OBJECTIVETo study the application of Bayes probability model in differentiating yin and yang jaundice syndromes in neonates.

METHODSTotally 107 jaundice neonates who admitted to hospital within 10 days after birth were assigned to two groups according to syndrome differentiation, 68 in the yang jaundice syndrome group and 39 in the yin jaundice syndrome group. Data collected for neonates were factors related to jaundice before, during and after birth. Blood routines, liver and renal functions, and myocardial enzymes were tested on the admission day or the next day. Logistic regression model and Bayes discriminating analysis were used to screen factors important for yin and yang jaundice syndrome differentiation. Finally, Bayes probability model for yin and yang jaundice syndromes was established and assessed.

RESULTSFactors important for yin and yang jaundice syndrome differentiation screened by Logistic regression model and Bayes discriminating analysis included mothers' age, mother with gestational diabetes mellitus (GDM), gestational age, asphyxia, or ABO hemolytic diseases, red blood cell distribution width (RDW-SD), platelet-large cell ratio (P-LCR), serum direct bilirubin (DBIL), alkaline phosphatase (ALP), cholinesterase (CHE). Bayes discriminating analysis was performed by SPSS to obtain Bayes discriminant function coefficient. Bayes discriminant function was established according to discriminant function coefficients. Yang jaundice syndrome: y1= -21. 701 +2. 589 x mother's age + 1. 037 x GDM-17. 175 x asphyxia + 13. 876 x gestational age + 6. 303 x ABO hemolytic disease + 2.116 x RDW-SD + 0. 831 x DBIL + 0. 012 x ALP + 1. 697 x LCR + 0. 001 x CHE; Yin jaundice syndrome: y2= -33. 511 + 2.991 x mother's age + 3.960 x GDM-12. 877 x asphyxia + 11. 848 x gestational age + 1. 820 x ABO hemolytic disease +2. 231 x RDW-SD +0. 999 x DBIL +0. 023 x ALP +1. 916 x LCR +0. 002 x CHE. Bayes discriminant function was hypothesis tested and got Wilks' λ =0. 393 (P =0. 000). So Bayes discriminant function was proved to be with statistical difference. To check Bayes probability model in discriminating yin and yang jaundice syndromes, coincidence rates for yin and yang jaundice syndromes were both 90% plus.

CONCLUSIONYin and yang jaundice syndromes in neonates could be accurately judged by Bayesian discriminating functions.

Bayes Theorem ; Hospitalization ; Humans ; Infant, Newborn ; Jaundice ; diagnosis ; Medicine, Chinese Traditional ; Models, Statistical ; Probability ; Syndrome

Objective To determinate the prognostic value of etiology in patients with chronic systolic heart failure (CSHF).Methods Data of in-hospital patients with CSHF were investigated between 2000 and 2010 from 12 hospitals in Hubei province.All patients were followed up through telephone calls.Univariate and multivariate Cox proportional hazards analyses were then used to explore the differences in the all-cause mortality,heart failure (HF) mortality and sudden cardiac death (SCD) among patients caused by different etiologies.Kaplan-Meier curve were then constructed and Univariate and multivariate Cox regression analyses were used to select demographic and clinical variables in predicting the all-cause mortality,HF mortality and SCD in CSHF patients.Multivariate logistic models and ROC curve were developed with or without the cinfirmed etiology to assess the incremental additive information related to different etiologies.Results (1)Over the median 3 (2-4) years follow-up program,6453 (38.69％) patients died,including 5505 (33.00％) due to HF prognosis and 717 (4.30％) died of SCD.All-cause mortality rates accounted for 34.50％,54.30％,41.48％ and 15.76％,with HF mortality rates as 30.11％,44.95％,36.25％ and 13.10％.SCDs accounted 8.46％,8.45％,9.84％ and 1.05％ in patients with CHD,DCM,HHD and RHD,respectively.(2) Compared with RHD patients,the adjusted HRs for all-cause mortality were 1.554 (1.240 to 1.947;P＜0.001),1.405(1.119 to 1.764;P=0.003) and 1.315(1.147 to 1.467;P=0.005) while the adjusted HRs and 95％CIs for HF mortality were 1.458( 1.213-1.751 ;P＜0.001 ),1.763( 1.448-2.147;P＜0.001 ) and 1.281 ( 1.067-1.537; P=0.008),in patients with CHD,DCM and HHD,respectively.There were no significant differences in CHD (HR 3.345; 95％ CI,1.291 to 8.666; P=0.013 ) or HHD (HR 2.062; 95％CI,0.794 to 5.352; P=0.137 ),while only DCM ( HR 4.764; 95％CI,1.799 to 12.618;P=0.002) remained significant in SCD despite of the multivariate adjustment.(3) Etiology increased the sensitivity and specificity of predicting models for all-cause mortality(AUC 0.839,95％CI,0.832to 0.845 vs.0.776,95％CI,0.768 to 0.784) and HF mortality(AUC 0.814,95％CI,0.806 to 0.822 vs.0.796,95％CI,0.788 to 0.804) but not with SCD (AUC 0.777,95％CI,0.749 to 0.809 vs.0.747,95％CI,0.727 to 0.766).Conclusion CSHF due to CHD,DCM and HHD carried a worse prognosis than that of RHD.Different etiologies provided significant incremental prognostic information beyond readily available clinical variables for all-cause mortality and HF mortality.

Objective To investigate the prevalence and related factors of medicinal therapy in patients with chronic systolic heart failure (CSHF).Methods Data on in-hospital patients with CSHF were studied from 12 hospitals in Hubei province,in 2000 and 2010.Differences on gender and age were calculated and Multivariate Cox regression analysis was performed to determinate the independent risk factors of all-cause mortality.Results (1) 16 681 patients were enrolled in this study.Among which,6453 died during the 5.82 ± 1.63 years of follow-up.The annual medical expenditure was larger in the survival group than in the dead ones (3.19 ± 0.65 vs.3.32 ± 0.57,P＜0.01).(2)The prevalence of Angiotensin Ⅱ receptor blocker increased along with age which accounted as 7.73％,7.35％,12.26％,14.29％,17.19％,19.87％ and 20.49％,respectively,in the ＜30,30-39,40-49,50-59,60-69,70-79 and ≥80-year groups.The distribution of digitalis,diuretics,β-receptor blocker,Angiorensin- converting enzyke inhibitors showed inversed U shape.(3)The annual medical expenditure increased as patients got older,with age groups ＜30,30-39,40-49,50-59,60-69 and 70-79 years old as 2.96 ± 0.70,3.09 ± 0.62,3.15 ± 0.58,3.30 ± 0.59 and 3.25 ±0.58,respectively (P＜0.01).It reduced to the same level as in the 50-59 year-old group.The distribution of annual medical expenditure showed similar pattern in males.However,the trends were only found in patients at 50-59,60-69,70-79 and ≥80 years-old groups in female.Conclusion More attention should be paid to medicinal therapy in patients with CSHF.Medicinal therapy shifted with age and gender,of which females had more adverse trend than in males.

Objective:To understand the influencing factors of the elderly' s demand for the pension mode of medical-nursing combination in Urumqi. Methods: A questionnaire survey was conducted among 300 elderly people randomly selected in Urumqi. Results:Univariate analysis showed that there was significant difference between retirement monthly income, life self-care ability, type of chronic disease, the degree of understanding on the pension mode of medical-nursing combination, family support and the demand rate of the elderly for the pension mode of medical-nursing combination ( P< 0 . 05 ) . Two Logistic regression analysis showed that life selfcare ability, types of chronic diseases, the degree of understanding on the pension mode of medical-nursing combination, and family support factors were statistically significant. Conclusion:It should change the traditional concept of single pension mode, improve the medical-nursing combination service system to meet the needs of all levels of the elderly, establish a long-term care insurance system, and improve the training mechanism of the elderly.

OBJECTIVETo determinate the prognostic value of red cell distribution width (RDW) and the relationships between RDW and clinical characteristics in patients with chronic heart failure (CHF).

METHODSA total of 16 681 in-hospital patients with chronic systolic HF and LVEF < 50% from 12 hospitals in Hubei province, China were enrolled. All patients were followed up with telephone call. Patients were divided into RDW ≤ 13.2% (n = 3981), 13.3% - 14.1% (n = 3996), 14.2% - 14.8% (n = 4319) and ≥ 14.9% (n = 4385) groups. Multivariate Cox regression analysis was performed to determine whether RDW is an independent risk factor of all-cause mortality in overall patients, patients with various etiologies. Multivariate Cox proportional hazard analysis was performed to determine the risk of all-cause mortality among various RDW groups.

RESULTS(1) Compared with RDW ≤ 13.2% group, adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality for RDW 13.3% - 14.1%, 14.2% - 14.8% and ≥ 14.9% were 0.892 (95%CI 0.818 - 0.973, P = 0.01), 0.859 (95%CI 0.793 - 0.931, P < 0.01) and 1.034 (95%CI 0.961 - 1.111, P = 0.373) respectively. (2) Compared with MCV normal group, the adjusted HRs of MCV elevation and MCV decline groups were 1.351 (95%CI 1.063 - 1.718, P < 0.01) and 1.316 (95%CI 1.034 - 1.675, P < 0.01), respectively. (3) Compared to patients with rheumatic heart diseases, the adjusted HR for all-cause mortality in patients with coronary heart disease, dilated cardiomyopathy and hypertensive heart disease with RDW > 16% were 1.437 (95%CI 1.141 - 1.810, P < 0.01), 1.651 (95%CI 1.276 - 2.138, P < 0.01) and 1.276 (95%CI 1.004 - 1.621, P < 0.01), respectively. (4) The RDW is independently correlated with BMI (r = -0.345, P < 0.01), diastolic blood pressure (r = -0.321, P < 0.01), albumin (r = -0.411, P < 0.01), blood urine nitrogen (r = 0.476, P < 0.01), right ventricular end-diastolic diameter (r = 0.383, P < 0.01), LVEF (r = -0.463, P < 0.01) and heart rate (r = 0.379, P < 0.01).

CONCLUSIONSThere is a J shape relationship between all-cause mortality and RDW. The elevation or decline of MCV with increased RDW is linked with increased all-cause mortality in CHF patients.

Aged ; Chronic Disease ; Erythrocyte Indices ; Female ; Heart Failure, Systolic ; blood ; diagnosis ; mortality ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors

OBJECTIVETo evaluate the current status of chronic heart failure (CHF) in Hubei province and analyze the epidemiology of CHF including the general condition, etiology and pharmacological therapy.

METHODSData of in-hospital patients with CHF were investigated between 2000 and 2010 from 12 hospitals in Hubei Province.

INCLUSION CRITERIAover 18 years of age, organic heart disease and with the symptom of HF including dyspnea and fatigue. Patients with a history of myocardial infarction in the prior 12 months, congenital heart disease, pericardial disease and the history of cancer were excluded.

RESULTS(1) A total of 12 450 patients were enrolled (7166 male, 57.56%). The average age was (62.0 ± 14.5) years. Patients in the scale of age ≥ 80, 70 - 79, 60 - 69, 50 - 59, 40 - 49 and < 40 was 9.53% (1187/12 450), 30.80% (3835/12 450), 23.45% (2920/12 450), 18.81% (2342/12 450), 10.73% (1336/12 450) and 6.67% (830/12 450), respectively (P < 0.01). The NYHA class I, II, III and IV was 0.60%, 23.20%, 50.31% and 26.50%, respectively. (2) The age of patients was significant reduced from 2000 - 2003, 2004 - 2006 to 2007 - 2010 [(66.4 ± 14.1) years, (64.9 ± 14.4) years and (64.2 ± 14.8) years, P < 0.01]. (3) The major causes of CHF were hypertension (31.54%), coronary heart disease (28.24%), dilated cardiomyopathy (26.57%) and rheumatic valvular heart disease (17.49%). The most frequent etiology for CHF was rheumatic valvular heart disease in patients aged less than 40 years old, dilated cardiomyopathy in patients aged 40 - 49 and 50 - 59 years and hypertension in patients aged 60-69, 70-79 and ≥ 80 years. (4) Drug use was as follows: Digitalis (47.49%), diuretics (68.75%), ACEI (50.66%), β-blocker (44.06%) and aldosterone antagonist (53.08%). Use of digitalis (Wald χ(2) = 903.41, P < 0.01;r = 0.271, P < 0.01), diuretics (Wald χ(2) = 818.05, P < 0.01; r = 0.249, P < 0.01), aldosterone antagonists (Wald χ(2) = 76.92, P < 0.01; r = 0.091, P < 0.01) increased while the β-blocker (Wald χ(2) = 160.65, P < 0.01; r = -0.117, P < 0.01) declined in proportion to NYHA class increase.

CONCLUSIONSThe age of in-hospital patients with CHF declined in the previous 10 years. The primary etiology was hypertension for aged CHF in-hospital patients with CHF. There was big gap between guideline recommended standard therapy and current drug use for in-hospital patients with CHF in Hubei province.

Adult ; Age Distribution ; Aged ; Aged, 80 and over ; China ; epidemiology ; Chronic Disease ; Female ; Heart Failure ; drug therapy ; epidemiology ; etiology ; Humans ; Inpatients ; Male ; Middle Aged ; Retrospective Studies

Objective To evaluate the image quality of coronary CT angiography (CTA) and the diagnostic accuracy for the assessment of coronary artery stenosis with a 64-slice CT scanner.Methods 120 patients with suspected coronary artery disease were studied by ECG-gated 64-slice spiral CT (120 kV, 850 mAs,0.33 s-rotation time,0.6 mm collimation);60 of them also underwent conventional coronary angiography(CCA).Patients with heart rates above 70 bpm received oral?-blockade before the scan. Enhanced scan was performed with an intravenous injection of 60-70 ml contrast agent (370 mg l/ml) and 50 ml saline chaser bolus at 4 ml/s.Images were retrospectively reconstructed under different reformations multiplanar reconstruse-tion(MPR),maximum intensity projection(MIP)and volume rendering technology (VRT)and reviewed by two observers.Image quality was assessed using a 3-point grading scale(excellent, sufficient and non-diagnostic)and the visibility of coronary branches was evaluated.The left main,left anterior descending,left circumflex and right coronary arteries were screened for the presence of over 50% stenosis.Results Sixty-nine percent of the included patients received?-bloekade.The average heart rate was 61?8 bpm and the scan time was 11.9?1.3 s.In the evaluation of image quality with VRT images, 77% patients′images were excellent,18% sufficient,and 5% non-diagnostic.All of the first,most of the second and third,and parts of the fourth subsegment branches could be shown with MPR,MIP and VRT reconstruction images.MPR and MIP displayed better visualization than VRT in showing small branches. Compared with CCA,the sensitivity,specificity,positive and negative predictive value of CTA to identify over 50% stenosis were 93%,98%,87% and 99%,respectively.Conclusion 64-slice spiral CT coronary angiography is a noninvasive and fast method that allows reliable diagnosis of coronary artery stenosis with high image quality.

Adult ; Animals ; Antibodies, Viral ; blood ; Cells, Cultured ; Cricetinae ; Hantaan virus ; immunology ; Hemorrhagic Fever with Renal Syndrome ; prevention & control ; Humans ; Immunization ; Infant ; Kidney ; virology ; Male ; Middle Aged ; Vaccines, Synthetic ; immunology ; Viral Vaccines ; immunology

OBJECTIVETo investigate the effect of temperature on hospital admission among patients with chronic systolic heart failure (CSHF).

METHODSData regarding in-hospital patients with CSHF were gathered from 12 hospitals in Hubei province, between 2000 and 2010. Patients with a history of congenital heart disease and the history of cancer from this series, were excluded. Chi-square (χ(2)) tests and t tests were used for descriptive analysis. Univariate and multivariate logistic regression methods were performed to determinate the risk of hospital admission of every month to compare with the previous one. We used 2-tailed 95% confidence interval (CI), and tests with P < 0.01 to consider the significant levels, statistically. We also used the SPSS 13.0 for Windows, release 15, 2006 (SPSS Inc, Chicago, Ill) for data analyses.

RESULTS(1) 48 964 patients were enrolled in the present study. The numbers of admission increased 18.71%, 13.84%, -21.90%, -34.62%, -21.97%, -3.81%, -2.04%, 10.13%, -17.13%, -0.85%, 21.54% and 42.70% from January to December when compared to the average number of admission. (2) The odds ratios (ORs) (95% CI, P values) of hospital admission in January, February and December were 1.09 (0.96 - 1.23, 0.54), 0.98 (0.84 - 1.10, 0.46) and 0.96 (0.84 - 1.08, 0.59), respectively in females which did not show any significant differences when compared to the number in August. However the ratios were 0.61 (0.54 - 0.69, < 0.01), 0.80 (0.68 - 0.92, < 0.01) and 0.73 (0.64 - 0.83, < 0.01), respectively, in males that showed significant differences when, compared to the figures in August. (3) The OR of admission increased more when temperature got lower for patients with coronary artery disease, hypertension heart disease or rheumatic heart disease, but not with dilated cardiomyopathy. (4) The OR of admission showed a different impact on patients with different occupation, along with the change of temperature. Low or high temperature did not seem to have different effects on the OR of admission in patients who were free-lanced or unemployed.

CONCLUSIONTemperature seemed to have significant effects on the risk of admission, which related to gender, etiology or occupation.

Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Climate ; Female ; Heart Failure ; Humans ; Inpatients ; statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Temperature

The clustered regularly interspaced short palindrome repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) system is a versatile genome editing tool with high efficiency. A guide sequence of 20 nucleotides (nt) is commonly used in application of CRISPR/Cas9; however, the relationship between the length of the guide sequence and the efficiency of CRISPR/Cas9 in porcine cells is still not clear. To illustrate this issue, guide RNAs of different lengths targeting the EGFP gene were designed. Specifically, guide RNAs of 17 nt or longer were sufficient to direct the Cas9 protein to cleave target DNA sequences, while 15 nt or shorter guide RNAs had loss-of-function. Full-length guide RNAs complemented with mismatches also showed loss-of-function. When the shortened guide RNA and target DNA heteroduplex (gRNA:DNA heteroduplex) was blocked by mismatch, the CRISPR/Cas9 would be interfered with. These results suggested the length of the gRNA:DNA heteroduplex was a key factor for maintaining high efficiency of the CRISPR/Cas9 system rather than weak bonding between shortened guide RNA and Cas9 in porcine cells.
Base Sequence ; Complement System Proteins ; CRISPR-Cas Systems ; DNA ; Genome ; Nucleotides ; RNA, Guide ; Swine