Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Objective:To investigate the relationship between fat-to-muscle mass ration(FMR) and cognitive impairment in older adults with type 2 diabetes mellitus and to further explore the gender difference.Methods:A cross-sectional study was conducted on 768 elderly type 2 diabetes mellitus patients(≥60 years old) who were hospitalized in the Endocrinology Ward of Tianjin Union Medical Center from July 2018 to May 2022. The body composition was measured by bioelectrical impedance analysis(BIA), and the cognitive function was assessed using mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA). According to the cognitive scale screening, type 2 diabetes mellitus patients were divided into normal cognitive function group and cognitive impairment group with stratified analysis by gender. New FMR indicators were developed based on BIA measurements, including fat mass(FM)/ appendicular skeletal muscle mass(ASM), FM/ skeletal muscle mass(SMM), and FM/ fat free mass(FFM). Binary logistic regression was used to analyze the relationship between FMRs and cognitive impairment risk, stratified by gender.Results:FMR indicators were not associated with cognitive impairment in females. In males, after adjusting for multiple factors, higher FMR values were significantly associated with an increased risk of cognitive impairment(FM/FFM: OR=1.722, 95% CI 1.230-2.409, P=0.002; FM/SMM: OR=1.337, 95% CI 1.118-1.599, P=0.001; FM/ASM: OR=1.240, 95% CI 1.077-1.427, P=0.003) and was independent of body mass index. For FM/FFM, every 0.1-unit increase raised the risk of cognitive impairment by 77.2%. FMR had a stronger association with cognitive impairment in the normal-weight group(body mass index<25 kg/m 2) than in the overweight/obese group(body mass index≥25 kg/m 2). The prevalence of cognitive impairment increased progressively with higher FMR . Conclusion:In men over 60 years with type 2 diabetes mellitus, FMR may be an independent risk factor for cognitive function.

Objective:To investigate the relationship between fat-to-muscle mass ration(FMR) and cognitive impairment in older adults with type 2 diabetes mellitus and to further explore the gender difference.Methods:A cross-sectional study was conducted on 768 elderly type 2 diabetes mellitus patients(≥60 years old) who were hospitalized in the Endocrinology Ward of Tianjin Union Medical Center from July 2018 to May 2022. The body composition was measured by bioelectrical impedance analysis(BIA), and the cognitive function was assessed using mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA). According to the cognitive scale screening, type 2 diabetes mellitus patients were divided into normal cognitive function group and cognitive impairment group with stratified analysis by gender. New FMR indicators were developed based on BIA measurements, including fat mass(FM)/ appendicular skeletal muscle mass(ASM), FM/ skeletal muscle mass(SMM), and FM/ fat free mass(FFM). Binary logistic regression was used to analyze the relationship between FMRs and cognitive impairment risk, stratified by gender.Results:FMR indicators were not associated with cognitive impairment in females. In males, after adjusting for multiple factors, higher FMR values were significantly associated with an increased risk of cognitive impairment(FM/FFM: OR=1.722, 95% CI 1.230-2.409, P=0.002; FM/SMM: OR=1.337, 95% CI 1.118-1.599, P=0.001; FM/ASM: OR=1.240, 95% CI 1.077-1.427, P=0.003) and was independent of body mass index. For FM/FFM, every 0.1-unit increase raised the risk of cognitive impairment by 77.2%. FMR had a stronger association with cognitive impairment in the normal-weight group(body mass index<25 kg/m 2) than in the overweight/obese group(body mass index≥25 kg/m 2). The prevalence of cognitive impairment increased progressively with higher FMR . Conclusion:In men over 60 years with type 2 diabetes mellitus, FMR may be an independent risk factor for cognitive function.

Humans ; HIV-1 ; Leukocytes, Mononuclear ; Lymphoma, Non-Hodgkin ; DNA ; HIV Infections

Hypertensive disorder of pregnancy (HDP) involves two major public health issues: mother-infant safety and prevention and controlling major chronic disease. HDP poses a serious threat to maternal and neonatal safety, and it is one of the leading causes of maternal and perinatal morbidity and mortality worldwide, as well as an important risk factor for long-term cardiovascular disease (CVD). In order to explore effective strategies to prevent and control the source of CVD and reduce its risk, we have established a cohort of HDPs in Shenzhen for the primordial prevention of CVD. The construction of the HDP cohort has already achieved preliminary progress till now. A total of 2 239 HDP women have been recruited in the HDP cohort. We have established a cohort data management platform and Biobank. The follow-up and assessment of postpartum cardiovascular metabolic risk in this cohort has also been launched. Our efforts will help explore the pathophysiological mechanism of HDP, especially the pathogenesis and precision phenotyping, prediction, and prevention of pre-eclampsia, which, therefore, may reduce the risk of adverse pregnancy outcomes, and provide a bridge to linking HDP and maternal-neonatal cardiovascular, metabolic risk to promote the cardiovascular health of mothers and their infants.

In recent decades, clinicians' research on the psychological distress of breast cancer patients mostly focuses on anxiety, depression and recurrence fear, and few researchers pay attention to the adverse effects of social constraints on breast cancer patients. This article briefly introduces the general situation of social constraints from the aspects of concept, characteristics, influencing factors and assessment tools, and summarizes the influence of social constraints on the psychological distress of breast cancer patients and intervention measures, in order to provide a theoretical basis for exploring effective intervention measures to help breast cancer patients who are psychologically distressed by social constraints.

ABSTRACT OBJECTIVE：To study the improvement effect of Periplaneta americana extract Ento-A on damp-heat ulcerative colitis（UC）model rats. METHODS：Totally 70 rats were randomly divided into normal control group（n＝8）and modeling group （n＝62）. The damp-heat UC model was induced in modeling group by high sugar，high fat，spicy diet combined with 2，4， 6-trinitrobenzene sulfonic acid enema. 48 modelrats were randomly divided into model control group，mesalazine group （300 mg/kg），Changyanning group（300 mg/kg）and Ento-A low-dose，medium-dose and high-dose（50，100，200 mg/kg，calculated by the extract），with 8 rats in each group. Normal control group and model control group were given normal saline intrsgastrically，and other groups were given relevant medicine intragastrically，once a day，for consecutive 14 days. After last administration， disease activity index （DAI）， colonic mucosal injury index （CMDI） and histopathological score （HS）of rats were determined. The spleen index，liver index and colon index in rats were determined. The serum levels of IL-8，IL-17，SOD and MDA，colonic levels of IL-2，PGE2 and MPO were detected by ELISA. RESULTS：Compared with normal control group，the DAI score，CMDI score，HS score，colonic index，the serum levels of IL-8，IL-17 and MDA， colonic levels of MPO and PGE2 were increased significantly（P＜0.01）；serum level of SOD and colonic level of IL-2 were decreased significantly （P＜0.01）. Compared with model control group，DAI score，CMDI score，serum levels of IL-17 and MDA，colonic levels of PGE2 were decreased significantly in Ento-A high-dose groups（P＜0.05 or P＜0.01），while serum level of SOD and colonic level of IL-2 were increased significantly（P＜0.01）. CMDI score and HS score，serum levels of IL-8，IL-17 and MDA，colonic levels of PGE2 and MPO were decreased significantly in Ento-A medium-dose group（P＜0.05 or P＜0.01）， while colonic level of IL-2 was increased significantly（P＜0.01）. HS score，serum levels of IL-17 and MDA，colonic levels of MPO and PGE2 were decreased significantly in Ento-A low-dose group（P＜0.05 or P＜0.01），while serum level of IL-2 was increased significantly（P＜0.01）. CONCLUSIONS：P. americana extract Ento-A may play improvement effect on damp-heat UC rats by regulating immune system balance and reducing inflammatory damage.

Objective:To explore the role of virtual reduction and design of 3D printed guide template in assisting reduction and internal fixation of comminuted patellar fractures.Methods:A retrospective study was conducted of 12 patients who had been treated for closed patellar fractures from March 2016 to April 2019 at Department of Orthopaedics, Jiangxi Provincial People's Hospital. They were 8 males and 4 females with an average age of 35.4 years (from 22 to 51). All their fractures were type 34-C3 (more than 3 fragments) according to the AO/OTA classification. Their preoperative CT data were imported into software Mimics to print a full patella, upper and lower halves of the patella, and a guide template for reduction. During operation, bone fragments were first temporarily fixated with a fine Kirschner wire after combined together with the assistance of reduction templates for upper and lower hemi-patellas. Next, the whole patella was precisely reset and definitely fixated using patellar ring ligation and tension band wire with the assistance of the reduction guide template for full patellar. Recorded were operation time, fluoroscopic frequency, and visual analogue scale (VAS), knee range of motion (ROM) and knee function B?stman scores at the last follow-up.Results:In this group of patients, operation time averaged 90 minutes (from 75 to 120 minutes), fluoroscopic frequency 4.5 times (from 3 to 8 times), follow-up duration 19 weeks (from 16 to 22 weeks), and fracture healing time 14 weeks (from 11 to 17 weeks). At their last follow-up, X-ray showed good patellar morphology, fine internal fixation positions and an average VAS pain scores of 0.3 (from 0 to 1), their knee joints could be fully straightened, their knee ROM averaged 130°(from 100° to 138°), and their knee B?stman scores 28.8 points (from 21 to 30 points), giving 9 excellent and 3 good cases.Conclusion:3D printed reduction guide templates can significantly improve the efficiency and quality of surgical reduction in comminuted patella fractures, enhancing fixation strength and facilitating early and full range exercise of the knee joint to achieve excellent recovery.

Objective To investigate the role of mutations in C region that may contribute to occult hepatitis B virus infection.Methods C genes were amplified from two OBI blood donor samples respectively.Plasmids with mutations in C region of hepatitis B virus were constructed by overlapping PCR.HBsAg and HBeAg in Huh7 cells and in the serum of Balb/c mice were detected by CMLA.HBcAg in liver tissue was detected by immunohistochemistry,while HBV-RNA was tested by RT-PCR.Results Mutations in C region significantly reduced the expression level of HBeAg and HBcAg,but had no significant effect on HBsAg and HBV-RNA.Conclusion The mutations in C region affect the expression level of HBeAg and HBcAg,which may play an important role in the occurrence of OBI.