Objective:To assess the influence of extreme temperature events on the mortality risk of nervous system diseases in residents of Jiangsu Province and identify patients with nervous system diseases who are susceptible to extreme temperature events.Methods:Acase-crossover design was used to investigate the cumulative lagged effects of extreme temperature events on the mortality risk of nervous system disease in local residents by using the data on causes of death from nervous system diseases in Jiangsu from 2014 to 2020 with conditional logistic regression model. The final definition of extreme temperature events was established using Akaike information criterion. The heat wave was defined as 4 or more consecutive days with daily mean temperatures above the 92.5 th percentile of annual daily mean temperatures, and the cold spell was defined as 2 or more consecutive days with daily mean temperatures below the 10 th percentile of annual daily mean temperatures. Furthermore, stratified analyses was conducted to compare the effects of extreme temperature events on mortality risk in populations in different gender, age and marital status groups to identify susceptible populations to extreme temperature event. Results:Statistical results showed that the effect values of heat wave and cold spell on the mortality risk of nervous system diseases all peaked at the 7 th day of the cumulative lag, with OR of 1.60 (95% CI: 1.44-1.76) and 1.33 (95% CI: 1.13-1.56), respectively. Heat wave exposure increased mortality risk for individuals with Alzheimer's and Parkinson's diseases, while cold spell exposure increased the mortality risk for those with Alzheimer's disease. Stratified analyses showed that the mortality risk for nervous system disease and Alzheimer's disease was higher in partnerless population after heat wave exposure. Conclusions:Heat wave and cold spell were associated with increased mortality risks for nervous system disease, highlighting the need for improved early warning systems for extreme temperature event. In the context of heat wave, interventions to protect individuals with nervous system disease should prioritize partnerless population.

Objective To systematically evaluate and integrate the experiences of people living with HIV in peer support,and to provide references and suggestions for improving peer support for HIV patients in clinical practice.Methods The computer retrieval was performed in PubMed,CINAHL(EBSCO),Web of Science,ProQuest,CNKI and Wanfang Data from January 1,1996 to September 30,2022,to collect qualitative studies in the experience of people living with HIV participating in peer support.This qualitative systematic review was conducted under the Joanna Briggs Institute guideline.This paper was written according to the enhancing transparency in reporting the synthesis of qualitative research(ENTREQ).Results A total of 7 qualitative studies were included,and 26 findings were extracted,which were summarized into 12 categories and integrated into 4 synthesized findings.Findings included that peer support provides patients with information and help them establish and maintain a healthy lifestyle;patients receive emotional support in peer support;patients receive instrumental support in peer support;the objective requirements and scenarios of peer support.Conclusion AIDS peer support has a positive effect on AIDS prevention and treatment,and it is important to address the practical needs of people living with HIV/AIDS.The practice of HIV peer support needs further theoretical support and scientific guidance.Building an HIV peer support model,providing systematic training and professional guidance to HIV peers is conducive to improving the accuracy of HIV peer support behaviors,the development of HIV peer support activities,and optimizing the effectiveness and sustainability of peer support for people living with HIV/AIDS.

Objective:To explore the protective effect of vitamin D in acute liver failure through a mouse model.Methods:Acute liver failure was induced by combining D-galactosamine (D-GalN) lipopolysaccharide (LPS) to observe the effect of long-term vitamin D deficiency on liver injury and inflammatory signals in a mouse model. Acute liver failure was induced by thioacetamide (TAA) to observe the effect of vitamin D deficiency on the survival rate, and further high-dose of vitamin D supplementation protective effect was determined in a mouse model. Liver function was evaluated by measuring serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and liver inflammation by hematoxylin-eosin staining. The expressions of tumor necrosis factor (TNF-α), interleukin (IL) -1β, NOD-like receptor family, pyrin domain containing 3 (NLRP-3), chemokines (CCL2, CXCL1 and CXCL2), etc. in liver tissues were detected by RT-qPCR. The quantitation of macrophages in liver tissue was detected by immunohistochemistry. The comparison between groups were performed by t-test. The survival curve was analyzed by log-rank (Mantel-Cox) test.Results:Long-term vitamin D deficiency had increased acute liver failure sensitivity in mice, which was manifested by increased blood cell extravasation, massive necrosis of parenchymal cells, up-regulation of TNF-α, IL-1β, and NLRP-3 mRNA expression ( P < 0.05), and increased macrophages quantitation ( P < 0.05) in liver tissues. At the same time, vitamin D deficiency had increased the mice mortality rate because of liver injury ( P < 0.01). On the contrary, pre-administration of high dose of vitamin D (100 IU/g) had significantly reduced liver injury, inhibited ALT and AST rise ( P < 0.01), alleviated liver necrosis, and down-regulated the mRNA expression of inflammatory factors in liver tissues ( P < 0.05). Conclusion:Mouse model shows that long-term vitamin D deficiency can aggravate drug-induced acute liver failure and reduce survival rates. Furthermore, high-dose of vitamin D has a certain hepatoprotective effect, which can significantly improve liver necrosis condition and inhibit inflammation. Therefore, adequate vitamin D can retain liver physiological balance to resist liver injury.

Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected. Six hundred and fifteen patients who were more than 18 years old and less than or equal to 65 years old were included in young and middle-aged group (YM). Eighty-two patients aged more than 65 years old were included in elderly group (E). Data of age, gender, residence, education level, cause of injury, location of injury, season of injury, total burn area, occurrence and area of full-thickness burn injury, wound site, inhalation injury incidence and severity, post burn admission time, proportion of delayed resuscitation, proportion of escharectomy or tangential excision and skin grafting, preinjury systemic disease, system complication during hospitalization, length of hospital stay, outcome of treatment, and reason of abandoning treatment of patients were analyzed. Data were processed with chi-square test and Mann-Whitney U test. The odds ratios of preinjury systemic disease, system complication during hospitalization, and adverse outcome of patients in group YM were compared with those in group E. Results: (1) The majority of patients in the two groups were male, but the proportion of male patients in group YM was higher. There was statistically significant difference in gender distribution of patients between the two groups (χ²=18.727, P<0.001). The majority of patients in the two groups were from rural areas, but the proportion of rural patients in group E was higher. There was statistically significant difference in residence distribution of patients between the two groups (χ²=9.306, P=0.002). Patients in group YM mainly had secondary education, while patients in group E mainly had primary education. There was statistically significant difference in distribution of education level of patients between the two groups (χ²=146.797, P<0.001). (2) The most common causes of injury of patients in the two groups were both flame, but the proportion of patients with flame burn injury in group E was higher. There was statistically significant difference in distribution of cause of injury of patients between the two groups (χ²=25.063, P<0.001). The main locations of injury of patients in groups YM and E were respectively public place and private residence. There was statistically significant difference in location distribution of injury of patients between the two groups (χ²=46.313, P<0.001). The main seasons of injury of patients in groups YM and E were respectively summer and winter. There was statistically significant difference in season distribution of patients between the two groups (χ²=23.143, P<0.001). There was statistically significant difference in distribution of total burn area of patients between the two groups (χ²=25.799, P=0.002). The occurrences of full-thickness burn injury of patients in the two groups were similar (χ²=2.685, P=0.101), while there was statistically significant difference in area of full-thickness burn injury of patients between the two groups (χ²=26.702, P=0.002). There was no statistically significant difference in distribution of wound site of patients between the two groups (χ²=3.954, P=0.785). There were no statistically significant differences in incidence and severity distribution of inhalation injury of patients between the two groups (with χ² values respectively 0.425 and 0.672, P values above 0.05). (3) There was statistically significant difference in distribution of admission time of patients between the two groups (χ²=6.632, P=0.036), but there was no statistically significant difference in proportion of delayed resuscitation of patients between the two groups (χ²=1.261, P=0.261). The proportion of escharectomy or tangential excision and skin grafting of patients in group YM was 72.0% (443/615), which was significantly higher than 35.4% (29/82) of group E (χ²=44.498, P<0.001). The incidence of preinjury systemic disease of patients in group YM was 13.2% (81/615), which was significantly lower than 61.0% (50/82) of group E (χ²=108.337, P<0.001). The risk of preinjury systemic disease of patients in group E was 10.30 times of that of patients in group YM [with 95% confidence interval (CI) of 6.24-17.01, P<0.001]. During hospitalization, 59.8% (49/82) of patients in group E suffered from system complications, which was significantly higher than 36.6% (225/615) of group YM (χ²=16.282, P<0.001). The risk of system complication of patients in group E was 2.57 times of patients in group YM (with 95% CI of 1.61-4.12, P<0.001). The length of hospital stay of patients in group E was significantly shorter than that of group YM (U=36 735, P<0.001). There was statistically significant difference in treatment outcome of patients between the two groups (χ²=106.251, P<0.001). The risk of adverse outcome of patients in group E was 7.52 times of group YM (with 95% CI of 4.40-12.88, χ²=67.709, P<0.001). The proportion of abandoning treatment of patients in group E was significantly higher than that of group YM (χ²=150.670, P<0.001). The risk of abandoning treatment of patients in group E was 15.86 times of that of group YM (with 95% CI of 9.36-26.88, P<0.001). There was no statistically significant difference in distribution of reason of abandoning treatment of patients between the two groups (χ²=4.178, P=0.243). Conclusions There were significant differences in the epidemiological characteristics of patients in groups E and YM. In elderly burn patients, the proportion of rural population was higher and the education level was lower. Flame burn was common and burns mostly occurred in private residences and in winter. The total burn area was slightly lower but the area of full-thickness burn injury was larger. The length of hospital stay was shorter and the proportion of surgical treatment was lower. The incidences of preinjury systemic disease and system complication during hospitalization were higher, and therefore the risks of adverse outcome and abandoning treatment were higher.

Liver plays a central role in regulation of nutrition.Due to metabolic abnormalities,patients with end-stage liver disease often demonstrate undernutrition,which has a close relationship with the prognosis of the patients.Correct nutritional assessment and nutrition support is therefore very important.Dietary intake alone could not meet the nutritional needs of patients with end-stage liver disease.In recent years,the use of enteral and parenteral nutrition formulation has significantly improved the nutritional status of such patients,but there still lacks a gold standard. How to develop appropriate nutrition support regimens is a challenge for clinicians.This paper summarizes nutrition-related issues in patients with end-stage liver disease,aiming to provide a reference for individualized nutritional intervention for patients with end-stage liver disease.

Objective To evaluate the efficacy of combination therapy of cholinergic receptor blocker Tolterodine and Alpha-adrenergic receptor blocker Tamsulosin sustained-release capsules on benign prostatic hyperplasia(BPH)with overactive bladder(OAB) in elderly men.Methods A total of 97 male BPH patients aged 80 years and over(80～98 years old,mean 87.7 years old)were enrolled in this study,who met the diagnosis and treatment guidelines of OAB formulated by Chinese Urological Association and were admitted to our hospital from Jan.2015 to July.2015.Patients were randomly divided into Tamsulosin group(n＝ 51,treated with Tamsulosin) and combination group(n＝ 46,treated with Tamsulosin and Tolterodine).Results In Tamsulosin group after treatment,the international prostate symptom score(IPSS) was reduced from (18.3 ± 2.7) to (13.3 ± 3.1) (t ＝ 14.94,P ＜ 0.05),OAB symptom score(OABSS) from (9.3 ± 2.7) to (6.8 ± 1.9) (t ＝ 3.92,P ＜ 0.05),and post void residual volume(PVRV)from(36.5±32.3)ml to(16.2±12.1)ml(t＝14.98,P＜0.01).And the daily frequency of urgency,urgency incontinence and nocturia were improved in Tamsulosin group after treatment.IPSS,OABSS and PVRV were improved more significantly in combination group after treatment than in Tamsulosin group,and the daily frequency of urgency,urgency incontinence and nocturia were reduced more significantly in combination group than in tamsulosin group(t＝-5.23,-3.98,9.01,11.5,14.8,P＜0.01).While there was no significant difference in prostate volume (PV)and PVRV between the two groups after 8 weeks of treatment(t＝ 1.22,-0.94,P＞0.05).The total incidences of adverse events (mainly mouth dryness)had no significant differences between the Tamsulosingroup and the combination group(8.7％ vs.5.9％,x2 ＝99.47,P＞0.05).No acute urinary retention was found in the two groups.Conclusions The combination therapy of Tamsulosin and Tolterodine has better efficacy and safety than single Tamsulosin application in the treatment of BPH with OAB in elderly men.

Objective To investigate the association between endoplasmic reticulum aminopeptidase 1 (ERAP1)gene polymorphisms and psoriasis vulgaris (PsV)in a Chinese Han population. Methods Five milliliters of venous blood samples were collected from 289 patients with PsV and 292 human controls of Han nationality after informed consent. Three single nucleotide polymorphisms (SNPs)in the encoding area of the ERAP1 gene, including rs27044, rs30187 and rs26653, were genotyped by ligase detection reaction (LDR). With the PLINK 1.07 package, statistical analysis was carried out by using the chi-square test for comparisons of allele and genotype frequencies between the patient group and control group. The allelic odds ratio (OR)and its 95% confidence interval (CI)were calculated. In addition, haplotype analysis was conducted with the Haploview software. Results The frequencies of rs30187-C and rs26653-G alleles were significantly lower in the patient group (0.460 2 and 0.430 8 respectively), especially in patients with early-onset PsV(0.448 5 and 0.422 7 respectively), than in the control group(0.534 2 and 0.501 7 respectively, all P <0.05). The SNPs rs27044, rs30187 and rs26653 showed strong linkage disequilibrium with each other (r2 ≥ 0.717, D′ ≥0.962). Genotype analysis showed that the frequency of the rs30187 CC genotype was significantly lower in the patient group, especially in patients with early-onset PsV, than in the control group (P < 0.05 and 0.016 7 respectively)under a recessive mode of inheritance. Haplotype analysis revealed that the frequency of the haplotype H4: CTC was significantly increased in the patient group(0.050), especially in patients with early-onset PsV(0.052), compared with the control group (0.022, P < 0.05 and 0.016 7 respectively). Conclusions ERAP1 gene polymorphisms are associated with PsV, especially with early-onset PsV in Chinese Han population. The risk haplotype H4: CTC may be a susceptible factor for PsV.

10.3969/j.issn.1008-9691.2013.03.016

To compare angiopoiesis ability of eutopic and ectopic endometrial tissue isolated from women with endometriosis and endometrium isolated from women without endometriosis (control), and to explore the inhibitory effects of medicated serum of Neiyi Recipe, a compound traditional Chinese herbal medicine.

OBJECTIVETo investigate the expression of cytokeratin 17 (CK17) in oral squamous cell carcinoma (OSCC) as well as its clinical significance.

METHODSDetection of the mRNA level and protein expression of CK17 in the in vitro cellular carcinogenesis model of OSCC, some OSCC cell lines and tissue specimens from 30 primary OSCC patients were performed using real-time polymerase chain reaction (PCR), Western blot and immunohistochemistry, respectively.

RESULTSIncreased CK17 mRNA level was observed in the HB56 and OSC cell lines compared with the HIOEC using real-time PCR technique. Western blot showed increased CK17 protein expression in all the cell lines compared with the HIOEC. Increased CK17 mRNA and immunoreaction levels were also observed in the cancerous tissue specimens from OSCC patients compared with normal adjacent tissues (P<0.01).

CONCLUSIONThe significantly increased CK17 gene may be associated with the tumorigenesis and development of OSCC.

Adult ; Blotting, Western ; Carcinoma, Squamous Cell ; Cell Line ; Cell Line, Tumor ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Immunohistochemistry ; Keratin-17 ; Male ; Middle Aged ; Mouth Neoplasms ; RNA, Messenger