Objective To investigate the relationship between brain natriuretic peptide (BNP)and heart function in elderly patients with acute myocardial infarction.Methods All data were taken from the hospitalized cases with acute myocardial infarction from December 2008 to August 2010.100 patients aged from 60 to 97 were enrolled.The data were divided into 4 groups (group 1,24 cases; group 2,32 cases,group 3,23 cases; group 4,21 cases) respectively according to Killip's classification.Left ventricular function was measured by echocardiography.Plasma BNP was determined with enzyme immunoassay.Results Compared with non heart failure group and normal group,heart failure group had much higher plasma BNP concentrations.The plasma BNP level had positive correlation with left ventricular end diastolic diameter (r =0.27,P ＜ 0.01) and left ventricular end-diastolic dimension (r=0.37,P＜0.01),while,had a negative correlation with left ventricular ejection fraction (r =-0.38,P ＜ 0.01).Conclusions Plasma BNP level was significantly elevated which could evaluate the heart function in elderly patients with acute myocardial infarction.

Objective::To preliminarily investigate the values of failure mode and postoperative radiotherapy in non-small cell lung cancer (NSCLC) patients with chest wall invasion.Methods:A total of 69 T 3 stage NSCLC patients who underwent thoracic surgery in our hospital from 2010 to 2018 and presented with postoperative pathological findings of chest wall invasion were recruited. The outcomes between the post-operative radiotherapy and non-radiotherapy groups were assessed by propsensity matching analysis. Kaplan- Meier survival analysis and Cox’s model prognostic factors analysis were performed. Results:The median survival time of 69 patients was 25 months and the median progression-free survival was 8 months. Thirty-six cases were diagnosed with primary stage M 0 including 28 cases (78%) of R 0 resection and 33 cases (48%) were diagnosed with stage M 1a and received non-R 0 resection because of pleural metastases. In total, 53 cases (77%) suffered from disease progression, and 26 cases (38%) experienced local recurrence including 58% of mediastinal lymph node recurrence and 36% of chest wall tumor bed recurrence. Distant metastases were observed in 50 cases (73%) including 43% of pleural metastases. Univariate analysis showed that age, pathological staging, range of primary lesion invasion, postoperative radiotherapy and postoperative targeted therapy were significantly associated with overall survival (all P<0.05). The overall survival in the postoperative radiotherapy group was better than that in the non-radiotherapy group. No statistical difference was observed in the progression-free survival, local recurrence-free survival and distant metastasis-free survival between two groups (all P>0.05). Conclusions:For NSCLC patients with chest wall invasion, distal metastasis failure is the main cause, while local failure mainly consists of mediastinal lymph node and chest wall recurrence. Postoperative radiotherapy may improve survival. Nevertheless, the combination and benefit degree of postoperative comprehensive treatment need to be further confirmed by prospective studies.

Objective To investigate the relationship between the protein expression of X-ray repair cross-complementing protein 3 (XRCC3) and human 8-hydroxyguanine glycosylase 1 (HOGG1) in esophageal squamous cell carcinoma (ESCC) tissue and the prognosis in ESCC patients after radiotherapy.Methods Immunohistochemical SP method was used to measure the protein expression of XRCC3 and HOGG1 in 171 ESCC tissue samples before radiotherapy.The Kaplan-Meier method was used for survival analysis,and the logrank test was used for analyzing the survival difference between negative and positive samples.The Cox model was used for multivariate prognostic analysis.Results The follow-up rate was 87.2％ ; 140 patients were followed up for at least 1 year,136 patients for at least 2 years,and 129 patients for at least 3 years.XRCC3 was mainly expressed in the nucleus,and HOGG1 was mainly expressed in the nucleus and mitochondria,with a coincidence degree of 72.5％ (x2 =23.94,P =0.000).The patients with positive XRCC3 expression and negative XRCC3 expression had similar short-term responses (x2 =0.98,P =0.614)as well as similar survival rates,and both patient groups had a median survival time of 54 months (x2 =0.17,P =0.683).The patients with positive HOGG1 expression and negative HOGG1 expression had similar short-term responses (x2 =0.26,P =0.880) as well as similar survival rates,and both patient groups had a median survival time of 49 months (x2 =0.08,P =0.780).The multivariate prognostic analysis showed that the response evaluation and tumor length were related to the prognosis of ESCC (x2 =7.99,P =0.005 ; x2 =3.76,P =0.045).Conclusions The protein expression of XRCC3 and HOGG1 may be unrelated to the prognosis of ESCC after radiotherapy.

Objective To access the effectiveness of modified early warning score (MEWS) and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) in predicting the degree of injury and outcome for emergently admitted polytrauma patients.Methods In this single-center prospective study,266 polytrauma patients hospitalized from June 2012 to January 2013 were enrolled.MEWS and APACHE Ⅱ score were collected and compared for the rate of ICU admission,high dependency unit admission,outpatient therapy,death,and discharge within 30 days.Diagnostic and predictive performance of MEWS and APACHE Ⅱ were assessed by the receiver operating characteristic curve (ROC).Results A higher values in MEWS and APACHE Ⅱ were linked to much severe injury,increased likelihood of admission to the ICU or high dependency unit and high mortality.Patients with MEWS value ≥5 had increased risk of death as compared with those with MEWS value ＜ 5 (x2 =90.749,P ＜0.01).MEWS =5,for injury severity evaluation,showed a sensitivity of 85.7％ and specificity of 84.8％.MEWS value≥5 predicted ICU admission with a sensitivity of 80.0％ and specificity of 91.1％ and high dependency unit admission with a sensitivity of 67.9％ and specificity of 79.9％.APACHE Ⅱ score ≥ 21 was associated with increased rate of death,with significant difference from that among patients with APACHE Ⅱ score ＜ 21 (x2 =73.518,P ＜ 0.01).APACHE Ⅱ score =21,for injury severity evaluation,showed a sensitivity of 90.5％ and specificity of 79.5％.APACHE Ⅱ score ≥ 21 predicted ICU admission with a sensitivity of 95.0％ and specificity of 73.6％ and high dependency unit admission with a sensitivity of 88.2％ and specificity of 72.8％.In prediction of prognosis,ICU admission and high dependency unit admission,area under the ROC curve with 95％ CI for NEWS was 0.889 (0.830-0.948),0.937 (0.900-0.975) and 0.946 (0.916-0.977) respectively and for APACHE Ⅱ was 0.939 (0.898-0.979),0.761 (0.677-0.845) and 0.832 (0.782-0.883) respectively.MEWS and APACHE Ⅱ score in death group were (6.4 ± 2.7) points and (29.9 ± 6.4) points,but lowered to (3.0 ± 1.5) points and (16.8 ± 5.7) points respectively in survival group (P ＜ 0.01).Conclusions Both APACHE Ⅱ and MEWS have the ability to discriminate the severity of polytrauma patients and identify the potential of seriously ill patients.MEWS is more suitable for early identification of critically ill trauma patient due to its easy and quick operation as well as low cost,while APACHE Ⅱ is more suitable for evaluation of emergency observing patients and ICU patients.

Objective To evaluate the incidence and influencing factors for post-operative healthcare-associated in-fection(HAI)in Uyghur patients undergoing cardiothoracic surgery in a hospital.Methods Clinical data of Uyghur patients hospitalized in the department of cardiothoracic surgery in a hospital of Kashgar region between June 2010 and June 2014 were collected,incidence of post-operative HAI was surveyed.Influencing factors for post-operative HAI were analyzed by univariate and multivariate logistic regression models.Results A total of 779 patients’clini-cal data were collected,53 patients (6.80%)developed post-operative HAI.The major infection sites were lower respiratory tract (2.44%),digestive tract(1 .28%),urinary tract(1 .16%),upper respiratory tract(1 .03%),and surgical sites(0.51 %).Multivariate logistic regression analysis showed that history of diabetes,body mass index (BMI)≥30 kg/m2 ,duration of operation ≥ 160 minutes,and invasive procedure were risk factors for post-opera-tive HAI in Uyghur patients undergoing cardiothoracic surgery.Conclusion Incidence of post-operative HAI in Uy-ghur patients undergoing cardiothoracic surgery in this hospital is high,risk factors for HAI are history of diabetes, high BMI,long duration of operation,and invasive procedure.

Objeetive To investigate the effects of nimodipine combined with edaravone on cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH).Methods The consecutive patients with aSAH who underwent microsurgical clipping were included retrospectively.All patients received intravenous prophylaxis with nimodipine,and some patients also used edaravone (30 mg,twice a day for 2 weeks).They were divided into either a CVS group or a non-CVS group according to the findings of transcranial Doppler.They were also divided into a DCI group and a non-DCI group according to the findings of CT reexamination and clinical examination.The demographics,baseline clinical data,Glasgow Coma Scale (GCS) score,Fisher grade,Humt-Hess grade,and aneurysm location of all patients were collected.The multivariate logistics regression analysis was used to identify the independent risk factors for CVS and DCI.Results A total of 220 patients with aSAH were enrolled in the study,132 (60.0％) had CVS and 106 (48.2％) had DCI.One hundred twenty-three patients (55.9％)were treated with nimodipine + edaravone,97 were treated with nimodipine alone,none of them died.The incidences of CVS (51.2％ vs.71.1％;x2 =8.962,P =0.003) and DCI (35.0％ vs.65.0％;x2 =19.535,P ＜0.001) in patients receiving nimodipine + edaravone therapy were significantly lower than those receiving nimodipine alone.The proportions of hypertension,hyperlipidemia,diabetes,smoking,high Fisher grade in the CVS group were significantly higher than those in the non-CVS group (all P ＜0.05),while the proportion of patients receiving nimodipine + edaravone therapy (47.7％ vs.68.2％;g2 =8.962,P =0.003) and the GCS score (11.2 ±3.1 vs.13.4 ±2.6;t =5.492,P＜0.001) were significantly lower than those in the non-CVS group.Multivariate logistic regression analysis showed that low GCS score (odds ratio [OR] 6.57,95％ confidence interval [CI] 1.04-12.96;P=0.001),high Fisher grade (OR 5.39,95％ CI 4.09-20.15;P =0.004),hyperlipidemia (OR 4.39,95％ CI 2.97-34.15;P =0.004),hypertension (OR 3.24,95％ CI 1.06-13.47;P=0.016) were the independent risk factors for CVS,while received nimodipine + edaravone was the independent protective factor for CVS (OR 0.39,95％ CI0.13-0.91;P =0.039).The proportions of patients with hypertension,hyperlipidemia,diabetes,smoking,and high Fisher grade in the DCI group were significantly higher than those in the non-DCI group (all P ＜0.05),while the proportion of patients received nimodipine + edaravone (40.6％ vs.70.2％;x2 =19.535,P ＜ 0.001) and the GCS score (10.2 ± 2.4 vs.13.8 ± 2.6;t =10.648,P ＜ 0.001) were significantly lower.Multivariate logistic regression analysis showed that low GCS score (OR 8.92,95％ CI 2.48-26.94;P =0.001),high Fisher grade (OR 7.49,95％ CI 1.96-20.47;P =0.001) were the independent risk factors for DCI,while.received nimodipine +edaravone was an independent protective factor for DCI (OR 0.27,95％ CI 0.08-0.97;P =0.020).Conclusions Compared with nimodipine alone,nimodipine combined with edaravone can significantly reduce the incidences of CVS and DCI.The GCS score,high Fisher grade,and hypertension are the independent risk factors for CVS and DCI in patients with aSAH,and nimodipine combined with edaravone is the independent protective factor for CVS and DCI.

Objective To explore the nutritional increased risk related factors in esophageal cancer patients after chemoradio‐therapy .Methods Sixty‐eight esophageal cancer patients undergoing concurrent chemoradiotherapy were prospectively investiga‐ted .The patient‐generated subjective global assessment(PG‐SGA) was adopted to grade the nutritional risk .All of the patients re‐ceived early nutrition education and short‐term nutrition support for severe malnutrition ,nutritional status was assessed again at the end of radiotherapy .The patients were divided into the mild‐to‐moderate malnutrition group[PG‐SGA(B)group] and the severe malnutrition group [PG‐SGA(C)group] according to the PG‐SGA score on admission .The body mass ,albumin(Alb) ,hemoglobin (Hb) ,white blood cells ,platelets ,neutrophils ,lymphocytes ,monocytes and other objective nutrition indicators were collected before and after chemoradiation .Results There were 24 cases in the PG‐SGA(B) group and 44 cases in the PG‐SGA(C) group;the gen‐der ,age and ethnic had no statistical differences between the two groups(P>0 .05) .Hb(χ2 =2 .710 ,P=0 .009) and Alb(χ2 =3 .743 ,P=0 .000) before chemoradiotherapy had no statistical difference between the two groups(P>0 .05);Hb and Alb after che‐moradiotherapy in the PG‐SGA(B) group were higher than those in the PG‐SGA(C) group .The body mass index(BMI)before and after chemoradiotherapy had statistically significant difference between the two groups (P<0 .05) .The percentage of body mass decrease in the two groups had no statistical significance (P=0 .487) .The PG‐SGA scores after chemoradiotherapy were positively correlated with the change of Hb ,Alb ,BMI parameters and percentage of weight decrease before and after chemoradiotherapy(rs=0 .240 ,0 .249 ,0 .282 ,0 .447 ,P<0 .05) .Conclusion The poor understanding of malnutrition ,the change of Hb ,Alb ,BMI parame‐ters and percentage of body weight decrease before and after chemoradiotherapy are the nutritional increased risk factors in esopha‐geal cancer patients after chemoradiotherapy .

Objective: To investigate the prevalence of hypertension, diabetes and dyslipidemia among physical examination populations at ages of 35 to 75 years in Karamay City of Xinjiang Uygur Autonomous Region, so as to provide insights into the management of chronic disease control. Methods: Residents receiving physical examinations at ages of 35 to 75 years were sampled from 9 communities in Karamay City using the cluster random sampling method. Demographic features and health-related behaviors were collected using questionnaires, and the height, weight, blood pressure, and fasting blood glucose and blood lipid levels were measured. The prevalence of hypertension, diabetes and dyslipidemia was descriptively analyzed, and their risk factors were identified using multivariable logistic regression analysis. Results: A total of 32 556 subjects were sampled, including 12 354 males ( 37.95% ) and 20 202 females ( 62.05% ), with a mean age of ( 56.63±12.78 ) years. The prevalence of hypertension, diabetes and dyslipidemia was 31.72%, 12.18% and 28.69%, and the common comorbidity was dyslipidemia with hypertension ( 2 483 cases, 7.63% ). Multivariable logistic regression analysis identified men ( OR=1.362, 1.823 and 1.130 ), ages of ≥40 years ( OR=3.327-14.019, 2.870-15.337 and 1.530-2.092 ), a family history of chronic diseases ( OR=1.147, 1.249 and 1.200 ), smoking ( OR=1.111, 1.464 and 1.248 ), meat-based diet ( OR=2.081, 2.266 and 1.110 ), vegetable-based diet ( OR=0.479, 0.353 and 0.634 ), underweight ( OR=0.504, 0.298 and 0.546 ), overweight ( OR=1.872, 1.565 and 1.289 ) and obesity ( OR=2.840, 2.177 and 1.230 ) as common influencing factors for hypertension, diabetes and dyslipidemia. Conclusions The prevalence of hypertension is high among physical examination populations at ages of 35 to 75 years in Karamay City. Gender, age, a family history of chronic diseases, smoking, diet habits and body mass index are common factors affecting hypertension, diabetes and dyslipidemia.

Objective: To construct a prediction model of non-alcoholic fatty liver disease (NAFLD) in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM), so as to provide basis for early screening and prevention of T2DM complicated with NAFLD. Methods: Patients aged 45 years and above and diagnosed with T2DM in Karamay Hospital of People's Hospital of Xinjiang Uygur Autonomous Region in 2021 were collected as the study subjects. The data of general demographic characteristics and biochemical test results were collected. The patients were randomly divided into training group (n=3 241) and validation group (n=1 389) according to the ratio of 7∶3. LASSO regression and multivariable logistic regression model were used to select predictive factors. The nomograph model for prediction of NAFLD risk in T2DM patients was established. The predictive value of the model was evaluated using the receiver operating characteristic (ROC), adjusted curve and decision clinical analysis. Results: Totally 4 630 T2DM cases were included, including 1 279 cases (27.62%) complicated with NAFLD. LASSO regression and multivariable logistic regression analysis identified gender, age, diastolic blood pressure, body mass index, alanine transaminase, triglycerides, low density lipoprotein cholesterol and platelet count as risk prediction factors for NAFLD in T2DM patients. The area under the ROC curve was 0.823 (95%CI: 0.814-0.832) for the training group and 0.809 (95%CI: 0.799-0.818) for the validation group, and Hosmer-Lemeshow test showed a good fitting effect (P>0.05). Decision curve analysis showed higher net clinical benefit of using the predictive model to predict NAFLD risk when the risk threshold probability was 0.27 to 0.85. Conclusion The nomogram model established has a good predictive value for the risk of NAFLD in T2DM patients aged 45 years and above.

BACKGROUND:It is stil disputed about the treatment of subacromial impingement syndrome at present, arthroscopic subacromial decompression or open subacromial decompression. OBJECTIVE:To assess the clinical therapeutic effects of arthroscopic subacromial decompressionversus open subacromial decompression in the treatment of subacromial impingement syndrome. METHODS:Controled trials on arthroscopic subacromial decompressionversus open acromioplasty in the treatment of subacromial impingement syndrome were colected in different databases through computer search. There was no limitation for language, randomized controled trials or blinded studies. At last, the meta-analysis was conducted by using RevMan5.0 software. RESULTS AND CONCLUSION:Four randomized controled trials and six non-randomized controled trials were included in this study, involving 583 patients with subacromial impingement syndrome. The results of meta-analysis prompted that as to the hospital inpatient days and time until return to work, the group of arthroscopic subacromial decompression was shorter than open subacromial decompression. However, as to the postoperative shoulder functional scores, the operative time, patient’s satisfaction, and the rate of excelent and good results of postoperative UCLAs, there were no significant statistical differences between two groups. Due to the certain limitations and deficiencies of the quantity and quality in the included trials, there must stil need large-sample, multi-centered, high-quality randomized controled trials to confirm these results.