Objective To identify the factors influencing the response to clopidogrel.Methods Seventy-two patients with acute coronary syndrome who were treated at Beijing Tongren Hospital from September,2005 to April,2006 were eligible for this study.10 ?mol/L ADP induced platelet aggregation was measured before and 7 days after clopidogrel treatment by the traditional optical aggregometry.According to the inhibition of platelet aggregation(?A),the population was divided into low response group and normal response group.Then some factors possibly influencing the response to clopidogrel were analyzed by specific statistical methods.Results Baseline characteristic showed that compard with that of normal response group,the body mass index and the percentage of obesity and STEMI were lower in low response group,while its percentage of hypertension and diabetes were higher(P

Objective:To understand the comprehensive geriatric assessment (CGA) scores in chronic kidney disease (CKD) patients aged 65 years and older, and analyze the related influencing factors of quality of life.Methods:A total of 189 patients who were over 65 years old and diagnosed with CKD in the Department of Nephrology of Shanxi Provincial People's Hospital from October 2016 to October 2019 were included retrospectively. The patients were divided into dialysis group ( n=90 cases) and non-dialysis group ( n=99 cases) according to whether dialysis or not. The concise CGA scores included age, basic activities of daily living (BADL), instrumental activities of daily living (IADL), and modified cumulative illness rating score for geriatrics (MCIRS-G). Pearson correlation analysis was used to analyze the relationship between different scale scores and clinical indexes. Multiple linear regression analysis was used to further analyze independent related factors of the quality of life in elderly CKD patients. Results:Compared with the non-dialysis group, the BADL score and IADL score in the dialysis group were significantly reduced [(70.00±33.28) vs (93.38±14.32), t=6.166, P<0.001; (9.78±7.12) vs (15.95±5.74), t=6.520, P<0.001], while the MCIRS-G score was significantly increased [(31.13±4.00) vs (27.29±5.17), t=-5.741, P<0.001]. Linear regression analysis performed on the data of non-dialysis group patients showed that estimated glomerular filtration rate (eGFR), serum uric acid (SUA), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), blood potassium and chlorine were positively correlated with BADL and IADL scores (all P<0.05). B-type natriuretic peptide (BNP) was negatively correlated with BADL score ( P<0.01). BNP and age were negatively correlated with IADL score (both P<0.05). Fasting blood glucose (FBG) was positively correlated with MCIRS-G or MCIRS-G other than kidney (both P<0.05), and eGFR, SUA, total cholesterol, and HDL-C were negatively correlated with MCIRS-G or MCIRS-G other than kidney (all P<0.05). Multiple linear regression analysis showed that eGFR was an independent influencing factor for BADL ( P<0.01). Age and eGFR were independent influencing factors for IADL (both P<0.05). Conclusions:The decline of quality of life in elderly CKD patients is related with eGFR, SUA, age, BNP and HDL-C levels, and eGFR and age are independent influencing factors.

Objective To analyze the inappropriate use of oral drugs in elderly patients admitted in internal medicine, and to guide clinical rational drugs use in elderly patients. Methods One hundred inpatients′ data over 65 years were collected in the department of geriatrics. The potentially inappropriate use of oral drug were analyzed according to the Beers criteria published in 2012 and drugs instructions. Results In 100 patients, (5.81 ± 2.78) kinds of oral drugs had been taken per inpatient. One patient was involved out-of-label usage. There were potentially inappropriate uses of oral drugs in 21 patients. Inappropriate use of oral drugs in three patients were not related to diagnosis or disease, and in 4 patients were related to morbid state, 14 patients used drugs that need to be used with caution in older adults. Conclusions There are off-label uses and potentially inappropriate medications in clinical practice, so clinical doctors should examine and assess the uses of drugs. Clinical doctors should strengthen the understanding and application of the comprehensive geriatric assessment.

Objective:To investigate the expression level of serum microRNA-122-5p (miR-122-5p) in elderly patients with chronic atrophic gastritis (CAG) and its correlation with inflammatory factors and disease severity.Methods:A total of 120 CAG patients admitted to our hospital from Dec. 2019 to Dec. 2021 were selected as as the experimental group. According to the gastric mucosa pathological score, the patients were grouped into 58 cases with normal condition and 62 cases with severe condition. Another 105 patients with chronic non-atrophic gastritis during the same period were included as the control group. The expression level of serum miR-122-5p was detected by qRT-PCR, the level of serum hs-CRP was detected by immunoturbidimetry, the levels of serum TNF-α and IL-6 were detected by enzyme-linked immunosorbent assay (ELISA), and the correlation of serum miR-122-5p expression level with hs-CRP, IL-6, TNF-α and disease severity in CAG patients was analyzed by Pearson method. Logistic regression was used to analyze the risk factors of affecting CAG.Results:There were no significant differences in gender, age, or the proportion of patients with smoking history between the CAG group and the control group ( P>0.05). The proportions of drinking and Hp positive patients in the CAG group were 52.50% and 62.50%, which were significantly higher than those in the control group (25.71%, 43.80%) ( P<0.05) ; The serum levels of miR-122-5p, hs-CRP, IL-6, and TNF-α in the CAG group were (2.31±0.42), (24.89±4.56) mg/L, (39.26±7.68) ng/mL, and (85.42±9.65) pg/ml, respectively, which were significantly higher than the control group [ (1.05±0.12), (16.54±3.85) mg/L, (22.39±5.21) ng/ml, (862.34±7.46) pg/ml] ( P<0.05) ; Serum hs-CRP, IL-6, TNF-αlevels, miR-122-5p expression levels, Hp positive infection rate and pathological score in patients with severe CAG disease were (28.14±3.21) mg/L, (44.55±5.73) ng/ml, (93.42±8.81) pg/ml, 2.74±0.30, 72.58%, (4.30±1.20) points, respectively, which were significantly higher than those of patients with normal disease [ (21.42±3.67) mg/L, (33.61±5.54) ng/ml, (76.87±7.59) pg/mL, 1.85±0.36, 51.72%, (1.60±0.30) points] ( P<0.05) ; correlation analysis showed that serum miR-122-5p expression level in CAG patients was positively correlated with hs-CRP, IL-6, TNF-α and disease severity ( r=0.475, 0.453, 0.505, 0.563, P<0.001). Multivariate logistic analysis showed that Hp positive infection ( OR=2.527, 95% CI=1.125-5.678), miR-122-5p ( OR=2.323, 95% CI=1.341-4.025) were independent risk factors for CAG ( P<0.05) . Conclusion:The expression level of serum miR-122-5p in elderly patients with CAG is increased, which is related to serum inflammatory factors, disease severity and Hp infection, and may be a marker for the diagnosis of CAG.

Objective:To study the risk factors of bronchopulmonary dysplasia (BPD) in extremely preterm/extremely low birth weight infants(EPT/ELBWIs).Methods:From June 2019 to March 2022, clinical data of EPT/ELBWIs with gestational age <28 weeks or birth weight <1 000 g admitted to NICU of our hospital were retrospectively analyzed. They were assigned into BPD group and non-BPD group. Multivariate logistic regression analysis was used to find the independent risk factors for BPD and receiver operating characteristic (ROC) curve was used to determine the cut-off value for BPD. The incidences of BPD of the two groups were compared and the correlation between independent risk factors and BPD severity was analyzed.Results:A total of 82 EPT/ELBWIs were enrolled, including 47 (57.3%) in BPD group and 35 (42.7%) in non-BPD group. The BPD group had longer duration of both invasive and non-invasive mechanical ventilation (MV) [24.0(8.0, 38.0)d vs. 6.0 (0.2, 11.6)d, (38.4±14.5)d vs. (32.4±10.9)d], lower birth weight [906 (800, 970)g vs. 980 (880, 1 050)g],higher incidences of ureaplasma urealyticum colonization (48.9% vs. 22.9%) and hemodynamically significant patent ductus arteriosus (hsPDA) (76.6% vs. 51.4%) than the non-BPD group(all P<0.05). Multivariate logistic regression analysis showed that the independent risk factor for BPD was the duration of invasive MV ( OR=1.003, 95% CI 1.001-1.005). The cut-off value of invasive MV duration for predicting BPD was 14.4 d. The duration of invasive MV was positively correlated with BPD severity ( r=0.604, P<0.001). Conclusions:BPD is more likely to occur in EPT/ELBWIs with longer duration of invasive MV.

Objective:To prepare the virus-like particle (VLP) of the GII.3[P12] human norovirus (HuNoV) strain GZ2013-L20 in Guangzhou and its polyclonal antibody, and systematically characterize its immunogenicity and receptor binding ability, which would provide data for prevention and control of HuNoV.Methods:ORF2 gene was amplified from the genome of the GZ2013-L20 strain to construct the recombinant transposon vector, which was further transformed into Escherichia coli DH10 Bac to develop the recombinant baculovirus Bacmid-L20-ORF2. VLP was expressed in the sf9 insect cells and then purified. Transmission electron microscopy, SDS-PAGE, Western blot (WB), and receptor binding experiments were performed to characterize the purified VLP. In addition, the polyclonal antibody from the immunized mice was evaluated by indirect enzyme-linked immunosorbent assay (ELISA) and the blocking test of receptor binding. Results:The recombinant baculovirus plasmid Bacmid-L20-ORF2 was constructed, and the target VLP was successfully obtained. The result by the transmission electron microscope demonstrated that the VLP were about 30 nm in diameter. SDS-PAGE and WB analyses showed that the protein’s relative molecular mass (Mr. ×10 3) was about 58. The result of receptor binding experiments showed that the VLP could bind to the secretory salivary receptors (types of A, B, AB and O), non-secretory salivary receptors (O type) and the porcine gastric mucin. The polyclonal antibody with a titer of 2 × 10 5 was detected in the immunized mice, which showed strong cross-immunoreactivity with capsid proteins of 20 (20/28) HuNoV genotypes. In addition, the result of blocking tests of receptor binding showed that the VLP polyclonal antibody only blocked the viral VLP of the same genotype, but had no neutralizing effects on the VLPs of GII.2, GII.4, GII.8 and GII.17. Conclusions:The VLP of GII.3[P12] HuNoV Guangzhou strain showed strong binding ability to both secretory and non-secretory salivary receptors, and its polyclonal antibody showed a broad spectrum of immunobinding, but its neutralization blocking feature was effective only against the virus of the same genotype. The result provide basic data for rational design of vaccine development.

Objective: To investigate the detection of thyroid nodules and related risk factors in nuclear power workers, and to provide scientific evidence for thyroid protection of nuclear power workers. Methods: In December 2018, select 295 workers of a nuclear power production enterprise and 238 administrative staff of it, and select 250 staff members of a thermal power generation enterprise 70 kilometers away from the nuclear power station to conduct thyroid ultrasound examination and questionnaire survey for single factor. Analysis and further multivariate logistic regression analysis were used to study the risk factors of thyroid nodules in the population. Results: Women and smoking history were independent risk factors for the increased incidence of thyroid nodules in the study population; three shifts work pattern was an independent risk factor for the increased prevalence of thyroid nodules in nuclear power workers (P<0.05) , and other factors such as the history of nuclear exposure had no significant correlation with thyroid nodules (P>0.05) . Conclusion Nuclear exposure has little effect on the prevalence of thyroid nodules in nuclear power workers.