ObjectiveTo assess negative risk factors associate with short-term and long-term poor outcome of acute heart failure syndromes(AHFS) and provide evidence to emergently proceed to AHFS low risk stratification.Methods A retrospective cohort study was conducted. 125 AHFS patients who met research criterion were enrolled from Guangxi Baise People's Hospital and Youjiang District People's Hospital of Baise City. The patients were divided into poor outcome and relatively low-risk groups by the results of short- and long-term follow-up of their outcomes. The patient's vital signs and disease history were collected at the first time after admission, and auxillary examination parameters were recorded. The poor outcomes occurring in the follow-up periods from the admission to after discharge for 30 days(short-term) and 1 year(long-term)were recorded, and Cox hazard regression was used to analyze the negative risk factor in the short- and long-term.Results There were 58 cases(46.4%)with poor outcome and 30 cases(24.0%)dead in short-term, and there were 111 cases(88.8%) with poor outcome and 39 cases(31.2%) dead in the long-term follow up. Seven negative risk factors were identified by Cox regression. They were no previous or de novo myocardial infarction〔short-term: hazard ratio(HR)=0.36, 95% confidence interval (95%CI)=0.20-0.65,P=0.001〕, lymphocyte ratio 0.20-0.40(short-term:HR=0.13, 95%CI=0.04-0.47, P=0.002; long-term:HR=0.42, 95%CI=0.26-0.68,P=0.001),oxygenation index(PaO2/FiO2)>300 mmHg (1 mmHg=0.133 kPa,short-term:HR=0.23, 95%CI=0.09-0.54,P=0.001),estimated glomerular filtration rate (eGFR)>60 mL·min-1·1.73 m-2(short-term:HR=0.31, 95%CI=0.16-0.64,P=0.002;long-term:HR=0.54, 95%CI=0.36-0.83,P=0.004),left ventricular ejection fraction(LVEF)>0.50(short-term:HR=0.29, 95%CI= 0.10-0.85,P=0.024), P wave terminal force in lead V1(PtfV1)>-0.04 mm·s(short-term:HR=0.29, 95%CI= 0.14-0.60,P=0.001), planar QRS-T angle<90°(long-term:HR=0.46, 95%CI=0.27-0.77,P=0.003). ConclusionsOur patients with AHFS cohort have very poor outcomes both in short-term and long-term follow up. Those with the following characteristics: no previous or de novo myocardial fraction, lymphocyte ratio 0.20-0.40, PaO2/FiO2>300 mmHg, eGFR>60 mL·min-1·1.73 m-2, PtfV1>-0.04 mm·s, LVEF>0.50 and planar QRS-T angle<90°are more likely to have optimal short-term and long-term outcome.

Objective:To evaluate the clinical effects of invisible bracketless appliance on the upper molar distalization.Methods:15 patients with class Ⅱ malocclusion(at the average age of 25.3 years) were treated by invisible bracketless appliance,the pre and post three-dimensional digital models were superimposed and measured,the effects of molar distalization were analysed.Results:After treatment,the maxillary first molars were distalized by 2.58 mm on both sides.The left and fight second molars were distalized by 2.57 mm and 2.68 mm respectively.Bilateral central incisors were moved mesially by 0.34 mm.There was no significant difference in the horizontal movement of central incisor.But the left and fight first molars were moved buccally by 0.96 mm and 0.97 mm respectively,the left and fight second molars were moved buccally by 1.01 mm and 1.11 mm separately.Bilateral first molars were intruded by 0.26 mm,the left and right second molars were intruded by 0.37 mm and 0.36 mm,respectively.But the central incisors had no significant vertical movement.There was no significant difference in the buccally or palatally rotation of bilateral first and second molars.Conclusion:Invisible bracketless appliance is efficient for distalization of upper molar,but it may result in mild molar intrusion and anterior anchorage loss.

Objective To optimize the technique of foam separation from extract of Catharsius molossus.Methods Single factor test was used to examine the key operational parameters by using enrichment ratio,recovery rate,and protein content as the evaluation indexes.Results The best conditions were as follow: airflow velocity,feed concentration,pH value,feed volume,and temperature were 600 mL/min,0.050 g/mL,pH 4,1 000 mL,and room temperature,respectively.Under the condition,the enrichment ratio was 1.56,recovery rate was 85.6%,and protein content was 20.37%.Conclusion Foam separation could be used to concentrate and separate protein from extract of C.molossus with higher recovery rate and protein content.

OBJECTIVETo optimize the preparation technology of effective fraction of Catharsius molossus, and investigate the feasibility of process control by the physical and chemical characterization of extracts.

METHODUsed single-factor test method, choosed the main effective components of peptides and amino acids as indexes, combined with theology, chemistry, electricity, and other characterization, the study researched the prepared technology of effective fraction of C. molossus including extraction, concentration, separation, purification, drying and so on.

RESULTThe optimal preparation technology of effective fraction of C. molossus was that soaked an amount of crude drugs with three times of 85% ethanol for 48 h, added 10 times of 85% ethanol, percolated in 4 mL x min(-1) x kg(-1), collected percolation liquid, concentrated to 1:1 at 50-55 degrees C, removed fat by frozen, adopted DA201-C macroporous resin, used 1 BV of water and 4 BV of 70% ethanol as eluting agent, collected eluant respectively. The water part was concentrated and dried, then washed twice with 85% ethanol, collected washing liquid and mixed with 70% ethanol eluant. The product was obtained by concentrating and dring. At the same time, the liquid-phase system of each link was characterized in preparation of effective fraction of C. molossus, which showed that the surface tension related to polypeptide was essentially unchanged, and the conductivity related to salt decreased by about 90% with ineffective substances closely related to salt The results showed that the preparation technology maximumly retained the effective information, and removed the invalid information.

CONCLUSIONThe preparation technology of effective fraction of C. molossus is stable and reliable, and the process control in physico-chemical characterization of extracts is feasible.

Amino Acids ; analysis ; Animals ; Chemical Fractionation ; Chemical Phenomena ; Chemistry, Pharmaceutical ; Coleoptera ; chemistry ; Peptides ; analysis

Objective:To investigate the stress distribution and the initial displacement of maxillary anterior teeth during en-masse retraction with clear aligner.Methods:The initial 3D finite element model of the maxillary teeth,PDL and alveolar bone was constructed by CBCT image reconstruction technique.Laser scanned image of crowns was merged with initial 3D model.The stress distribution and the initial displacement were analyzed by ANSYS Workbench when aligner was loaded.Results:The high simulation maxillary complex was constructed.Distal and lingual crown tipping of central incisors and lateral incisors were observed.The tendency of extrusion of the central and lateral incisors was consistant.The same tendency of stress distribution in PDL and initial displacement was appeared on incisors.The distal tipping movement was occurred on canine.Conclusion:Tipping movement along with extrusion can be produced by maxillary anterior teeth during en-rnasse retraction in extraction treatment with clear aligner.

Objective:To explore the experience of breast cancer case managers in the process of carrying out case management for patients, so as to provide a basis for further improving the work mode of case management and talent training.Methods:From June to October 2020, purpose sampling was adopted to select the hospital in Guangzhou where the breast cancer case manager position was set up as the research site. The phenomenological research method was used to carry out semi-structured interviews with 9 breast cancer case managers. Colaizzi 7-step analysis method was used for data analysis.Results:A total of two positive experiences were refined, namely comprehensive ability improvement and real sense of accomplishment. A total of four negative experiences were refined, complicated interpersonal relationships, unknown future, unstoppable spinning top and empty back.Conclusions:The case management model led by the case manager has obvious advantages, but there are obstacles. It is necessary to provide targeted support measures to promote its implementation and promotion.

Objective:To evaluate the effect of age on mood of patients during induction of general anesthesia with remimazolam.Methods:Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱpatients of both sexes, undergoing elective surgery with general anesthesia requiring tracheal intubation, aged 5-80 yr, with body mass index 18-30 kg/m 2, were divided into 4 groups ( n=20 each) according to different ages: juvenile group (R 1 group, 5-17 yr), youth group (R 2 group, 18-44 yr), middle-aged group (R 3 group, 45-59 yr) and elderly group (R 4 group, 60-80 yr). Remimazolam was intravenously injected in a loading dose of 0.1 mg/kg for induction of general anesthesia, followed by an infusion of 0.1 mg·kg -1·h -1 for maintenance of general anesthesia, and the other anesthetics for induction and maintenance of anesthesia were all the same in each group.The changes in emotion and brain wave within 3 min after remimazolam injection were recorded.The brain waves and Modified Observer′s Assessment of Alertness and Sedation (MOAA/S) scale score were recorded at 1, 2 and 3 min after administration.Adverse effects during anesthesia induction were also recorded. Results:Compared with group R 1, the incidence of happy mood was significantly decreased, the grade of mood was decreased, and the dream Likert score and MOAA/S score were decreased in R 3 and R 4 groups, and the dream Likert score and MOAA/S score were decreased in group R 2, and the incidence of hypoxemia during induction of general anesthesia was increased in group R 4( P<0.01). Compared with group R 2, the incidence of happy mood was significantly decreased in R 3 and R 4 groups, and MOAA/S score was significantly decreased in group R 4 ( P<0.05). Compared with R 1 and R 2 groups, the proportion of beta bands was significantly decreased, and the proportion of theta and delta bands was increased in R 3 and R 4 groups ( P<0.01). Compared with group R 3, the proportion of beta band was significantly decreased, and the proportion of delta band was increased in group R 4 ( P<0.01). Conclusion:Remimazolam 0.1 mg/kg used for induction of general anesthesia can cause happy mood, accompanied by enhanced brain electrical signal activity of beta band, especially in the patients under 45 yr of age.

Cardiac auscultation is the basic way for primary diagnosis and screening of congenital heart disease(CHD). A new classification algorithm of CHD based on convolution neural network was proposed for analysis and classification of CHD heart sounds in this work. The algorithm was based on the clinically collected diagnosed CHD heart sound signal. Firstly the heart sound signal preprocessing algorithm was used to extract and organize the Mel Cepstral Coefficient (MFSC) of the heart sound signal in the one-dimensional time domain and turn it into a two-dimensional feature sample. Secondly, 1 000 feature samples were used to train and optimize the convolutional neural network, and the training results with the accuracy of 0.896 and the loss value of 0.25 were obtained by using the Adam optimizer. Finally, 200 samples were tested with convolution neural network, and the results showed that the accuracy was up to 0.895, the sensitivity was 0.910, and the specificity was 0.880. Compared with other algorithms, the proposed algorithm has improved accuracy and specificity. It proves that the proposed method effectively improves the robustness and accuracy of heart sound classification and is expected to be applied to machine-assisted auscultation.
Algorithms ; Heart Defects, Congenital ; diagnosis ; Heart Sounds ; Humans ; Neural Networks (Computer) ; Sensitivity and Specificity

OBJECTIVE： To investigate the potential mechanism of Sophora tonkinensis in the treatment of leukemia. METHODS： The active components and their target proteins of S. tonkinensis were searched by the analysis of traditional Chinese medicine system pharmacology platform， and UniProt database and PubMed database were used to query corresponding gene names of target proteins of active components. Cytoscape 3.6.0 software was used to construct compound-target network. The genes related to leukemia were searched by DisGeNET databases， and OmicShare platform was used to screen the intersection genes of the active component targets of S. tonkinensis and leukemia disease targets. STRING database and Cytoscape 3.6.0 software were used to construct PPI network， and topological analysis was performed. GO analysis and KEGG pathway enrichment analysis were performed by using DAVID bioinformatics database. RESULTS： There were 13 active components and 204 target proteins in S. tonkinensis. The components and targets with high node degree included quercetin， kaempferol， PTGS2， PRSS1， CAMKK2， etc. There were 24 intersection genes between the active component target and leukemia target， including IRF1， BCL2， CYP1A1， PIM1， etc. PPI network of the above intersection genes contained 24 nodes and 142 edges， with an average node degree of 6.5 and an average medium of 0.045. The results of GO analysis showed that the biological process of the above-mentioned genes involved in apoptosis signaling pathway in vitro without ligands， negative regulation of apoptosis process， positive regulation of B cell proliferation， etc. Molecule function mainly included that protein homology activity and binding of the same protein. Cell components mainly included extracellular region， mitochondria and so on. KEGG pathway enrichment showed that above-mentioned genes were mainly associated with T cell receptor signaling pathway， JAK/STAT signaling pathway， HTLV-Ⅰ infection. CONCLUSIONS： Through JAK/STAT signaling pathway and HTLV-Ⅰ infection pathway， the active components of S. tonkinensis may act on PTGS2， PRSS1， CAMKK2 and other targets， and then play a therapeutic role on leukemia， showing the characteristics of multi-component， multi-target and multi-channel.

Objective To investigate the frequency of therapy-oriented oral radiation in Nanping, China and its distribution, and to provide a basis for the rational application of therapy-oriented oral radiation and the effective allocation of resources in Nanping. Methods A questionnaire was designed to investigate the frequency of therapy-oriented oral radiation in all oral radiation diagnosis and treatment institutions in Nanping. Results In 2021, there were 54 oral radiation diagnosis and treatment institutions and 79 oral radiation machines in Nanping. The total frequency of therapy-oriented oral radiation was 61593 visits and the radiation frequency was 19.54 visits per thousand patients. The average annual frequency of medical institutions at all levels was 721.87 to 3713.25 visits per institution; the male-to-female composition ratio of frequency of therapy-oriented oral radiation in December 2021 was 50.5%:49.5%. The proportion of radiation frequency of different devices was as follows: 38.7% (intraoral dental film), 46.5% (oral panorama), 10.3% (oral computed tomography [CT]), and 4.5% (cranial photography). The proportion of radiation frequency in patients of different ages was as follows: 17.1% (0−15 years), 48.2% (15−40 years), and 34.7% (over 40 years). The frequency of therapy-oriented oral radiation grew by 77.43%, 35.18%, and 8.16% every two years from 2015 to 2021, respectively. Conclusion The frequency level of therapy-oriented oral radiation in Nanping is at the level of Class II health care. The distribution of therapy-oriented oral radiation is highly unbalanced and is related to the level of economic development. Private healthcare institutions are growing rapidly, and public healthcare institutions of grade two and above occupy the main healthcare resources. The oral panorama accounts for the most, cranial photography accounts for the least, and oral CT is the fastest-growing portion. Therapy-oriented oral radiation is predominantly performed in the young and middle-aged populations, regardless of sex. Except for intraoral dental films, the general trend is upward.