Objective To evaluate the effect of nutrition support on nutritional status and clinical outcome of patients at nutritional risk in internal medical departments.Methods 148 patients at nutritional risk as identified by Nutritional Risk Screening 2002 were numbered according to the order of admission and divided into standard care group (control group,odd numbers,n =75) and individualised nutrition support group (intervention group,even numbers,n =73).Intervention consisted of encouraging food intake,designing food plan,and assuring implementation of food prescription.Energy and protein intake,body weight,length of hospital stay,hospitalization expenses and complications were compared between the two groups.Results In the interventions group,protein intake was significantly higher than that in the control group [(45.1 ± 2.2) g/d vs.(54.8±2.5) g/d,P=0.004],and energyintake higher than that in the control group [(4 180.0± 227.4) kJ/d vs.(4 589.6 ± 150.5) kJ/d,P =0.135] but without statistical significance.Intervention led to an intake of ≥75％ of requirements in 46.6％ patients in the intervention group,significantly higher than the proportion in the control group (30.7％) (P =0.047).The change of body weight was significantly smaller in the intervention group than in the control group [(-0.4 ± 0.2) kg vs.(-1.1 ± 0.2) kg,P =0.025].The length of hospital stay,hospitalization expenses,and incidence of complications showed no significant differences between the control group and the intervention group [(13.5 ±0.9) d vs.(12.4 ±0.6) d,P=0.310;(17834±1824) yuanvs.(16099±1243) yuan,P=0.435;12.8％ vs.8.1％,P=0.184].Conclusions Patients at nutritional risk in internal medical departments could benefit from nutrition support in terms of protein intake and body weight maintenance.A large-scale randomized controlled trial is necessary to confirm the effect of nutrition support on clinical outcomes of patients at nutritional risk.

Teaching of clinical practice is the most important part of education of Tradi-tional Chinese Medicine(TCM).We plan to make clinical rotation internships,standardize the whole process of internships,standardized management of clinical teaching,in order to achieve our objectives of TCM Clinical teaching.We hope to guide the medical students to link theory with clinical practice during clinical rotation internships,set up clinical thinking of intern,and practice the basic skills and operating specifications of intern.

OBJECTIVETo establish the quality standards of Linmaoxiang Jiedu pills.

METHODCinobufagin and bufogenin were determined by HPLC simultaneously.

RESULTThe average recoverys of Cinobufagin and bufogenin was 100.5% and 100.3%, their linear range were 48.74-731.10 ng and 49.90-748.50 ng, respectively.

CONCLUSIONThe method for quantification is reproducible and realizable. The method can be used to control quality of Linmaoxiang Jiedu pills as the quality standards.

Objective To investigate the relationship between glucokinase regulator protein ( GCKR) gene polymorphism rs780094 and hyperuricemia in Uygur in Xinjiang. Methods A case-control study including 1 026 patients with hyperuricemia and 1 030 normal subjects was conducted. All the subjects were genotyped for GCKR gene rs780094 by Sequenom MassARRAY system. The results of rs780094 genotype and allele frequency between hyperuricemia group and control group were compared. The associations of different genotypes of rs780094 with blood pressure, blood lipid, and blood glucose were analyzed. Logistic regression analysis was used to analyse the relationship between polymorphism of rs780094 and hyperuricemia in Uygur in Xinjiang. Results The distributions of three genotypes(G/G, A/G, A/A) and two allele frequency (G and A) in GCKR rs780094 revealed statistical difference ( P<0. 05 ) between hyperuricemia group and control group. A tendency toward association with hyperuricemia was observed under dominant model(OR=1. 295, 95%CI 1. 078~1. 554,P=0. 006) and recessive model(OR=1. 284, 95% CI 1. 024 ~1. 611,P=0. 030). The levels of systolic blood pressure, diastolic blood pressure, and total cholesterol were lower in hyperuricemia group with GCKR gene rs780094 loci GG genotype than those with AA+AG genotype. After adjusting confounding factors which had significant difference in the single factor analysis, logistic regression analysis showed that rs780094 A/A and A/G might be risk factors of hyperuricemia in Uygur in Xinjiang (OR=1. 355,95% CI 1. 094 ~1. 679,P=0. 005). Conclusion The GCKR rs780094 is associated with hyperuricemia in Uygur in Xinjiang. The A/A and A/G genotype of the GCKR rs780094 may increase the risk of hyperuricemia.

Objective To explore the effect of hospital-community integration follow-up pattern on medication compliance in patients with mental disorder. Methods From January 2016 to January 2017, 96 patients were treated effectively with systemic therapy in psychosomatic department and TCM WM department, and 96 discharged mental disorder patients were treated with brief psychiatric rating scale (BPRS) ≤ 28. The patients were randomly divided into 48 cases in the intervention group and the control group; both groups were standardized medication; control group received an outpatient referral, intervention group combined with medical doctors in our hospital and community doctors for one year follow-up intervention. Observed the condition of illness and medication compliance after six months and one year intervention between two groups, compared the patient recurrence rate of one year after discharge. Results BPRS score of intervention group was significantly lower than control group (P＜0. 01), the difference was statistically significant, while intervention group had higher compliance than control group (P＜0. 01), and the difference was statistically significant. Recurrence rate (20. 83％) of intervention group was significantly lower than control group (38. 78％) ( 2 = 4. 03, P＜0. 05), the difference was statistically significant. Conclusion Hospital-community integration follow-up has positive effect on stabilizing patients with mental disorder and improving compliance and decreasing relapse rate.

The expression levels of serum tenascin-C, osteopontin(OPN), and transforming growth factor-β1(TGF-β1) in the patients of diabetic mellitus were measured by ELISA. With the increase of the UACR, the expression of tenascin-C, osteopontin, and transforming growth factor-β1 showed a trend of increase and hypertension will argument this phenomenon. Pearson correlation analysis showed that levels of tenascin-C were positively correlated with HbA1C , body mass index, systolic blood pressure, diastolic blood pressure, UACR, osteopontin, and transforming growth factor-β1.

OBJECTIVE: To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program. METHODS: A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed. RESULTS: NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035. CONCLUSION NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.
Aneuploidy ; Cost-Benefit Analysis ; Female ; Humans ; Noninvasive Prenatal Testing ; Pregnancy ; Retrospective Studies ; Trisomy 18 Syndrome/genetics*

Objective To observe the incidence of pericardial tamponade(PT)after left atrial appendage closure(LAAC)in patients with non-valvular atrial fibrillation(NVAF),and to explore its related factors and outcomes.Methods NVAF patients who were hospitalized and treated with LAAC in Department of Cardiology of our hospital from August 2014 to March 2023 were selected for the study.The general clinical data,preoperative transthoracic echocardiography and transesophageal echocardiography data,results of routine preoperative laboratory tests,intraoperative data and follow-up data of the patients were collected through the hospital medical record management system.The enrolled patients were classified into the non-PT group(n=8)and the PT group(n =1184)according to whether PT occurred after LAAC or not.The incidence of PT,related risk factors and outcomes were statistically analyzed.Results This study included 639 males(53.6%)and 553 females(46.4%),with an average age of 68.1±9.65 years.The CHA2 DS2-VASc score was 4.51±1.72,and the HAS-BLED score was 3.36±1.09.PT occurred in 8 cases(0.67%),among them,6 cases occurred 1 to 33 h after LAAC,and 2 cases occurred on day 19 and day 27 after LAAC.As for the results of transesophageal echocardiography(TEE)and LAA angiography,compared with the non-PT group,the PT group had the significantly larger maximum caliber of the LAA(P=0.025,P=0.015),smaller maximum depth of the LAA(P=0.028,P=0.031),and lower success rate of one-time placement of the occluder(P=0.031);The occluder compression rate of the PT group was significantly greater than that of the non-PT group(P=0.046).Multivariate analysis showed that larger maximum diameter of LAA,smaller average effective depth of LAA and larger compression rate of occluder were the main risk factors for PT.All the 8 PT patients were cured by stopping antithrombotic drugs,pericardiocentesis or surgical drainage.During a mean follow-up of 39±27 months,there were no device-related thrombosis(DRT),ischemic stroke,systemic embolism and other complications in the PT group.Conclusion The incidence of PT after LAAC is low,which is related to the large diameter of LAA,the relatively insufficient depth of the LAA and the large compression rate of the occlude.PT can be cured by stopping antithrombotic drugs and pericardiocentesis/surgical drainage.

Objective To explore the influence of gender on the prognosis of patients with atrial fibrillation(AF)undergoing left atrial appendage occlusion(LAAO).Methods All non-valvular AF patients who were admitted in our hospital and underwent LAAO from August 2014 to August 2021 were enrolled and grouped according to gender.Their general information,including gender,age,comorbid underlying diseases,and results of transthoracic echocardiography and transesophageal echocardiography(TEE)were collected.The incidences of device-related thrombosis(DRT),pericardial tamponade,stroke,bleeding,hospitalization for heart failure,and cardiac death were recorded during follow-up.The influence of gender on the prognosis of these patients was analyzed.Results There were totally 673 patients with non-valvular AF were enrolled,including 366 males and 307 females,at a mean age of 68.2±9.4 years.When compared with the male patients,the female ones had a higher CHA2DS2-VASc score(P＜0.01),but smaller proportions of history of stroke,average compression ratio of occluders,and incidence of residual shunt(＜3 mm)after occlusion(P＜0.05).In 45～60 d after surgery,TEE revealed that there were 17 cases of DRT,including 8 males(2.2％)and 9 females(2.9％),though without statistical difference between the groups.Among the 17 DRT cases,1 experienced stroke,and the incidence of stroke was 5.9％in those with DRT and 0.5％without.There were 4 cases of postoperative pericardial tamponade,including 1 in the male group and 3 in the female group(no significant difference),and all of them were improved after pericardial puncture and fluid extraction.During the follow-up period of 40.2±20.5 months,no obvious differences were observed between the 2 groups in terms of stroke,bleeding,hospitalization for heart failure,and cardiogenic death.Conclusion Gender shows no significant effect on the prognosis of patients with non-valvular AF after LAAO.

Solar energy, which is essential for the origin and evolution of all life forms on Earth, can be objectively recorded through attributes such as climatic ambient temperature (CAT), ultraviolet radiation (UVR), and sunlight duration (SD). These attributes have specific geographical variations and may cause different adaptation traits. However, the adaptation profile of each attribute and the selective role of solar energy as a whole during human evolution remain elusive. Here, we performed a genome-wide adaptation study with respect to CAT, UVR, and SD using the Human Genome Diversity Project-Centre Etude Polymorphism Humain (HGDP-CEPH) panel data. We singled out CAT as the most important driving force with the highest number of adaptive loci (6 SNPs at the genome-wide 1 × 10-7 level;401 at the suggestive 1 × 10-5 level). Five of the six genome-wide significant adaptation SNPs were successfully replicated in an independent Chinese population (N = 1395). The corresponding 316 CAT adaptation genes were mostly involved in development and immunity. In addition, 265 (84％) genes were related to at least one genome-wide associationstudy (GWAS)-mapped human trait, being significantly enriched in anthropometric loci such as those associated with body mass index (x2;P<0.005), immunity, metabolic syndrome, and cancer (x2;P<0.05). For these adaptive SNPs, balancing selection was evident in Euro-Asians, whereas obvious positive and/or purifying selection was observed in Africans. Taken together, our study indicates that CAT is the most important attribute of solar energy that has driven genetic adaptation in development and immunity among global human populations. It also supports the non-neutral hypothesis for the origin of disease-predisposition alleles in common diseases.