expressions of GRP78 and CHOP were reduced and in Maimendong Tang group 2.Conclusion Maimendong Tang can significantly improve lung function and reduce lung interstitial collagen deposition, which may be related to regulation of protein expressions of GRP78 and CHOP in AECⅡs in consolidation zone of lung tissue, relief of ERS, and recovery of normal AECⅡs function.

Objective To predict the risk of in-hospital death in patients with chronic heart failure(CHF)complicated by lung infections using interpretable machine learning.Methods The clinical data of 1415 patients diagnosed with CHF complicated by lung infections were obtained from the MIMIC-IV database.According to the pathogen type,the patients were categorized into bacterial pneumonia and non-bacterial pneumonia groups,and their risks of in-hospital death were compared using Kaplan-Meier survival curves.Univariate analysis and LASSO regression were used to select the features for constructing LR,AdaBoost,XGBoost,and LightGBM models,and their performance was compared in terms of accuracy,precision,F1 value,and AUC.External validation of the models was performed using the data from eICU-CRD database.SHAP algorithm was applied for interpretive analysis of XGBoost model.Results Among the 4 constructed models,the XGBoost model showed the highest accuracy and F1 value for predicting the risk of in-hospital death in CHF patients with lung infections in the training set.In the external test set,the XGBoost model had an AUC of 0.691(95%CI:0.654-0.720)in bacterial pneumonia group and an AUC of 0.725(95%CI:0.577-0.782)in non-bacterial pneumonia group,and showed better predictive ability and stability than the other models.Conclusion The overall performance of the XGBoost model is superior to the other 3 models for predicting the risk of in-hospital death in CHF patients with lung infections.The SHAP algorithm provides a clear interpretation of the model to facilitate decision-making in clinical settings.

Systemic lupus erythematosus (SLE) complicated with acquired hemophilia A (AHA) is a rare condition with frequently delayed diagnosis and a high mortality rate, so it is necessary to strengthen the understanding of this disease. In this study, the characteristics and treatment in 1 case of SLE complicated by AHA is reported and analyzed, and a literature review is conducted. The patient was a 29-year-old young female with a 10-year history of SLE, the main clinical manifestation was severe abdominal bleeding. Laboratory tests revealed that the activated partial thromboplastin time (APTT) was notably prolonged (118.20 s), and the coagulation factor VIII activity (FVIII꞉C) was extremely decreased (0.20%) with high-titer of factor VIII (FVIII) inhibitor (31.2 BU/mL). After treating with high-dose glucocorticoid, immunoglobulin, cyclophosphamide, rituximab, blood transfusion, and intravenous infusion of human coagulation FVIII, the coagulation function and coagulation FVIII꞉C were improved, and FVIII inhibitor was negative without serious adverse reactions. During the next 5-year follow-up, the patient's condition was stable and no bleeding occurred. In the case of coagulation dysfunction in SLE, especially with isolated APTT prolongation, AHA should be screened. When the therapeutic effects of glucocorticoid combined with immunosuppressants are not desirable, rituximab could be introduced.
Female ; Humans ; Adult ; Hemophilia A/therapy* ; Rituximab ; Glucocorticoids ; Factor VIII ; Lupus Erythematosus, Systemic/complications* ; Hemorrhage/complications*