Objective: To analyze the mortality trend of acute myocardial infarction in Nan'an District, Chongqing Municipality from 2019 to 2025, so as to provide a basis for the prevention and treatment of acute myocardial infarction. Methods: Data of acute myocardial infarction cases from 2019 to 2025 were collected through the Chongqing Municipality Death Cause Surveillance Information System. The crude mortality was analyzed, and the standardized mortality was calculated using the data from the Sixth National Population Census in 2010. The average annual percent change (AAPC) was used to analyze the trend in mortality of acute myocardial infarction stratified by gender and age. Results: A total of 1 108 acute myocardial infarction deaths were reported in Nan'an District from 2019 to 2025, with a crude mortality of 14.23/105 and a standardized mortality of 10.89/105. The overall trends were not statistically significant (AAPC=-4.357%, -6.759%, both P>0.05). There were 665 male deaths and 443 female deaths, with a male-to-female ratio of 1.50∶1. The crude and standardized mortality for males were 17.31/105 and 13.47/105, respectively, with trends not statistically significant (AAPC=-4.697%, -6.543%, both P>0.05). The crude and standardized mortality for females were 11.21/105 and 8.42/105, respectively, with trends not statistically significant (AAPC=-3.667%, -6.938%, both P>0.05). The number of acute myocardial infarction deaths in the groups aged <40 years, 40-<65 years and ≥65 years was 42, 242 and 824 cases, accounting for 3.79%, 21.84% and 74.37%, respectively. From 2019 to 2025, the crude mortality of the groups aged <40 years and ≥65 years were 1.10/105 and 82.30/105, respectively, presenting downward trends (AAPC=-11.809%, -11.342%, both P<0.05). The crude mortality of the group aged 40-<65 years was 8.51/105, showing an upward trend (AAPC=5.471%, P<0.05). Conclusions The overall mortality of acute myocardial infarction remained stable in Nan'an District from 2019 to 2025, but the mortality increased among middle-aged population aged 40-<65 years. It is necessary to strengthen early screening and risk factor intervention targeting males and middle-aged and elderly population.

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To evaluate the relationship between proton pump inhibitor (PPI) and the risk of spontaneous bacterial peritonitis (SBP) in cirrhosis patients systematically.Methods The literature on the related databases as of February 2019 was searched.Case-control studies,cohort studies,and randomized controlled studies (RCT),which set the theme as the relationship between PPI and SBP in cirrhosis patients,whose main outcome indicator was SBP incidence,and which had high quality assessed by Newcastle-Ottawa Scale or modified Jadad scoring method,were collected.The meta-analysis was performed using Rev Man 5.3 software.Results A total of 18 studies were enrolled in the meta-analysis.Of the 18 studies,8 were case-control studies,9 were cohort studies,and 1 was RCT;6 were prospective studies and 12 were retrospective studies;13 were single-center studies and 5 were multi-center studies.A total of 6 961 patients were included,3 353 in the trial group and 3 608 in the control group.The patients in the trial group received PPI alone and the patients in the control group did not receive any acid-suppressing drug.Overall analysis of the 18 studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.83,95％ CI:1.43-2.33,P ＜ 0.001).The results of subgroup analysis for 8 case-control studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group(OR =2.38,95％ CI:1.69-3.36,P ＜ 0.001).The results of subgroup analysis for 9 cohort studies showed that the risk of SBP of patients in the trial group was markedly higher than that in the control group (OR =1.27,95％ CI:1.04-1.55,P =0.020).The results of subgroup analysis for 12 retrospective studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.81,95％CI:1.34-2.45,P=0.001).The results of subgroup analysis for 6 perspective studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.88,95％ CI:1.27-2.79,P =0.002).The results of subgroup analysis for 13 single-center studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.97,95％ CI:1.41-2.76,P ＜ 0.001).The results of subgroup analysis for 5 multicenter studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.69,95％CI:1.33-2.13,P＜0.001).Conclusions PPI can increase the risk of SBP in patients with liver cirrhosis.It is suggested that PPI be used cautiously in patients with liver cirrhosis.

Objective To evaluate the relationship between proton pump inhibitor (PPI) and the risk of spontaneous bacterial peritonitis (SBP) in cirrhosis patients systematically.Methods The literature on the related databases as of February 2019 was searched.Case-control studies,cohort studies,and randomized controlled studies (RCT),which set the theme as the relationship between PPI and SBP in cirrhosis patients,whose main outcome indicator was SBP incidence,and which had high quality assessed by Newcastle-Ottawa Scale or modified Jadad scoring method,were collected.The meta-analysis was performed using Rev Man 5.3 software.Results A total of 18 studies were enrolled in the meta-analysis.Of the 18 studies,8 were case-control studies,9 were cohort studies,and 1 was RCT;6 were prospective studies and 12 were retrospective studies;13 were single-center studies and 5 were multi-center studies.A total of 6 961 patients were included,3 353 in the trial group and 3 608 in the control group.The patients in the trial group received PPI alone and the patients in the control group did not receive any acid-suppressing drug.Overall analysis of the 18 studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.83,95％ CI:1.43-2.33,P ＜ 0.001).The results of subgroup analysis for 8 case-control studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group(OR =2.38,95％ CI:1.69-3.36,P ＜ 0.001).The results of subgroup analysis for 9 cohort studies showed that the risk of SBP of patients in the trial group was markedly higher than that in the control group (OR =1.27,95％ CI:1.04-1.55,P =0.020).The results of subgroup analysis for 12 retrospective studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.81,95％CI:1.34-2.45,P=0.001).The results of subgroup analysis for 6 perspective studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.88,95％ CI:1.27-2.79,P =0.002).The results of subgroup analysis for 13 single-center studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.97,95％ CI:1.41-2.76,P ＜ 0.001).The results of subgroup analysis for 5 multicenter studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.69,95％CI:1.33-2.13,P＜0.001).Conclusions PPI can increase the risk of SBP in patients with liver cirrhosis.It is suggested that PPI be used cautiously in patients with liver cirrhosis.

OBJECTIVETo study genetic mutations and clinical features of a pedigree affected with MYH9-related disorders from Guangxi.

METHODSBlood platelets were counted with a hemocytometer. Blood smear was carried out to detect the inclusion body in peripheral blood neutrophils. DNA and mRNA samples were extracted from blood samples from the members of the pedigree. Fragments of the MYH9 gene were amplified with PCR and directly sequenced.

RESULTSThe affected individuals presented with a triad of giant platelets, decreased platelet count and inclusion bodies in the neutrophils with variable expressivity. A heterozygous deletional mutation (c.5803delG) in exon 41 of the MYH9 gene was found in all of the 8 affected individuals, which led to a frame-shift and change of 26 amino acids at the C-end of the tail domain of nonmuscle myosin heavy chain IIA (NMMHC-IIA) (p.Ala1935Profs*12). The same mutation was not found among healthy members of the pedigree.

CONCLUSIONThe c.5803delG mutation probably underlies the MYH9-related disorders in this pedigree. The mutation has altered the C-end of the tail domain of the NMMHC-IIA protein, resulting in mild clinical symptoms in the affected individuals.

Adult ; Base Sequence ; China ; Female ; Humans ; Male ; Molecular Motor Proteins ; genetics ; Molecular Sequence Data ; Myosin Heavy Chains ; genetics ; Pedigree ; Sequence Deletion ; Thrombocytopenia ; diagnosis ; genetics

Objective To access the incidence,clinical characteristics and the factors affecting therapy of respiratory distress syndrome (RDS) in the infants at term and near term delivered by elective cesarean section.Methods A retrospective cohort study among consecutively admitted infants with RDS at the Neonatal Intensive Care Unit of the Department of Neonatology,Xiangya Hospital,Central South University from Jan.2004 to Dec.2011 were conducted.The inborn infants at 36-42 weeks gestation with RDS,whom were delivered by Elective Cesarean Section from January 1 st,2004 to December 31st,2011 were enrolled.These cases with the timing of elective caesarean section,gestational age,intrauterine infection,asphyxia at birth,which affecting the occurrence of RDS were compared.Results Fifty one infants were entered into the study,which were all met standard of Elective Cesarean Section.Among these infants,33 cases (64.7％,33/51 cases) were delivered by cesarean section without any reason.In these 51 cases,the constituent ratio of elective caesarean section in gestational age ＞ 39 weeks was lower than in gestational age ＞ 36-＜39 weeks,and the difference was significant (31.4％ vs 68.6％,x2 =0.560,P ＜0.01).Asphyxia at birth was the main risk factors of term and near term with RDS (OR =7.306,95％CI:0.018-51.101,P =0.041).Compared to the infants whom born without asphyxia,the infants born with asphyxia usually came out to RDS right after born (x2 =0.080,P ＜ 0.01),required longer time of mechanical ventilation and had significant lower effective ratio (x2 =0.071,8.843,all P ＜ 0.01).Conclusions Asphyxia is the first manifestations of term and near term infants with RDS.These infants often can be onset after birth.