Objective To assess the heritability of serum uric acid in adult,using the classic twin design.Methods Adult Twins were recruited from the Qingdao Twin Registry.Uric acid,height,weight were measured.Zygosity in all the same-sex twin pairs was determined by 16 polymorphic markers.Heritability was assessed by structural equation models,with age,gender and body mass index(BMI) included as covariates.Results In total,687 twin pairs were available for data analyses,including 420 pairs of monozygotic and 267 pairs of dizygotic twins.After logarithm transformed,uric acid in males ( 17.47±1.91 ) was significantly higher than in females ( 15.22±1.70,P＜0.0001 ).After adjustment on age,sex and BMI,intraclass correlations for uric acid were 0.70 for monozygotic twins and 0.40 for dizygotic twins.The sex-limitation AE model,combining additive genetic and unique environmental factors,could produce the best fit for the data.Heritability estimate for uric acid was 70.5% (95% CI:65.9-74.6),with the proportion of unique environmental effects as 29.5%(95%CI:25.4-34.2).Conclusion Additive genetic effects appeared to be the major contributor to the variation of uric acid in this twins sample being studied.

OBJECTIVE: To study the relationship between the lymphoid follicles in mucous membrane of pharynx and mucosal associated lymphoid tissues (MALT). METHOD: Ten folliculi obtained from 10 patients of follicular pharyngitis and mucosa taken form 10 patients of paranasal sinusitis were fixed in neutral formalin and embedded in paraffin. Sections were prepared, stained by H. E and by immunohistochemical method staining with S-100,and observe by light microscopy. We observed the morphology of lymphoid follicles in mucous membrane of pharynx with MALT in mucosa of paranasal sinusitis as the contrast. RESULT: Lymphoid follicles in mucosa of pharynx compared with MALT in the mucosa of paranasal sinuses, there was no mantle zone, no typical germinal center and no mucosal epithelium, immunological staining with S-100 was week. CONCLUSION The lymphoid follicles in mucosa of pharynx does not belong to the MALT.
Chronic Disease ; Humans ; Immunohistochemistry ; Lymphoid Tissue ; pathology ; Nasal Mucosa ; pathology ; Paranasal Sinuses ; pathology ; Pharyngitis ; pathology ; Pharynx ; pathology ; Sinusitis ; pathology

Adult ; Arthroscopy ; methods ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Shoulder Joint ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo explore a new technique of reduction and internal fixation for tibia intercondylar eminence fractures under arthroscopy.

METHODSFrom June 2004 to February 2006, 9 patients with fresh tibia intercondylar eminence fracture (type II in 4 cases and type III in 5 cases) were treated with reduction and internal fixation using suture anchors (Depuy Mitek) under arthroscopy. All the patients, subject to regular post-operation functional exercise, were followed up for 6 to 22 months. The results were evaluated in the aspects of fracture reduction healing, knee joint relaxation and ROM, and functional restoration of overall limbs.

RESULTSIn the nine patients, the tibia intercondylar eminence fractures healed without displacement and nonunion. No knee joint relaxation or extension-restriction was found. Lysholm score indicated 93.8 +/- 2.3 at the 6th postoperative months.

CONCLUSIONThe reduction and internal fixation of tibia intercondylar eminence fractures under arthroscopy using suture anchors demonstrate a reliable and easy-to-use technique. Operation under arthroscopy helps diagnose and treat other complications inside knee joint, merely resulting in slight injury. In addition,early functional exercise contributes to rapid recovery of knee joint's functions.

Adult ; Arthroscopy ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Suture Anchors ; Tibia ; physiopathology ; surgery ; Tibial Fractures ; physiopathology ; surgery

Objective:To evaluate the correlation between inflammatory diet and reflux esophagitis (RE) with the dietary inflammatory index (DII), and to provide scientific evidence for the prevention and treatment of RE at the level of dietary guidance.Methods:From December 2021 to September 2022, 145 RE patients (RE group) who visited the First Affiliated Hospital of Xinjiang Medical University were recruited. During the same period, 145 subjects who underwent check-ups at the First Affiliated Hospital of Xinjiang Medical University were selected as the healthy control group, and age and gender were matched according to the ratio of 1 to 1. The baseline data of the 2 groups, including body mass index, the history of smoking and drinking, poor dietary habits, and physical activity intensity were collected. Dietary intake of the patients was assessed by a semi-quantitative food frequency questionnaire, and the overall DII was calculated to evaluate the potential anti-inflammatory or pro-inflammatory effects of diet. According to the tertiles of the DII of the healthy control group (33.3% and 66.7% as the cut-off), dietary inflammatory potential was divided into low (<-0.06), moderate (-0.06 to 1.11) and high pro-inflammatory potential diet (>1.11). Logistic regression model was performed to analyze the correlation between DII and RE risk. Linear trend test was used to compare the overall change trend of RE risk OR value along with the increase of DII. Independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:The body mass index of RE group was higher than that of healthy control group( (24.11±2.57) kg/m 2 vs. (23.38 ±2.60) kg/m 2), and the difference was statistically significant ( t=-2.41, P=0.017). The proportions of smoking, drinking, over-eating, and eating within 3 h before bedtime of RE group was higher than those of the healthy control group (42.8%, 62/145 vs. 31.0%, 45/145; 31.0%, 45/145 vs. 16.6%, 24/145; 33.1%, 48/145 vs. 17.9%, 26/145; 52.4%, 76/145 vs. 13.1%, 19/145), and the differences were statistically significant ( χ2=4.28, 8.39, 8.78 and 50.86, P=0.039, 0.004, 0.003 and<0.001). While the proportions of night snacking and moderate to severe physical activity of RE group were lower than those of the healthy control group (14.5%, 21/145 vs. 24.1%, 35/145; 22.8%, 33/145 vs.37.2%, 54/145), and the differences were statistically significant ( χ2=4.34 and 7.24, P=0.037 and 0.007). The DII of RE group was higher than that of the healthy control group (1.05 (0.03, 1.62) vs. 0.34(-0.61, 1.35)), and the difference was statistically significant ( Z=8 661.50, P=0.010). Compared with the low pro-inflammatory potential diet, high pro-inflammatory potential diet had a 1.30-fold increased the risk of RE ( OR=2.30, 95% confidence interval (95% CI) 1.29 to 4.09, P=0.005). After adjusting for total energy intake, age, gender, ethnicity, body mass index, education level, and physical activity intensity, the high pro-inflammatory potential diet was still positively correlated with the risk of RE ( OR=2.58, 95% CI 1.16 to 5.76, P=0.020). In the continuous DII, the risk of RE increased by 36% for each 1 increase in DII ( OR=1.36, 95% CI 1.11 to 1.68, P=0.003). After adjusting for major confounding factors, the continuous DII was still positively correlated with the risk of RE ( OR=1.41, 95% CI 1.08 to 1.85, P=0.012; OR=1.42, 95% CI 1.05 to 1.93, P=0.023). The results of trend test showed that the higher the DII, the greater the risk of RE ( P=0.039). Conclusions:Pro-inflammatory diet is correlated with the increased risk of RE, and there is a certain dose-response relationship. Reasonable reduction of the intake of pro-inflammatory food may be beneficial to reduce the risk of RE.

Compared with conventional cardiopulmonary resuscitation (CCPR), extracorporeal cardiopulmonary resuscitation (ECPR) can improve the survival rate of patients with cardiac arrest, and reduce the risk of reperfusion injury. However, it is still difficult to avoid the risk of secondary brain damage. Low temperature management has good neuroprotective potential for ECPR patients, which minimizes brain damage. However, unlike CCPR, ECPR has no clear prognostic indicator. The relationship between ECPR combined with hypothermia management-related treatment measure and neurological prognosis is not clear. This article reviews the effect of ECPR combined with different therapeutic hypothermia on brain protection and provides a reference for the prevention and treatment of neurological injury in patients with ECPR.
Humans ; Brain ; Cardiopulmonary Resuscitation ; Brain Injuries ; Hypothermia, Induced ; Heart Arrest

Pharmacokinetic parameters can be significantly altered for acute kidney injury (AKI), extracorporeal membrane oxygenation (ECMO) and continuous veno-venous hemofiltration therapy (CVVH). Here we reported a case of individualized vancomycin dosing for a patient diagnosed as severe acute pancreatitis treated with concurrent ECMO and CVVH. A 65 kg 32-year-old woman was admitted to hospital presented with severe acute pancreatitis (SAP), respiratory failure, metabotropic acidosis and hyperkalemia. She was admitted to intensive care unit (ICU) on hospital day 1 and was initiated on CVVH. She progressed to multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) on ICU day 2, and veno-venous ECMO was instituted. Several catheters were inserted into the body to support ECMO, CVVH and pulse indicator continuous cardiac output (PiCCO), so vancomycin was prescribed empirically on ICU day 3 for prevention of catheter-related infection. Given the residual renal function and continuous hemofiltration intensity on day 3, vancomycin bolus of 1 000 mg was prescribed, followed by a maintenance dose of 500 mg every 8 hours. On ICU day 4, a vancomycin trough serum concentration of 14.1 mg/L was obtained before the fourth dose, which was within the target range of 10-20 mg/L. By ICU day 7, vancomycin dosage was elevated to 1.0 g every 12 hours because of aggravated infection and improved kidney function. On ICU day 14, a vancomycin trough serum concentration of 17 mg/L was obtained. Her white blood cell (WBC) and neutrophil percentage (Neut%) dropped to the normal level by ICU day 19. This vancomycin regimen was successful in providing a target attainment of trough serum concentration ranging from 10-20 mg/L quickly and in controlling infection-related symptoms and signs properly. With the help of this case report we want to call attention to the clinically significant alteration in vancomycin pharmacokinetics among critically ill patients. Individualized vancomycin dosing regimens and therapeutic drug monitoring are necessary for critically ill patients receiving CVVH and ECMO to ensure that the target serum vancomycin levels are reached to adequately treat the infection and avoid nephrotoxicity.
Adult ; Anti-Bacterial Agents/administration & dosage* ; Critical Illness ; Extracorporeal Membrane Oxygenation ; Female ; Hemofiltration ; Humans ; Pancreatitis/drug therapy* ; Vancomycin/administration & dosage*

Objective: To explore the diagnostic value and model of serum Golgi protein 73 (GP73) in patients with hepatitis C cirrhosis. Methods: 271 cases with chronic hepatitis C virus infection who were treated in the Fifth Medical Center of PLA General Hospital from January 2010 to December 2017 were retrospectively collected as the research objects, including 126 cases with hepatitis and 145 cases with liver cirrhosis. Serum GP73 and liver stiffness measurement (LSM) based on transient elastography test were performed in all patients. Simultaneously, blood routine, liver function, coagulation function and other related indicators were collected. GP73 diagnostic efficiency for liver cirrhosis was evaluated by receiver operating characteristic curve (ROC). GP73 diagnostic value was clarified after comparison with aspartate aminotransferase/platelet ratio index (APRI), FIB-4 index (FIB-4) and LSM. Compensated hepatitis C virus-related cirrhosis diagnostic model based on serological index was established by logistic regression analysis. Results: The area under the receiver operating characteristic curve (AUC) of GP73, LSM, FIB-4 and APRI in the diagnosis of compensated hepatitis C virus-related cirrhosis were 0.923, 0.839, 0.836 and 0.800 respectively, and GP73 had the best diagnostic efficiency (P <0.001). LSM and GP73 combined use had improved the diagnostic sensitivity of cirrhosis to 97.24%. Multivariate logistic regression analysis revealed that GP73, age, and platelets were independent predictors of cirrhosis.Compensated hepatitis C virus-related cirrhosis diagnostic model (GAP) was established based on the result: LogitP=1/[1+exp(6.145+0.013×platelet-0.059×age-0.059×GP73)].AUC model for diagnosing compensated liver cirrhosis was 0.944, and the optimal cut-off value was 0.56, with sensitivity and specificity of 84.03% and 92.06%, respectively, and the diagnostic efficiency of this model was better than that of APRI, FIB-4, LSM and GP73 alone (P<0.05). Conclusion: GP73 is a reliable serum biomarker for the diagnosis of compensated hepatitis C virus-related cirrhosis. The GAP diagnostic model based on GP73, platelet count, and age can further improve the diagnostic efficiency and help to diagnose patients with compensated hepatitis C virus-related cirrhosis.
Aspartate Aminotransferases ; Biomarkers ; Fibrosis ; Hepatitis C ; Hepatitis C, Chronic/complications* ; Humans ; Infant, Newborn ; Liver/pathology* ; Liver Cirrhosis/pathology* ; Polyesters ; ROC Curve ; Retrospective Studies

Objective: To investigate the predictive value of N-terminal type B natriuretic peptide（NT-proBNP) on the prognosis of elderly hospitalized patients without heart failure（non-heart failure). Method: Elderly patients aged 65 years or older, who were admitted to Beijing Hospital from September 2018 to February 2019, were enrolled in this study. Patients with clinical diagnosis of heart failure or left ventricular ejection fraction（LVEF)<50% were excluded. The patients were divided into 2 groups based on the serum NT-proBNP level: low NT-proBNP group （<125 ng/L) and high NT-proBNP group（≥125 ng/L). Patients were followed up at 3, 6, and 12 months after enrollment, and the major adverse events were recorded. The composite endpoint events included all-cause mortality, readmission or Emergency Department visits. Cardiovascular events include death, readmission or emergency room treatment due to cardiogenic shock, myocardial infarction, angina pectoris, arrhythmia, heart failure or stroke/transient ischemic attack. Results: A total of 600 elderly patients with non-heart failure were included in the analysis. The average age was （74.9±6.5) years, including 304（50.7%) males. The median follow-up time was 344（265, 359) days. One hundred and seventy-eight（29.7%) composite endpoint events were recorded during the follow-up, 19（3.2%) patients died, and 12（2.0%) patients were lost to follow-up. There were 286(47.7%) cases in low NT-proBNP group and 314 cases（52.3%) in high NT-proBNP group. Patients were older, prevalence of atrial fibrillation and myocardial infarction was higher; MMSE scores and ADL scores, albumin and creatinine clearance rate were lower in high NT-proBNP group than in low NT-proBNP group（all P<0.05). At 1-year follow-up, the incidence of composite endpoint events was significantly higher in high NT-proBNP group than in low NT-proBNP group（33.4%（105/314) vs. 24.8%（71/286), P = 0.02). Cardiovascular events were more common in high NT-proBNP group than in low NT-proBNP group（17.5%（55/314) vs. 8.4%（24/286), P = 0.001). Kaplan-Meier survival analysis showed both composite endpoint events（Log-rank P=0.016) and cardiovascular events（Log-rank P=0.001) were higher in high NT-proBNP group than in low NT-proBNP group. All-cause mortality was also significantly higher in highNT-proBNP group than in lowNT-proBNP group（4.8%（15/314) vs. 1.4%（4/286), P = 0.020), and Kaplan-Meier survival analysis demonstrated borderline statistical significance（Log-rank P = 0.052). Cox proportional hazard regression analysis showed that after adjusting for age, sex, creatinine clearance rate, myocardial infarction, and atrial fibrillation, NT-proBNP remained as an independent risk factor for composite endpoint events（HR=1.376，95%CI 1.049-1.806, P=0.021), and cardiovascular events（HR=1.777, 95%CI 1.185-2.664, P=0.005), but not for all-cause mortality（P=0.206). Conclusions: NT-proBNP level at admission has important predictive value on rehospitalization and cardiovascular events for hospitalized elderly non-heart failure patients. NT-proBNP examination is helpful for risk stratification in this patient cohort.
Aged ; Aged, 80 and over ; Biomarkers ; Heart Failure ; Humans ; Male ; Natriuretic Peptide, Brain ; Peptide Fragments ; Prognosis ; Stroke Volume ; Ventricular Function, Left