Objective To investigate the impact of COVID-19 infection on the early clinical outcomes of patients undergoing valve replacement. Methods Perioperative data of patients who underwent single valve replacement at the Second Affiliated Hospital of Chinese People&#39;s Liberation Army Medical University from January to February 2023 were consecutively collected. Based on COVID-19 infection status, patients were divided into a COVID-19 group and a non-COVID-19 group. The perioperative data were compared between the two groups. Results A total of 136 patients were included, comprising 53 males and 83 females, with a mean age of (53.4±10.2) years. There were 32 patients receiving aortic valve replacements, 102 mitral valve replacements, and 2 tricuspid valve replacements. The COVID-19 group comprised 70 patients, and the non-COVID-19 group included 66 patients. No statistical difference was observed in the incidence of postoperative complications between the two groups [9.09% (6/66) vs. 11.43% (8/70), P=0.654]. However, the COVID-19 group had longer postoperative mechanical ventilation duration [1 201.00 (1 003.75, 1 347.75) min vs. 913.50 (465.50, 1 251.00) min, P=0.001] and ICU stay [3 (2, 3) days vs. 2 (2, 3) days, P<0.001] compared to the non-COVID-19 group. Additionally, troponin I [4.76 (2.55, 7.93) ng/mL vs. 2.66 (1.19, 5.65) ng/mL, P=0.001] and brain natriuretic peptide [608.50 (249.75, 1 150.00) pg/mL vs. 192.00 (100.93, 314.75) pg/mL, P<0.001] levels were significantly higher in the COVID-19 group. Conclusion For patients with single valve disease undergoing elective surgery, short-term outcomes after recovery from COVID-19 infection are favorable, with no significant increase in in-hospital mortality or postoperative complication rates.

Objective To investigate the relationship between correcting abnormal glucose metabolism and mortality risk of malignant tumors of digestive system. Methods A retrospective cohort study was conducted. 1308 patients with abnormal glucose metabolism in our hospital from January 2019 were divided into exposed group (n=777) and non-exposed group (n=531) according to the presence or absence of glucose metabolism correction therapy. The patients were retrospectively followed up until December 2022. The incidence of digestive system tumors and the influencing factors of tumors were compared between the two groups. Results There were 31 patients with digestive system tumor and 9 patients died. The incidence of digestive system tumors was lower in the exposed group (3/777) than in the non-exposed group (28/531). The mortality rate in the exposed group (1/777) was lower than that in the non-exposed group (8/531). Cox regression model analysis showed that correcting abnormal glucose metabolism was a protective factor for the risk of death from malignant tumors of the digestive system in patients (HR value<1, P<0.05) ; increased FBG, combined abnormal lipid metabolism, increased pulse pressure difference, family history of malignant tumors, and alcohol consumption were shown as risk factors for the risk of death from malignant tumors of the digestive system in patients (HR values>1, P<0.05). Conclusion Correcting abnormal glucose metabolism is of positive significance in reducing the risk of death from malignant tumors of digestive system. Patients with increased FBG, abnormal lipid metabolism, increased pulse pressure difference, family history of malignant tumors and alcohol consumption should pay special attention to correct abnormal glucose metabolism in time.

Objective To analyze the relationship between serum hyaluronic acid levels and Child classification of liver function in Steatosis patients. Methods A total of 110 Steatosis patients admitted to Shaanxi People&#39;s Hospital from January 2017 to September 2018 were selected There were 23 cases in Child a group, 52 cases in Child B group and 35 cases in Child C Group. Sex, age, body mass index (BMI) and serum hyaluronic acid (ha) were compared among the three groups. Results There were no significant differences in sex, age and BMI among Child A, Child B and Child C groups (P>0.05) . The level of serum hyaluronic acid in Child class C (91.39±24.67) was significantly higher than that in Child class B (38.26.9.36) and Child class A (29.55±6.97)（P<0.05）. There was no significant difference in serum hyaluronic acid levels between Child B (38.26.9.36) and Child A (29.55 ± 6.97) groups (P > 0.05). Conclusion Serum hyaluronic acid levels are high in Steatosis patients with poor liver function.

Objective To investigate the clinical features of hospitalized children with pertussis.Methods The clinical data of 87 hospitalized children with pertussis admitted to Women and Children&#39;s Hospital Affiliated to Xiamen University from January 2019 to December 2022 were retrospectively analyzed.According to the age of the children,they were divided into group A(≤3 months of age,35 cases),group B(4-12 months of age,36 cases)and group C(>12 months of age,16 cases).The clinical features of children at different ages were compared.Results The majority of children with pertussis were<1 year old(81.61%),and August was the month of high incidence.Spastic cough(72.41%)was the main clinical manifestation.Other manifestations included redness or cyanosis,vomiting after coughing,crow echo,etc.There were statistically significant differences in the incidence of spastic cough,redness or cyanosis and the contact history of patients with chronic cough among three groups(P<0.05).There were significant differences in the incidence of pneumonia and the average length of hospital stay among three groups(P<0.05).There was significant difference in C-reactive protein level among three groups(P<0.05).Among 87 children with pertussis,37 cases(42.53%)were infected with other pathogens,among which virus infection was the most common.The treatment is effective with macrolides and compound sulfamethoxazole.Conclusion Pertussis is more common in infants under 1 year of age,and the incidence is high in August.Chronic cough patients with close contact may be the source of infection.Spastic cough is the main clinical symptom of children;the younger,the more common symptoms such as spastic cough,redness and cyanosis,the higher incidence of pneumonia and the longer hospital stay.

Cardiovascular diseases is the leading cause of threat to human life and health worldwide. Early risk assessment, timely diagnosis, and prognosis evaluation are critical to the treatment of cardiovascular diseases. Currently, the evaluation of diagnosis and prognosis of cardiovascular diseases mainly relies on imaging examinations such as coronary CT and coronary angiography, which are expensive, time-consuming, partly invasive, and require high professional competence of the operator, making it difficult to promote in the community or in areas where medical resources are scarce. The fundus microcirculation is a part of the human microcirculation and has similar embryological origins and physiopathological features to cardiovascular circulation. Several studies have revealed fundus imaging biomarkers associated with cardiovascular diseases, and developed and validated intelligent diagnosis and treatment models for cardiovascular diseases based on fundus imaging data. Fundus imaging is expected to be an important adjunct to cardiovascular disease diagnosis and treatment given its noninvasive and convenient nature. The purpose of this review is to summarize the current research status, challenges, and future prospects of the application of artificial intelligence based on multimodal fundus imaging data in cardiovascular disease diagnosis and treatment.

Objective To analyze the effect of different environments risks on the prognosis of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 231 patients diagnosed with COPD who visited Mianyang Hospital of Traditional Chinese Medicine from April 2018 to January 2021 were selected as the study subjects and divided into two groups according to whether the residence was changed after discharge, that is, Mianyang Environmental Living Suzhou Environmental Living Group. The follow-up time was 2019 December to September 2021. The contents include relative humidity, temperature, PM_2.5, PM₁₀, air quality index, exposure to household smoking environment, and open windows for ventilation. The regional environment was mainly measured three times, namely October to February (expressed as cold period), June to August (expressed as warm period), March to May and September to October (expressed as suitable period). The family environment was followed up every 2 months by means of questionnaires and interviews, and detailed records were recorded. After the follow-up, the COPD Assessment Test (CAT) and Modified Dyspnea Rating Score (mMRC) were analyzed. Concentration-response curves were used to analyze the influence of living environment exposure on the prognosis of COPD patients. The generalized additive model with semi-Poisson distribution as the connection function was used to study the influence of univariate and multifactor environmental factors on COPD. Results The air quality index of Mianyang was higher than that of Suzhou during the cold period, while that of Mianyang was lower than that of Suzhou during the suitable period. Meanwhile, the average relative humidity of Suzhou was higher than that of Mianyang during the warm period. The comparison of CAT and mMRC scores of COPD patients in the two regions in different quarters showed that the CAT and mMRC scores of COPD patients in Mianyang City were lower than those in Suzhou City during the cold period, and the difference between groups was statistically significant (P<0.01). PM_2.5 (warm period), PM₁₀ (warm period) and NO2 (suitable period) increased by 10μg/m³, 8μg/m³, 12μg/m³ and CO (suitable period) increased by 0.3mg/m³ respectively caused COPD function The scores of indicators CAT and mMRC increased. After adjusting for other pollutants, PM_2.5, CO were still related to the prognosis of COPD. Concentration-response curve results showed that the risk of increasing CAT score decreased with increasing daily windowing time; conversely, the risk of increasing CAT score was increasing with increasing environmental exposure to smoking. Conclusion Pollutant exposure and living environment factors have a significant impact on the prognosis of COPD, and improving the environment is of great significance for the recovery of COPD pulmonary function.

Objective To investigate the status of hepatitis B virus (HBV) infection in children in Wuhan, and to analyze the expression pattern and distribution of serum markers. Methods Five serum markers of HbsA, HbsAb, HbeAg, HbeAb and HBcAb were detected by electrochemiluminescence immunoassay in 67 027 children aged 0-18 years including inpatients, outpatients, and physical examinees in Wuhan Children&#39;s Hospital. SPSS24.0 statistical software was used to analyze the results by age and gender. Results The ^“all negative^” detection rate of all 67,027 children was 18.98%. There was a significant difference in the positive rate of HBcAb between male and female. The positive rate of HBcAb was higher in 0~28 days and 1~12 months group and decreased significantly after 1 year old. The positive rate of HBcAb was 5.02% in 1-14 years old but increased slightly in 15-18 years old. Among HBsAb positive children, the positive rate of HBsAb reached the peak of 95.65% in 1~2 years old group and the lowest of 68.90% in 6~14 years old group, and gradually decreased before 15 years old. Among the children with HBsAb concentration ≥100 IU/L, the proportion of 1~2 years old group was the highest (76.99%), and the proportion of 6~14 years old group was the lowest (40.99%). A total of 20 HBsAb serum marker expression patterns were detected, and the detection rates of ^“single HBsAb+^”, ^“all negative^”, ^“HBsAb+/HBcAb+^”, and ^“HBsAb+/HBeAb+/HBcAb+^” were 71.40%, 18.98%, 4.80% and 4.20%, respectively. Among them, 11 kinds of uncommon expression patterns were detected, and 9 kinds of uncommon expression patterns were detected in neonates, with a detection rate of 1.21%, which was higher than that in other age groups. Among all serological patterns, only the detection rate of ^“single HBcAb+^” showed a statistical difference between male and female. Conclusion The HBV infection rate in all ages of 0~18 years old children in Wuhan is low. ^“Single HBsAb+^” is the main serological pattern, and the concentration distribution of HBsAb is mostly in the range of 100-999 IU /L. There is a high ^“all negative^” detection rate. School-age children should be inoculated with hepatitis B vaccine, which may be beneficial to reduce the risk of infection.

Objective To investigate the growth, development and health management of children with type 1 diabetes, and to provide guidance for the treatment of children with type 1 diabetes. Methods From June 2018 to June 2021, 86 children with type 1 diabetes diagnosed and treated in the Department of Endocrinology of our hospital from January 2000 to December 2002 were selected, including 41 males and 45 females, the onset age of 6-9 years old, all of whom were followed up by telephone. Height, weight, age of onset of youth, age of menarche, blood glucose control and complications were recorded and analyzed from onset to adulthood. Results The initial height of children were lower than those of children of the same age (P<0.05), and there was no difference in height between children of the same age and children of the same age when they reached lifetime height (P>0.05).The median age of initiation of puberty in boys was (12.10±1.50) years later than that in the general population (P<0.05), and the median age of initiation of puberty and menarche in girls were (11.20±1.40) years and (14.90±2.10) years later than that in the general population (P<0.05). 11.63% (10/86) of children HbAl-c <7.0%, 30.23% (26/86) in children with HbAl-c is 7.00% -8.00%, 58.14% (50/86) in children with HbAl-c > 8.0%. There were 1 (1.16%) cases of retinopathy and 4 (4.65%) cases of microalbuminuria. 84 cases (97.67%) were monitored for blood glucose or urine glucose, and only 2 cases were not monitored. Conclusion Due to poor self-control and growth, the blood glucose control of children with type 1 diabetes is often not ideal. Although complications are rare, most blood glucose control is not ideal and blood glucose detection is not enough. Therefore, It is necessary to strengthen the publicity and education of diabetes and regularly monitor blood glucose.

AIM: To compare the efficacy of intravitreal conbercept or ranibizumab for myopic choroidal neovascularization(CNV).

METHODS: A retrospective cohort study. This study included 46 patients(46 eyes)with myopic CNV who were treated with conbercept(conbercept group, 20 cases, 20 eyes)or ranibizumab(ranibizumab group, 26 cases, 26 eyes)from March 2015 to August 2019. Central macular thickness(CMT), the number of injections and complications measured by best-corrected visual acuity(BCVA)and optical coherence tomography(OCT)were compared between the two groups before treatment and 1, 3, 6mo after treatment.

RESULTS: Before treatment, the BCVA(LogMAR)of conbercept and ranibizumab groups were 0.81±0.51, 0.83±0.66(P=0.900). After treatment, the BCVA(LogMAR)in the conbercept group at 1, 3 and 6mo were 0.59±0.33, 0.49±0.34, 0.44±0.32, in the ranibizumab group were 0.53±0.54, 0.47±0.47, 0.40±0.43. The BCVA was significantly improved in both groups after treatment(all P<0.001). Before treatment, the CMT of conbercept and ranibizumab groups were 242.30±73.27, 233.38±66.63μm(P=0.669). After treatment, the CMT in the conbercept group at 1, 3, and 6mo were 217.00±54.78, 208.65±55.38, 206.00±45.34μm, in the ranibizumab group were 197.42±50.47, 198.38±55.19, 192.15±51.97μm. The CMT was significantly decreased in both groups after treatment(all P<0.05). There were no significant differences in the number of injections, BCVA and CMT at each follow-up time points between conbercept and ranibizumab groups(all P>0.05). Systemic adverse reactions and serious ocular complications were not found during the treatment period.

CONCLUSION: Intravitreal conbercept or ranibizumab provide similar efficacy to improve the BCVA and reduce the CMT in the patients with myopic CNV. Both conbercept and ranibizumab could be a choice of treatment for myopic CNV.

Aims: Polymyxins are an important last-line treatment for infections caused by multidrug-resistant Gram-negative bacteria. Nonetheless, the emergence of polymyxin-resistance and the limiting of polymyxin monotherapy urgently demands its optimisation. Aquilaria malaccensis (Agarwood) has been widely used as traditional medicine. Many parts of the plant including leaves exhibit a considerable in vitro antibacterial activity against microbial pathogens. Exploiting A. malaccensis in combination with polymyxins provides a novel strategy in fighting antimicrobial resistance. The objective of this study was to evaluate the combination effects of A. malaccensis extract with polymyxins against Acinetobacter baumannii and Klebsiella pneumoniae. Methodology and results: In vitro time-kill studies and GC-MS analysis were performed to evaluate the bacterial killing of polymyxin B and extract combination and analyse chemical compounds of the extract, respectively. The combination of polymyxin B (1 mg/L) and A. malaccensis extract (32 mg/mL and 64 mg/mL) treatments exhibited enhanced bacterial killing compared to polymyxin B alone at 4 h and 24 h. Combination treatments also inhibited the bacterial growth of both A. baumannii and K. pneumoniae observed throughout the 24 h. More than sixty compounds including phytol, 9,12-octadecadienal, fatty acid, alkanes and terpenoids were putatively identified as the compounds that likely contributed to the antibacterial activity. Conclusion, significance and impact of study This study was the first to report the potential application of A. malaccensis extract in combination with polymyxin B in treatment against A. baumannii and K. pneumoniae and can be further investigated and optimized for the treatment of bacterial infectious diseases.
Thymelaeaceae ; Polymyxins ; Acinetobacter baumannii--immunology ; Klebsiella pneumoniae--immunology