1.Analysis and prediction of epidemiological characteristics of tuberculosis deaths among Chinese residents from 2006 to 2021
Zheng LI ; Letian FANG ; Ming HU ; Huixian ZENG ; Hongsen CHEN ; Xiaojie TAN
Chinese Journal of Epidemiology 2024;45(6):824-832
Objective:The epidemiological characteristics of tuberculosis deaths among Chinese residents from 2006 to 2021 were analyzed, and the tuberculosis mortality rate from 2022 to 2027 was predicted to provide a reference for tuberculosis prevention and control in China.Methods:The data set of tuberculosis deaths from 2006 to 2021 was published regularly by the China CDC, and the crude mortality rate (CMR) and age-standardized mortality rates (ASMR) were calculated according to the population structure of China in 2000. The distribution characteristics of age, sex, region, and time of tuberculosis deaths were analyzed, the Joinpoint regression analysis model was used to analyze the changing trend, and the grey model was applied to predict CMR and ASMR from 2022 to 2027.Results:From 2006 to 2021, the CMR and ASMR of tuberculosis showed a downward trend among males and females, urban and rural areas, and all age groups, in a word, all the Chinese residents. Except for the age group ≥85 years old, the mortality trend was insignificant. In the eastern, central, or western regions. CMR and ASMR were significantly higher in males than in females.CMR and ASMR were significantly lower in urban areas than in rural areas. In general, active tuberculosis patients present a higher mortality rate. The CMR and ASMR in the western region were higher than those in the eastern and central regions and lower in the eastern region than in the central region, but the differences were less obvious. The ASMR of the eastern cities was lower than that of the central and western regions, and the ASMR of the central cities was higher than that of the western region from 2006 to 2009 and 2012 and lower than that of the western region in other years. The ASMR in the western countryside was higher than that in the eastern and central regions and lower in the eastern part than in the central region, but the difference was not obvious. The grey model prediction results show that the CMR (/100 000) of Chinese residents from 2022 to 2027 is 1.585, 1.471, 1.360, 1.250, 1.143, and 1.038, and the ASMR (/100 000) is 0.779, 0.653, 0.531, 0.411, 0.295 and 0.181, respectively.Conclusions:The CMR and ASMR of tuberculosis will continue to decline, and extraordinary achievements have been made in tuberculosis prevention and control in Chinese residents from 2006 to 2021 and, presumably, from 2022 to 2027. However, tuberculosis screening and treatment programs in the western region, men, the elderly population, and rural areas should be further strengthened, and targeted prevention and control measures should be formulated to reduce mortality.
2.Analysis of PICU management and follow-up after Montgomery T-tube placement in children
Yan DU ; Letian TAN ; Pan LIU ; Lijia DU ; Yuxin LIU ; Jinhao TAO ; Chao CHEN ; Zhengzheng ZHANG ; Guoping LU ; Weiming CHEN
Chinese Pediatric Emergency Medicine 2024;31(5):342-348
Objective:To analyze the clinical situation of critically ill children with Montgomery T-tube,aiming to summarize the characteristics of T-tube application in pediatric and the experience of postoperative airway management in PICU.Methods:The etiology,clinical characteristics,complications and ICU admissions of patients with Montgomery T-tube admitted to the Pediatric Hospital of Fudan University from April 2019 to December 2021 were analyzed,and the application of T-tube in patients with critical conditions requiring long-term mechanical ventilation was described in the light of clinical experience.Results:During the study period,seven children were admitted to the PICU after T-tube insertion,including three males and four females,aged 9~75 months.Five children received mechanical ventilation.Among them,there were five cases with congenital laryngeal malformations,one case with tracheoesophageal fistula,and one case with laryngeal papilloma.The main complications were sputum blockage,infection,and granulation proliferation.One child died of secretion blockage,while the other children were successfully evacuated from the T-tube.The longest retention time of the T-tube was 367 days.Five patients experienced hoarseness after removing the T-tube,and upon re-examination with fiberoptic bronchoscopy,no recurrence of subglottic stenosis was observed.There was no respiratory distress or wheezing,and there were no abnormalities observed during regular outpatient follow-up after discharge.After discharge,the quality of life of the six surviving children improved compared to preoperative,and they all resumed oral feeding.There were no complaints of swallowing difficulties or aspiration during outpatient follow-up.But they were all combined with malnutrition.Conclusion:The Montgomery T-tube is a secure and dependable airway stent utilized for airway remodeling and the maintenance of airway patency following interventional surgery.For critically ill children,early management of airway clearance and infection prevention are imperative.
3. Evaluation and treatment of children′s laryngeal clefts
Chao CHEN ; Letian TAN ; Zhengmin XU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2018;53(1):9-15
Objectives:
To provide the experience about the diagnostic process and following management, and to discuss the outcome and predictors in children with laryngeal cleft (LC).
Methods:
A retrospective case study was conducted at an academic children′s hospital. Thirty children were diagnosed as laryngeal cleft between January 2016 and April 2017.Airway evaluations were performed using both flexible and rigid endoscopy, and swallowing evaluations were performed using fiberoptic endoscopic examination of swallowing or modified barium swallow.
Results:
Of 30 cases, 18 were male and 12 were female, ranging in age from birth to 8 years. Two cases were diagnosed as type 0 LC, and they were offered thickened liquid without medication. Throughout follow-up, they remained asymptomatic and showed no respiratory complications. Nineteen children were diagnosed as type Ⅰ LC. Six of them were significantly improved by anti-reflux therapy and feeding instructions. Four children were concomitant with swallowing dysfunction and/or neuromuscular disorders, and they were given a tracheotomy and routine management. Another 4 children were submitted surgical repair when routine treatment failed, and their symptoms were relieved. Five children were concomitant with larygomalacia, and their symptoms were totally ameliorated by supraglottoplasty. Three children were diagnosed as type Ⅱ LC. Two of them received surgical repair and clinically improved, and the rest one was treated by anti-reflux therapy and still under follow-up. Three children were diagnosed as type Ⅲ LC. One of them was underwent surgical repair and clinically improved. Two children were tracheotomized and treated by anti-reflux therapy. Three cases were diagnosed as type Ⅳ LC at birth and no one survived.
Conclusions
Laryngeal cleft is a rare congenital anomaly manifesting with a variety of symptoms, including swallowing disorder, aspirations, dyspnea, stridor and hoarseness. Diagnosis and treatment of laryngeal clefts is a challenge. The best way to evaluate the LC is FEES by laryngeal endoscopy combined with MLB. Cases with type 0-Ⅰ mostly were significantly improved by anti-reflux therapy and feeding instructions. When routine treatment failed, surgical repair is needed. All the cases with LC type Ⅱ-Ⅲ need surgical repair as soon as possible. For type Ⅳ cases, early diagnosis, appropriate treatment and management help to reduce mortality and morbidity.
4.Target gene prediction and related pathway analysis of miR-223-3p in high glucose induced H9c2 cell injury
Jianning QIN ; Yang HAN ; Yao TAN ; Letian YU ; Shunlin QU
Chinese Journal of Arteriosclerosis 2024;32(11):947-954
Aim The effect of miR-223-3p on H9c2 cells in high glucose environments was investigated through bioinformatics and its role in the mechanism of development of diabetic cardiomyopathy was analyzed in conjunction with transcriptomic sequencing results.The objective was to identify novel therapeutic targets at the molecular level and explore the specific mechanisms of action of miR-223-3p.Methods In high glucose-cultivated H9c2 cells,miR-223-3p inhibition and control were transfected,respectively.RT-qPCR was used to detect the differences in miR-222-3p expression between the two cell groups.Differential mRNA was identified through high-throughput sequen-cing.GO functional analysis was conducted using TopGO software.DESeq2 software(v1.16.1)filtered differentially expressed genes and analyzed them using a miR-223-3p target gene database.This process predicted the target genes of miR-223-3p and validated the changes in their expression through RT-qPCR.Results The activity of H9c2 cells trea-ted with high glucose decreased significantly.Significant differences in gene expression between the control group and the inhibitor group had been indicated by transcriptomic sequencing results.GO function enrichment analysis showed that the predicted target gene set was significantly enriched in G protein-coupled receptor activity,glycerol ether monooxygenase ac-tivity,cellular anion homeostasis,and chloride ion homeostasis,among others.KEGG pathway enrichment analysis fur-ther showed that these genes were mainly involved in the TNF signaling pathway and the IL-17 signaling pathway.In ad-dition,they were related to type 1 diabetes,cytochrome P450 metabolism of exogenous drugs,and other diseases and phys-iological processes.Target gene prediction suggested that miR-223-3p may be associated with the expression changes of Cxcl10,Creb313,Mmp3,and Bc13,among others.Conclusion The prediction of miR-223-3p and its downstream target genes in high glucose induced H9c2 cell injury may provide new targets for the treatment of diabetic cardiomyopa-thy,which is of great significance for revealing the pathogenesis of diabetic cardiomyopathy and developing new treatment strategies.